医护人员中与 COVID-19 相关的欺凌、骚扰和污名化风险：一项分析性横断面全球研究。
Risk of COVID-19-related bullying, harassment and stigma among healthcare workers: an analytical cross-sectional global study.
机构信息
Department of Obstetrics and Gynecology, University of Rochester, School of Medicine and Dentistry, Rochester, New York, USA
Department of Obstetrics and Gynecology, University of Rochester, School of Medicine and Dentistry, Rochester, New York, USA.
出版信息
BMJ Open. 2020 Dec 30;10(12):e046620. doi: 10.1136/bmjopen-2020-046620.
OBJECTIVES
Essential healthcare workers (HCW) uniquely serve as both COVID-19 healers and, potentially, as carriers of SARS-CoV-2. We assessed COVID-19-related stigma and bullying against HCW controlling for social, psychological, medical and community variables.
DESIGN
We nested an analytical cross-sectional study of COVID-19-related stigma and bullying among HCW within a larger mixed-methods effort assessing COVID-19-related lived experience and impact. Adjusted OR (aOR) and 95% CIs evaluated the association between working in healthcare settings and experience of COVID-19-related bullying and stigma, controlling for confounders. Thematic qualitative analysis provided insight into lived experience of COVID-19-related bullying.
SETTING
We recruited potential participants in four languages (English, Spanish, French, Italian) through Amazon Mechanical Turk's online workforce and Facebook.
PARTICIPANTS
Our sample included 7411 people from 173 countries who were aged 18 years or over.
FINDINGS
HCW significantly experienced more COVID-19-related bullying after controlling for the confounding effects of job-related, personal, geographic and sociocultural variables (aOR: 1.5; 95% CI 1.2 to 2.0). HCW more frequently believed that people gossip about others with COVID-19 (OR: 2.2; 95% CI 1.9 to 2.6) and that people with COVID-19 lose respect in the community (OR: 2.3; 95% CI 2.0 to 2.7), both which elevate bullying risk (OR: 2.7; 95% CI 2.3 to 3.2, and OR: 3.5; 95% CI 2.9 to 4.2, respectively). The lived experience of COVID-19-related bullying relates frequently to public identities as HCW traverse through the community, intersecting with other domains (eg, police, racism, violence).
INTERPRETATION
After controlling for a range of confounding factors, HCW are significantly more likely to experience COVID-19-related stigma and bullying, often in the intersectional context of racism, violence and police involvement in community settings.
目的
基本医护人员（HCW）不仅是 COVID-19 的治疗者，而且可能是 SARS-CoV-2 的携带者。我们评估了与 COVID-19 相关的针对 HCW 的污名化和欺凌行为，同时控制了社会、心理、医学和社区变量。
设计
我们在一项评估与 COVID-19 相关的生活经历和影响的更大混合方法研究中嵌套了一项关于与 COVID-19 相关的污名化和欺凌行为的分析性横断面研究。调整后的优势比（aOR）和 95%置信区间（CI）评估了在控制混杂因素的情况下，在医疗保健环境中工作与经历与 COVID-19 相关的欺凌和污名之间的关联。主题定性分析提供了与 COVID-19 相关的欺凌行为的生活经历的深入了解。
设置
我们通过亚马逊 Mechanical Turk 的在线劳动力和 Facebook 以四种语言（英语、西班牙语、法语、意大利语）招募潜在参与者。
参与者
我们的样本包括来自 173 个国家的 7411 名年龄在 18 岁及以上的人。
发现
在控制与工作相关、个人、地理和社会文化变量相关的混杂效应后，HCW 经历了更多与 COVID-19 相关的欺凌行为（aOR：1.5；95%CI 1.2 至 2.0）。HCW 更频繁地认为人们会八卦患有 COVID-19 的他人（OR：2.2；95%CI 1.9 至 2.6），并且患有 COVID-19 的人在社区中失去尊重（OR：2.3；95%CI 2.0 至 2.7），这两者都增加了欺凌风险（OR：2.7；95%CI 2.3 至 3.2，和 OR：3.5；95%CI 2.9 至 4.2）。与 COVID-19 相关的欺凌行为的生活经历经常与 HCW 在社区中穿行的公共身份有关，与其他领域（例如警察、种族主义、暴力）相交织。
解释
在控制了一系列混杂因素后，HCW 更有可能经历与 COVID-19 相关的污名化和欺凌行为，通常是在种族主义、暴力和警察参与社区环境的交叉背景下。
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