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美国 COVID-19 疫情初期一线医护人员压力的主要驱动因素和心理表现。

Primary drivers and psychological manifestations of stress in frontline healthcare workforce during the initial COVID-19 outbreak in the United States.

机构信息

Columbia University School of Nursing, 630 W. 168th Street, Mail Code 6, New York, NY 10032, United States.

Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY 10032, United States.

出版信息

Gen Hosp Psychiatry. 2021 Mar-Apr;69:20-26. doi: 10.1016/j.genhosppsych.2021.01.001. Epub 2021 Jan 10.

Abstract

OBJECTIVE

The purpose of this study was to understand the physical and psychological impact of high stress clinical environments and contributory factors of burnout in multidisciplinary healthcare workforce during the initial outbreak of COVID-19.

METHOD

In-person qualitative interviews informed by an adaptation of Karasek's Job Demand-control model were conducted with a convenience sample of healthcare workforce from March to April 2020.

RESULTS

Themes emerging from interviews coalesced around three main areas: fear of uncertainty, physical and psychological manifestations of stress, and resilience building. Shifting information, a lack of PPE, and fear of infecting others prompted worry for those working with Covid-infected patients. Participants reported that stress manifested more psychologically than physically. Individualized stress mitigation efforts, social media and organizational transparency were reported by healthcare workers to be effective against rising stressors.

CONCLUSION

COVID-19 has presented healthcare workforce with unprecedented challenges in their work environment. With attention to understanding stressors and supporting clinicians during healthcare emergencies, more research is necessary in order to effectively promote healthcare workforce well-being.

摘要

目的

本研究旨在了解 COVID-19 初始爆发期间多学科医疗保健工作者在高压临床环境中的身心影响,以及导致 burnout 的因素。

方法

本研究采用 Karasek 的工作需求-控制模型进行改编,对 2020 年 3 月至 4 月期间的医疗保健工作者进行了方便样本的现场定性访谈。

结果

访谈中出现的主题围绕三个主要领域:对不确定性的恐惧、压力的身心表现,以及韧性建设。为感染 COVID-19 的患者工作的人担心信息不断变化、缺乏个人防护设备 (PPE) 和担心感染他人。参与者报告说,压力主要表现为心理上的,而不是身体上的。医疗工作者报告说,个性化的减轻压力的措施、社交媒体和组织透明度对对抗不断增加的压力源是有效的。

结论

COVID-19 给医疗保健工作者的工作环境带来了前所未有的挑战。在医疗紧急情况下,关注对压力源的理解和对临床医生的支持,对于有效促进医疗保健工作者的福祉,还需要更多的研究。

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