Kellogg College, University of Oxford, Oxford, UK.
Royal College of Surgeons of England, London, UK.
BMC Health Serv Res. 2021 Mar 21;21(1):262. doi: 10.1186/s12913-021-06279-6.
The association of workplace factors on mental health of healthcare workers (HCWs) during the COVID-19 pandemic needs to be urgently established. This will enable governments and policy-makers to make evidence-based decisions. This international study reports the association between workplace factors and the mental health of HCWs during the pandemic.
An international, cross-sectional study was conducted in 41 countries. The primary outcome was depressive symptoms, derived from the validated Patient Health Questionnaire-2 (PHQ-2). Multivariable logistic regression identified factors associated with mental health outcomes. Inter-country differences were also evaluated.
A total of 2527 responses were received, from 41 countries, including China (n = 1213; 48.0%), UK (n = 891; 35.3%), and USA (n = 252; 10.0%). Of all participants, 1343 (57.1%) were aged 26 to 40 years, and 2021 (80.0%) were female; 874 (34.6%) were doctors, and 1367 (54.1%) were nurses. Factors associated with an increased likelihood of depressive symptoms were: working in the UK (OR = 3.63; CI = [2.90-4.54]; p < 0.001) and USA (OR = 4.10; CI = [3.03-5.54]), p < 0.001); being female (OR = 1.74; CI = [1.42-2.13]; p < 0.001); being a nurse (OR = 1.64; CI = [1.34-2.01]; p < 0.001); and caring for a COVID-19 positive patient who subsequently died (OR = 1.20; CI = [1.01-1.43]; p = 0.040). Workplace factors associated with depressive symptoms were: redeployment to Intensive Care Unit (ICU) (OR = 1.67; CI = [1.14-2.46]; p = 0.009); redeployment with perceived unsatisfactory training (OR = 1.67; CI = [1.32-2.11]; p < 0.001); not being issued with appropriate personal protective equipment (PPE) (OR = 2.49; CI = [2.03-3.04]; p < 0.001); perceived poor workplace support within area/specialty (OR = 2.49; CI = [2.03-3.04]; p < 0.001); and perceived poor mental health support (OR = 1.63; CI = [1.38-1.92]; p < 0.001).
This is the first international study, demonstrating that workplace factors, including PPE availability, staff training pre-redeployment, and provision of mental health support, are significantly associated with mental health during COVID-19. Governments, policy-makers and other stakeholders need to ensure provision of these to safeguard HCWs' mental health, for future waves and other pandemics.
在 COVID-19 大流行期间，需要紧急确定工作场所因素与医护人员（HCW）心理健康之间的关联。这将使政府和决策者能够做出基于证据的决策。这项国际研究报告了大流行期间工作场所因素与 HCW 心理健康之间的关联。
在 41 个国家进行了一项国际横断面研究。主要结局是抑郁症状，来自经过验证的患者健康问卷-2（PHQ-2）。多变量逻辑回归确定了与心理健康结果相关的因素。还评估了国家间的差异。
共收到来自 41 个国家的 2527 份回复，包括中国（n=1213；48.0%）、英国（n=891；35.3%）和美国（n=252；10.0%）。所有参与者中，1343 人（57.1%）年龄在 26 至 40 岁之间，2021 人（80.0%）为女性；874 人（34.6%）为医生，1367 人（54.1%）为护士。与抑郁症状可能性增加相关的因素包括：在英国（OR=3.63；CI=[2.90-4.54]；p<0.001）和美国（OR=4.10；CI=[3.03-5.54]；p<0.001）工作；女性（OR=1.74；CI=[1.42-2.13]；p<0.001）；护士（OR=1.64；CI=[1.34-2.01]；p<0.001）；照顾 COVID-19 阳性患者，随后患者死亡（OR=1.20；CI=[1.01-1.43]；p=0.040）。与抑郁症状相关的工作场所因素包括：重新部署到重症监护病房（ICU）（OR=1.67；CI=[1.14-2.46]；p=0.009）；重新部署并认为培训不满意（OR=1.67；CI=[1.32-2.11]；p<0.001）；未获得适当的个人防护设备（PPE）（OR=2.49；CI=[2.03-3.04]；p<0.001）；在区域/专业领域感到工作场所支持不佳（OR=2.49；CI=[2.03-3.04]；p<0.001）；感到心理健康支持不佳（OR=1.63；CI=[1.38-1.92]；p<0.001）。
这是第一项国际研究，表明工作场所因素，包括 PPE 可用性、员工重新部署前的培训以及提供心理健康支持，与 COVID-19 期间的心理健康显著相关。政府、决策者和其他利益相关者需要确保提供这些措施，以保障 HCW 的心理健康，为未来的浪潮和其他大流行做好准备。
