Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, California, United States of America.
Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, United States of America.
PLoS One. 2021 Apr 16;16(4):e0250294. doi: 10.1371/journal.pone.0250294. eCollection 2021.
The COVID-19 pandemic has compounded the global crisis of stress and burnout among healthcare workers. But few studies have empirically examined the factors driving these outcomes in Africa. Our study examined associations between perceived preparedness to respond to the COVID-19 pandemic and healthcare worker stress and burnout and identified potential mediating factors among healthcare workers in Ghana.
Healthcare workers in Ghana completed a cross-sectional self-administered online survey from April to May 2020; 414 and 409 completed stress and burnout questions, respectively. Perceived preparedness, stress, and burnout were measured using validated psychosocial scales. We assessed associations using linear regressions with robust standard errors.
The average score for preparedness was 24 (SD = 8.8), 16.3 (SD = 5.9) for stress, and 37.4 (SD = 15.5) for burnout. In multivariate analysis, healthcare workers who felt somewhat prepared and prepared had lower stress (β = -1.89, 95% CI: -3.49 to -0.30 and β = -2.66, 95% CI: -4.48 to -0.84) and burnout (β = -7.74, 95% CI: -11.8 to -3.64 and β = -9.25, 95% CI: -14.1 to -4.41) scores than those who did not feel prepared. Appreciation from management and family support were associated with lower stress and burnout, while fear of infection was associated with higher stress and burnout. Fear of infection partially mediated the relationship between perceived preparedness and stress/burnout, accounting for about 16 to 17% of the effect.
Low perceived preparedness to respond to COVID-19 increases stress and burnout, and this is partly through fear of infection. Interventions, incentives, and health systemic changes to increase healthcare workers' morale and capacity to respond to the pandemic are needed.
COVID-19 大流行使医疗保健工作者的压力和倦怠这一全球危机更加恶化。但很少有研究从实证角度研究这些结果在非洲的驱动因素。我们的研究调查了加纳医护人员对 COVID-19 大流行应对准备的认知与医护人员压力和倦怠之间的关联,并确定了其中的潜在中介因素。
2020 年 4 月至 5 月,加纳的医护人员通过在线自填方式完成了一项横断面调查;分别有 414 人和 409 人完成了压力和倦怠问题的调查。使用经过验证的心理社会量表来衡量应对准备、压力和倦怠。我们使用具有稳健标准差的线性回归来评估关联。
准备情况的平均得分为 24(SD = 8.8),压力的平均得分为 16.3(SD = 5.9),倦怠的平均得分为 37.4(SD = 15.5)。在多变量分析中,感觉有些准备和有准备的医护人员压力(β = -1.89,95%CI:-3.49 至-0.30 和 β = -2.66,95%CI:-4.48 至-0.84)和倦怠(β = -7.74,95%CI:-11.8 至-3.64 和 β = -9.25,95%CI:-14.1 至-4.41)得分均低于没有准备的医护人员。管理层的赞赏和家庭支持与较低的压力和倦怠相关,而对感染的恐惧与较高的压力和倦怠相关。对感染的恐惧部分中介了对 COVID-19 应对准备认知与压力/倦怠之间的关系,占影响的约 16%至 17%。
对 COVID-19 应对准备的认知不足会增加压力和倦怠,而这在一定程度上是由于对感染的恐惧。需要采取干预措施、激励措施和卫生系统变革,以提高医护人员的士气和应对大流行的能力。