Sato Christa, Adumattah Anita, Abulencia Maria Krisel, Garcellano Peter Dennis, Li Alan Tai-Wai, Fung Kenneth, Poon Maurice Kwong-Lai, Vahabi Mandana, Wong Josephine Pui-Hing
Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada.
JMIR Form Res. 2022 Mar 22;6(3):e35280. doi: 10.2196/35280.
Since the pandemic, more Canadians have reported poorer mental health. A vital group experiencing a high level of stressors consists of health care providers (HCPs) caring for COVID-19 patients, carrying out public health responses, or working with vulnerable populations. The mental health of HCPs is negatively affected by the pandemic, not only at work but also at home and in the community. Intersecting stressors at multiple levels contribute to HCPs' experiences of fatigue, insomnia, anxiety, depression, and posttraumatic stress symptoms.
The aim of this qualitative study was to explore the pandemic stressors experienced by HCPs at work, at home, and in the community before participating in the Pandemic Acceptance and Commitment to Empowerment Response (PACER) online intervention.
Informed by a social ecological approach, we used a qualitative reflective approach to engage 74 HCPs in diverse roles. Data were collected during the first 2 waves of the COVID-19 pandemic (June 2020 to February 2021) in Canada.
Informed by a social ecological framework, 5 overarching themes were identified in our thematic analysis: (1) personal level stressors that highlight HCPs' identities and responsibilities beyond the workplace; (2) interpersonal level stressors from disrupted social relationships; (3) organizational stressors that contributed to unsettled workplaces and moral distress; (4) community and societal stressors attributed to vicarious trauma and emotional labor; and (5) the multilevel and cumulative impacts of COVID-19 stressors on HCPs' health.
COVID-19 is not merely a communicable disease but also a social and political phenomenon that intensifies the effects of social inequities. Current understanding of pandemic stressors affecting HCPs is largely partial in nature. Although workplace stressors of HCPs are real and intense, they need to be explored and understood in the context of stressors that exist in other domains of HCPs' lives such as family and community to ensure these experiences are not being silenced by the "hero" discourses or overshadowed by professional demands.
自疫情大流行以来，越来越多的加拿大人报告心理健康状况较差。经历高度压力源的一个重要群体是照顾新冠病毒患者、开展公共卫生应对措施或与弱势群体合作的医疗保健提供者（HCP）。疫情大流行对HCP的心理健康产生了负面影响，不仅在工作中，在家中和社区中也是如此。多个层面相互交织的压力源导致HCP出现疲劳、失眠、焦虑、抑郁和创伤后应激症状。
这项定性研究的目的是在参与“疫情接受与赋权应对（PACER）”在线干预之前，探索HCP在工作、家庭和社区中所经历的疫情压力源。
以社会生态方法为指导，我们采用定性反思方法，让74名担任不同角色的HCP参与研究。数据收集于加拿大新冠疫情大流行的前两波期间（2020年6月至2021年2月）。
在社会生态框架的指导下，我们的主题分析确定了5个总体主题：（1）个人层面的压力源，突出了HCP在工作场所之外的身份和责任；（2）人际关系层面的压力源，源于社会关系的中断；（3）组织压力源，导致工作场所不稳定和道德困扰；（4）社区和社会压力源，归因于替代性创伤和情感劳动；（5）新冠疫情压力源对HCP健康的多层次和累积影响。
新冠病毒不仅是一种传染病，也是一种加剧社会不平等影响的社会和政治现象。目前对影响HCP的疫情压力源的理解在很大程度上是片面的。虽然HCP的工作场所压力源真实且强烈，但需要在HCP生活的其他领域（如家庭和社区）存在的压力源背景下进行探索和理解，以确保这些经历不会被“英雄”话语掩盖或被专业需求所忽视。
