Perilli Enrico, Perazzini Matteo, Bontempo Danilo, Ranieri Fabrizio, Di Giacomo Dina, Crosti Cristina, Marcotullio Simona, Cobianchi Stefano
Public Health, Life and Environmental Sciences, Department of Clinical Medicine, University of L'Aquila, L'Aquila, Italy.
Ospedale Regionale San Salvatore dell'Aquila, L'Aquila, Italy.
Front Psychol. 2022 Jun 9;13:891470. doi: 10.3389/fpsyg.2022.891470. eCollection 2022.
COVID-19 pandemic imposed psychosocial stress increasing in frontline healthcare workers, who managed by responding with different coping strategies. General practitioners were targeted by an extraordinary increase in the demand for reception, diagnosis and treatment from all patients even if working in solo. In Italy, the emergency changed risk assumption and roles in between primary care, unraveling the emotional distress of general practitioners, who suffered not only for isolation, but also emotional threatens. In this correlational study we wanted to evaluate trait anxiety and stress as perceived by general practitioners working in individual ambulatory practice room, and by hospital ward nurses working in group, during a chronic phase (February-May 2021) of COVID-19 pandemic. Our hypothesis is that a different work social organization in clinic contest as for general practitioners compared with nurses could induce adaptive or non-adaptive coping to stress under emergency and mindful attitude could be crucial. A number of 37 general practitioners, and 36 nurses were taken from the sanitary district of ASL1 Avezzano-Sulmona-L'Aquila in Italy. For our analyses we used the Health Professions Stress and Coping Scale to assess the risk of burn-out, and detect the coping strategies. We also used the Cognitive and Affective Mindfulness Scale-Revised, investigating whether clinicians used an eventual mindful attitude to prevent anxiety and responding with adaptive coping strategies. General practitioners reported high levels of anxiety, associated to an increased use of emotional distress. Mindful attitude was protective for anxiety in both general practitioners and nurses. As anxiety increased, it was coped by increasing the demand for social support. This coping strategy correlated with emotional distress and when enhanced, it corresponded to avoidance of the problem. Mindful attitude addressed general practitioners to adaptive coping strategies as the solution of the problem. On the other side, nurses accepted the problem but addressed it to others, by avoiding solving it themselves as beyond their role and organizational responsibility. In conclusion, mindful attitude can prevent dysfunctional reactive behaviors among clinicians at the forefront of emergency and reduce emotional distress for isolation as suffered by general practitioners.
新冠疫情给一线医护人员带来了与日俱增的心理社会压力，他们通过采用不同的应对策略来进行应对。即便全科医生是独自工作，所有患者对诊疗接待、诊断和治疗的需求也出现了异常增长，这让他们成为了关注焦点。在意大利，这场疫情改变了基层医疗中的风险承担和角色，揭开了全科医生的情绪困扰，他们不仅遭受着隔离之苦，还面临着情感威胁。在这项相关性研究中，我们希望评估在新冠疫情慢性阶段（2021年2月至5月），在个体门诊诊室工作的全科医生以及在病房团队工作的医院护士所感受到的特质焦虑和压力。我们的假设是，与护士相比，全科医生在临床环境中的工作社会组织形式不同，这可能会在紧急情况下引发对压力的适应性或非适应性应对，而正念态度可能至关重要。我们从意大利阿韦扎诺-苏尔莫纳-拉奎拉省第一地方卫生机构的卫生区选取了37名全科医生和36名护士。在分析过程中，我们使用了《健康职业压力与应对量表》来评估职业倦怠风险，并检测应对策略。我们还使用了修订后的《认知与情感正念量表》，调查临床医生是否采用了最终的正念态度来预防焦虑并以适应性应对策略做出回应。全科医生报告了高水平的焦虑，这与更多地使用情绪困扰应对方式相关。正念态度对全科医生和护士的焦虑都具有保护作用。随着焦虑的增加，人们通过增加对社会支持的需求来应对。这种应对策略与情绪困扰相关，当这种策略增强时，就相当于回避问题。正念态度引导全科医生采用适应性应对策略来解决问题。另一方面，护士接受了问题，但将其转交给他人，避免自己解决，因为这超出了他们的角色和组织责任。总之，正念态度可以预防处于紧急情况前沿的临床医生出现功能失调的反应行为，并减少全科医生因隔离而遭受的情绪困扰。
