Young Kevin P, Kolcz Diana L, Ferrand Jennifer, O'Sullivan David M, Robinson Kenneth
Psychological Testing Service, Psychology/Psychiatry, Institute of Living, Hartford Hospital, Hartford, CT, United States.
Wellness, Medical Affairs, Hartford HealthCare, Hartford, CT, United States.
Front Psychol. 2022 Jul 14;13:924913. doi: 10.3389/fpsyg.2022.924913. eCollection 2022.
INTRODUCTION/BACKGROUND: HealthCare worker (HCW) mental health and wellbeing are uniquely affected by the complexities of COVID-19 due to exposure to the virus, isolation from family and friends, risk and uncertainty. Little if any inquiry has examined the effects on an entire healthcare system, particularly immediately post-surge. We sought to examine the prevalence of psychiatric symptoms and behavioral health difficulties as a healthcare system transitioned out of the first wave. We assessed the effects of work role, setting and individual diversity factors on employee distress and coping strategies.
This was an Institutional Review Board approved, unfunded, voluntary survey sent via REDCap link, to all employees of Hartford HealthCare, a mid-sized healthcare system ( ≈ 29,900) between May 15th and June 26th, 2020. Two system-wide emails and two emails targeting managers were sent during this time frame. Eight thousand four hundred and ninety four employees (28.4% of all e-mails distributed) participated in the survey, representing clinical, support, administrative, and medical staff across hospital, outpatient, residential, and business settings. The survey contained items assessing personal background, work environment/culture, and formal measures, including: patient health questionnaire-9 (PHQ-9), general anxiety disorder-7 (GAD-7), primary care post-traumatic stress disorder screen for DSM-5 (PC-PTSD), alcohol use disorders identification test (AUDIT-C), and the insomnia severity index (ISI).
Almost 1/3 of respondents (31%) reported symptoms of clinically significant anxiety; 83% moderate to severe depression; and 51% moderate to severe insomnia. Thirteen percent screened positive for post-traumatic stress disorder. Frontline staff ( ≤ 0.001 vs. others) and females ( < 0.001 vs. males) endorsed the highest levels of distress, while race ( ≤ 0.005) and ethnicity ( < 0.03 for anxiety, PTSD and insomnia) had a complex and nuanced interaction with symptoms.
Pandemic stress effects all healthcare employees, though not equally. The effects of work role and environment are intuitive though critical. These data suggest individual diversity factors also play an important role in mental health and wellbeing. All must be considered to optimize employee functioning.
引言/背景：由于接触病毒、与家人和朋友隔离、风险和不确定性，医护人员的心理健康和幸福感受到新冠疫情复杂性的独特影响。几乎没有任何研究探讨过这对整个医疗系统的影响，尤其是在疫情高峰刚过之后。我们试图研究在一个医疗系统度过第一波疫情时，精神症状和行为健康问题的患病率。我们评估了工作角色、工作环境和个体差异因素对员工痛苦程度和应对策略的影响。
这是一项经机构审查委员会批准的、无资金支持的自愿调查，于2020年5月15日至6月26日通过REDCap链接发送给哈特福德医疗保健公司（一个中等规模的医疗系统，约有29,900名员工）的所有员工。在此期间发送了两封全系统邮件和两封针对管理人员的邮件。8494名员工（占所有发送邮件的28.4%）参与了调查，代表了医院、门诊、住院和商业环境中的临床、支持、行政和医务人员。该调查包含评估个人背景、工作环境/文化以及正式测量指标的项目，包括：患者健康问卷-9（PHQ-9）、广泛性焦虑障碍-7（GAD-7）、《精神疾病诊断与统计手册》第5版初级保健创伤后应激障碍筛查量表（PC-PTSD）、酒精使用障碍识别测试（AUDIT-C）以及失眠严重程度指数（ISI）。
近三分之一的受访者（31%）报告有临床上显著的焦虑症状；83%有中度至重度抑郁；51%有中度至重度失眠。13%的人创伤后应激障碍筛查呈阳性。一线员工（与其他人员相比，P≤0.001）和女性（与男性相比，P<0.001）的痛苦程度最高，而种族（P≤0.005）和族裔（焦虑、创伤后应激障碍和失眠的P<0.03）与症状有复杂且细微的相互作用。
疫情压力影响所有医护人员，但程度不一。工作角色和环境的影响直观但至关重要。这些数据表明个体差异因素在心理健康和幸福感中也起着重要作用。为了优化员工的工作表现，所有这些因素都必须加以考虑。
