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新冠疫情大流行两年后中国武汉医务人员的倦怠和创伤后应激障碍症状:社会支持和韧性的中介作用。

Burnout and post-traumatic stress disorder symptoms among medical staff two years after the COVID-19 pandemic in Wuhan, China: Social support and resilience as mediators.

机构信息

School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China.

出版信息

J Affect Disord. 2023 Jan 15;321:126-133. doi: 10.1016/j.jad.2022.10.027. Epub 2022 Oct 21.

Abstract

BACKGROUND

Evidence on the relationship between burnout and post-traumatic stress disorder (PTSD) is limited. We aimed to evaluate the association between burnout and PTSD symptoms among medical staff two years after the coronavirus disease 2019 (COVID-19) pandemic in Wuhan, China, and explore the mediating roles of social support and psychological resilience.

METHODS

A multicenter survey was conducted online from January to March 2022 among healthcare professionals from six general hospitals. Hierarchical linear regression was used to detect the predictors of PTSD symptoms. Structural equation modeling (SEM) was used to analyze the pathways from burnout to PTSD symptoms.

RESULTS

Hierarchical linear regression showed that burnout, social support, and psychological resilience were significant predictors of PTSD symptoms among medical staff. In the SEM, the standardized total effect of burnout on PTSD symptoms was 0.336(bias-corrected 95 % confidence interval [0.303, 0.367], P < 0.001). Social support and psychological resilience partially mediated the relationship between burnout and PTSD symptoms (indirect effects accounted for 22.3 % of the total effect).

LIMITATIONS

Owing to the cross-sectional design, only clues to causal explanations can be provided.

CONCLUSIONS

Burnout has significant direct and indirect effects on PTSD symptoms. Furthermore, social support and psychological resilience might be effective ways to reduce the impact of burnout on PTSD symptoms in medical staff after a major public health outbreak.

摘要

背景

关于倦怠和创伤后应激障碍(PTSD)之间关系的证据有限。我们旨在评估 COVID-19 大流行两年后武汉医务人员倦怠与 PTSD 症状之间的关联,并探讨社会支持和心理弹性的中介作用。

方法

2022 年 1 月至 3 月,采用多中心在线调查的方式,对六家综合医院的医护人员进行调查。采用分层线性回归来检测 PTSD 症状的预测因素。采用结构方程模型(SEM)来分析从倦怠到 PTSD 症状的途径。

结果

分层线性回归显示,倦怠、社会支持和心理弹性是医务人员 PTSD 症状的显著预测因素。在 SEM 中,倦怠对 PTSD 症状的标准化总效应为 0.336(偏校正 95%置信区间[0.303,0.367],P<0.001)。社会支持和心理弹性部分中介了倦怠与 PTSD 症状之间的关系(间接效应占总效应的 22.3%)。

局限性

由于横断面设计,只能提供因果解释的线索。

结论

倦怠对 PTSD 症状有显著的直接和间接影响。此外,社会支持和心理弹性可能是减轻重大公共卫生事件后医务人员倦怠对 PTSD 症状影响的有效途径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d6c/9585849/5614324788c6/gr1_lrg.jpg

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