Department of Medicine for Integrated Approach to Social Inclusion, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Sci Rep. 2022 Dec 23;12(1):22218. doi: 10.1038/s41598-022-26332-6.
Perceived discrimination and work impairment are commonly observed in COVID-19 survivors, but their relationship has not been well understood. We aimed to evaluate the role of discrimination in the development of psychological distress and work impairment in COVID-19 survivors. From April 2020 to November 2021, 309 patients were recruited at two designated COVID-19 hospitals in Japan. Participants completed a standardized questionnaire including COVID-19 sequelae, psychological distress, impairments in work performance and perceived discrimination. The majority of participants (62.5%) experienced one or more COVID-19 sequelae. Psychological distress was observed in 36.9% and work impairment in 37.9%. In multivariate logistic regression analyses, COVID-19 sequelae and discrimination were associated with both psychological distress and work impairment. Mediation analysis demonstrated that the direct effect of sequelae on work impairment was non-significant after accounting for psychological distress, suggesting that the effect of sequelae on work impairment was mainly mediated through psychological distress. These findings were replicated in a subgroup analysis limited to patients with mild COVID-19. We conclude that discrimination plays an important role in the development of psychological distress and work impairment, and that both discrimination and psychological distress should be targets of intervention in COVID-19 survivors.
在 COVID-19 幸存者中，普遍观察到感知歧视和工作障碍，但它们之间的关系尚未得到很好的理解。我们旨在评估歧视在 COVID-19 幸存者心理困扰和工作障碍发展中的作用。2020 年 4 月至 2021 年 11 月，在日本的两家指定 COVID-19 医院招募了 309 名患者。参与者完成了一份标准化问卷，包括 COVID-19 后遗症、心理困扰、工作表现障碍和感知歧视。大多数参与者（62.5%）经历了一种或多种 COVID-19 后遗症。36.9%的人出现心理困扰，37.9%的人出现工作障碍。在多变量逻辑回归分析中，COVID-19 后遗症和歧视与心理困扰和工作障碍都有关。中介分析表明，在考虑心理困扰后，后遗症对工作障碍的直接影响不显著，这表明后遗症对工作障碍的影响主要通过心理困扰来介导。在仅限于轻度 COVID-19 患者的亚组分析中，也得到了类似的结果。我们得出结论，歧视在心理困扰和工作障碍的发展中起着重要作用，歧视和心理困扰都应该是 COVID-19 幸存者干预的目标。
