Unidad de Investigación Médica en Otoneurología, Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico.
Departamento de Psiquiatría, Hospital de Especialidades del Centro Médico Nacional Siglo XXI del Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico.
Int J Environ Res Public Health. 2023 Feb 23;20(5):3989. doi: 10.3390/ijerph20053989.
In addition to the sanitary constrains implemented due to the pandemic, frontline physicians have faced increased workloads with insufficient resources, and the responsibility to make extraordinary clinical decisions. In 108 physicians who were at the forefront of care of patients with COVID-19 during the first two years of the pandemic, mental health, moral distress, and moral injury were assessed twice, in between two late waves of COVID-19 contagions, according to their adverse psychological reactions, in-hospital experience, sick leave due to COVID-19, quality of sleep, moral sensitivity, clinical empathy, resilience, and sense of coherence. Three months after the wave of contagions, the adverse emotional reactions and moral distress decreased, while moral injury persisted. Moral distress was related to clinical empathy, with influence from burnout and sick leave due to COVID-19, and moral injury was related to the sense of coherence, while recovery from moral distress was related to resilience. The results suggest that measures to prevent physician infection, as well as strengthening resilience and a sense of coherence, may be helpful to prevent persistent mental damage after exposure to a sanitary crisis.
除了因大流行而实施的卫生限制外，一线医生还面临着工作量增加和资源不足的问题，以及做出非凡临床决策的责任。在大流行的头两年，在照顾 COVID-19 患者的前线的 108 名医生中，根据他们的不良心理反应、住院经历、因 COVID-19 而请的病假、睡眠质量、道德敏感性、临床同理心、适应力和归属感，对他们进行了两次心理健康、道德困境和道德伤害评估。在疫情传播的高峰期过后三个月，不良情绪反应和道德困境有所减少，而道德伤害仍然存在。道德困境与临床同理心有关，与倦怠和因 COVID-19 而请的病假有关，而道德伤害与归属感有关，而道德困境的恢复与适应力有关。研究结果表明，采取措施预防医生感染，以及增强适应力和归属感，可能有助于防止在暴露于卫生危机后持续的精神损害。
