Foo Cheryl Yunn Shee, Tay Alvin Kuowei, Yang Yexinyu, Verdeli Helen
Department of Counseling and Clinical Psychology, Teachers College, Columbia University of New York, 525 W 120 St, Box 102, New York, NY, 10027, USA.
MGH Center of Excellence for Psychosocial and Systemic Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 1 Bowdoin St, 9th Floor, Boston, MA, 02114, USA.
Confl Health. 2023 Apr 3;17(1):17. doi: 10.1186/s13031-023-00512-1.
While trauma exposure is an established predictor of poor mental health among humanitarian aid workers (HAWs), less is known about the role of psychosocial work-related factors. This study aims to establish a psychosocial model for burnout and psychological distress in HAWs that tests and compares the effects of adversity exposure and workplace stressors in combination, and explores the potential mediating role of individual coping styles.
Path analysis and model comparison using cross-sectional online survey data were collected from full-time international and local HAWs in Bangladesh between December 2020 and February 2021. HAWs self-reported on exposure to adversities, workplace psychosocial stressors (Third Copenhagen Psychosocial Questionnaire), coping styles (Coping Inventory for Stressful Situations), burnout (Maslach Burnout Inventory-Human Services Survey), and psychological distress (Kessler-6).
Among N = 111 HAWs, 30.6%, 16.4%, 12.7%, and 8.2% screened positive for moderate psychological distress (8 ≤ Kessler-6 ≤ 12), emotional exhaustion (EE ≥ 27), depersonalization (DP ≥ 13), and severe psychological distress (K-6 ≥ 13), respectively. 28.8% reported a history of mental disorder. The preferred model showed distinct pathways from adversity exposure and workplace stressors to burnout, with negative emotion-focused coping and psychological distress as significant intervening variables. While greater exposure to both types of stressors were associated with higher levels of burnout and distress, workplace stressors had a stronger association with psychological outcomes than adversity exposure did (β = .52, p ≤ .001 vs. β = .20, p = .032). Workplace stressors, but not adversities, directly influenced psychological distress (β = .45, p ≤ .001 vs. β = -.01, p = .927). Demographic variables, task-focused and avoidance-focused coping were not significantly associated with psychological outcomes.
Compared to exposure to adversities, workplace stressors primarily influenced occupational stress syndromes. Reducing workplace stressors and enhancing adaptive coping may improve psychological outcomes in humanitarian staff.
虽然创伤暴露是人道主义援助工作者（HAWs）心理健康不佳的既定预测因素，但对于社会心理工作相关因素的作用了解较少。本研究旨在建立一个关于HAWs职业倦怠和心理困扰的社会心理模型，该模型测试并比较逆境暴露和工作场所压力源的综合影响，并探索个体应对方式的潜在中介作用。
使用2020年12月至2021年2月期间从孟加拉国全职国际和本地HAWs收集的横断面在线调查数据进行路径分析和模型比较。HAWs自我报告了暴露于逆境、工作场所社会心理压力源（哥本哈根社会心理问卷第三版）、应对方式（应激情境应对量表）、职业倦怠（马氏职业倦怠量表-人类服务调查）和心理困扰（凯斯勒6项量表）的情况。
在N = 111名HAWs中，分别有30.6%、16.4%、12.7%和8.2%的人中度心理困扰（凯斯勒6项量表评分8≤Kessler-6≤12）、情感耗竭（EE≥27）、去个性化（DP≥13）和重度心理困扰（K-6≥13）筛查呈阳性。28.8%的人报告有精神障碍病史。首选模型显示了从逆境暴露和工作场所压力源到职业倦怠的不同路径，以消极情绪为中心的应对方式和心理困扰是重要的中介变量。虽然两种压力源的暴露增加都与更高水平的职业倦怠和困扰相关，但工作场所压力源与心理结果的关联比逆境暴露更强（β = 0.52，p≤0.001 vs.β = 0.20，p = 0.032）。工作场所压力源而非逆境直接影响心理困扰（β = 0.45，p≤0.001 vs.β = -0.01，p = 0.927）。人口统计学变量、以任务为中心和以回避为中心的应对方式与心理结果无显著关联。
与逆境暴露相比，工作场所压力源主要影响职业应激综合征。减少工作场所压力源并增强适应性应对方式可能会改善人道主义工作人员的心理结果。
