EPIMED Research Center, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
Division of Psychiatry, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
Psychiatry Res. 2023 Aug;326:115305. doi: 10.1016/j.psychres.2023.115305. Epub 2023 Jun 12.
The aim of this study was to identify how previously existing burnout and its changes during the pandemic contributed to PTSD symptoms and psychological distress in a cohort of 388 healthcare workers (HCWs). Each HCW was surveyed in Sep 2019 (before COVID-19) and again in Dec 2020-Jan 2021 (during the pandemic) to assess burnout (MBI); and in the second wave only to assess PTSD (PCL-5-SF), psychological distress (GHQ-12) and resilience (CD-RISC-10). Changes in emotional exhaustion (EE) and depersonalisation (DEP) were stronger in HCWs with lower EE and DEP baseline values. HCWs with higher baseline poor personal accomplishment (PPA) improved more than those with lower baseline values. In multivariable-adjusted models, pre-pandemic EE and its changes were equally associated to both outcomes: standardised-βs of 0.52 and 0.54 for PTSD, respectively; and 0.55 and 0.53 for psychological distress. Changes in DEP were associated with PTSD only (0.10). Changes in PPA had a higher association with psychological distress (0.29) than pre-pandemic PPA (0.13). Resilience was associated with lower psychological distress (-0.25). Preventive actions aimed at reducing EE, e.g., addressing organisational dysfunctions, are needed to mitigate the impact of future crises, whereas improving personal accomplishment levels is a key target to protect HCWs from mental health disorders during a pandemic.
本研究旨在确定先前存在的倦怠及其在大流行期间的变化如何导致 388 名医护人员（HCWs）的 PTSD 症状和心理困扰。每位 HCW 在 2019 年 9 月（COVID-19 之前）和 2020 年 12 月至 2021 年 1 月（大流行期间）再次接受调查，以评估倦怠（MBI）；仅在第二波中评估 PTSD（PCL-5-SF）、心理困扰（GHQ-12）和韧性（CD-RISC-10）。基线 EE 和 DEP 值较低的 HCWs 的情绪衰竭（EE）和去人格化（DEP）变化更强。基线较差的个人成就感（PPA）较高的 HCWs 比基线值较低的 HCWs 改善更多。在多变量调整模型中，大流行前的 EE 及其变化与这两个结果同样相关：PTSD 的标准化β分别为 0.52 和 0.54；心理困扰的标准化β分别为 0.55 和 0.53。DEP 的变化仅与 PTSD 相关（0.10）。PPA 的变化与心理困扰的相关性更高（0.29），而大流行前的 PPA 相关性较低（0.13）。韧性与较低的心理困扰相关（-0.25）。需要采取旨在减少 EE 的预防措施，例如解决组织功能障碍，以减轻未来危机的影响，而提高个人成就感水平是保护 HCWs 在大流行期间免受心理健康障碍的关键目标。
