Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Robert J Havey, MD Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
BMJ Open. 2023 Aug 28;13(8):e072155. doi: 10.1136/bmjopen-2023-072155.
This study aims to characterise the physical and psychological well-being of maternal and newborn healthcare workers (MNHCWs) during the COVID-19 pandemic.
Observational repeated cross-sectional study.
An online questionnaire was distributed to MNHCWs around the globe in three separate rounds from March 2020 to March 2021.
Total samples of N=1357 (round 1) and N=420 (round 3) primarily consisted of doctors, midwives and nurses in maternal and newborn specialties. Samples represented all WHO regions, with 33% (round 1) and 42% (round 3) from low- or middle-income countries (LMICs).
Responses from rounds 1 (March-June 2020) and 3 (December 2020-March 2021) were analysed to measure self-reported levels of relative stress and workplace protection from COVID-19, while associated factors were determined through multivariable ordinal logistic regression.
In round 1, 90% of MNHCWs reported increased stress levels and 45% reported insufficient personal protective equipment (PPE) access. Nurses and physicians were less likely to report increased stress than midwives at the pandemic onset. Factors associated with increased stress included being female, being from an LMIC and insufficient PPE. In round 3, 75% reported similar or increased stress while 10% reported insufficient PPE. In both rounds, over 50% of MNHCWs felt relatively or completely unprotected from COVID-19 in the workplace. Those from LMICs were more likely to report feeling unprotected, while receiving organisational information that valued safety was associated with better feelings of protection in the workplace.
Among our international sample of MNHCWs, we observed high rates of self-reported stress increase at the start of the pandemic with persistence or increase up to a year later. High rates of feeling unprotected persisted even as PPE became more available. These results may inform interventions needed to support and protect MNHCWs during this and future pandemics.
本研究旨在描述 COVID-19 大流行期间母婴保健工作者（MNHCWs）的身心健康状况。
观察性重复横断面研究。
在 2020 年 3 月至 2021 年 3 月期间，分三批向全球 MNHCWs 发放了在线问卷。
总样本量 N=1357（第 1 轮）和 N=420（第 3 轮）主要由妇产科、新生儿科的医生、助产士和护士组成。样本代表了所有世卫组织区域，其中 33%（第 1 轮）和 42%（第 3 轮）来自中低收入国家（LMICs）。
分析第 1 轮（2020 年 3 月至 6 月）和第 3 轮（2020 年 12 月至 2021 年 3 月）的应答，以衡量自我报告的相对压力水平和 COVID-19 期间的工作场所保护水平，同时通过多变量有序逻辑回归确定相关因素。
第 1 轮，90%的 MNHCWs 报告压力水平升高，45%报告个人防护设备（PPE）不足。在大流行开始时，护士和医生报告压力增加的可能性低于助产士。与压力增加相关的因素包括女性、来自 LMICs 和 PPE 不足。第 3 轮，75%报告压力水平相似或增加，10%报告 PPE 不足。两轮中，超过 50%的 MNHCWs 感到在工作场所相对或完全没有受到 COVID-19 的保护。来自 LMICs 的人更有可能报告感到不受保护，而收到重视安全的组织信息与在工作场所更好地感到保护相关。
在我们的国际 MNHCWs 样本中，我们观察到大流行开始时自我报告的压力增加率很高，一年后仍持续或增加。即使 PPE 变得更加可用，感到不受保护的比例仍然很高。这些结果可能为支持和保护 MNHCWs 在此次大流行及未来大流行期间提供干预措施提供信息。
