纽约市医护人员在 COVID-19 大流行期间遭受与系统性种族主义相关的痛苦的心理负担。
Psychological Burden of Systemic Racism-Related Distress in New York City Healthcare Workers During the COVID-19 Pandemic.
机构信息
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Medical Education, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA.
出版信息
J Gen Intern Med. 2024 Feb;39(3):450-459. doi: 10.1007/s11606-023-08422-x. Epub 2023 Oct 16.
BACKGROUND
Little is known about the relationship among systemic racism, psychological symptoms (depression, anxiety, and/or post-traumatic stress disorders), and burnout in healthcare workers (HCWs).
OBJECTIVE
To determine whether distress related to awareness of systemic racism contributes to psychological symptoms and/or burnout in HCWs. We explored whether this form of racism-related distress may moderate the relationship between race, ethnicity, psychological symptoms, and burnout.
DESIGN
A cross-sectional survey was conducted from November 19, 2020, through January 11, 2021. Statistical analysis was conducted from May 3, 2022, to June 15, 2022.
PARTICIPANTS
Frontline HCWs at an urban tertiary care hospital in New York City.
MAIN MEASURES
Distress related to awareness of systemic racism (SR) and racial disparities in COVID-19 outcomes (RD), psychological symptoms, and burnout.
KEY RESULTS
Two thousand one of 4654 HCWs completed the survey (response rate 43.0%). Most HCWs reported experiencing distress related to awareness of systemic racism (1329 [66.4%]) and to racial disparities in COVID-19 outcomes (1137 [56.8%]). Non-Hispanic Black participants (SR odds ratio (OR) 2.84, p < .001; RD OR 2.34, p < .001), women (SR OR 1.35, p = .01; RD OR 1.67, p < .001), and those with history of mental illness (SR OR 2.13, p < .001; RD OR 1.66, p < .001) were more likely to report SR- and RD-related distress, respectively. HCWs who experienced "quite-a-bit to extreme" SR-related distress were more likely to screen positive for psychological symptoms (OR 5.90, p < .001) and burnout (OR 2.26, p < .001).
CONCLUSIONS
Our findings suggest that distress related to awareness of systemic racism, not race/ethnicity, was associated with experiencing psychological symptoms and burnout in HCWs. As the medical community continues to critically examine the role of systemic racism in healthcare, our work is a first step in characterizing its toll on the psychological well-being of HCWs.
背景
对于系统性种族主义、心理症状（抑郁、焦虑和/或创伤后应激障碍）以及医疗保健工作者（HCWs）中的倦怠之间的关系知之甚少。
目的
确定与系统性种族主义意识相关的困扰是否会导致 HCWs 的心理症状和/或倦怠。我们探讨了这种形式的与种族有关的困扰是否会加剧种族、族裔、心理症状和倦怠之间的关系。
设计
一项横断面调查于 2020 年 11 月 19 日至 2021 年 1 月 11 日进行。统计分析于 2022 年 5 月 3 日至 2022 年 6 月 15 日进行。
参与者
纽约市一家城市三级保健医院的一线 HCWs。
主要措施
与系统性种族主义意识相关的困扰（SR）和 COVID-19 结果中的种族差异（RD）、心理症状和倦怠。
主要结果
在 4654 名 HCWs 中，有 211 名（应答率为 43.0%）完成了调查。大多数 HCWs 报告经历了与系统性种族主义意识相关的困扰（1329 名[66.4%]）和 COVID-19 结果中的种族差异相关的困扰（1137 名[56.8%]）。非西班牙裔黑人参与者（SR 优势比（OR）2.84，p<0.001；RD OR 2.34，p<0.001）、女性（SR OR 1.35，p=0.01；RD OR 1.67，p<0.001）和有精神病史的参与者（SR OR 2.13，p<0.001；RD OR 1.66，p<0.001）更有可能分别报告与 SR 和 RD 相关的困扰。经历“相当多到极端”与 SR 相关的困扰的 HCWs 更有可能出现心理症状（OR 5.90，p<0.001）和倦怠（OR 2.26，p<0.001）的阳性筛查结果。
结论
我们的研究结果表明，与系统性种族主义意识相关的困扰，而不是种族/民族，与 HCWs 出现心理症状和倦怠有关。随着医学界继续批判性地审视系统性种族主义在医疗保健中的作用，我们的工作是描述其对 HCWs 心理健康影响的第一步。
Zotero 插件