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英格兰国民保健制度工作人员中的种族不平等:新冠疫情期间的工作场所经历。

Ethnic inequalities among NHS staff in England: workplace experiences during the COVID-19 pandemic.

机构信息

Psychological Medicine, King's College London - Institute of Psychiatry, Psychology & Neuroscience, London, UK

Centre for Society and Mental Health, King's College London - Strand Campus, London, UK.

出版信息

Occup Environ Med. 2024 Mar 8;81(3):113-121. doi: 10.1136/oemed-2023-108976.

Abstract

OBJECTIVES

This study aims to determine how workplace experiences of National Health Service (NHS) staff varied by ethnicity during the COVID-19 pandemic and how these experiences are associated with mental and physical health at the time of the study.

METHODS

An online Inequalities Survey was conducted by the Tackling Inequalities and Discrimination Experiences in Health Services study in collaboration with NHS CHECK. This Inequalities Survey collected measures relating to workplace experiences (such as personal protective equipment (PPE), risk assessments, redeployments and discrimination) as well as mental health (Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder 7 (GAD-7)), and physical health (PHQ-15) from NHS staff working in the 18 trusts participating with the NHS CHECK study between February and October 2021 (N=4622).

RESULTS

Regression analysis of this cross-sectional data revealed that staff from black and mixed/other ethnic groups had greater odds of experiencing workplace harassment (adjusted OR (AOR) 2.43 (95% CI 1.56 to 3.78) and 2.38 (95% CI 1.12 to 5.07), respectively) and discrimination (AOR 4.36 (95% CI 2.73 to 6.96) and 3.94 (95% CI 1.67 to 9.33), respectively) compared with white British staff. Staff from black ethnic groups also had greater odds than white British staff of reporting PPE unavailability (AOR 2.16 (95% CI 1.16 to 4.00)). Such workplace experiences were associated with negative physical and mental health outcomes, though this association varied by ethnicity. Conversely, understanding employment rights around redeployment, being informed about and having the ability to inform redeployment decisions were associated with lower odds of poor physical and mental health.

CONCLUSIONS

Structural changes to the way staff from ethnically minoritised groups are supported, and how their complaints are addressed by leaders within the NHS are urgently required.

摘要

目的

本研究旨在确定在 COVID-19 大流行期间,国民保健服务(NHS)员工的工作场所经历因种族而异的程度,以及这些经历如何与研究时的身心健康相关。

方法

由 Tackling Inequalities and Discrimination Experiences in Health Services 研究与 NHS CHECK 合作进行了一项在线不平等调查。该不平等调查从 NHS CHECK 研究中的 18 家信托机构中收集了与工作场所经历(如个人防护设备(PPE)、风险评估、调配和歧视)以及心理健康(患者健康问卷(PHQ-9)、广泛性焦虑症 7 项(GAD-7))和身体健康(PHQ-15)相关的措施,调查对象为在 2021 年 2 月至 10 月期间参与 NHS CHECK 研究的 NHS 员工(N=4622)。

结果

对这一横断面数据的回归分析显示,来自黑人和混合/其他种族群体的员工更有可能经历工作场所骚扰(调整后的优势比(AOR)分别为 2.43(95%置信区间 1.56 至 3.78)和 2.38(95%置信区间 1.12 至 5.07))和歧视(AOR 分别为 4.36(95%置信区间 2.73 至 6.96)和 3.94(95%置信区间 1.67 至 9.33)),与英国白人员工相比。与英国白人员工相比,来自黑人种族群体的员工报告无法获得个人防护设备的可能性也更高(AOR 2.16(95%置信区间 1.16 至 4.00))。这些工作场所经历与负面的身心健康结果相关,但这种关联因种族而异。相反,了解有关重新部署的就业权利、了解并能够告知重新部署决策与较差的身心健康的可能性较低相关。

结论

迫切需要对少数民族群体员工的支持方式进行结构性改革,以及 NHS 内部的领导人如何处理他们的投诉。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca14/10958323/d3856fd4ace4/oemed-2023-108976f01.jpg

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