COVID-19 大流行期间医护人员心理健康的预测因素：经验性回避、情绪调节和韧性的作用。

Predictors of mental health in healthcare workers during the COVID-19 pandemic: The role of experiential avoidance, emotion regulation and resilience.

机构信息

Department of Psychology, School of Human and Social Sciences, Universidad Pontificia Comillas, Madrid, Spain.

Department of Psychology and Sociology, School of Social and Human Sciences, Universidad de Zaragoza, Teruel, Spain.

出版信息

J Adv Nurs. 2024 Oct;80(10):4089-4102. doi: 10.1111/jan.16122. Epub 2024 Feb 21.

DOI:10.1111/jan.16122

PMID:38382909

Abstract

AIMS

This study explores the mediational role of resilience, experiential avoidance and emotion regulation in the levels of anxiety, depression and posttraumatic stress disorder (PTSD) of healthcare workers during the COVID-19 pandemic. Additionally, we explored the association of such levels with personal and professional variables.

DESIGN

Cross-sectional study.

METHODS

Healthcare professionals working in Spain (N = 786) were recruited following a snowball approach in November and December 2021. Resilience, emotion regulation, experiential avoidance, depression, anxiety, PTSD and work-related variables were measured. Mean differences and correlations were computed, and a path analysis with latent variables (PALV) model was tested.

RESULTS

In total, 18.8% of the sample scored above the cut-off score for depression, 24.6% for anxiety and 36.4% for PTSD. Higher resilience and lower experiential avoidance and expression suppression were correlated with better mental health. The PALV model explained 42%-53% of mental health outcomes. Experiential avoidance showed the greatest explanatory power and mediated the impact that stressors had on mental health. Some work-related variables correlated with greater psychological impact. These factors encompassed being a nurse, feeling that their job remained stressful and had not yet returned to its pre-pandemic state and having interacted with individuals facing economic difficulties due to the pandemic, and those who had lost their lives to COVID-19.

CONCLUSION

Healthcare workers showed high levels of psychological impact during the COVID-19 pandemic. Such impact was predicted from some work-stress variables and the reliance on maladaptive strategies such as experiential avoidance and expressive suppression.

IMPACT

Training healthcare professionals to use coping strategies incompatible with experiential avoidance may improve their mental health. Additionally, better working conditions are fundamental for reducing the impact of critical situations on healthcare workers' mental health.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

摘要

目的

本研究探讨了韧性、体验回避和情绪调节在 COVID-19 大流行期间医护人员焦虑、抑郁和创伤后应激障碍（PTSD）水平中的中介作用。此外，我们还探讨了这些水平与个人和专业变量的关系。

设计

横断面研究。

方法

我们于 2021 年 11 月至 12 月，采用滚雪球的方法招募在西班牙工作的医护人员（N=786）。测量了韧性、情绪调节、体验回避、抑郁、焦虑、创伤后应激障碍和与工作相关的变量。计算了均值差异和相关性，并测试了潜变量路径分析（PALV）模型。

结果

共有 18.8%的样本抑郁得分高于临界值，24.6%的样本焦虑得分高于临界值，36.4%的样本 PTSD 得分高于临界值。较高的韧性和较低的体验回避及表达抑制与更好的心理健康相关。PALV 模型解释了 42%-53%的心理健康结果。体验回避显示出最大的解释力，并介导了应激源对心理健康的影响。一些与工作相关的变量与更大的心理影响相关。这些因素包括护士、认为自己的工作仍然有压力且尚未恢复到疫情前的状态、与因疫情面临经济困难的人互动以及因 COVID-19 失去生命的人。