Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
Curtin enAble Institute, Curtin University, Perth, Australia.
PLoS One. 2024 Mar 7;19(3):e0299584. doi: 10.1371/journal.pone.0299584. eCollection 2024.
Healthcare workers globally have experienced increased social and occupational stressors in their working environments and communities because of COVID-19 which has increased the risk of mental health concerns. This study aimed to explore the prevalence and correlates of depression and anxiety amongst healthcare workers during the COVID-19 pandemic in the Western Cape, South Africa. In addition, role-related stressors and coping strategies were explored.
We conducted a cross-sectional survey of doctors and nurses working in public healthcare facilities across the Western Cape, South Africa. Participants completed the Generalized Anxiety Disorder-7 (GAD-7), the Center for Epidemiologic Studies Depression (CES-D), the Professional Quality of Life (PROQL-R-IV), and the Brief Coping Orientation to Problems Experienced (COPE-R) scales. Data were analysed using multivariable logistic regression analysis.
The sample comprised 416 health workers (303 nurses, 113 doctors). Almost 40% of the sample (n = 161) had CES-D scores suggestive of probable depression, and 45.9% (n = 186) had GAD-7 scores suggestive of anxiety. In the logistic regression model, the odds of probable depression were higher for female participants compared to men (OR = 2.26, 95% CI 1.00-5.10) and for participants who used behavioural disengagement as a coping strategy (OR = 1.50, 95% CI 1.14-1.97). More time spent working with COVID patients was associated with increased odds of having high levels of anxiety [OR = 1.13, 95% CI (1.02-1.25). Substance use (OR = 1.39, 95% CI 1.08-1.81), venting (OR = 1.31, 95% CI 1.01-1.70), and self-blame (OR = 1.42, 95% CI 1.08-1.87) were some of the coping strategies used by healthcare workers. High levels of secondary traumatic stress and burnout were found to increase the odds of both depression and anxiety.
Findings of this study suggest that there is a high prevalence of mental health issues among healthcare workers, and a critical need to focus on workplace mental health interventions to support these frontline workers.
由于 COVID-19，全球医护人员在工作场所和社区中经历了更多的社会和职业压力源，这增加了他们心理健康问题的风险。本研究旨在探讨南非西开普省 COVID-19 大流行期间医护人员的抑郁和焦虑患病率及其相关因素。此外，还探讨了与角色相关的压力源和应对策略。
我们对南非西开普省公立医疗机构的医生和护士进行了横断面调查。参与者完成了广泛性焦虑障碍 7 项量表（GAD-7）、流行病学研究中心抑郁量表（CES-D）、职业生活质量量表（PROQL-R-IV）和问题经历简要应对取向量表（COPE-R）。使用多变量逻辑回归分析对数据进行分析。
该样本包括 416 名卫生工作者（303 名护士，113 名医生）。近 40%的样本（n=161）出现 CES-D 评分提示可能患有抑郁症，45.9%（n=186）出现 GAD-7 评分提示可能患有焦虑症。在逻辑回归模型中，与男性相比，女性参与者（OR=2.26，95%CI 1.00-5.10）和使用行为脱离作为应对策略的参与者（OR=1.50，95%CI 1.14-1.97）出现可能抑郁的可能性更高。与 COVID 患者一起工作的时间增加与出现高焦虑水平的几率增加相关[OR=1.13，95%CI（1.02-1.25）]。物质使用（OR=1.39，95%CI 1.08-1.81）、发泄（OR=1.31，95%CI 1.01-1.70）和自责（OR=1.42，95%CI 1.08-1.87）是医护人员使用的一些应对策略。较高的二级创伤应激和倦怠水平被发现会增加抑郁和焦虑的几率。
本研究结果表明，医护人员中存在较高的心理健康问题患病率，迫切需要关注工作场所心理健康干预措施，以支持这些一线工作人员。
