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在 COVID-19 大流行期间,污名化、歧视和暴力的经历及其对医护人员心理健康的影响。

Experiences of stigma, discrimination and violence and their impact on the mental health of health care workers during the COVID-19 pandemic.

机构信息

Department of Epidemiology, Second Faculty of Medicine, Charles University, Prague, Czechia.

Division of Medical Psychology, Third Faculty of Medicine, Charles University, Prague, Czechia.

出版信息

Sci Rep. 2024 May 8;14(1):10534. doi: 10.1038/s41598-024-59700-5.

Abstract

Health care workers have been exposed to COVID-19 more than people in other professions, which may have led to stigmatization, discrimination, and violence toward them, possibly impacting their mental health. We investigated (1) factors associated with stigma, discrimination, and violence, (2) the association of stigma, discrimination, and violence with mental health, (3) everyday experiences of stigmatization, discrimination, and violence. We chose a combination of a quantitative approach and qualitative content analysis to analyze data collected at three time points: in 2020, 2021 and 2022. A higher age was associated with lower odds of experiencing stigma, discrimination, and violence, whereas female gender was related to more negative experiences. The intensity of exposure to COVID-19 was associated with greater experience with stigmatization, discrimination, and violence across all three years (for example in 2022: odds ratio, 95% confidence interval: 1.74, 1.18-2.55 for mild exposure; 2.82, 1.95-4.09 for moderate exposure; and 5.74, 3.55-9.26 for severe exposure, when compared to no exposure). Stigma, discrimination, and violence were most strongly associated with psychological distress in 2020 (odds ratio = 2.97, 95% confidence interval 2.27-3.88) and with depressive symptoms in 2021 (odds ratio = 2.78, 95% confidence interval 2.12-3.64). Attention should be given to the destigmatization of contagious diseases and the prevention of discrimination, violence, and mental health problems, both within workplaces and among the public.

摘要

医护人员比其他职业更容易接触到 COVID-19,这可能导致他们受到污名化、歧视和暴力对待,从而影响他们的心理健康。我们调查了:(1)与污名化、歧视和暴力相关的因素;(2)污名化、歧视和暴力与心理健康之间的关联;(3)日常的污名化、歧视和暴力经历。我们选择了定量方法和定性内容分析相结合的方法,以分析在三个时间点收集的数据:2020 年、2021 年和 2022 年。年龄较大与经历污名化、歧视和暴力的可能性较低有关,而女性性别则与更负面的经历有关。接触 COVID-19 的强度与所有三年的污名化、歧视和暴力经历呈正相关(例如,在 2022 年:轻度暴露的比值比,95%置信区间:1.74,1.18-2.55;中度暴露的比值比,1.95-4.09;严重暴露的比值比,5.74,3.55-9.26,与无暴露相比)。污名化、歧视和暴力与 2020 年的心理困扰(比值比=2.97,95%置信区间 2.27-3.88)和 2021 年的抑郁症状(比值比=2.78,95%置信区间 2.12-3.64)关联最为密切。应关注传染性疾病的去污名化和歧视、暴力以及心理健康问题的预防,这不仅应在工作场所内,还应在公众中得到重视。

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