Ruini Chiara, Pira Giorgio Li, Cordella Erika, Vescovelli Francesca
Department for Life Quality Studies, University of Bologna, Rimini, Italy.
Department of Psychology "Renzo Canestrari", University of Bologna, Bologna, Italy.
J Psychiatr Ment Health Nurs. 2025 Feb;32(1):192-202. doi: 10.1111/jpm.13099. Epub 2024 Aug 19.
WHAT IS KNOWN ON THE SUBJECT?: In the past 2 years, the COVID-19 pandemic had a robust negative impact on the mental health of healthcare providers, with increasing rates of depression, anxiety, acute stress and burnout. Healthcare workers experiencing poor mental health are reluctant to seek help and treatment because they are afraid of being stigmatized and excluded by their colleagues and employers. During the pandemic positive emotions, resilience and psychological well-being buffered distress and burnout in healthcare workers. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This paper describes positive mental health, depression, anxiety and burnout in healthcare workers during the second wave of the pandemic. Forty-eight per cent of healthcare workers were flourishing (high levels of positive emotions and well-being), 10% languishing (absence of well-being and positivity). Flourishing individuals reported lower levels of depression, anxiety and burnout. These findings documented a relevant number of resilient healthcare workers, who restored/maintained their well-being also under stressful conditions. Vulnerable healthcare workers were less than 20%, and they reported severe anxiety, depression and burnout. No differences emerged between languishing and moderate mental health groups in their levels of anxiety, depression and burnout. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The condition of flourishing is the only one that provides protection from depression and anxiety and burnout, while moderate mental health does not differ substantially from the languishing state. The study confirms the importance of maintaining and/or promoting the well-being of healthcare workers. Interventions for promoting positive mental health of vulnerable workers are needed. Mental health nurses can have the skills and expertise for evaluating early symptoms of psychological distress and for implementing interventions for promoting and restoring well-being. These interventions may include informational campaign (i.e. preparing and distributing pamphlets and guidelines) and emotional support programmes (psychoeducation and training, mental health support team, peer support and counselling) that can be delivered also via digital platforms.
INTRODUCTION: Few studies focused on healthcare workers' positive mental health (i.e. high levels of psychological well-being) and its association with anxiety, depression and burnout in the second wave of the pandemic.
To evaluate the protective role of well-being in buffering burnout and psychological distress.
We evaluated 173 Italian healthcare workers with indicators of psychological distress (Depression Anxiety Stress Scales [DASS]-21), burnout (Copenhagen Burnout Inventory [CBI]) and positive mental health (Mental Health Continuum) and we cross-classified them according to their levels of mental health (flourishing, languishing and moderate mental health) and their levels of anxiety, depression and burnout.
Forty-eight per cent of health workers were classified as flourishing, 10% as languishing and 42% as moderate mental health. Flourishing individuals presented lower scores on DASS and CBI scales, whereas no differences emerged between languishing and moderate mental health groups. More than 80% of health workers with clinically significant symptoms of anxiety, depression and risk of burnout were classified as not flourishing.
This investigation documented the presence of flourishing mental health in almost half of the sample of Italian healthcare workers. However, those with moderate or languishing mental health manifested higher levels of anxiety, depression and higher risks of burnout.
The study confirms the importance of maintaining and/or promoting the well-being of this population, with a crucial role of mental health nurses who can easily approach other healthcare workers and provide them informational (training, guidelines) and emotional support programmes (psychoeducation, mental health support team, peer support and counselling) when facing adverse working conditions.
关于该主题已知的信息有哪些？：在过去两年中，新冠疫情对医护人员的心理健康产生了严重负面影响，抑郁、焦虑、急性应激和职业倦怠的发生率不断上升。心理健康状况不佳的医护人员不愿寻求帮助和治疗，因为他们害怕被同事和雇主 stigmatized 和排斥。在疫情期间，积极情绪、恢复力和心理健康有助于缓解医护人员的痛苦和职业倦怠。
本文描述了疫情第二波期间医护人员的积极心理健康、抑郁、焦虑和职业倦怠情况。48%的医护人员状态良好（积极情绪和幸福感水平较高），10%状态不佳（缺乏幸福感和积极性）。状态良好的个体报告的抑郁、焦虑和职业倦怠水平较低。这些发现表明，相当数量的医护人员具有恢复力，即使在压力条件下也能恢复/维持其幸福感。脆弱的医护人员不到20%，他们报告有严重的焦虑、抑郁和职业倦怠。状态不佳和心理健康中等的群体在焦虑、抑郁和职业倦怠水平上没有差异。
状态良好是唯一能预防抑郁、焦虑和职业倦怠的状态，而心理健康中等状态与状态不佳状态没有实质性差异。该研究证实了维持和/或促进医护人员幸福感的重要性。需要针对脆弱医护人员开展促进积极心理健康的干预措施。心理健康护士具备评估心理困扰早期症状以及实施促进和恢复幸福感干预措施的技能和专业知识。这些干预措施可能包括信息宣传活动（如编写和分发宣传册及指南）和情感支持项目（心理教育和培训、心理健康支持团队、同伴支持和咨询），这些也可以通过数字平台提供。
引言：很少有研究关注医护人员的积极心理健康（即高水平的心理幸福感）及其在疫情第二波期间与焦虑、抑郁和职业倦怠的关联。
评估幸福感在缓冲职业倦怠和心理困扰方面的保护作用。
我们用心理困扰指标（抑郁焦虑压力量表[DASS]-21）、职业倦怠指标（哥本哈根职业倦怠量表[CBI]）和积极心理健康指标（心理健康连续体）对173名意大利医护人员进行评估，并根据他们的心理健康水平（状态良好、状态不佳和心理健康中等）以及焦虑、抑郁和职业倦怠水平对他们进行交叉分类。
48%的医护人员被归类为状态良好，10%为状态不佳，42%为心理健康中等。状态良好的个体在DASS和CBI量表上得分较低，而状态不佳和心理健康中等的群体之间没有差异。超过80%有临床显著焦虑、抑郁症状和职业倦怠风险的医护人员被归类为状态不佳。
这项调查表明，在几乎一半的意大利医护人员样本中存在良好的心理健康状况。然而，心理健康中等或不佳的人表现出更高水平的焦虑、抑郁和更高的职业倦怠风险。
该研究证实了维持和/或促进这一人群幸福感重要性，心理健康护士在其中起着关键作用，他们可以轻松接触其他医护人员，并在面对不利工作条件时为他们提供信息（培训、指南）和情感支持项目（心理教育、心理健康支持团队、同伴支持和咨询）。
