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新型冠状病毒相关创伤后应激症状和心理化在医护人员向后疫情时代过渡过程中感知压力与心理健康之间的中介作用。

The mediation effects of COVID-19-related traumatic stress symptoms and mentalization on the relationship between perceived stress and psychological well-being in healthcare workers transitioning to a post-pandemic world.

机构信息

The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.

New York Psychoanalytic Society & Institute, New York, New York, United States of America.

出版信息

PLoS One. 2024 Sep 4;19(9):e0309561. doi: 10.1371/journal.pone.0309561. eCollection 2024.

Abstract

BACKGROUND

In context of COVID-19 as a collective trauma and the intense involvement of healthcare workers (HCWs) in the pandemic, perceived stress continues to have a tremendous impact on their psychological well-being. However, few studies have attempted to delineate the underlying mechanisms. This study examined whether COVID-19-related traumatic stress symptoms and mentalization act as mediators.

METHODS

A sample of HCWs (N = 2610) from 22 hospitals in Beijing, China participated in this cross-sectional investigation. Data on their perceived stress, psychological well-being, the impact of event, and reflective function during the COVID-19 pandemic were collected using self-report questionnaires. Different mediating models were tested.

RESULTS

COVID-19-related stress symptoms and mentalization independently mediate the association between perceived stress and psychological well-being. These two mediators also compose a serial mediation model. In particular, higher perceived stress inhibits the psychological well-being of HCWs through increased severity of traumatic stress symptoms, which in turn is associated with hypomentalizing.

CONCLUSION

These findings shed light on the mechanisms underlying the relationship between perceived stress and psychological well-being in HCWs. We strongly recommend incorporating a mentalization framework with trauma-informed practice in prevention and intervention work with this population during this and future healthcare crisis.

摘要

背景

在 COVID-19 作为集体创伤的背景下,医护人员(HCWs)在大流行期间的大量参与,感知压力继续对他们的心理健康产生巨大影响。然而,很少有研究试图阐明潜在的机制。本研究检验了 COVID-19 相关创伤性应激症状和心理化是否作为中介。

方法

本研究在北京 22 家医院招募了 2610 名 HCWs 作为样本,采用问卷调查法收集了他们在 COVID-19 期间的感知压力、心理健康、事件影响和反思功能等数据。测试了不同的中介模型。

结果

COVID-19 相关应激症状和心理化独立地介导了感知压力与心理健康之间的关系。这两个中介也构成了一个串联中介模型。具体来说,较高的感知压力通过增加创伤性应激症状的严重程度来抑制 HCWs 的心理健康,而创伤性应激症状又与心理化不足有关。

结论

这些发现揭示了感知压力与 HCWs 心理健康之间关系的潜在机制。我们强烈建议在当前和未来的医疗保健危机期间,将心理化框架与创伤知情实践纳入该人群的预防和干预工作中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3f0/11373818/4e3ed0e939f0/pone.0309561.g001.jpg

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