Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Psychiatry and Psychotherapy of the University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Int J Equity Health. 2024 Oct 10;23(1):207. doi: 10.1186/s12939-024-02286-1.
The integration of sex and gender aspects into the research process has been recognized as crucial to the generation of valid data. During the coronavirus pandemic, a great deal of research addressed the mental state of hospital staff, as they constituted a population at risk for infection and distress. However, it is still unknown how the gender dimension was included. We aimed to appraise and measure qualitatively the extent of gender sensitivity.
In this scoping review, we searched MEDLINE, EMBASE, CINAHL PsycINFO and Social Sciences Citation Index (SSCI) from database inception to November 11, 2021. All quantitative studies with primary data published in English, German, or Spanish and based in the European Union were selected. Included studies had to have assessed the mental health of hospital staff using validated psychometric scales for depression, anxiety, PTSD symptoms, distress, suicidal behavior, insomnia, substance abuse or aggressive behavior. Two independent reviewers applied eligibility criteria to each title/abstract reviewed, to the full text of the article, and performed the data extraction. A gender sensitivity assessment tool was developed and validated, consisting of 18 items followed by a final qualitative assessment. Two independent reviewers assessed the gender dimension of each included article.
Three thousand one hundred twelve studies were identified, of which 72 were included in the analysis. The most common design was cross-sectional (75.0%) and most of them were conducted in Italy (31.9%). Among the results, only one study assessed suicidal behaviors and none substance abuse disorders or aggressive behaviors. Sex and gender were used erroneously in 83.3% of the studies, and only one study described how the gender of the participants was determined. Most articles (71.8%) did not include sex/gender in the literature review and did not discuss sex/gender-related findings with a gender theoretical background (86.1%). In the analysis, 37.5% provided sex/gender disaggregated data, but only 3 studies performed advanced modeling statistics, such as interaction analysis. In the overall assessment, 3 papers were rated as good in terms of gender sensitivity, and the rest as fair (16.7%) and poor (79.2%). Three papers were identified in which gender stereotypes were present in explaining the results. None of the papers analyzed the results of non-binary individuals.
Studies on the mental health of hospital staff during the pandemic did not adequately integrate the gender dimension, despite the institutional commitment of the European Union and the gendered effect of the pandemic. In the development of future mental health interventions for this population, the use and generalizability of current evidence should be done cautiously.
将性别方面纳入研究过程已被认为对产生有效数据至关重要。在冠状病毒大流行期间，大量研究关注了医院工作人员的精神状态，因为他们是感染和困扰的高危人群。然而，目前尚不清楚性别维度是如何被纳入的。我们旨在评估和定性衡量性别敏感性的程度。
在这项范围综述中，我们检索了 MEDLINE、EMBASE、CINAHL PsycINFO 和 Social Sciences Citation Index（SSCI），检索时间从数据库建立到 2021 年 11 月 11 日。所有纳入的研究均为使用经过验证的抑郁、焦虑、创伤后应激障碍症状、痛苦、自杀行为、失眠、物质滥用或攻击行为的心理计量学量表评估医院工作人员心理健康的原始数据的定量研究。纳入的研究必须在欧盟基于评估医院工作人员心理健康的原始数据的定量研究，必须使用经过验证的抑郁、焦虑、创伤后应激障碍症状、痛苦、自杀行为、失眠、物质滥用或攻击行为的心理计量学量表。两名独立的审查员将符合条件的标准应用于每一篇经审查的标题/摘要、文章全文，并进行数据提取。开发并验证了一个性别敏感性评估工具，由 18 个项目组成，最后进行定性评估。两名独立的审查员评估了每一篇纳入文章的性别维度。
共确定了 3112 项研究，其中 72 项纳入分析。最常见的设计是横断面研究（75.0%），其中大多数在意大利进行（31.9%）。在结果中，只有一项研究评估了自杀行为，没有研究评估物质滥用障碍或攻击行为。在 83.3%的研究中，性和性别被错误使用，只有一项研究描述了如何确定参与者的性别。大多数文章（71.8%）在文献综述中未包含性/性别，也未从性别理论背景讨论与性/性别相关的发现（86.1%）。在分析中，37.5%的文章提供了按性别划分的数据，但只有 3 项研究进行了交互分析等高级建模统计。在总体评估中，3 篇文章在性别敏感性方面被评为良好，其余 16.7%为一般，79.2%为较差。在解释结果时，有 3 篇文章存在性别刻板印象。没有一篇文章分析非二元个体的结果。
尽管欧盟有机构承诺，且大流行具有性别影响，但在大流行期间对医院工作人员心理健康的研究并未充分纳入性别维度。在为这一人群制定未来的心理健康干预措施时，应谨慎使用和推广当前的证据。
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