Sinai Health, 600 University Ave, Toronto, ON, M5G 1X5, Canada.
University of Toronto, 27 King's College Circle, Toronto, ON, M5S 1A1, Canada.
BMC Health Serv Res. 2024 Oct 10;24(1):1214. doi: 10.1186/s12913-024-11577-w.
COVID-19 added to healthcare provider (HCP) distress, but patterns of change remain unclear. This study sought to determine if and how emotional distress varied among HCP between March 28, 2021 and December 1, 2023.
This longitudinal study was embedded within the 42-month prospective COVID-19 Cohort Study that recruited HCP from four Canadian provinces. Information was collected at enrollment, from annual exposure surveys, and vaccination and illness surveys. The 10-item Kessler Psychological Distress Scale (K10) was completed approximately every six months after March 28, 2021. Linear mixed effects models, specifically random intercept models, were generated to determine the impact of time on emotional distress while accounting for demographic and work-related factors.
Between 2021 and 2023, the mean K10 score fell by 3.1 points, indicating decreased distress, but scores increased during periods of high levels of mitigation strategies against transmission of SARS-CoV-2, during winter months, and if taking antidepression, anti-anxiety or anti-insomnia medications. K10 scores were significantly lower for HCP who were male, older, had more children in their household, experienced prior COVID-19 illness(es), and for non-physician but regulated HCP versus nurses. A sensitivity analysis that included only those who had submitted at least five K10 surveys consisted of the factors in the full model excluding previous COVID-19 illness, occupation, and season, after adjustment. Models were also created for K10 anxiety and depression subscales.
K10 scores decreased as the COVID-19 pandemic continued but increased during periods of high mitigation and the winter months. Personal and work-place factors also impacted HCP distress scores. Further research into best practices in distress identification and remediation is warranted to ensure future public health disasters are met with healthcare systems that are able to buffer HCP against short- and long-term mental health issues.
COVID-19 增加了医疗保健提供者 (HCP) 的压力，但变化模式仍不清楚。本研究旨在确定 2021 年 3 月 28 日至 2023 年 12 月 1 日期间 HCP 的情绪困扰是否以及如何发生变化。
这项纵向研究嵌入在为期 42 个月的前瞻性 COVID-19 队列研究中，该研究从加拿大四个省份招募 HCP。在入组时、每年进行的暴露调查以及疫苗接种和疾病调查中收集信息。大约在 2021 年 3 月 28 日之后的每六个月完成一次 10 项 Kessler 心理困扰量表 (K10)。生成线性混合效应模型，特别是随机截距模型，以确定时间对情绪困扰的影响，同时考虑人口统计学和工作相关因素。
在 2021 年至 2023 年期间，K10 评分平均下降 3.1 分，表明压力减轻，但在 SARS-CoV-2 传播的缓解策略水平较高、冬季和服用抗抑郁药、抗焦虑药或安眠药时，评分增加。在男性、年龄较大、家中有更多孩子、经历过先前 COVID-19 疾病的 HCP 中，K10 评分显著较低，而非医生但受监管的 HCP 与护士相比。在调整后，仅包括至少提交了五次 K10 调查的人员的敏感性分析排除了先前的 COVID-19 疾病、职业和季节，包含了完整模型中的因素。还为 K10 焦虑和抑郁子量表创建了模型。
随着 COVID-19 大流行的继续，K10 评分下降，但在高缓解和冬季期间增加。个人和工作场所因素也影响 HCP 的压力评分。需要进一步研究压力识别和缓解的最佳实践，以确保未来的公共卫生灾难得到应对，医疗保健系统能够缓冲 HCP 免受短期和长期的心理健康问题的影响。
