Newnham Elizabeth A, Mergelsberg Enrique L P, Stanley Susanne, Hood Sean, Tearne Jessica, Celenza Antonio, Stevenson Teresa, Mavaddat Nahal, Demore Gavin, Kavanagh Hyranthi, McEvoy Peter M
School of Population Health, Curtin University, Australia; and Curtin enAble Institute, Perth, Australia.
EnBerg Analytics, Perth, Australia.
BJPsych Open. 2024 Dec 5;10(6):e222. doi: 10.1192/bjo.2024.809.
Western Australia's response to the COVID-19 pandemic was swift and effective in implementing public health protections and preventing the spread of the virus for the first 2 years. However, healthcare staff continued to be at increased risk of mental health concerns.
To investigate the longitudinal patterns of post-traumatic stress symptoms (PTSS), depression and anxiety among healthcare workers in Western Australia, and the risk and protective factors associated with changes in status during the first wave.
Participants comprised 183 healthcare staff working at tertiary hospitals and major clinics across Perth, for whom longitudinal data were available. Questionnaire data were collected before Western Australia's first major COVID-19 community wave in early 2022 and following the first wave in late 2022. Online surveys comprised validated measures assessing psychological symptoms, risk and protective factors, and original measures of workplace factors.
Overall rates of PTSS, depression and anxiety remained stable across the two assessment points. However, latent growth models revealed that those with lower PTSS, depression or anxiety symptoms at baseline reported a larger increase in symptoms over time, and those with higher symptoms at baseline had a smaller decline over time, indicating a 'catch-up' effect. Workplace stressors, sleep difficulties and trauma exposure were key risk factors for changes in psychological symptoms from baseline, and workplace and social supports played protective roles.
Improvements in systemic workplace factors are needed to support healthcare workers' mental health during periods of acute stress, even in settings with high levels of emergency preparedness.
在最初两年里,西澳大利亚州对新冠疫情的应对迅速且有效,实施了公共卫生防护措施并防止了病毒传播。然而,医护人员面临心理健康问题的风险依然较高。
调查西澳大利亚州医护人员创伤后应激症状(PTSS)、抑郁和焦虑的纵向模式,以及与第一波疫情期间状态变化相关的风险和保护因素。
参与者包括珀斯各大三级医院和主要诊所的183名医护人员,他们有纵向数据。在2022年初西澳大利亚州首次出现重大新冠社区疫情之前以及2022年末第一波疫情之后收集问卷数据。在线调查包括评估心理症状、风险和保护因素的有效量表,以及工作场所因素的原始量表。
在两个评估点,PTSS、抑郁和焦虑的总体发生率保持稳定。然而,潜在增长模型显示,基线时PTSS、抑郁或焦虑症状较低的人随着时间推移症状增加幅度较大,而基线时症状较高的人随着时间推移下降幅度较小,这表明存在“追赶”效应。工作场所压力源、睡眠困难和创伤暴露是心理症状从基线开始变化的关键风险因素,工作场所和社会支持起到了保护作用。
即使在应急准备水平较高的环境中,在急性应激期间也需要改善系统性工作场所因素,以支持医护人员的心理健康。