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[疫情带来的另一课:智利医护人员心理健康保护中的上级社会支持]

[Another Lesson from the Pandemic: Supervisor Social Support for Mental Health Protection in Healthcare Workers, Chile].

作者信息

Cruz Andrés González-Santa, Ansoleaga Elisa, Los Reyes Macarena Vargas-Plaza de

机构信息

Universidad Diego Portales, Santiago, Chile.

Facultad de Psicología, Universidad Diego Portales, Santiago, Chile.

出版信息

Rev Med Chil. 2024 Nov;152(8):875-888. doi: 10.4067/s0034-98872024000800875.

Abstract

UNLABELLED

The mental health of healthcare workers is strongly affected, and more evidence is needed to determine the dimensions of risk and protection related to the presence of anxious and depressive symptomatology.

AIM

To determine whether working conditions, social support and socio-occupational characteristics are associated with anxious and depressive symptoms reported by healthcare workers during the pandemic in Chile.

METHODS

Observational, correlational and cross-sectional study. A survey was applied to 875 healthcare workers (76% women) through SurveyMonkey between 2020-2021. It included mental health (depressive and anxious symptomatology), related to the pandemic working conditions (i.e., insufficient masks, contact with patients with COVID-19, reassignment of work/place/area, confidence in governmental management to protect personnel), social support (from peers, superiors, and outside work) and socio-occupational variables (sex, occupational status). Bivariate analyses and logistic regressions were conducted to examine the association of pandemic working and socio-occupational conditions on the odds of anxious and depressive symptomatology, and sensitivity analyses to underrepresentation (via post-stratification), missing data and measurement errors (using Rogan-Gladen correction) with 95% confidence intervals(95%CI).

RESULTS

Forty-four point five percent (95% CI 35.6-53.8) [crude percentage: 46%] and 41,4% (95% CI 34.5-48.6) [36%] of the respondents reported scores indicative of anxious and depressive symptoms, respectively. Greater superior support was associated with lower odds of anxious (aOR [adjusted Odds ratio]= 0.87 95%CI 0.79-0.96) and depressive (aOR= 0.86 95%CI 0.78-0.94) symptoms. Also, women had twice the odds of anxious symptomatology versus men (aOR= 2.00 95%CI 1.28-3.19), and those who mistrust the government had twice the odds of depressive symptomatology vs. those who did not (aOR= 1.98 95%CI 1.34-2.94).

CONCLUSIONS

Superior support emerges as a critical factor in the mental health of personnel in health crises. Prioritizing the protective role of organizational and social support over individual or psychological support in similar contexts is suggested. Urgent measures are needed to prevent anxiety symptoms in female workers, who report them more.

摘要

未标注

医护人员的心理健康受到严重影响,需要更多证据来确定与焦虑和抑郁症状相关的风险及保护因素。

目的

确定智利医护人员在疫情期间的工作条件、社会支持和社会职业特征是否与焦虑和抑郁症状相关。

方法

观察性、相关性和横断面研究。2020年至2021年期间,通过SurveyMonkey对875名医护人员(76%为女性)进行了一项调查。调查内容包括心理健康(抑郁和焦虑症状)、与疫情工作条件相关的内容(如口罩不足、接触新冠患者、工作/地点/区域重新分配、对政府保护人员管理措施的信心)、社会支持(来自同事、上级和工作之外的支持)以及社会职业变量(性别、职业地位)。进行了双变量分析和逻辑回归,以检验疫情工作条件和社会职业状况与焦虑和抑郁症状发生率之间的关联,并进行敏感性分析,以处理代表性不足(通过事后分层)、数据缺失和测量误差(使用Rogan-Gladen校正),置信区间为95%。

结果

分别有44.5%(95%置信区间35.6 - 53.8)[原始百分比:46%]和41.4%(95%置信区间34.5 - 48.6)[36%]的受访者报告的分数表明存在焦虑和抑郁症状。上级给予更多支持与焦虑(调整后的优势比[aOR]=0.87,95%置信区间0.79 - 0.96)和抑郁(aOR = 0.86,95%置信区间0.78 - 0.94)症状发生率较低相关。此外,女性出现焦虑症状的几率是男性的两倍(aOR = 2.00,95%置信区间1.28 - 3.19),不信任政府的人出现抑郁症状的几率是信任者的两倍(aOR = 1.98,95%置信区间1.34 - 2.94)。

结论

上级支持是健康危机期间人员心理健康的关键因素。建议在类似情况下,优先考虑组织和社会支持的保护作用,而非个人或心理支持。需要采取紧急措施预防报告此类症状较多的女性工作人员出现焦虑症状。

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