了解医护人员的心理健康需求:一项关于数字干预措施的定性研究的见解

Understanding health care workers' mental health needs: insights from a qualitative study on digital interventions.

作者信息

Agarwal Anish K, Gonzales Rachel E, Southwick Lauren, Schroeder Devon, Sharma Meghana, Bellini Lisa, Asch David A, Mitra Nandita, Balachandran Mohan, Wolk Courtney Benjamin, Becker-Haimes Emily M, Kishton Rachel E, Beck Sarah, Merchant Raina M

机构信息

Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, 3600 Civic Center Boulevard, Philadelphia, PA, 19104, USA.

Center for Health Care Transformation and Innovation, Penn Medicine, University of Pennsylvania, Philadelphia, PA, USA.

出版信息

BMC Health Serv Res. 2025 May 7;25(1):654. doi: 10.1186/s12913-025-12678-w.

Abstract

IMPORTANCE

Health care workers (HCWs) face significant mental health challenges when delivering care and over the span of their careers. Despite growing recognition of these issues, barriers such as stigma, structural limitations, and individual obstacles continue to impede progress in supporting HCWs mental health needs. Digital mental health platforms continue to expand in health systems as they offer novel approaches to address these gaps, but more evidence is needed to understand their reception among HCWs.

OBJECTIVE

To examine the perceptions of HCWs regarding their mental health, explore barriers and facilitators to accessing mental health care, and assess their experiences with digital mental health interventions within the context of the pandemic.

DESIGN

A qualitative study using semi-structured interviews with HCWs who participated in a prior randomized controlled trial (RCT) assessing the impact of a digital mental health platform on anxiety and depression.

SETTING

A large, urban, academic health system.

PARTICIPANTS

A purposive sample of 64 HCWs, including physicians, nurses, technicians, administrative staff, and social workers, was recruited. Participants were selected from the upper and lower quartiles of anxiety and depression scores from the parent RCT to capture a range of mental health symptomatology.

OUTCOMES AND MEASURES

The study aimed to identify HCWs' attitudes toward mental health care, barriers to utilizing professional resources, and their experiences with the digital mental health platform at the local institution. A thematic content analysis was used to analyze the interview data.

RESULTS

Five major themes were identified: (1) the evolving mental health challenges during and after the pandemic, (2) individual barriers to accessing care, such as personal coping strategies and familial responsibilities, (3) structural barriers like workload and limited access to mental health clinicians, (4) experiences with digital mental health interventions, including text message-based assessments, and (5) recommendations for future digital health strategies to improve access and reduce stigma.

CONCLUSION

Digital mental health interventions provide a promising avenue to support HCWs by reducing stigma and improving access to mental health resources and clinicians. However, personalized and system-level changes are necessary to address the ongoing mental health challenges faced by the workforce.

摘要

重要性

医护人员在提供护理服务以及整个职业生涯中面临着重大的心理健康挑战。尽管对这些问题的认识不断提高,但诸如耻辱感、结构限制和个人障碍等障碍继续阻碍着满足医护人员心理健康需求方面的进展。数字心理健康平台在卫生系统中不断扩展,因为它们提供了应对这些差距的新方法,但需要更多证据来了解医护人员对它们的接受程度。

目的

研究医护人员对其心理健康的看法,探讨获得心理保健的障碍和促进因素,并评估他们在疫情背景下使用数字心理健康干预措施的经历。

设计

一项定性研究,采用对参与先前一项评估数字心理健康平台对焦虑和抑郁影响的随机对照试验(RCT)的医护人员进行半结构化访谈的方法。

地点

一个大型城市学术卫生系统。

参与者

招募了64名医护人员的目的抽样样本,包括医生、护士、技术人员、行政人员和社会工作者。参与者从母RCT的焦虑和抑郁评分的上四分位数和下四分位数中选取,以涵盖一系列心理健康症状。

结果和测量

该研究旨在确定医护人员对心理保健的态度、利用专业资源的障碍以及他们在当地机构使用数字心理健康平台的经历。采用主题内容分析法对访谈数据进行分析。

结果

确定了五个主要主题:(1)疫情期间及之后不断演变的心理健康挑战,(2)获得护理的个人障碍,如个人应对策略和家庭责任,(3)工作量和获得心理健康临床医生的机会有限等结构障碍,(4)数字心理健康干预措施的经历,包括基于短信的评估,以及(5)对未来数字健康策略的建议,以改善获得机会并减少耻辱感。

结论

数字心理健康干预措施通过减少耻辱感并改善获得心理健康资源和临床医生的机会,为支持医护人员提供了一条有前景的途径。然而,需要进行个性化和系统层面的变革,以应对医护人员持续面临的心理健康挑战。

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