She Rui, Li Lijuan, Yang Qian, Lin Jianyan, Ye Xiaoli, Wu Suliu, Yang Zhenggui, Guan Suzhen, Zhang Jianxin, Lau Joseph
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
School of Public Health, Dali University, Dali, China.
Stress Health. 2025 Jun;41(3):e70037. doi: 10.1002/smi.70037.
Experiences during the COVID-19 pandemic may be traumatic to healthcare workers (HCWs). This study investigated the associations of resilience and mindfulness with posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG), and the mediation role of adaptive coping and stigmatisation related to HCWs' role in these associations from the perspective of trauma and positive psychology research. An anonymous online survey was conducted among 1449 doctors and nurses (85.4% females; mean age 34.1 years) from five hospitals in different regions of China between October and November 2020, which was about six months after the COVID-19 outbreak was almost 'put under control' in China. PTSS and PTG were assessed using the 17-item PTSS Scale-Self-Report and Posttraumatic Growth Inventory, respectively. The prevalence of PTSS and PTG was 42% and 65%, respectively. Results of structural equation modelling suggested that the association between resilience and PTSS was partially mediated by adaptive coping, self-stigma, and the serial path via adaptive coping and self-stigma, which accounted for 66% of the total association. The association between mindfulness and PTSS was partially mediated by adaptive coping and serially mediated by adaptive coping and self-stigma. In contrast, only adaptive coping was a significant mediator in the associations between resilience/mindfulness and PTG. The findings first unravelled the mechanisms between resilience, mindfulness, and posttraumatic outcomes of COVID-19 among a large sample of HCWs. Health promotion may consider alleviating PTSS and promoting PTG for HCWs experiencing traumatic stressful events via strengthening resilience and mindfulness, fostering adaptive coping, and reducing stigmatisation.
新型冠状病毒肺炎疫情期间的经历可能会给医护人员带来创伤。本研究从创伤和积极心理学研究的角度，调查了心理韧性和正念与创伤后应激症状（PTSS）及创伤后成长（PTG）之间的关联，以及适应性应对和污名化在这些关联中对医护人员角色的中介作用。2020年10月至11月，对来自中国不同地区五家医院的1449名医生和护士（女性占85.4%；平均年龄34.1岁）进行了一项匿名在线调查，此时距离中国新型冠状病毒肺炎疫情几乎“得到控制”约六个月。分别使用17项创伤后应激症状自评量表和创伤后成长问卷对PTSS和PTG进行评估。PTSS和PTG的患病率分别为42%和65%。结构方程模型结果表明，心理韧性与PTSS之间的关联部分由适应性应对、自我污名以及通过适应性应对和自我污名的连续路径介导，这占总关联的66%。正念与PTSS之间的关联部分由适应性应对介导，并由适应性应对和自我污名连续介导。相比之下，在心理韧性/正念与PTG之间的关联中，只有适应性应对是一个显著的中介因素。这些发现首次揭示了在大量医护人员样本中，心理韧性、正念与新型冠状病毒肺炎创伤后结果之间的机制。健康促进可考虑通过增强心理韧性和正念、培养适应性应对以及减少污名化，来减轻经历创伤性应激事件的医护人员的PTSS并促进其PTG。
