Martin Christopher A, Baggaley Rebecca F, Teece Lucy, Pan Daniel, Nazareth Joshua, Bryant Luke, Rivas Carol, Woolf Katherine, Pareek Manish
Department of Respiratory Sciences, University of Leicester, Maurice Shock Medical Sciences Building, University Road, Leicester, LE1 9HN, UK.
Development Centre for Population Health, University of Leicester, Maurice Shock Medical Sciences Building, University Road, Leicester, LE1 9HN, UK.
BMC Med. 2025 Jul 22;23(1):438. doi: 10.1186/s12916-025-04208-6.
Healthcare workers' (HCW) health and wellbeing directly affect patient care, yet little is known about their health-related quality of life (HRQoL) in the United Kingdom (UK). Using data from a nationwide study conducted during the COVID-19 pandemic in the UK (December 2020 to March 2021), we evaluated self-reported HRQoL among HCWs and its variation by sociodemographic characteristics.
HRQoL was measured using the five-dimension-five-level EuroQoL (EQ-5D-5L) questionnaire, covering five health dimensions. We explored differences in reported HRQoL by age, sex, Index of Multiple Deprivation (IMD) quintile, ethnicity, migration status and occupational group. Each HRQoL dimension was collapsed into a binary outcome (any problems versus none) and associations analysed using logistic regression. We also examined EQ-5D-5L visual analogue scale (VAS) scores using linear regression.
Among 12,026 HCWs, 75.9% were female, 26.7% overseas-born and 29.9% from non-White ethnic groups. HCWs reported high levels of pain/discomfort and anxiety/depression (43.7% and 46.1% reporting at least slight problems, respectively). Women were more likely than men to report problems across all EQ-5D-5L dimensions. Reporting health problems increased with increased deprivation. Asian overseas-born and Black HCWs were less likely than White UK-born HCWs to report anxiety/depression. Compared to the Medical group, other HCW types reported more problems with pain/discomfort (32.2% Medical, 55.4% Nursing, 45.4% Allied Health Professionals, 49.8% Ambulance groups) and anxiety/depression (36.8% Medical, 52.9% Nursing, 50.5% Ambulance groups). Nurses and ambulance workers showed particularly high rates of pain/discomfort. Overall, all HCWs reported more problems with anxiety/depression, usual activities and pain/discomfort than the Medical group. Similar associations were demonstrated in a parallel analysis of VAS scores.
In the largest study of HRQoL in HCWs to date, EQ-5D-5L VAS scores were lower than those reported elsewhere for the general UK population (for ages up 45 years), with high levels of anxiety/depression and pain/discomfort and substantial heterogeneities across EQ-5D-5L dimensions by sex, occupation and deprivation level. However, HCWs' circumstances during the COVID-19 pandemic may have influenced their reporting of HRQoL. Our findings highlight the need for further research to understand the causes of lower HRQoL, particularly among women and certain occupational groups, and to inform targeted interventions.
医护人员的健康和福祉直接影响患者护理，但在英国，人们对他们与健康相关的生活质量（HRQoL）知之甚少。利用在英国新冠疫情期间（2020年12月至2021年3月）进行的一项全国性研究的数据，我们评估了医护人员自我报告的HRQoL及其在社会人口学特征方面的差异。
使用五维度五级的欧洲生活质量量表（EQ-5D-5L）问卷来测量HRQoL，该问卷涵盖五个健康维度。我们探讨了按年龄、性别、多重剥夺指数（IMD）五分位数、种族、移民身份和职业群体划分的报告HRQoL的差异。每个HRQoL维度都被归纳为一个二元结果（有任何问题与无问题），并使用逻辑回归分析关联。我们还使用线性回归检查了EQ-5D-5L视觉模拟量表（VAS）得分。
在12026名医护人员中，75.9%为女性，26.7%出生在海外，29.9%来自非白人种族群体。医护人员报告了高水平的疼痛/不适和焦虑/抑郁（分别有43.7%和46.1%报告至少有轻微问题）。在EQ-5D-5L的所有维度上，女性比男性更有可能报告问题。随着贫困程度的增加，报告健康问题的情况也有所增加。出生在海外的亚洲人和黑人医护人员比出生在英国的白人医护人员报告焦虑/抑郁的可能性更小。与医疗组相比，其他医护人员类型报告的疼痛/不适问题更多（医疗组为32.2%，护理组为55.4%，专职医疗人员为45.4%，救护组为49.8%），焦虑/抑郁问题也更多（医疗组为36.8%，护理组为52.9%，救护组为50.5%）。护士和救护人员的疼痛/不适发生率特别高。总体而言，所有医护人员报告的焦虑/抑郁、日常活动和疼痛/不适问题都比医疗组更多。在对VAS得分的平行分析中也显示了类似的关联。
在迄今为止对医护人员HRQoL的最大规模研究中，EQ-5D-5L VAS得分低于英国其他地方针对一般人群（45岁及以下）报告的得分，焦虑/抑郁和疼痛/不适水平较高，并且在EQ-5D-5L维度上按性别、职业和贫困水平存在显著异质性。然而，新冠疫情期间医护人员的情况可能影响了他们对HRQoL的报告。我们的研究结果强调需要进一步研究以了解HRQoL较低的原因，特别是在女性和某些职业群体中，并为有针对性的干预措施提供依据。
