新型冠状病毒疫情常态化防控背景下急诊科与发热门诊医务人员健康状况影响因素分析

目的 了解新型冠状病毒疫情常态化防控背景下急诊科与发热门诊医务人员心理健康状况及其影响因素，为有效制定心理干预措施提供依据。方法 选取2022年4—8月盐城市医院正常在岗、无精神疾病的医务人员为调查对象，使用一般资料调查问卷及症状自评量表对其进行调查。结果 33.49%的医务人员存在心理异常情况。多因素Logistic回归分析结果显示,“主要从事临床护理研究”是影响医务人员心理健康状态的主要因素。结论 新型冠状病毒疫情常态化防控背景下，盐城市医院急诊科和发热门诊医务人员心理异常检出率较高，管理部门应重视医务人员心理健康状况，并给予相应的心理干预措施。     

新冠疫情下某三甲综合医院医务人员心理状态及相关影响因素分析

目的 了解新型冠状病毒肺炎疫情下综合医院医务人员的心理状态及其相关影响因素。方法 采用便利抽样法抽取某院医护人员1 007名,采用一般资料问卷、广泛性焦虑障碍量表、患者健康问卷抑郁自评量表、患者健康问卷PHQ-15进行横断面自评问卷调查,筛选问卷并进行统计分析,有效问卷1 005份。结果 上述医务人员中203人(20.20%)存在焦虑症状,338人(33.63%)存在抑郁症状,376人(37.41%)存在躯体化症状,557人(55.42%)自觉失眠。既往有焦虑抑郁病史、院内一线人员均与焦虑、抑郁、失眠呈正相关,每天关注疫情时间>1 h、护士岗位均与焦虑和躯体化症呈正相关。既往有焦虑抑郁病史、年龄与躯体化症状呈正相关。另外每天关注疫情时间>1 h与失眠呈正相关。结论 疫情期间医务人员焦虑、抑郁、躯体化症状、失眠高发,建议重点关注护士、院内一线人员、既往有焦虑抑郁症病史、年龄偏高的医务人员的身心健康,有侧重点地给予心理干预。     

2020年珠海市医务人员心理症状自评量表(SCL-90)结果分析

目的了解珠海市医务人员心理健康状况及其影响因素,为制定心理干预措施提供科学依据。方法通过方便抽样,使用症状自评量表(SCL-90)问卷于2020-07-28/08-14对5862名医务人员进行在线调查,运用方差分析和t检验比较总均分、因子均分与疫情响应期间普通居民、中国成人常模的差异,运用卡方检验和Logistic回归分析心理症状筛查阳性的相关影响因素。采用R 3.6.1软件进行统计分析,检验水准设为α=0.05。结果医务人员SCL-90总均分为(1.30±0.44)分,心理症状检出率为19.40%。总均分及躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性9个因子均分均低于中国常模人群(P均<0.05)。Logistic回归模型显示,女性(OR=1.53,95%CI:1.30~1.81)、年龄<50岁(OR=1.61,95%CI:1.19~2.22)以及新冠疫情工作经历(OR=1.64,95%CI:1.44~1.87)是医务人员出现心理症状的危险因素。变量重要性分析显示,新冠疫情工作经历、性别、年龄、婚姻状况的McFadden’s R²分别为0.0091、0.0046、0.0022和0.0005。结论珠海市医务人员心理健康水平良好,疫情工作经历对医务人员心理症状发生起着主要的影响作用,不同人口学特征的医务人员心理症状易感性不同,应有针对性开展心理危机干预和疏导,促进医务人员心理健康素养水平提高。     

新冠疫情期间苏州医务人员心理健康状况及影响因素分析

目的了解新冠疫情期间苏州市医务人员的心理健康状况及其影响因素,为开展心理干预提供参考。方法采取抑郁症筛查量表、汉密尔顿焦虑量表和自行编制的睡眠状况量表,对滚雪球抽样的1 435名苏州市医务人员开展电子化问卷调查,利用多种logistic回归模型分析抑郁、焦虑、睡眠问题的影响因素。结果新冠疫情期间,存在抑郁和焦虑的医务人员分别占37.0%(531人)和21.3%(305人);存在难入睡、睡眠质量差和早醒睡眠问题的分别占25.9%(372人)、22.5%(323人)和16.5%(237人);抑郁、焦虑和睡眠问题两两之间均存在正相关(P值均0.05)。多因素分析发现,年轻和高学历的医务人员容易抑郁;男性、每天了解疫情信息时间过少或过多、独居的医务人员易发生焦虑;三级医院较疾控中心的医务人员容易发生睡眠问题,主要工作与疫情有关更容易发生睡眠问题。结论新冠肺炎疫情下,医务人员出现了不同种类不同程度的心理问题,抑郁、焦虑和睡眠问题之间存在正相关,但危险因素不完全相同,应开展针对性的心理干预。     

结核病定点医院医务人员心理健康状况及工作相关因素的影响

目的调查结核病定点医院医务人员在突发公共卫生事件中的心理健康状况及工作相关因素的影响,为今后医务人员心理管理及干预提供科学依据。方法采用失眠(AIS)、抑郁(PHQ-9)和焦虑(GAD-7)心理量表,通过在线问卷的方式对参与应对突发公共卫生事件的264名医务人员进行匿名调查,分析医务人员失眠、抑郁和焦虑现状及工作相关因素的影响。结果医务人员中失眠发生率为76.5%,中度及以上抑郁情绪者占21.6%,中度及以上焦虑者占8.7%。近期工作内容有变化组的医务人员失眠发生率高于无变化组,差异具有统计学意义(P0.05);现工作时长8h和现工作任务未结束的医务人员抑郁发生率和焦虑发生率较高,组间比较差异均有统计学意义(P0.05)。结论医务工作人员出现不同程度的失眠、焦虑和抑郁反应。在应对突发公共卫生事件时,切实关心一线医务人员的心理健康,保障医务人员休息时间,完善心理管理及干预。     

江苏省医务人员付出-回报失衡、组织支持与抑郁症状的关系研究

目的探讨医务人员付出-回报失衡、组织支持与抑郁症状的关系,为提高医务人员心理健康水平提供参考。方法分层抽取江苏省1696名医务人员进行调查,付出-回报失衡(ERI)量表、组织支持感量表(POS)、12题一般健康问卷(GHQ-12)分别测量医务人员付出-回报状况、组织支持与抑郁症状,分层嵌套Logistic回归探索三者之间的关系。结果 52.06%的医务人员处于付出-回报失衡工作模式(ERI1),45.87%的处于超负荷状态;医务人员抑郁症状检出率为31.07%。分层回归分析表明,付出-回报失衡(OR=1.68,95%CI:1.28～2.20)、超负荷(OR=2.43,95%CI:2.03～2.92)是医务人员的抑郁症状发生的危险因素,组织支持感降低医务人员抑郁症状(OR=0.76,95%CI:0.67～0.86)。结论合理的工作负担、经济激励和组织支持能够提高医务人员的心理健康。     

疫情防控常态下发热门诊医务人员心理状态的调查研究

目的 调查新冠肺炎疫情常态下发热门诊医务人员心理状态情况,并分析影响心理变化的因素。方法 采用方便抽样的方法选择2021年1月至2021年6在我院发热门诊工作的医务人员共计90名,采用心理弹性量表（CD-RISC）对研究对象进行评定,使用SPSS 26.0进行数据统计分析。结果 发热门诊的医务人员的CD-RISC与全国的常模相比,具有统计学意义（P<0.05）;根据收集医务人员的人口学资料及心理弹性得分情况做单因素分析后得出,年龄、职称、婚否及发热门诊工作时间与心理弹性之间均有统计学意义（P<0.01）;各因素与医务工作者CD-RISC的线性回归分析结果显示,影响发热门诊医务工作者心理弹性的主要因素为发热门诊的工作时间、医务人员的职称及婚否情况。结论 新冠肺炎疫情常态下发热门诊医护人员的心理弹性降低,压力水平升高。     

心理调适在抗击新型冠状病毒肺炎疫情医护人员中的应用效果

目的调查某三甲医院抗击新型冠状病毒肺炎疫情的医护人员的心理状况,探讨心理调适的应用效果。方法选取2020年1月23日至3月16日医院支援发热门诊和隔离病区的医护人员60名作为调查对象,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)调查其心理状况,并给予心理调适干预,比较干预前后的SAS、SDS评分。结果干预前,60名医护人员中,53.33%(32/60)有焦虑症状,56.67%(34/60)有抑郁症状;干预后的SAS、SDS评分低于干预前,差异有统计学意义(P<0.05);不同性别医护人员干预后的SAS、SDS评分均低于干预前,差异有统计学意义(P<0.05)。结论面对突发疫情,大部分医护人员存在心理应激反应,应及时采取干预措施,以有效改善医护人员的焦虑、抑郁症状。     

长沙市医务人员压力调查及其结果分析

目的了解长沙市医务人员压力现状、压力来源,并提出合理建议。方法通过对长沙市医务人员多阶段分层整群随机抽样获得样本数据,对医务人员自评压力等级、焦虑得分、抑郁得分、社会支持得分进行统计描述和相关分析。结果共调查1 600名医务人员,收回有效问卷1 474份,有效率为92.13%。医务人员自评34.3%的人员存在重大压力,焦虑标准得分为(47.83±10.35)分,有重度焦虑情绪的医务人员占3.2%;抑郁标准得分为(54.08±10.78)分,有重度抑郁情绪的医务人员占6.4%;社会支持总得分(37.76±8.56)分;两两相关分析,焦虑总得分、抑郁总得分与社会支持总得分呈负相关(r=-0.277、-0.375);焦虑总得分与抑郁总得分呈正相关(r=0.494)。结论长沙市医务人员普遍存在职业压力,医院管理者应重点关注重度抑郁、重度焦虑的医务人员,建设医院人文环境,合理配备医务人员,减轻工作强度,提高社会支持度。     

发热门诊医务人员心理弹性在焦虑与失眠间的中介效应

目的 分析心理弹性在发热门诊医务人员焦虑与失眠间的中介作用，为改善发热门诊医务人员的失眠症状提供理论依据。方法 2022年1—7月，采用一般资料调查表、广泛性焦虑量表（7-tiem generalized anxiety disorder scale,GAD-7）、心理弹性量表简化版（10-item Connor-Davidson resilience scale,CD-RISC-10）、失眠严重指数量表（insomnia severity index,ISI），对天津市某三级甲等医院发热门诊医务人员进行调查。采用SPSS 22.0软件进行描述性统计、相关分析；采用AMOS 25.0构建结构方程模型，并用Bootstrap法检验心理弹性在焦虑与失眠间的中介效应。结果 收回问卷251份，其中有效问卷245份，有效回收率97.6%。40.0%(98/245)的医务人员有焦虑症状，39.1%(96/245)的医务人员存在失眠症状。工龄越长、职称越高的医务人员其焦虑水平也越高（P <0.05）。焦虑与失眠为正相关（r=0.276,P <0.01），焦虑与心理弹性为负相关（r=-0....     

Burnout and engagement among resident doctors in the Netherlands: a national study

Medical Education 2010: 44 : 236–247 Objectives This study was performed in order to gather insight into the well‐being of Dutch medical residents. Methods In 2005, all Dutch residents registered through the Medical Registration Committee (n = 5245) were sent a self‐report questionnaire to assess socio‐demographic and work‐related characteristics, burnout and engagement. Results Of the 5140 eligible residents, 2115 completed the questionnaire (41%). Of those, 21% fulfilled the criteria for moderate to severe burnout and 27% were highly engaged with their work. Women reported more emotional exhaustion and less depersonalisation than men; age was weakly but significantly related to depersonalisation, and married residents and parents reported less depersonalisation than their single or childless counterparts. More men than women were found to be highly engaged and men specifically reported more vigour. Number of years in training was weakly but significantly related to absorption. With regard to occupational risk factors, significant between‐group differences were found for the effects of clinical setting on emotional exhaustion, engagement, vigour and absorption. Residents in training in a mental health clinic were most emotionally exhausted and those in a rehabilitation centre were least engaged. General surgery represented the specialty with the lowest number of residents suffering from burnout, followed by obstetrics and gynaecology and any supportive specialty. General surgery residents were also found to be more highly engaged, vigorous, dedicated and absorbed than others. Conclusions As more than a fifth of the medical residents who responded could be diagnosed as suffering from burnout, we conclude that this problem needs addressing in the Dutch health care system, especially given that a relationship was proven between burnout and suboptimal patient care. We must look for solutions and interventions which will improve the work situation of medical residents. Striving for healthy workers in health care has to become daily practice.     

上海市三甲医院医务人员职业压力与倦怠调查及对策研究

目的调查医务人员的工作压力源和职业倦怠情况,为探索建立适合卫生系统行业特点的心理援助机制提供依据。方法采用医务人员工作压力源调查表和MBI-SS量表对1 180名医务人员进行调查,并分析压力源和职业倦怠的相关性。结果使医务人员最感到压力的问题依次为外部环境、工作负荷和职业发展。情感衰竭、去人格化、个人成就感的阳性率分别为76.0%、78.8%和54.2%。7个方面的压力源分量全部与情感衰竭、去人格化呈正相关,5个方面的压力源分量与个人成就感呈负相关。结论医务人员的工作压力较大,职业倦怠状况较为普遍,倦怠程度较高,应有针对地建立起具有行业特色的员工关爱体系。     

医护人员工作倦怠与工作满意度现况调查及其影响因素

目的分析医护人员工作倦怠及工作满意度的影响因素。方法采用职业倦怠问卷（Maslach Burnout Inventory,MBI）及明尼苏达工作满意度问卷（Minnesota Satisfaction Questionnaire,MSQ）对辽宁省铁岭煤矿集团总医院的600名医护人员进行自填式问卷调查。结果 30～39岁年龄组及工作年数在10～19 a的医护人员的情绪衰竭、人格解体维度得分最高,分别为11.70±7.01、6.15±5.68和11.92±5.82、6.26±5.95;离异的医护人员个人成就感最低,得分为19.81±6.93。承担科主任或护士长管理职位的医护人员的工作倦怠度比未承担管理职位的医护人员低。高级技术职称的医护人员个人成就感明显高于初级职称者,没有夜班的医护人员在总体工作满意度上得分明显高于有夜班人员。医患关系严重紧张的医护人员的情绪衰竭、人格解体维度得分高于一般紧张的医护人员,而工作满意度得分低于一般紧张的医护人员。医护人员的工作满意度与情绪衰竭、人格解体、离职意愿呈负相关关系,而与个人成就感呈正相关关系。结论年龄、工作年数、婚姻状况、管理职务、技术职称、夜班工作、医患关系都影响到医护人员的工作倦怠及工作满意度。医护人员的工作倦怠及工作满意度影响离职意愿。     

Psychological Empowerment and Child Welfare Worker Outcomes: A Path Analysis

The purpose of this study was to investigate how work environment and psychological empowerment related to worker outcomes in public child welfare. These relationships were examined by testing a conceptual model in which psychological empowerment mediated the relationships between work environment variables (quality of supervision and role ambiguity) and worker outcome variables (emotional exhaustion and intentions to remain employed in child welfare). Responses from 234 public child welfare front-line workers in a southeastern state were used to test the proposed mediating model. The results of the study revealed that quality of supervision and psychological empowerment were directly related to workers’ intentions to remain employed in child welfare. An indirect relationship between quality of supervision and intentions to remain through the mediating variable of psychological empowerment was found. Quality of supervision was also indirectly related to worker emotional exhaustion through the mediating variable of psychological empowerment. While the work environment variable role ambiguity was not directly related to the outcomes emotional exhaustion or intentions to remain, indirect relationships through the mediating variable of psychological empowerment were found.     

新型冠状病毒肺炎疫情下发热门诊医务人员心理健康状况和知信行调查与防控研究

目的 了解发热门诊医务人员的心理健康状况及工作过程中的薄弱环节,以完善发热门诊流程,帮助发热门诊医务人员做好个人防护,降低院内感染发生的风险.方法 以甘肃省收治确诊新型冠状病毒肺炎患者的定点医院发热门诊医务人员为调查对象,于2020年2月23日-3月21日,采用手机问卷星的方式调查267名发热门诊医务人员,了解其在进入...     

The prevalence of chronic psychological complaints and emotional exhaustion among overweight and obese workers

Purpose

Literature suggests a relationship between overweight and obesity, and mental health problems, but data regarding prevalence rates are scarce. This study aimed to determine the prevalence of chronic psychological complaints and emotional exhaustion among overweight and obese workers.

Methods

Data were used from the Netherlands Working Conditions Survey (NWCS), which is representative for Dutch employees (n?=?43,928). Based on self-reported body mass index (BMI), workers were classified into underweight, healthy weight, overweight, and obesity. Respondents indicated whether they suffered from chronic psychological complaints. Emotional exhaustion was measured by using the UBOS subscale. Logistic regression analyses were used to test differences in prevalence across weight categories, with healthy weight as the reference group. Analyses were stratified for gender, age, education, and occupation.

Results

Of the obese workers, 15.7% reported emotional exhaustion and 3.7% reported chronic psychological complaints. These prevalence rates were significantly higher than among healthy weight workers. A significant J shape was found with healthy weight workers reporting the lowest prevalence of both indicators of mental health problems. This J shape was generally also seen among the gender, age, education, and occupation subgroups, though not consistently significant.

Conclusion

Considering the proportion of obese workers that also suffers from psychological co-morbidities, interventions targeting obesity should take this into account. As weight-related stigma may play a role in the risk for mental health problems among obese workers, future longitudinal research on the mechanisms for the relation between overweight and mental health problems are recommended.     

'We are also dying like any other people, we are also people': perceptions of the impact of HIV/AIDS on health workers in two districts in Zambia

In countries with a high AIDS prevalence, the health workforce is affected by AIDS in several ways. In Zambia, which has a prevalence rate of 16.5%, a study was carried out in 2004 with the aim to: explore the impact of HIV/AIDS on health workers, describe their coping mechanisms and recommend supportive measures. The qualitative study was complemented by a survey using self-administered questionnaires in four selected health facilities in two rural districts in Zambia, Mpika and Mazabuka. It is one of the few studies to have explored the impact of HIV/AIDS from the perspective of health workers and managers in the region. Thirty-four in-depth interviews and five group discussions were conducted with health workers, managers and volunteers, and 82 self-administered questionnaires were filled out by health workers. In addition, burnout among 42 health workers was measured using the Maslach Burnout Inventory (MBI). The MBI measures three components that contribute to burnout: emotional exhaustion, depersonalization and personal accomplishment. The results show that in both districts, HIV/AIDS has had a negative impact on workload and has considerably changed or added tasks to already overburdened health workers. In Mpika, 76% of respondents (29/38), and in Mazabuka, 79% (34/44) of respondents, expressed fear of infection at the workplace. HIV-positive health workers remained 'in hiding', did not talk about their illness and suffered in silence. Despite the fact that health workers were still relatively motivated, emotional exhaustion occurred among 62% of the respondents (26/42). The interviews revealed that counsellors and nurses were especially at risk for emotional exhaustion. In each of the selected facilities, organizational support for health workers to deal with HIV/AIDS was either haphazardly in place or not in place at all. AIDS complicates the already difficult work environment. In addition to health workers, management also needs support in dealing with AIDS at the workplace.     

Selling your self? The psychological impact of street sex work and factors affecting support seeking

Previous research investigating the risks of female street sex work has tended to focus on the most tangible risks to physical health and safety. This is reflected in the provision of support services for sex workers, where these aspects are prioritised. There is little research focusing solely on the psychological risks of sex work. This qualitative study aimed to explore the perceived psychological impact of street sex work and factors that affected support seeking. Interviews were carried out with a sample of UK female street sex workers (n = 7) who attended a drop‐in clinic and health professionals (n = 5) who provided input to the drop‐in service. The analytic process, which drew from an interpretative phenomenological approach, revealed four main themes that work together to describe the emotional impact of selling sex. Implications for support services and future research are highlighted.     

上海市村居公共卫生应急联防联控人员焦虑、抑郁现况及影响因素分析

  目的  了解疫情期间基层村居公共卫生应急联防联控人员焦虑、抑郁现状及其影响因素,为完善基层村居公共卫生联防联控人员的心理服务体系提供依据。
  方法  采用随机整群抽样法抽取上海市某镇19个村居委开展调查。使用广泛性焦虑量表(GAD-7)和抑郁症状群量表(PHQ-9)对研究对象开展调查,并对结果进行多因素非条件logistic回归分析。
  结果  421名村居公共卫生应急联防联控人员参加了调查,其中村居人员、警务人员、医务人员分别占42.76%、25.65%和31.59%。村居公共卫生应急联防联控人员焦虑发生率为60.6%,抑郁发生率为61.8%,均以轻度为主;合并焦虑、抑郁阳性率为56.3%。logistic回归分析结果显示:村居人员发生焦虑、抑郁,以及合并焦虑、抑郁的风险分别是医务人员的0.371、0.424、0.486倍(P均 < 0.05);生活压力较小的调查对象发生焦虑、抑郁,以及合并焦虑、抑郁症状的风险分别是生活压力较大的调查对象的0.218、0.286、0.301倍(P均 < 0.05);工作压力较小的调查对象发生抑郁、合并焦虑、抑郁症状的风险分别是工作压力较大的0.286、0.194倍(P均 < 0.05);主观健康评价良好的调查对象发生合并焦虑、抑郁症状的风险是主观健康评价较差的0.219倍(P < 0.05)。
  结论  上海市某镇村居公共卫生应急联防联控人员存在一定的焦虑、抑郁症状,但症状较轻微。应在村居建立相应的心理服务体系,提供必要的心理保健服务。
     

Identifying and Prioritizing Workplace Climate Predictors of Burnout Among VA Primary Care Physicians

Burnout, or job-related stress, affects more than half of all US physicians and has been linked to increased medical errors, staff turnover, and reduced productivity. Primary care physicians (PCPs) experience among the highest burnout rates in medicine. Workplace climate, defined as shared worker attitudes and perceptions of their work environment, is a leading determinant of physician burnout. However, prior studies have not examined the relative importance of different elements of workplace climate (eg, leadership, support). Our study identifies and prioritizes workplace climate predictors of physician burnout among PCPs employed by Veterans Affairs (VA) nationwide. We conducted a cross-sectional analysis of data from the 2013-2017 VA All Employee Survey (AES), an annual organizational census that includes questions on burnout and workplace climate. Dependent variables addressed two dimensions of burnout from the Maslach Burnout Inventory (eg, emotional exhaustion and depersonalization); symptoms > once per week indicated burnout. Independent variables included 30 questions related to elements of workplace climate (ie, leadership, support, rewards, recognition, autonomy, satisfaction, tolerance, conflict, workload, growth opportunity, physical and psychological safety, communication, collaboration, risk-taking, and sense of belonging and purpose) scored on a 5-point agreement/satisfaction scale. We included PCP demographic covariates. Independent and dependent variables were measured from separate random samples to avoid method bias. Collapsing AES responses among PCPs on the medical-site level by reporting year, we used the semi-automated LASSO procedure to identify workplace climate predictors of burnout and assessed their relative importance using the Shapely value decomposition. PCPs employed at 157 VA medical sites nationwide. Among a sample of 305 facility-year observations, an average of 65.5% of PCPs screened positive for emotional exhaustion and 47.8% for depersonalization. We identified 7 workplace climate predictors of emotional exhaustion (pseudo R2 for full model = 0.667). The majority of explained variation in emotional exhaustion was attributable to perceptions of workload (32.6%), organization satisfaction (28.2%), and organization support (19.4%); other contributors included praise (7.8%), employee development (8.1%), psychological safety (1.9%), and innovation (2.0%). We identified 9 workplace climate predictors of depersonalization (pseudo R2 for full model = 0.590). The majority of explained variation in depersonalization was attributable to workload (25.3%), organization satisfaction (22.9%), and connection to VA mission (20.7%); other contributors included job control (11.4%), praise (9.6%), work/family balance (9.1%), quality of direct supervision (<1%), psychological safety (<1%), and innovation (<1%). Apart from innovation, higher agreement/satisfaction scores for workplace climate predictors were associated with a lower likelihood of PCP burnout. The most influential workplace climate predictors of burnout among PCPs included perceptions of workload, organization satisfaction, organization support, and connection to institutional mission. Praise, employee development, job control, and work/family balance were moderately influential. Identifying and understanding the relative importance of workplace climate factors are important for guiding optimal allocation of health organization resources to mitigate and prevent burnout within the PCP workforce. To address burnout, our research suggests organizations should prioritize practices and policies that reduce physician workload and create a supportive work environment that promotes employee satisfaction and sense of connection to institutional mission. Department of Veterans Affairs.