PDF(Pubmed)
Abstract：
BACKGROUND: Past research has suggested a cross-sectional association between COVID-19-related discrimination and PTSD symptom severity. However, no cohort study has examined the longitudinal association that better supports causal interpretation. Also, even if such an association genuinely exists, the specific pathway remains unclear.
METHODS: We conducted a two-year follow-up study, obtaining data from healthcare workers in a hospital setting. We first evaluated how COVID-19-related discrimination in 2021 was associated with subsequent PTSD symptom severity in 2023. Thereafter, we conducted causal mediation analysis to examine how this association was mediated by psychological distress in 2022, accounting for exposure-mediator interaction. Missing data were handled using random forest imputation.
RESULTS: A total of 660 hospital staff were included. The fully adjusted model showed greater PTSD symptom severity in individuals who experienced any COVID-19-related discrimination compared with those without such experiences (β, 0.44; 95% CI, 0.04-0.90). Regarding each type of discrimination, perceived discrimination was associated with greater PTSD symptom severity (β, 0.52; 95% CI, 0.08-0.96), whereas verbal discrimination did not reach statistical significance. Psychological distress mediated 28.1%-38.8% of the observed associations.
CONCLUSIONS: COVID-19-related discrimination is associated with subsequent PTSD symptom severity in healthcare workers. Psychological distress may serve as an important mediator, underscoring the potential need for interventions targeting this factor.
METHODS: We conducted a two-year follow-up study, obtaining data from healthcare workers in a hospital setting. We first evaluated how COVID-19-related discrimination in 2021 was associated with subsequent PTSD symptom severity in 2023. Thereafter, we conducted causal mediation analysis to examine how this association was mediated by psychological distress in 2022, accounting for exposure-mediator interaction. Missing data were handled using random forest imputation.
RESULTS: A total of 660 hospital staff were included. The fully adjusted model showed greater PTSD symptom severity in individuals who experienced any COVID-19-related discrimination compared with those without such experiences (β, 0.44; 95% CI, 0.04-0.90). Regarding each type of discrimination, perceived discrimination was associated with greater PTSD symptom severity (β, 0.52; 95% CI, 0.08-0.96), whereas verbal discrimination did not reach statistical significance. Psychological distress mediated 28.1%-38.8% of the observed associations.
CONCLUSIONS: COVID-19-related discrimination is associated with subsequent PTSD symptom severity in healthcare workers. Psychological distress may serve as an important mediator, underscoring the potential need for interventions targeting this factor.
摘要：
背景：过去的研究表明，与COVID-19相关的歧视与PTSD症状严重程度之间存在横断面关联。然而,没有一项队列研究对纵向关联进行了更多支持因果解释的研究.此外，即使这样的协会真的存在，具体途径尚不清楚.
方法：我们进行了为期两年的随访研究，从医院环境中的医护人员那里获取数据。我们首先评估了2021年与COVID-19相关的歧视与2023年随后的PTSD症状严重程度之间的关系。此后,我们在2022年进行了因果中介分析,以研究这种关联是如何由心理困扰介导的,并考虑了暴露-中介相互作用.使用随机森林插补来处理丢失的数据。
结果：共纳入660名医院工作人员。与没有这种经历的人相比，完全调整的模型显示，经历过任何与COVID-19相关的歧视的人的PTSD症状严重程度更高(β，0.44；95%CI，0.04-0.90）。关于每种类型的歧视，感知的歧视与更大的PTSD症状严重程度相关(β，0.52；95%CI，0.08-0.96），而言语歧视没有达到统计学意义。心理困扰介导了观察到的关联的28.1%-38.8%。
结论：与COVID-19相关的歧视与医护人员随后的PTSD症状严重程度有关。心理困扰可能是一个重要的中介，强调针对这一因素的干预措施的潜在需求。
方法：我们进行了为期两年的随访研究，从医院环境中的医护人员那里获取数据。我们首先评估了2021年与COVID-19相关的歧视与2023年随后的PTSD症状严重程度之间的关系。此后,我们在2022年进行了因果中介分析,以研究这种关联是如何由心理困扰介导的,并考虑了暴露-中介相互作用.使用随机森林插补来处理丢失的数据。
结果：共纳入660名医院工作人员。与没有这种经历的人相比，完全调整的模型显示，经历过任何与COVID-19相关的歧视的人的PTSD症状严重程度更高(β，0.44；95%CI，0.04-0.90）。关于每种类型的歧视，感知的歧视与更大的PTSD症状严重程度相关(β，0.52；95%CI，0.08-0.96），而言语歧视没有达到统计学意义。心理困扰介导了观察到的关联的28.1%-38.8%。
结论：与COVID-19相关的歧视与医护人员随后的PTSD症状严重程度有关。心理困扰可能是一个重要的中介，强调针对这一因素的干预措施的潜在需求。
