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Abstract：
BACKGROUND: The detrimental mental health effects which emerged from COVID-19 have profoundly affected healthcare workers (HCWs) worldwide. The aim of this study was to investigate the mediating effects of traumatic stress and loneliness on the fears of contracting and dying from COVID-19, and anxiety and depression of HCWs during the pandemic.
METHODS: A cross-sectional online survey was completed by HCWs in a province of Turkey. The Hospital Anxiety Depression Scale, Impact of Events Scale-Revised and numerical rating scales (for fears of COVID-19 and loneliness) were used and a bootstrap approach was used in the analyses with SPSS PROCESS macro software.
RESULTS: Of the HCWs evaluated, 150 (34.4%) were doctors, with a mean duration of work experience of 10.6 ± 7.5 years. The results indicated that fear of contracting COVID-19 was directly related to anxiety (β = 0.244, p < 0.001) and depression (β = 0.135, p < 0.01) and that traumatic stress and loneliness mediated the relationships between the fear of contracting COVID-19 and anxiety (β = 0.435, p < 0.001; β = 0.235, p < 0.001, respectively) and depression (β = 0.365, p < 0.001; β = 0.294, p < 0.001, respectively). The fear of dying from COVID-19 was determined to be directly associated with anxiety (β = 0.190, p < 0.001) but not with depression (β = 0.066, p = 0.116), and traumatic stress and loneliness mediated the relationships between the fear of dying from COVID-19 and anxiety (β = 0.476, p < 0.001; β = 0.259, p < 0.001, respectively) and depression (β = 0.400, p < 0.001; β = 0.311, p < 0.001, respectively).
CONCLUSIONS: The study results demonstrated the important roles of traumatic stress and loneliness in exacerbating the negative consequences of fears of COVID-19 on anxiety and depression, and provide insights for identifying HCWs at greater risk.
METHODS: A cross-sectional online survey was completed by HCWs in a province of Turkey. The Hospital Anxiety Depression Scale, Impact of Events Scale-Revised and numerical rating scales (for fears of COVID-19 and loneliness) were used and a bootstrap approach was used in the analyses with SPSS PROCESS macro software.
RESULTS: Of the HCWs evaluated, 150 (34.4%) were doctors, with a mean duration of work experience of 10.6 ± 7.5 years. The results indicated that fear of contracting COVID-19 was directly related to anxiety (β = 0.244, p < 0.001) and depression (β = 0.135, p < 0.01) and that traumatic stress and loneliness mediated the relationships between the fear of contracting COVID-19 and anxiety (β = 0.435, p < 0.001; β = 0.235, p < 0.001, respectively) and depression (β = 0.365, p < 0.001; β = 0.294, p < 0.001, respectively). The fear of dying from COVID-19 was determined to be directly associated with anxiety (β = 0.190, p < 0.001) but not with depression (β = 0.066, p = 0.116), and traumatic stress and loneliness mediated the relationships between the fear of dying from COVID-19 and anxiety (β = 0.476, p < 0.001; β = 0.259, p < 0.001, respectively) and depression (β = 0.400, p < 0.001; β = 0.311, p < 0.001, respectively).
CONCLUSIONS: The study results demonstrated the important roles of traumatic stress and loneliness in exacerbating the negative consequences of fears of COVID-19 on anxiety and depression, and provide insights for identifying HCWs at greater risk.
摘要：
背景：COVID-19带来的有害精神健康影响已经深刻地影响了全世界的医护人员(HCWs)。这项研究的目的是调查大流行期间创伤压力和孤独感对感染和死亡的恐惧以及医护人员焦虑和抑郁的中介作用。
方法：土耳其某省的HCWs完成了一项横断面在线调查。医院焦虑抑郁量表,使用事件影响量表修订和数字评定量表(用于担心COVID-19和孤独感)，并在SPSSPROCESS宏软件的分析中使用自举方法。
结果：在评估的HCWs中，150人(34.4%)是医生，平均工作经验10.6±7.5年。结果表明，对感染COVID-19的恐惧与焦虑（β=0.244，p<0.001）和抑郁（β=0.135，p<0.01）直接相关，创伤压力和孤独介导了对感染COVID-19的恐惧与焦虑（β=0.435，p<0.001；β=0.235，p<0.001）和抑郁（β=0.365，p<0.001；β=0.294，p<0.001）之间的关系。对COVID-19死亡的恐惧被确定为与焦虑直接相关（β=0.190，p<0.001），但与抑郁无关（β=0.066，p=0.116），创伤应激和孤独感介导了对COVID-19死亡的恐惧与焦虑（β=0.476，p<0.001；β=0.259，p<0.001）和抑郁（β=0.400，p<0.001；β=0.311，p<0.001）之间的关系。
结论：研究结果表明，创伤压力和孤独感在加剧对COVID-19的恐惧对焦虑和抑郁的负面影响方面具有重要作用，并为识别风险更大的HCWs提供见解。
方法：土耳其某省的HCWs完成了一项横断面在线调查。医院焦虑抑郁量表,使用事件影响量表修订和数字评定量表(用于担心COVID-19和孤独感)，并在SPSSPROCESS宏软件的分析中使用自举方法。
结果：在评估的HCWs中，150人(34.4%)是医生，平均工作经验10.6±7.5年。结果表明，对感染COVID-19的恐惧与焦虑（β=0.244，p<0.001）和抑郁（β=0.135，p<0.01）直接相关，创伤压力和孤独介导了对感染COVID-19的恐惧与焦虑（β=0.435，p<0.001；β=0.235，p<0.001）和抑郁（β=0.365，p<0.001；β=0.294，p<0.001）之间的关系。对COVID-19死亡的恐惧被确定为与焦虑直接相关（β=0.190，p<0.001），但与抑郁无关（β=0.066，p=0.116），创伤应激和孤独感介导了对COVID-19死亡的恐惧与焦虑（β=0.476，p<0.001；β=0.259，p<0.001）和抑郁（β=0.400，p<0.001；β=0.311，p<0.001）之间的关系。
结论：研究结果表明，创伤压力和孤独感在加剧对COVID-19的恐惧对焦虑和抑郁的负面影响方面具有重要作用，并为识别风险更大的HCWs提供见解。
