背景:在COVID-19大流行期间,加拿大的医护人员(HCWs)经历了艰难的病情。许多人在传染性环境中照顾患者时长时间工作。这带来了额外的负担,可能导致精神健康状况恶化。
目的:在本研究中,与大流行开始前相比,我们研究了与HCWs精神健康状况恶化相关的因素.
方法:我们使用加拿大统计局对HCWs进行的一项调查数据。回归模型用于估计大流行开始后心理健康恶化的比值比(OR)。估计的赔率比(OR)与不同的独立变量相关联,这些变量包括人口统计数据(年龄、性别,移民身份,和地理区域),职业因素(工作状态,职业组,和暴露类别),和个人防护设备(PPE)的不同访问级别。
结果:在接受调查的18,139名合格参与者中,13,990(77.1%)提供了有效的答复。我们发现,与参考组(35-44岁)相比,年龄小于35岁的医护人员更有可能(OR1.14,95%CI1.03-1.27;P=.01)表现出心理健康恶化。至于性,与女性HCWs相比,男性HCWs的心理健康恶化可能性较小(OR0.76,95%CI0.67-0.86;P<.001)。与非移民HCW相比,移民HCW也不太可能(OR0.57,95%CI0.51-0.64;P<.001)表现出心理健康恶化。Further,与在其他地方工作的医护人员相比,在艾伯塔省工作的医护人员表现出精神健康状况恶化的可能性最高(大西洋省,魁北克,曼尼托巴省,萨斯喀彻温省,安大略省,不列颠哥伦比亚省,和北部领土)。一线工人比非一线工人更有可能(OR1.26,95%CI1.16-1.38;P<.001)表现出心理健康恶化。与全职HCWs相比,兼职HCWs不太可能(OR0.85,95%CI0.76-0.93;P<.001)表现出心理健康恶化。报告遇到COVID-19病例的医护人员与报告未接触该疾病的医护人员相比,更有可能(OR1.55,95%CI1.41-1.70;P<.001)表现出精神健康状况恶化。至于PPE,从来没有接触过呼吸器的医护人员,保护眼睛,面罩更有可能表现出1.31的精神健康恶化(95%CI1.07-1.62;P<.001),1.51(95%CI1.17-1.96;P<.001),和1.41(95%CI1.05-1.92;P=.02)比那些始终可以使用相同PPE的人,分别。
结论:不同的HCW群体根据其人口统计学和职业背景以及获得PPE的机会而经历了不同的大流行。这些发现对于参与个性化支持计划计划的利益相关者很重要,并有助于在未来的危机中缓解心理健康。某些群体需要更多的关注。
BACKGROUND: Health care workers (HCWs) in Canada have endured difficult conditions during the COVID-19 pandemic. Many worked long hours while attending to patients in a contagious environment. This introduced an additional burden that may have contributed to worsened mental health conditions.
OBJECTIVE: In this study, we examine the factors associated with worsened mental health conditions of HCWs as compared to before the start of the pandemic.
METHODS: We use data from a survey of HCWs by Statistics Canada. A regression model is used to estimate the odds ratios (ORs) of worsened mental health after the start of the pandemic. The estimated odds ratio (OR) is associated with different independent variables that include demographics (age, sex, immigration status, and geographic area), occupational factors (work status, occupational group, and exposure category), and different access levels to personal protective equipment (PPE).
RESULTS: Of 18,139 eligible participants surveyed, 13,990 (77.1%) provided valid responses. We found that HCWs younger than 35 years old were more likely (OR 1.14, 95% CI 1.03-1.27; P=.01) to exhibit worsened mental health as compared to the reference group (35-44 years old). As for sex, male HCWs were less likely (OR 0.76, 95% CI 0.67-0.86; P<.001) to exhibit worsened mental health as compared to female HCWs. Immigrant HCWs were also less likely (OR 0.57, 95% CI 0.51-0.64; P<.001) to exhibit worsened mental health as compared to nonimmigrant HCWs. Further, HCWs working in Alberta had the highest likelihood of exhibiting worsened mental health as compared to HCWs working elsewhere (Atlantic provinces, Quebec, Manitoba, Saskatchewan, Ontario, British Columbia, and Northern Territories). Frontline workers were more likely (OR 1.26, 95% CI 1.16-1.38; P<.001) to exhibit worsened mental health than nonfrontline HCWs. Part-time HCWs were less likely (OR 0.85, 95% CI 0.76-0.93; P<.001) to exhibit worsened mental health than full-time HCWs. HCWs who reported encountering COVID-19 cases were more likely (OR 1.55, 95% CI 1.41-1.70; P<.001) to exhibit worsened mental health as compared to HCWs who reported no contact with the disease. As for PPE, HCWs who never had access to
respirators, eye protection, and face shields are more likely to exhibit worsened mental health by 1.31 (95% CI 1.07-1.62; P<.001), 1.51 (95% CI 1.17-1.96; P<.001), and 1.41 (95% CI 1.05-1.92; P=.02) than those who always had access to the same PPE, respectively.
CONCLUSIONS: Different HCW groups experienced the pandemic differently based on their demographic and occupational backgrounds as well as access to PPE. Such findings are important to stakeholders involved in the planning of personalized support programs and aid mental health mitigation in future crises. Certain groups require more attention.