背景:在COVID-19大流行期间,公共卫生工作者的不良心理健康状况和相关危险因素被忽视。本研究使用努力-奖励不平衡模型来调查工作-压力特征(努力,过度承诺,在中国COVID-19大流行期间,一线公共卫生工作者的奖励)和心理健康问题(焦虑和抑郁)。
方法:通过自我构建的社会人口统计学问卷收集了4850份有效的在线问卷,改编的ERI问卷,9项患者健康问卷(PHQ-9)和7项一般焦虑症量表(GAD-7)。进行了分层逻辑回归分析,以调查ERI因素与心理健康问题之间的关联(即,抑郁和焦虑),在这样的协会中,奖励被视为潜在的主持人。
结果:数据显示,努力和过度承诺与抑郁和焦虑呈正相关,而奖励与抑郁和焦虑呈负相关。发展和工作接受是奖励缓冲了努力/过度承诺对抑郁和焦虑的有害影响的两个维度,而自尊并不显著。
结论:这项研究证实了在中国COVID-19大流行期间,公共卫生工作者的努力和过度承诺对心理健康的有害影响。这种影响可以通过适当的奖励系统来减轻,特别是这种系统的开发和工作接受维度。这些发现凸显了建立紧急奖励制度的重要性,包括合理的工作分配机制,奖金和荣誉称号,持续的教育体系和更好的职业发展机会。
BACKGROUND: Poor mental health status and associated risk factors of public health workers have been overlooked during the COVID-19 pandemic. This study used the effort-reward imbalance model to investigate the association between work-stress characteristics (effort, over-commitment, reward) and mental health problems (anxiety and depression) among front-line public health workers during the COVID-19 pandemic in China.
METHODS: A total of 4850 valid online questionnaires were collected through a self- constructed sociodemographic questionnaire, the adapted ERI questionnaire, the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item General Anxiety Disorder Scale (GAD-7). Hierarchical logistic regression analysis was conducted to investigate the association between ERI factors and mental health problems (i.e., depression and anxiety), with reward treated as a potential moderator in such associations.
RESULTS: The data showed that effort and over-commitment were positively associated with depression and anxiety, while reward was negatively associated with depression and anxiety. Development and job acceptance were the two dimensions of reward buffered the harmful effect of effort/over-commitment on depression and anxiety, whereas esteem was non-significant.
CONCLUSIONS: This study confirmed the harmful effects of effort and over-commitment on mental health among public health workers during the COVID-19 pandemic in China. Such effects could be alleviated through an appropriate reward system, especially the development and job acceptance dimensions of such a system. These findings highlight the importance of establishing an emergency reward system, comprising reasonable work-allocation mechanism, bonuses and honorary titles, a continuous education system and better career-development opportunities.