The impact of the Covid-19 pandemic on the mental health of workers in health services: building resilience in post-conflict territories

Covid-19 大流行对卫生服务工作者心理健康的影响：在冲突后地区建设复原力

• 批准号: ES/V013157/1
• 负责人: Neil Pearce
• 金额: $ 42.76万
• 依托单位: London School of Hygiene & Tropical Medicine
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2021
• 资助国家: 英国
• 起止时间: 2021 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=ES%2FV013157%2F1
• 关键词: impact; Covid; 19; pandemic; mental

COVID-19 was declared a global pandemic by WHO on March 11. Even though Colombia declared a national emergency early in the pandemic (March 17) and has taken other mitigation measures, the infection has spread across the country. Colombia is the eleventh highest in the world in terms of the number of cases. One of the significant concerns during the pandemic is the high demand for health services that exceed the service capacities. For these demanding healthcare needs, COVID-19 pandemic can affect the physical and mental health of healthcare workers (HWs) (including clinical and non-clinical staff). During this pandemic, HWs are exposed to high levels of stress due to long working hours, changes in their functions, and fear of the disease. In addition, HWs can be exposed to the death of patients, hopelessness, and ethical dilemmas. These stressors can increase the risk of developing mental health problems. The most important reasons to study this problem in Colombia are the high risk of mental problems in HW, lack of resources in health services, and the history of violence due to the armed conflict which has meant that HWs were highly stressed even before the pandemic arrived. We therefore propose to: 1. To study the mental health of health workers in Colombia and some regions of the Development Programs with a Territorial Approach (PDET), and to assess how mental health problems vary according to the personal history of violence and resilience levels2. To assess the association between stressors derived from the COVID-19 pandemic and mental health in the health workers in a first measurement, and at 3, 6 and 12 months of follow-up 3. To explore how a history of exposure to armed conflict modifies the effects of the stressors from the COVID-19 pandemic on mental health.4. To design and evaluate the feasibility and satisfaction of an eHealth-based intervention to prevent symptoms of depression and anxiety, and increase resilience in health workersMethods: 1) Cross-sectional study of 3,000 health workers (clinical and non-clinical personnel including administrative personnel and support personnel) to estimate the prevalence and distribution of mental health stressors. Sampling will be convenient through health institutions, medical associations, hospitals and social networks. In the cross-sectional study, we will also include a specific sample of health workers from Florida, Pradera, Apartado and Turbo (n = 150) and will compare the proportions of mental health problems between the national level with the specific data of these regions (prioritized as post-conflict). 2) Cohort study: we will include healthcare workers (n=3,100) from the cities of Bogota, Medellin and Cali who will be followed up -3, -6, and -12 months after the first measurement. This information will be used to assess the medium-term impacts of the pandemic stressors on mental health as well as the protective and risk factor for mental health 3) Design and evaluation of an intervention based on eHealth that allows the detection and prevention of depression and anxiety and promotion of resilience in health workers. 4) component of social appropriation of knowledge that includes dissemination strategies of research results, eHealth intervention for prevention of mental health problems in health workers. In addition, we will design educational material in videos and infographics to promote the mental health of health workers, and conduct forums with the presentation of the results, as well as produce short reports for decision makers.

WO 3月11日被WHO宣布为全球大流行。尽管哥伦比亚在大流行（3月17日）宣布了全国紧急情况（3月17日），并采取了其他缓解措施，但感染仍在全国各地传播。就病例数而言，哥伦比亚是世界上排名第十的第十一高。大流行期间的重要问题之一是对卫生服务的高需求超过了服务能力。对于这些苛刻的医疗保健需求，Covid-19大流行会影响医护人员的身心健康（HWS）（包括临床和非临床人员）。在这个大流行期间，由于工作时间长，功能变化和对疾病的恐惧，HWS承受着高水平的压力。此外，HW可以暴露于患者的死亡，绝望和道德困境。这些压力源可以增加患心理健康问题的风险。在哥伦比亚研究这一问题的最重要原因是，HW中缺乏精神问题的高风险，缺乏卫生服务的资源以及由于武装冲突而引起的暴力历史，这意味着HWS甚至在大流行就到来之前就受到了极大的压力。因此，我们建议：1。以领土方法（PDET）研究哥伦比亚卫生工作者的心理健康以及开发计划的某些地区，并评估心理健康问题如何根据暴力和弹性水平的个人历史来差异2。为了评估卫生工作者在卫生工作者中衍生出的压力源与随访的3、6和12个月的卫生工作者之间的关联。3。探索武装冲突的暴露史如何改变了COVID-19大流行对精神健康对压力源的影响4。设计和评估基于EHealth的干预措施的可行性和满意度，以防止抑郁症和焦虑症状，并增加卫生工作者的弹性：1）对3,000名卫生工作者（包括行政人员和支持人员）的3,000名卫生工作者（包括行政人员和支持人员）的横断面研究，以估计心理健康压力者的普遍性和分布。采样将通过卫生机构，医疗协会，医院和社交网络方便。在横断面研究中，我们还将包括佛罗里达州，普拉德拉，Aptarado和Turbo（n = 150）的特定卫生工作者样本，并将比较国家水平之间的心理健康问题比例与这些地区的特定数据（在冲突后优先考虑）。 2）队列研究：我们将包括来自波哥大，麦德林和卡利城市的医护人员（n = 3,100），他们将在第一次测量后跟踪-3，-6和-12个月。该信息将用于评估大流行压力源对心理健康的中期影响，以及心理健康的保护和风险因素3）设计和评估基于eHealth的干预措施，该干预措施允许发现和预防抑郁症，焦虑以及促进卫生工作者的韧性。 4）社会授权知识的组成部分，包括研究结果的传播策略，eHealth干预预防卫生工作者心理健康问题的干预措施。此外，我们还将在视频和信息图表中设计教育材料，以促进卫生工作者的心理健康，并在结果呈现后进行论坛，并为决策者制作简短的报告。

项目成果

Inequality on the frontline: A multi-country study on gender differences in mental health among healthcare workers during the COVID-19 pandemic

前线不平等：一项关于 COVID-19 大流行期间医护人员心理健康性别差异的多国研究

• DOI: 10.21203/rs.3.rs-3173748/v1
• 发表时间: 2023
• 作者: Czepiel D

Exhausting care: On the collateral realities of caring in the early days of the Covid-19 pandemic

• DOI: 10.1016/j.socscimed.2024.116617
• 发表时间: 2024-01-26
• 期刊: SOCIAL SCIENCE & MEDICINE
• 影响因子: 5.4
• 作者: Rhodes，Tim;Osorio，Maria Paula Ruiz;Lancaster，Kari
• 通讯作者: Lancaster，Kari