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COVID-19 大流行的多个维度:“隐形”卫生工作者常见精神障碍的流行情况及其与职业压力源的关系。

Dimensions of the COVID-19 pandemic: prevalence of common mental disorders in "invisible" health workers and their association with occupational stressors.

机构信息

Universidade Estadual de Feira de Santana, Epidemiology Center - Feira de Santana (BA), Brazil.

Bahia State Secretariat of Health, Eastern Regional Health Center - Salvador (BA), Brazil.

出版信息

Rev Bras Epidemiol. 2024 Jul 29;27:e240039. doi: 10.1590/1980-549720240039. eCollection 2024.

Abstract

OBJECTIVE

To evaluate the association between occupational stressors and common mental disorders (CMD) among "invisible" health workers in the context of the COVID-19 pandemic.

METHOD

Cross-sectional study including a probabilistic sample of 1,014 health workers from three municipalities in Bahia. CMDs were assessed using the SRQ-20. The Effort-Reward Imbalance (ERI) scale and the Demand-Control Model assessed occupational stressors. Descriptive, bivariate, and multiple analysis to evaluate the association between the variables of interest.

RESULTS

The global prevalence of CMD was 39.9%; it was higher among CHA/EDCA (47.2%), followed by management and surveillance staff (38.6%), technicians (35.4%), and support/maintenance/cleaning staff (29.9%). The association between occupational stressors and CMD varied among occupations: 1. Excessive work commitment (EWC), effort-reward imbalance (ERI), and psychological demand were associated with CMD among support/maintenance/cleaning workers; 2. EWC and ERI were associated with CMD among CHA/EDCA; 3. EWC, ERI, and low control over work were associated with CMD among technicians; 4. Among management and surveillance workers, only ERI remained associated with CMD.

CONCLUSIONS

Occupational stressors played a relevant role in mental illness, with variation between occupational strata, demanding attention, monitoring, and control.

摘要

目的

评估在 COVID-19 大流行背景下,职业压力源与“隐形”卫生工作者常见精神障碍(CMD)之间的关系。

方法

这是一项包含巴伊亚州三个城市的概率抽样的横断面研究,共纳入 1014 名卫生工作者。采用 SRQ-20 评估 CMD。采用工作投入-回报失衡(ERI)量表和需求-控制模型评估职业压力源。采用描述性、双变量和多变量分析评估感兴趣变量之间的关联。

结果

CMD 的总患病率为 39.9%;CHA/EDCA(47.2%)较高,其次是管理人员和监督人员(38.6%)、技术人员(35.4%)和支持/维护/清洁人员(29.9%)。职业压力源与 CMD 之间的关系因职业而异:1. 过度工作投入(EWC)、工作投入-回报失衡(ERI)和心理需求与支持/维护/清洁人员的 CMD 相关;2. EWC 和 ERI 与 CHA/EDCA 的 CMD 相关;3. EWC、ERI 和工作控制不足与技术人员的 CMD 相关;4. 管理人员和监督人员中,只有 ERI 与 CMD 相关。

结论

职业压力源在精神疾病中起着重要作用,不同职业阶层之间存在差异,需要加以关注、监测和控制。

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