COVID-19疫情防控常态化时期社会工作者心理健康水平调查及影响因素分析: 以北京市朝阳区为例

A Survey on the Mental Health Status of Social Workers Under Long-term Stress of COVID-19 and the Exploration of Associated Factors: A Case Study of Chaoyang District, Beijing

  • 摘要:
    目的 了解COVID-19疫情防控常态化期间, 社工焦虑、抑郁、睡眠障碍发生情况并分析其影响因素。
    方法 采用分层整群抽样法, 于2021年11月—2022年3月期间选取北京市朝阳区酒仙桥、望京、太阳宫、十八里店、孙河5个街道的全部社工为研究对象(社工组), 并以该5个街道对应社区医院且具有相同年龄范围的在职一线医护人员(医护组)、社区居民(居民组)为对照人群。社工组、医护组、居民组比例为1∶1∶1。采用问卷星平台, 向社工、医护人员、社区居民微信群发放电子问卷展开调查。比较3组焦虑、抑郁、睡眠障碍筛查阳性率, 并采用多因素Logistic回归和决策树分析社工焦虑、抑郁、睡眠障碍的影响因素。
    结果 共回收问卷954份, 其中62份不合格予以剔除, 最终纳入892份(93.5%)有效问卷进行数据分析。其中社工组372份(41.7%), 医护组262份(29.4%), 居民组258份(28.9%)。社工组焦虑、抑郁、睡眠障碍筛查阳性率分别为15.3%、22.0%、48.1%, 较医护组(7.6%、10.3%、30.5%)和居民组(7.0%、8.5%、29.5%)明显升高(P均<0.001)。多因素Logistic回归显示, 家庭负担(OR=1.80, 95% CI: 1.09~2.96)、中文版压力知觉量表(Chinese perceived stress scale, CPSS)评分(OR=1.34, 95% CI: 1.24~1.45)是社工焦虑的独立影响因素, CPSS评分(OR=1.29, 95% CI: 1.20~1.39)、社会支持评定量表(social support rating scale, SSRS)评分(OR=0.96, 95% CI: 0.92~1.00)是社工抑郁的独立影响因素, 有精神疾病家族史(OR=4.91, 95% CI: 1.27~18.94)、CPSS评分(OR=1.20, 95% CI: 1.14~1.27)、SSRS评分(OR=0.95, 95% CI: 0.91~0.98)是社工睡眠障碍的独立影响因素。决策树分析结果与多因素Logistic回归分析结果基本一致, 家庭负担、CPSS评分、SSRS评分是影响社工心理健康的重要变量, 其中CPSS评分与社工焦虑、抑郁、睡眠障碍均呈强关联。
    结论 在COVID-19疫情防控常态化时期, 相较于医护人员和社区居民, 社工表现出更高水平的心理健康问题。压力知觉、社会支持为社工心理健康的重要影响因素, 尤其以压力知觉的影响为著。

     

    Abstract:
    Objective To study the prevalence of depression, anxiety, and insomnia among social workers during the prolonged battle against the COVID-19 pandemic and explore the associated risk factors.
    Methods Using a stratified cluster sampling method, we selected all social workers in the five streets of Chaoyang District, Beijing(Jiuxianqiao, Wangjing, Taiyanggong, Shibalidian, Sunhe) from November 2021 to March 2022 as the study population(social worker group), and the frontline medical staffs(medical professional group) of the same age range of the corresponding community hospitals of the same five streets, and the community residents(resident group) as the control population. The ratio of the social worker group, medical professional group, and resident group was 1∶1∶1. The Sojump platform was used to send electronic questionnaires to the wechat groups of social workers, healthcare workers, and community residents to carry out the survey. The screen positive rates for anxiety, depression, and sleep disorders were compared among the 3 groups. Multifactorial Logistic regression and decision tree were used to analyze the influencing factors of anxiety, depression, and sleep disorders among social workers.
    Results A total of 954 questionnaires were collected, of which 62 were disqualified and excluded. Finally, 892 valid questionnaires(93.5%) were included for data analysis. Among them, there were 372 questionnaires(41.7%) from the social worker group, 262(29.4%) from the medical professional group, and 258(28.9%) from the resident group. The prevalences of anxiety, depression, and sleep disorders among social workers group were found to be 15.3%, 22.0%, and 48.1%, respectively, which were significantly higher than those in the medical professional group(7.6%, 10.3%, and 30.5%) and the resident group(7.0%, 8.5%, and 29.5%), all P < 0.001. Multiple Logistic regression showed that family burden(OR=1.80, 95% CI: 1.09-2.96) and Chinese perceived stress scale(CPSS) score(OR=1.34, 95% CI: 1.24-1.45) were independent influencing factors for anxiety among social workers; CPSS score(OR=1.29, 95% CI: 1.20-1.39) and social support rating scale(SSRS) score(OR=0.96, 95% CI: 0.92-1.00) were independent influencing factors for depression among social workers; family history of mental illness(OR=4.91, 95% CI: 1.27-18.94), CPSS score(OR=1.20, 95% CI: 1.14-1.27), and SSRS score(OR=0.95, 95% CI: 0.91-0.98) were independent influencing factors for sleep disorders among social workers. The results of decision tree analysis were consistent with those of multiple Logistic regression analysis. Family burden, CPSS score, and SSRS score were important variables affecting the mental health of social workers, among which CPSS score was strongly associated with anxiety, depression, and sleep disorders among social workers.
    Conclusions Social workers exhibited significant levels of anxiety, depression, and sleep disorders during the long-term pandemic prevention, with CPSS being the most significant influencing factor.

     

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