医务工作者正念水平在心理弹性与焦虑症状、抑郁症状间的中介效应

Mediating effects of mindfulness level on resilience and symptoms of anxiety and depression among healthcare workers

目的 探讨医务工作者正念水平在心理弹性与焦虑症状、抑郁症状间的中介效应,为制定有效的心理干预措施提供依据。方法 于2023年1月选取山东省青岛、济南、日照、济宁和聊城5个城市,采用分层随机抽样方法,按照医院、疾病预防控制中心及卫生部门分层,抽取临床医生、护士和公共卫生专业技术人员为研究对象。采用一般人口学调查问卷、5条目正念注意觉知量表、心理弹性量表、广泛性焦虑障碍量表和病人健康问卷分别调查收集医务工作者的基本资料、正念水平、心理弹性、焦虑症状和抑郁症状。采用Process程序分析正念水平在心理弹性与焦虑症状、抑郁症状间的中介效应。结果 调查医务工作者1 836人,其中男性472人,占25.71%;女性1 364人,占74.29%。年龄M(QR)为39 (12)岁。临床医生629人,占34.26%;护士963人,占52.45%;公共卫生专业技术人员244人,占13.29%。正念水平得分M(QR)为22(7)分;心理弹性得分M(QR)为20(4)分;焦虑症状检出率为49.78%;抑郁症状检出率72.28%。中介效应分析结果显示,正念水平在心理弹性与焦虑症状间起部分中介效应(β=-0.510,P<0.001),直接效应值为-0.130,中介效应值为-0.046,中介效应占总效应的26.14%;正念水平在心理弹性与抑郁症状间也起部分中介效应(β=-0.575,P<0.001),直接效应值为-0.120,中介效应值为-0.052,中介效应占总效应的30.23%。结论 医务工作者正念水平在心理弹性与焦虑症状、抑郁症状间发挥中介作用。

Objective To examine the mediating effects of mindfulness level on resilience and symptoms of anxiety and depression among healthcare workers,so as to provide the reference for developing effective psychological intervention.Methods The clinical doctors,nurses and public health professionals were selected using the stratified random cluster sampling method from hospitals,disease prevention and control centers,and health departments in five cities in Shan⁃dong Province,including Qingdao,Jinan,Rizhao,Jining and Liaocheng in January 2023.Basic information,mindfulness level,resilience and symptoms of anxiety and depression among healthcare workers were collected using general demographic questionnaires,the 5-item Mindful Attention Awareness Scale,10-item Connor-Davidson Resilience Scale,Gen⁃eralized Anxiety Disorder Scale and Patient Health Questionnaire,respectively.The Process program was used to ana⁃lyze the mediating effects of mindfulness level on resilience and symptoms of anxiety and depression.Results A total of 1836 healthcare workers were investigated,including 472 males(25.71%)and 1364 females(74.29%),and the me⁃dian age was 39(interquartile range,12)years.There were 629 clinical doctors(34.26%),963 nurses(52.45%)and 244 public health professionals(13.29%).The median scores of mindfulness level and resilience were 22(interquartile range,7)and 20(interquartile range,4)points,respectively.The detection rates of anxiety and depression symptoms were 49.78%and 72.28%,respectively.The mediation analysis showed that mindfulness level exerted a partial mediat⁃ing effect between resilience and anxiety symptoms(β=-0.510,P<0.001),with a direct effect value of-0.130 and a me⁃diating effect value of-0.046,and the mediating effect accounted for 26.14%of the total effect;mindfulness level also exerted a partial mediating effect between resilience and depression symptoms(β=-0.575,P<0.001),with a direct effect value of-0.120 and a mediating effect value of-0.052,and the mediating effect accounted for 30.23%of the total ef⁃fect.Conclusion Mindfulness level plays a mediating effect between resilience and symptoms of anxiety and depression among healthcare workers.