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. 2023 Oct-Dec;16(4):221-224.
doi: 10.1016/j.rpsm.2021.06.001. Epub 2021 Jun 18.

Association between perceived discrimination and mental health outcomes among health workers during the initial COVID-19 outbreak

Roberto Mediavilla  1 , Eduardo Fernández-Jiménez  2 , Jorge Andreo  3 , Inés Morán-Sánchez  4 , Ainoa Muñoz-Sanjosé  2 , Berta Moreno-Küstner  5 , Franco Mascayano  6 , José Luis Ayuso-Mateos  7 , María-Fe Bravo-Ortiz  8 , Gonzalo Martínez-Alés  9 ; COVID-19 HEalth caRe wOrkErS – Spain (HEROES-SPA) Working Group
Affiliations

Association between perceived discrimination and mental health outcomes among health workers during the initial COVID-19 outbreak

Roberto Mediavilla et al. Span J Psychiatry Ment Health. 2023 Oct-Dec.

Abstract
in English, Spanish

Background: During the initial COVID-19 outbreak, health systems faced unprecedented organizational stress. Meanwhile, reports of episodes of discrimination and violence towards healthcare workers increased globally. This study explores the association between perceived discrimination and mental health outcomes in a large sample of healthcare workers in Spain.

Materials and methods: Healthcare workers from inpatient and outpatient facilities (N=2,053) filled an on-line questionnaire in May or June 2020. Mental health outcomes included depression symptoms (Patient Health Questionnaire [PHQ-9]), psychological distress (General Health Questionnaire [GHQ-12]) and death thoughts (Columbia Suicide Severity Rating Scale [C-SSRS]). We also measured perceived discrimination and/or stigmatization due to being a healthcare worker since pandemic onset. Regression models adjusted for potential confounding sources (age, sex, history of a mental health diagnosis and type of job) were fitted.

Results: Thirty percent of the respondents reported discrimination and/or stigmatization. Perceived discrimination was associated with higher depression (B=2.4, 95 percent CI: 1.8, 2.9) and psychological distress (B=1.1, 95 percent CI: 0.7, 1.4) scores, and with a 2-fold increase in risk of reporting death thoughts (OR=2.0, 95 percent CI: 1.4, 3.1).

Conclusions: Perceived discrimination is a modifiable driver of mental health problems among healthcare workers. Mass media, legislators, and healthcare institutions must put in place prevention and restoration strategies to limit discrimination towards healthcare workers and reduce its mental health impact.

Antecedentes: Los sistemas de salud fueron sometidos a un nivel de estrés sin precedentes durante la primera ola de la pandemia de COVID-19. Al mismo tiempo, se registró un aumento de episodios de discriminación y violencia contra los trabajadores sanitarios. Este estudio explora la asociación entre la discriminación percibida y la salud mental en una gran muestra de trabajadores sanitarios en España.

Material y métodos: Trabajadores sanitarios hospitalarios y no hospitalarios (N = 2.053) completaron una encuesta en línea entre mayo y junio de 2020. Se incluyeron los siguientes indicadores de salud mental: síntomas depresivos (PHQ-9), malestar psicológico (GHQ-12) e ideas de muerte (C-SSRS). También se midió la discriminación y/o estigmatización percibida desde el inicio de la pandemia por el hecho de ser trabajador sanitario. Se calcularon modelos de regresión ajustados por potenciales fuentes de confusión (edad, sexo, antecedentes psiquiátricos y tipo de trabajo).

Resultados: Un 30% de los encuestados refirieron haberse sentido discriminados y/o estigmatizados. La discriminación percibida se asoció con mayores puntuaciones en depresión (B = 2,4, intervalo de confianza [IC] al 95% de 1,8 a 2,9) y malestar psicológico (B = 1,1, IC 95% de 0,7 a 1,4), y con el doble de riesgo de referir ideas de muerte (OR = 2,0, IC al 95% de 1,4 a 3,1).

Conclusiones: La discriminación percibida es un estresor modificable que puede disparar problemas de salud mental en profesionales sanitarios. Medios de comunicación, legisladores e instituciones sanitarias deben poner en marcha estrategias preventivas y restaurativas reducir la discriminación contra los sanitarios y reducir el impacto sobre la salud mental.

Keywords: COVID-19; Discrimination; Healthcare workers; Mental health; Stigma.

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Figures

Figure 1
Figure 1
Depression scores and psychological distress scores by type of job and by perceived discrimination.
See this image and copyright information in PMC

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