一場心理健康風暴？：新冠肺炎三級警戒下醫務社工心理情緒困擾之相關影響因素研究

A Hidden Mental Health Storm? Factors Affecting the Emotional Distress of Medical Social Workers in Taiwan under the Level 3 COVID-19 Alert

本研究採社會生態學觀點，探討新冠肺炎三級警戒期間醫務社工心理情緒困擾情形，並分析個人與家庭、工作職場，以及新冠肺炎疫情層面等解釋因素與醫務社工心理情緒困擾關係；同時檢測心理情緒困擾解釋因素與新冠肺炎壓力之環境脈絡交互作用。使用橫斷面調查研究，分層隨機抽樣台灣北、中、南、東（含離島）區域，再依醫院層級分地區醫院、區域醫院與醫學中心選取受訪樣本。以SurveyCake©雲端問卷平台蒐集資料，並與中華民國醫務社會工作協會合作調查。結果共得有效樣本405 人，其中46.4%醫務社工在疫情三級警戒下有心理情緒困擾。階層邏輯迴歸分析結果顯示：復原力總分越低、生活品質評價較差、擔任醫務社工部門主管、有經歷醫療職場暴力、較高的職場疲勞情形、過去沒有照顧傳染性疾病經驗和新冠肺炎壓力越大者，其心理情緒困擾機率就越高。部分顯著解釋因素和新冠肺炎壓力具有交互作用。本研究最後根據研究結果進行討論，並提出新冠肺炎疫情下醫務社工的身心照顧和關懷策略建議。

This paper discusses the emotional distress experienced by medical social workers in Taiwan under the Level 3 COVID-19 alert from the social ecological perspective. The correlation of personal, family, workplace, and pandemic-related factors with the emotional distress these social workers experience was investigated. The interaction between emotional distress explanatory factors and the COVID-19-induced stress was also examined. In this cross-sectional investigation, through stratified random sampling, Taiwan was divided into the northern, central, southern, and eastern (including outlying islands) regions according to the levels of urban and regional development. The medical institutions were categorized into district hospitals, regional hospitals, and medical centres according to their levels. Researchers of this study collaborated with the Medical Social Work Association R.O.C to collect data through SurveyCake©, a cloud-Based survey platform. Among the 405 sampled medical social workers, 46.4% were experiencing emotional distress under the Level 3 COVID-19 alert. According to the hierarchical logistic regression analysis results, medical social workers who showed a lower total score in resilience, demonstrated less satisfaction with their quality of life, worked as the heads of medical social work department, experienced medical workplace violence, experienced higher workplace fatigue, had no experience caring for patients with communicable diseases, and exhibited more severe COVID-19-induced stress were more likely to experience emotional distress. Associated significant explanatory factors and the COVID-19-induced stress interacted. A conclusion based on the research results is presented, along with suggestions on providing physical and mental care to medical social workers during the COVID-19 pandemic.