COVID-19 Omicron疫情對中部二家區域醫院護理人員心理困擾之影響：相關因素、復原力與其關聯性

The Impact of the COVID-19 Omicron Pandemic on Psychological Distress Among Nursing Staff in Two Regional Hospitals in Central Taiwan: Associated Factors, Resilience, and Their Correlation

目的
本研究旨在探討COVID-19 Omicron疫情高峰期間，中部同體系二家區域醫院護理人員之憂鬱、焦慮與壓力狀態，分析其相關個人與工作特質，並評估心理復原力在心理困擾中的保護作用。
方法
採橫斷式調查設計，以二家區域醫院全體臨床護理人員為研究對象，於2022年8月進行匿名問卷調查。工具包括DASS-21評估憂鬱、焦慮與壓力、CD-RISC-10測量心理復原力，以及個人與工作特質問卷。資料分析使用廣義線性模型與多元迴歸分析。
結果
共回收676份有效問卷，護理人員DASS-21平均得分憂鬱5.33、焦慮4.95、壓力7.09，壓力盛行率最高（34.8％）。心理復原力平均24.6，30.1％屬低復原力。自覺心理或生理健康不佳、家庭經濟受疫情影響及接觸COVID-19患者的護理人員，心理困擾顯著較高且復原力較低；50歲以上、與子女同住及曾接受COVID-19訓練者，復原力較高且心理困擾較低。心理復原力與憂鬱、焦慮、壓力呈顯著負相關，顯示其保護作用。
結論
Omicron疫情對護理人員心理健康造成顯著影響，特別是在壓力構面。身心健康不佳與經濟壓力是心理困擾的關鍵風險因子，而COVID-19相關訓練與高心理復原力則具保護作用。建議政策制定單位與醫院應加強心理健康篩檢、經濟支持及壓力調適訓練，並透過組織支持與強化復原力，降低護理人員心理困擾，維持醫療系統的正常運作。

Purposes
The aim of this study was to examine the levels of depression, anxiety, and stress among nursing staff working in two regional hospitals within the same healthcare system in central Taiwan during the peak of the COVID-19 Omicron pandemic. It further examined the association of personal and work-related factors and evaluated the protective role of psychological resilience against psychological distress.
Methods
A cross-sectional survey was conducted in August 2022 among all nursing staff from the two hospitals using an anonymous questionnaire. The instruments included the Depression, Anxiety, and Stress Scale-21 (DASS-21) to assess psychological distress, and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) to measure psychological resilience. Additionally, data on personal and work-related characteristics were collected. Statistical analyses were performed using generalized linear models and multivariate regression.
Results
A total of 676 valid responses were collected. The mean DASS-21 scores among nursing staff were 5.33 for depression, 4.95 for anxiety, and 7.09 for stress, with stress showing the highest prevalence (34.8%). The mean CD-RISC-10 score was 24.6, with 30.1% of participants classified as having low resilience. Nurses who reported poor physical or mental health, experienced financial difficulties due to the pandemic, or experienced caring for COVID-19 patients had significantly higher psychological distress and lower resilience. In contrast, those aged 50 years or older, living with children, or who had received COVID-19-related training demonstrated higher resilience and lower psychological distress. Psychological resilience was negatively associated with depression, anxiety, and stress, highlighting its protective role.
Conclusions
The Omicron pandemic had a significant impact on the psychological health of nursing staff, particularly in terms of stress. Poor physical or mental health and financial strain were key risk factors for psychological distress, whereas COVID-19-related training and higher resilience served as protective factors. Policymakers and hospitals are advised to strengthen psychological health screening, provide financial support and stress management training, and enhance organizational support and resilience-building initiatives to reduce psychological distress among nursing staff and ensure the proper functioning of the healthcare system.