Experiences of Work-Family Conflict and Mental Health Symptoms by Gender Among Physician Parents During the COVID-19 Pandemic.
Experiences of Work-Family Conflict and Mental Health Symptoms by Gender Among Physician Parents During the COVID-19 Pandemic.
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DOI：
10.1001/jamanetworkopen.2021.34315
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发表时间：
2021-11-01
影响因子：
13.8
通讯作者：
Guille C
中科院分区：
文献类型：
--
作者：
Frank E;Zhao Z;Fang Y;Rotenstein LS;Sen S;Guille C
这项队列研究评估了COVID-19大流行与医生父母在工作-家庭因素和心理健康方面的性别差异之间的关系。COVID-19大流行是否与医生母亲和父亲之间的职业和心理健康差异有关？在这项针对276名医生的队列研究中，在2019冠状病毒病大流行期间，母亲比父亲更有可能负责儿童保育或学校教育和家务，主要在家工作，减少工作时间，并经历工作与家庭冲突，家庭与工作冲突以及抑郁和焦虑症状。在2019冠状病毒病大流行期间，在医生父母中观察到抑郁症状的性别差异，这在大流行之前并不存在。这项研究表明，大流行病的条件与医疗领域的性别不平等增加有关，并表明进一步关注和资源的重要性，以减轻对医生母亲的职业和福祉的潜在不利影响。COVID-19大流行给医护人员带来更大压力，并以前所未有的方式扰乱儿童保育和学校安排。由于在大流行病之前，医学领域存在严重的性别不平等，医生母亲可能特别容易受到不利的职业和心理后果的影响。评估COVID-19大流行期间医生父母在工作-家庭因素和心理健康方面的性别差异。这项前瞻性队列研究包括276名美国医生参加了实习生健康研究，因为他们的第一年住院医师培训。在2007至2008和2008至2009学年期间作为实习生参加主要研究并选择参加次要纵向随访研究的医生被邀请在2018年8月和2020年8月完成在线调查。工作-家庭经历包括3个单项问题和工作与家庭冲突量表，心理健康症状包括患者健康问卷-9（PHQ-9）和广泛性焦虑症-7量表。主要结果是2020年8月期间的工作与家庭和家庭与工作冲突以及抑郁症状和焦虑症状。按性别比较2018年（COVID-19疫情前）与2020年（COVID-19疫情期间）的抑郁症状。在完成2020年8月调查的215名医生父母中，114名（53.0%）为女性，加权平均（SD）年龄为40.1（3.57）岁。在医生父母中，女性更有可能负责儿童保育或学校教育（24.6% [95% CI，19.0%-30.2%] vs 0.8% [95% CI，0.01%-2.1%]; P < .001）和家务劳动（31.4% [95% CI，25.4%-37.4%] vs 7.2% [95% CI，3.5%-10.9%]; P <0.001）。女性也比男性更有可能主要在家工作（40.9% [95% CI，35.1%-46.8%] vs 22.0% [95% CI，17.2%-26.8%]; P < .001），并减少工作时间（19.4% [95% CI，14.7%-24.1%] vs 9.4% [95% CI，6.0%-12.8%]; P = .007）。妇女经历了更大的工作与家庭的冲突（β = 2.79; 95% CI，1.00 - 4.59; P = .03），家庭与工作冲突（β = 3.09; 95% CI，1.18-4.99; P = .02），抑郁（β = 1.76; 95% CI，0.56-2.95; P = 0.046）和焦虑（β = 2.87; 95% CI，1.49-4.26; P <0.001）症状与男性相比。我们观察到，在COVID-19大流行期间，女性和男性在抑郁症状方面存在差异（平均[SD] PHQ-9评分：5.05 [6.64] vs 3.52 [5.75]; P = .009），而在大流行之前则不存在这种差异（平均[SD] PHQ-9评分：3.69 [5.26] vs 3.60 [6.30]; P = .86）。这项研究发现，在COVID-19大流行期间，医生父母在工作和家庭经历以及心理健康症状方面存在显著的性别差异，这可能会导致自杀风险增加，医疗错误以及医生母亲的患者护理质量降低。需要采取体制和公共政策解决办法，以减轻对妇女职业和福祉的潜在不利影响。
This cohort study evaluates the association of the COVID-19 pandemic with gender differences in work-family factors and mental health among physician parents. Has the COVID-19 pandemic been associated with differences in careers and mental health between physician mothers and fathers? In this cohort study of 276 physicians during the COVID-19 pandemic, mothers were more likely than fathers to be responsible for childcare or schooling and household tasks, to work primarily from home, to reduce their work hours, and to experience work-to-family conflict, family-to-work conflict, and depressive and anxiety symptoms. A gender difference in depressive symptoms was observed among physician parents during the COVID-19 pandemic that was not present before the pandemic. This study suggests that pandemic conditions are associated with an increase in gender inequalities within medicine and signals the importance of further attention and resources to mitigate the potential adverse consequences for the careers and well-being of physician mothers. The COVID-19 pandemic has placed increased strain on health care workers and disrupted childcare and schooling arrangements in unprecedented ways. As substantial gender inequalities existed in medicine before the pandemic, physician mothers may be at particular risk for adverse professional and psychological consequences. To assess gender differences in work-family factors and mental health among physician parents during the COVID-19 pandemic. This prospective cohort study included 276 US physicians enrolled in the Intern Health Study since their first year of residency training. Physicians who had participated in the primary study as interns during the 2007 to 2008 and 2008 to 2009 academic years and opted into a secondary longitudinal follow-up study were invited to complete an online survey in August 2018 and August 2020. Work-family experience included 3 single-item questions and the Work and Family Conflict Scale, and mental health symptoms included the Patient Health Questionnaire–9 (PHQ-9) and Generalized Anxiety Disorder–7 scale. The primary outcomes were work-to-family and family-to-work conflict and depressive symptoms and anxiety symptoms during August 2020. Depressive symptoms between 2018 (before the COVID-19 pandemic) and 2020 (during the COVID-19 pandemic) were compared by gender. Among 215 physician parents who completed the August 2020 survey, 114 (53.0%) were female and the weighted mean (SD) age was 40.1 (3.57) years. Among physician parents, women were more likely to be responsible for childcare or schooling (24.6% [95% CI, 19.0%-30.2%] vs 0.8% [95% CI, 0.01%-2.1%]; P < .001) and household tasks (31.4% [95% CI, 25.4%-37.4%] vs 7.2% [95% CI, 3.5%-10.9%]; P < .001) during the pandemic compared with men. Women were also more likely than men to work primarily from home (40.9% [95% CI, 35.1%-46.8%] vs 22.0% [95% CI, 17.2%-26.8%]; P < .001) and reduce their work hours (19.4% [95% CI, 14.7%-24.1%] vs 9.4% [95% CI, 6.0%-12.8%]; P = .007). Women experienced greater work-to-family conflict (β = 2.79; 95% CI, 1.00 to 4.59; P = .03), family-to-work conflict (β = 3.09; 95% CI, 1.18-4.99; P = .02), and depressive (β = 1.76; 95% CI, 0.56-2.95; P = .046) and anxiety (β = 2.87; 95% CI, 1.49-4.26; P < .001) symptoms compared with men. We observed a difference between women and men in depressive symptoms during the COVID-19 pandemic (mean [SD] PHQ-9 score: 5.05 [6.64] vs 3.52 [5.75]; P = .009) that was not present before the pandemic (mean [SD] PHQ-9 score: 3.69 [5.26] vs 3.60 [6.30]; P = .86). This study found significant gender disparities in work and family experiences and mental health symptoms among physician parents during the COVID-19 pandemic, which may translate to increased risk for suicide, medical errors, and lower quality of patient care for physician mothers. Institutional and public policy solutions are needed to mitigate the potential adverse consequences for women’s careers and well-being.
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