Perceptions around occupational mental well-being of community health workers and an intervention package for its promotion: A mixed-methods study in rural Chiapas, Mexico
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引用次数: 0
Abstract
Background
The challenging working conditions experienced by community health workers (CHWs) have an impact on their mental health, as detected by the NGO Compañeros En Salud (CES) in rural Mexico. In response to this situation, CES designed through a participatory process a package of interventions to promote the mental well-being of CHWs, beginning implementation in 2021. The objective of the present study was to learn how CES CHWs' work affects their mental well-being and to evaluate the intervention package to promote CHWs’ mental well-being implemented by CES.
Methods
In June–August 2023, 52 CHWs from the CES-supported communities participated in the study, responding to a survey and participating in 10 focus group discussions. Quantitative data were analyzed using statistical descriptive analysis and qualitative data using thematic analysis.
Findings
Participants highlighted the impact on their communities as one of the main aspects of their job that contribute positively to their mental well-being, as well as the challenging work-life balance as one of the main aspects that contribute negatively. As for the interventions, most participants considered them significant and positive for their mental well-being, highlighting positive aspects such as the possibility of creating community with their peers or a feeling of self-efficacy. However, the access to interventions was uneven among participants and most interventions presented areas for improvement, such as the periodicity of psychological distress screening or the response time to material needs.
Conclusions
Efforts to support CHW well-being in the areas they signal as needs can impact their experiences around work and their perceived well-being. Access to work materials, preparedness on clinical topics, and relationships with their teams are key areas that may have a bearing on CHWs' emotional and mental well-being. Interventions aimed at these areas can positively impact CHWs’ self-efficacy, their community with each other, and their interactions with patients.
背景正如非政府组织 "Compañeros En Salud(CES)"在墨西哥农村地区所发现的那样,社区医疗工作者(CHWs)所经历的具有挑战性的工作条件对他们的心理健康产生了影响。针对这种情况,CES 通过参与式过程设计了一套干预措施,以促进社区卫生工作人员的心理健康,并于 2021 年开始实施。本研究的目的是了解 CES 社区保健工作者的工作如何影响他们的心理健康,并对 CES 实施的促进社区保健工作者心理健康的一揽子干预措施进行评估。研究结果参与者强调,对社区的影响是其工作中对心理健康有积极影响的主要方面之一,而具有挑战性的工作与生活平衡则是对心理健康有消极影响的主要方面之一。至于干预措施,大多数参与者认为这些措施对其心理健康具有重要和积极的意义,并强调了一些积极的方面,如与同龄人建立社区的可能性或自我效能感。然而,参与者获得干预措施的情况参差不齐,大多数干预措施都有需要改进的地方,如心理困扰筛查的周期性或对物质需求的响应时间。工作材料的获取、临床课题的准备以及与团队的关系是可能影响社区保健工作者情绪和心理健康的关键领域。针对这些方面的干预措施可以对社区保健工作者的自我效能感、他们之间的社区关系以及他们与患者之间的互动产生积极影响。