Psychological distress among healthcare workers in Kabul following the 2021 transition.

IF 3.4 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Conflict and Health Pub Date : 2025-08-08 DOI:10.1186/s13031-025-00702-z

Shoaib Naeemi, Sayed Murtaza Sadat Hofiani, Ahmad Komail Frogh, Said Mohammad Rahim Niazy, Ali Mirzazadeh, Said Iftekhar Sadaat, Narges Neyazi

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Abstract

Background: Healthcare workers (HCWs) in conflict and post-conflict settings are particularly susceptible to psychological distress due to persistent occupational stress and limited systemic support. This study examined the prevalence of psychological distress among HCWs in Kabul, Afghanistan, in the wake of the political changes in August 2021.

Methods: A cross-sectional survey study was conducted from September to October 2021 in 16 public tertiary hospitals in Kabul. The Afghan Symptoms Checklist (ASCL) was used to assess psychological distress and its related symptoms. Multivariable analysis using Generalized Linear Model (GLM) was performed to find the associated factors of psychological distress utilizing STATA 18.

Results: A total of 277 HCWs participated in the study, with 48.4% identifying as female. Approximately 62% had considered leaving Afghanistan, and 64% had witnessed colleagues emigrate. The overall prevalence of psychological distress was 25% (CI 95%: 19.9-30.6), with stress-induced reactivity as the most prevalent symptom (35%, CI 95%: 29.8-41.4). Female HCWs were significantly more likely to report sadness with social withdrawal and somatic distress (POR = 2.32, CI 95%: 1.07-5.02, p = 0.03) and stress-induced reactivity (POR = 2.56, CI 95%: 1.22-5.44, p = 0.013). A lack of optimism about the future was associated with higher odds of stress-induced reactivity (POR = 3.14, CI 95%: 1.55-6.38, p = 0.001), ruminative sadness without withdrawal (POR = 3.05, CI 95%: 1.68-6.24, p = 0.002), and sadness with withdrawal and somatic distress (POR = 3.73, CI 95%: 1.71-8.13, p = 0.001).

Conclusion: One in four HCWs reported psychological distress, with stress-induced reactivity being the most common symptom. Female gender and pessimism about the future were key associated factors of elevated distress. The findings highlight the critical need for long-term mental health support programs specifically designed for HCWs, broader support within the health system, and continued research into how HCWs cope and build resilience.

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2021年过渡后喀布尔医护人员的心理困扰。

背景：由于持续的职业压力和有限的系统支持，冲突和冲突后环境中的卫生保健工作者（HCWs）特别容易受到心理困扰。本研究调查了2021年8月政治变革后，阿富汗喀布尔医护人员心理困扰的普遍程度。方法：于2021年9月至10月对喀布尔16所公立三级医院进行横断面调查研究。使用阿富汗症状检查表（ASCL）评估心理困扰及其相关症状。采用广义线性模型（GLM）进行多变量分析，利用STATA 18找出心理困扰的相关因素。结果：共有277名医护人员参与研究，其中女性占48.4%。大约62%的人考虑过离开阿富汗，64%的人目睹过同事移民。心理困扰的总体患病率为25% (CI 95%: 19.9-30.6)，压力诱发的反应性是最常见的症状（35%,CI 95%: 29.8-41.4）。女性HCWs更有可能报告悲伤伴社交退缩和躯体痛苦（POR = 2.32, CI 95%: 1.07-5.02, p = 0.03）和应激性反应（POR = 2.56, CI 95%: 1.22-5.44, p = 0.013）。对未来缺乏乐观与压力诱发的反应（POR = 3.14, CI 95%: 1.55-6.38, p = 0.001）、无戒断的反思性悲伤（POR = 3.05, CI 95%: 1.68-6.24, p = 0.002）以及伴有戒断和躯体痛苦的悲伤（POR = 3.73, CI 95%: 1.71-8.13, p = 0.001）的几率较高相关。结论：四分之一的医护人员报告了心理困扰，压力诱发的反应是最常见的症状。女性的性别和对未来的悲观情绪是增加痛苦的关键相关因素。研究结果强调，迫切需要专门为卫生保健工作者设计的长期心理健康支持方案，在卫生系统内提供更广泛的支持，并继续研究卫生保健工作者如何应对和建立复原力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Conflict and Health Medicine-Public Health, Environmental and Occupational Health

CiteScore

6.10

自引率

5.60%

发文量

审稿时长

18 weeks

期刊介绍： Conflict and Health is a highly-accessed, open access journal providing a global platform to disseminate insightful and impactful studies documenting the public health impacts and responses related to armed conflict, humanitarian crises, and forced migration.