In this study, we explored the level of humanistic care ability of mental health workers and its potential influencing factors during the COVID-19 pandemic.
We found that 79.8% of mental health workers have a low level of humanistic care ability, which is consistent with previous studies [12, 14]. Although medical education and clinical practice pay more and more attention to integrate the concept of humanistic care into personal ability development and clinical work practices (such as the establishment of patient-doctor relationship, patient treatment and rehabilitation, and colleague relations, etc.), and some progress has been made, but it is undeniable that drug therapy is still the subject of mental health [2, 27, 28]. In addition, Létourneau et al. [27] also pointed out that the doctors or nurses who have just entered the clinic may voice their desire to provide humane care and maintain the ideal of humanistic practice, but perhaps because of work overload or fear of crossing the ‘professional boundaries’ due to “too close” to their patient. There is a distance between their desire and practice, which hinders the further development of humanistic care ability. It must be mentioned that the “coercion” in psychiatry perpetuates power imbalances in care relationships, causes mistrust, exacerbates stigma and discrimination, which may cause service users to hide their true feelings and needs [23]. Health workers may become emotionally indifferent due to long-term care of patients with abnormal cognitive function, thus neglecting the patient's personality, dignity and satisfaction of needs. Therefore, it is difficult for mental health workers to establish a relationship of mutual trust with patients and conduct active and effective communication. Finally, during the COVID-19 pandemic, medical staff are faced with more work pressure, workload and burnout [29]. They are often powerless and difficult to achieve humane care. Previous studies [15, 30] have also pointed out that to maintain the humanistic spirit and practice, it is necessary to reduce work-related stress and burnout.
Interestingly, demographic variables in this study did not predict the humanistic care ability of mental health workers in every dimension, and work characteristics including work shift, work pressure, practice environmental satisfaction, salary satisfaction, work-family conflicts were not statistically significant after entering linear regression. This is different from previous studies. In a previous study [14], there were statistical differences in the humanistic care ability and sub-dimension scores of medical staff of different ages, education levels, and hospital levels. Although we cannot provide evidence-based reasons for this finding, we speculate that it may be due to the impact of the epidemic, such as changes in the working environment and priorities, service restructuring, remote counseling, measures to control infection risk, anxiety, depression and other negative emotions, and high workload [31], which caused mental health workers to have no time to take care of humanities during this period. Furthermore, the complexity of the healthcare environment, sample differences may also contribute to this result. In follow-up research, this may need to be further confirmed.
This research provides new directions for cultivating the humanistic care ability of mental health workers, that is, improving the level of psychological capital or adopting intervention measures to promote the change of personality traits that individuals want. psychological capital has a positive impact on the overall humanistic care ability and cognition, and patience. psychological capital is a positive psychological state during an individuals’ growth and development [32]. It can help individuals adapt to changing demands and demonstrate emotional stability when faced with adversity [32, 33]. Medical staff with high levels of psychological capital are more inclined to calmly and confidently solve the obstacles in the humane care process, and constantly seek the development of self-care ability. Meantime, they are more patient to explore the needs of themselves and others, and give care and support to the care recipients. In addition, previous studies have explored the positive effects of psychological capital, such as preventing burnout and reducing the negative effects of work pressure [34]. In other words, psychological capital can also indirectly promote the development of humanistic care ability.
Personality traits affect the individual's unique perception and response to the external environment, leading to different results. In this study, psychoticism has a negative impact on the overall humanistic care ability and three sub-dimensions; neuroticism is a negative factor for the overall humanistic care ability and courage; extroversion is a positive factor for the overall humanistic care ability, cognition, and courage. Extroverts are usually positive and optimistic. They are easy to build harmonious and stable interpersonal relationships at work, and communicate effectively with patients or colleagues [35], so as to understand the real needs of the care recipients. In addition, extroverts tend to view work positively, and are more courageous and responsible when solving various problems in the workplace. They are also more likely to feel more happiness, and this significantly predicts provision of spiritual care to patients [36]. People with high psychoticism scores may lack sympathy, carelessness or unkindness to others at work, and cannot integrate well into society or interpersonal relationships. For them, it may be difficult to establish emotional and interpersonal relationships with patients, and to listen to the patients' inner needs, or they may not have the patience to do this. People with high neuroticism scores are emotionally unstable and prone to negative emotional reactions such as anxiety. Their ability to withstand stress is weakened, and tend to amplify the importance of certain situations, thereby experiencing a higher degree of work overload [35], which hinders their humanistic practice to some extent. Also, neurotic medical workers tend to accumulate negative emotions and produce irrational thinking. They do not have the courage or ability to deal with unknown challenges and provide caring behaviors for patients.
This study has several limitations. First, we collected the data in a specific area, and whether the results can be generalized to other healthcare systems or territories with a different epidemic situation may need to be further verified by multi-center and large-sample studies in the future. Secondly, the cross-sectional design limits the inferences of causal relationships among the variables, and further longitudinal research may be required. Finally, self-report questionnaires, the results may be biased.