This study explored the level of humanistic care ability of mental health workers and its potential influencing factors. We found that mental health workers’ humanistic care ability was at a low level. Psychological capital and personality traits were significant predictors of humanistic care ability and its sub-dimensions, but social-demographic variables were not.
Our findings indicated that mental health workers had a low level of humanistic care ability, which is consistent with previous studies [12, 14]. Although medical education and clinical practice are increasingly focusing on integrating 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 [2, 27], and also made some progress. But it is undeniable that medication is still a theme in the field of mental health, ignoring a deeper and interpersonally rich paradigm of understanding and treating mental illness, such as empathetic and humanistic interventions [28, 29]. Furthermore, economic forces and commercial interests now drive the healthcare industry to focus on clinical productivity, efficiency, performance metrics and regulations, resulting in less time for mental health workers to meaningfully interact with patients and impeding humanistic culture [30]. Létourneau et al. [27] also pointed out that the doctors or nurses who have just entered the clinic may voice their desire to provide humanistic care and maintain the ideal of humanistic practice. However, 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]. Mental 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. As a result, it is difficult for mental health workers to establish a relationship of mutual trust and carry out positive and effective communication with patients. Finally, during the COVID-19 pandemic, mental health workers are faced with more work pressure, workload and burnout [31, 32]. They are often powerless and difficult to achieve humanistic care. Previous studies [15, 33] have also pointed to the need to reduce work-related stress and burnout to maintain the humanistic spirit and practice.
Interestingly, none of the social-demographic variables in this study predicted the humanistic care ability of mental health workers. 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 may be due to the impact of the epidemic, such as changes in the work environment and priorities, service restructuring, remote counseling, measures to control infection risk, anxiety, depression and other negative emotions, and high workload [34], which caused mental health workers to have no time to care for their patients 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 explored.
The study noted that psychological capital was positively correlated with humanistic care ability and its two dimensions (cognition and patience). Psychological capital is a positive psychological state during an individuals’ growth and development [35]. It can help individuals adapt to changing demands and demonstrate emotional stability when faced with adversity [35, 36]. Mental health workers 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 humanistic 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 [37]. In other words, psychological capital may also indirectly play a positive role in the development of humanistic care ability of mental health workers.
Another important finding in this study was that personality traits were significantly associated with humanistic care ability. Among them, psychoticism was negatively correlated with humanistic care ability and its three dimensions (cognition, courage and patience); neuroticism was negatively correlated with humanistic care ability and its one dimension (courage); extroversion was positively correlated with humanistic care ability and its two dimensions (cognition and courage). Personality traits affect the individual's unique perception and response to the external environment, leading to different results. 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 [38], 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 humanistic care to patients [39]. 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 [38], which hinders their humanistic practice to some extent. Also, neurotic medical workers tend to accumulate negative emotions and produce irrational thinking. They may 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.