Coping strategies used by migrant healthcare workers to support their mental health during COVID-19 in the United Kingdom: a qualitative analysis

<b>Background:</b> The incidence of mental illness has risen since the coronavirus disease 2019 (COVID-19) pandemic. The number of healthcare workers (HCWs) needing mental health support has increased significantly. <b>Objective:</b> This secondary analysis of qualitative data explored the coping strategies of migrant HCWs living in the UK during the COVID-19 pandemic. Our aim was to identify the coping strategies used by migrant HCWs, and how they could be explored post-pandemic as support mechanisms of an increasingly diverse workforce. <b>Method:</b> As part of the United Kingdom Research study into Ethnicity And COVID-19 outcomes among Healthcare workers (UK-REACH), we conducted in-depth semi-structured interviews and focus groups with clinical and non-clinical HCWs across the UK, on Microsoft Teams, from December 2020 to July 2021. We conducted a thematic analysis using Braun and Clarke’s framework to explore the lived experiences of HCWs born overseas and living in the UK during the COVID-19 pandemic. The key themes that emerged were described using Lazarus and Folkman’s transactional model of stress and coping. <b>Results:</b> The emerging themes include stressors (situation triggering stress), appraisal (situation acknowledged as a source of stress), emotion-focused coping (family and social support and religious beliefs), problem-focused coping (engaging in self-care, seeking and receiving professional support), and coping strategy outcomes. The participants described the short-term benefit of the coping strategies as a shift in focus from COVID-19, which reduced their anxiety and stress levels. However, the long-term impact is unknown. <b>Conclusion:</b> We found that some migrant HCWs struggled with their mental health and used various coping strategies during the pandemic. With an increasingly diverse healthcare workforce, it will be beneficial to explore how coping strategies (family and social support networks, religion, self-care, and professional support) could be used in the future and how occupational policies and infrastructure can be adapted to support these communities. Migrant (non-UK-born) HCWs used various coping strategies to sustain their mental health during the COVID-19 pandemic.The study conceptualized the coping mechanisms that enabled participants to cope with the COVID-19 pandemic crisis, using Lazarus and Folkman's transactional model of stress and coping.Future research should explore whether short-term gains due to coping during the pandemic were maintained in the long term. Migrant (non-UK-born) HCWs used various coping strategies to sustain their mental health during the COVID-19 pandemic. The study conceptualized the coping mechanisms that enabled participants to cope with the COVID-19 pandemic crisis, using Lazarus and Folkman's transactional model of stress and coping. Future research should explore whether short-term gains due to coping during the pandemic were maintained in the long term.

<b>研究背景：</b>自2019冠状病毒病（COVID-19）大流行以来，精神疾病的发病率呈上升趋势，需要精神健康支持的医护人员（healthcare workers, HCWs）数量显著增加。<b>研究目的：</b>本项质性数据二次分析，旨在探究2019冠状病毒病大流行期间旅居英国的移民医护人员的应对策略。本研究旨在明确移民医护人员所采用的应对策略，并探讨在后疫情时代，如何将这些策略作为支撑日益多元化医护从业人员队伍的支持机制。<b>研究方法：</b>作为“英国医护人员种族与COVID-19预后研究”（United Kingdom Research study into Ethnicity And COVID-19 outcomes among Healthcare workers, UK-REACH）的子研究，本研究于2020年12月至2021年7月期间，通过微软Teams（Microsoft Teams）平台对英国境内的临床与非临床医护人员开展半结构化深度访谈与焦点小组讨论。本研究采用布朗与克拉克（Braun and Clarke）的分析框架开展主题分析，以探究海外出生、旅居英国的医护人员在2019冠状病毒病大流行期间的亲身经历，并借助拉扎勒斯与弗克曼（Lazarus and Folkman）的压力与应对交易模型对核心主题进行阐释。<b>研究结果：</b>本研究提炼出的核心主题包括：压力源（触发压力的情境）、评估（将情境识别为压力来源）、聚焦情绪的应对策略（家庭与社会支持及宗教信仰）、聚焦问题的应对策略（开展自我护理、寻求并获取专业支持），以及应对策略的相关结局。受试者表示，此类应对策略的短期效益在于将注意力从2019冠状病毒病疫情中转移，从而缓解了自身的焦虑与压力水平，但长期影响尚不明晰。<b>研究结论：</b>本研究发现，部分移民医护人员在大流行期间存在心理健康困境，并采用了多种应对策略以维持心理健康。随着医护从业人员队伍日益多元化，未来可进一步探索如何将此类应对策略（家庭与社会支持网络、宗教信仰、自我护理及专业支持）应用于临床实践，以及如何调整职业政策与配套设施以支持此类群体。本研究借助拉扎勒斯与弗克曼的压力与应对交易模型，对帮助受试者应对2019冠状病毒病大流行危机的应对机制进行了概念化阐释。未来研究应探究疫情期间通过应对策略获得的短期收益能否在长期得以维持。移民（非英国出生）医护人员在2019冠状病毒病大流行期间采用了多种应对策略以维持自身心理健康。本研究借助拉扎勒斯与弗克曼的压力与应对交易模型，对帮助受试者应对2019冠状病毒病大流行危机的应对机制进行了概念化阐释。未来研究应探究疫情期间通过应对策略获得的短期收益能否在长期得以维持。