Key Points Question What have been the range of concerns and the sources of distress among health care workers in Canada as the COVID-19 pandemic has evolved? Findings In this qualitative study of a public online COVID-19 forum available for 21 555 employees in a university health network, common concerns relating to the pandemic included risks of contamination, appropriate personal protective equipment, and worker safety. Although these concerns manifested as individual distress, they also intersected with and were reflective of concerns relating to health care institutions’ policies, communication practices, and politics. Meaning The findings suggest that a mismatch between institutional sources of concern and individual-level interventions may affect the uptake of mental health supports even as the level of distress remains high. Importance Mental health and coping difficulties among health care workers (HCWs) have been reported during pandemics and particularly during the COVID-19 pandemic. Objective To examine sources of distress and concern for HCWs in Canada during the COVID-19 pandemic. Design, Setting, and Participants In this qualitative study, a critical discourse analysis was performed of questions posed by HCWs to hospital senior leadership between March 16, 2020, and December 1, 2020, through an online employee forum as part of a larger mixed-methods evaluation of a stepped-care mental health support program for HCWs at 1 of Canada’s largest health care institutions. Questions could be submitted online anonymously in advance of the virtual forums on COVID-19 by any of the University Health Network’s 21 555 employees, and staff members were able to anonymously endorse questions by upvoting , indicating that an already posed question was of interest. Main Outcomes and Measures Themes, text structure, and rhetorical devices used within the questions were analyzed, taking into consideration their larger institutional and societal context. Results Unique individual views of the forums ranged from 2062 to 7213 during the study period. Major individual-level concerns related to risks of contamination and challenges coping with increased workloads as a result of the pandemic intersected with institutional-level challenges, such as feeling or being valued within the health care setting and long-standing stratifications between types of HCWs. Concerns were frequently reported in terms of calls for clarity or demands for transparency from the institutional leadership. Conclusions and Relevance The findings of this qualitative study suggest that larger institutional-level and structural concerns need to be addressed if HCWs are to be engaged in support and coping programs. Potential service users may be dissuaded from seeing their needs as being met by workplace mental health interventions that solely relate to individual-level concerns. This qualitative analysis uses an online COVID-19 forum available to employees at a large health care institution to examine sources of distress and concern for health care workers in Canada during the COVID-19 pandemic.
【초록키워드】 COVID-19, Stratification, Personal protective equipment, pandemic, mental health, COVID-19 pandemic, hospital, risk, Intervention, Contamination, Health, HCWs, Pandemics, Health care worker, concern, Canada, university, Care, Critical, Analysis, distress, HCW, Major, Support, study period, measure, participant, finding, Affect, objective, setting, Result, analyzed, reported, was performed, question, submitted, manifested, Importance, addressed, Potential, ranged, anonymously, Point, Relevance, 【제목키워드】 COVID-19, Qualitative, concern, Canada, individual, worker,