番茄社区

Healthcare workers were less likely to be grossed out by things that might make others queasy, British researchers found.

In a small, non-peer-reviewed study, people who worked in care homes had lower levels of self-reported disgust and were less likely to look away from unpleasant images than controls who didn't work in healthcare, reported Edwin Dalmaijer, DPhil, of the University of Bristol in England, and colleagues in .

Some of those images included "heavily soiled toilets and bloody bandages," Dalmaijer told 番茄社区 in an email. While the control group "preferred not to look at the types of disgusting materials one would find around a care home," he said, "healthcare assistants showed no such avoidance."

"We interpreted this as evidence for the idea that they had habituated to familiar disgust elicitors over a long period [of] months to years," Dalmaijer added.

While Dalmaijer cautioned that the study had a small sample size and thus the work should be seen as preliminary, healthcare workers related to the early findings. Gerard Brogan, RN, director of nursing practice for National Nurses United, said working in conditions that others might find hard to stomach is "just part of the job."

"The fact that nurses are not particularly bothered about it is a real testament to the nursing ethos and the profession as a whole, in that this is giving unconditional love to complete strangers," Brogan told 番茄社区.

Brogan said nurses take pride in managing difficult situations while ensuring patients maintain their dignity. He cited an example from early in his 42-year career of a patient with multiple sclerosis who required manual evacuation of his feces.

"We chatted throughout the whole process, and I don't think he felt embarrassed," Brogan said. "It's an aspect of our role that we take very seriously."

Dalmaijer and his team got the idea for the research when Charlotte Edgar, MSc, a student and study co-author, had reached out to him about his on how short-term disgust habituation "just does not happen," he said. Edgar worked in a care home as she was doing her master's in psychology, and "firmly believed that it HAD happened in herself because of her work," Dalmaijer said. "Obviously, we had to test this!"

So they enrolled 32 healthcare assistants (about two-thirds female) from U.K. care homes, who'd been working there for an average of 2 years, and compared them with 50 controls who didn't work in healthcare.

For the first part of their study, the researchers used the , which had 21 items equally divided between three subscales of pathogen, sexual, and moral disgust sensitivity. They also conducted a behavioral disgust avoidance task, which involved repeatedly looking at two images side-by-side -- one that was disgusting, and another that was neutral -- and tracking where participants looked.

Overall, they found that self-reported pathogen disgust sensitivity was lower for care workers than controls -- but there was no difference in self-reported sexual or moral disgust sensitivity between the two groups.

In the image task, they found no disgust avoidance among care workers, but disgust avoidance was "pronounced" in the control group, who showed far longer "dwell time" on neutral images rather than disgusting images, while care workers showed no bias toward either image, they reported.

"What was very surprising to me -- but, credit where it's due, predicted by Charlotte -- is that healthcare assistants also showed no avoidance of disgust elicitors that they wouldn't be as familiar with," Dalmaijer said. "We interpreted this as evidence that their disgust habituation had generalized beyond the context of their work."

The researchers also saw a significant correlation between the number of months care workers were on the job and self-reported pathogen disgust, "suggesting long-term habituation," they wrote.

The study was limited by its cross-sectional nature, as it may be influenced by selection bias, the researchers noted.

"We know that those who choose to do work in certain medical disciplines are less disgust sensitive to begin with, and it's not inconceivable that people who are more disgust sensitive are more likely to exit the profession at some point in their career," Dalmaijer said.

He added that he and another colleague found in a double-blind, placebo-controlled trial in that the anti-emetic domperidone, which "works on the stomach but barely crosses the blood-brain barrier," reduced disgust avoidance. "The fact that it worked suggests the stomach itself is involved in disgust avoidance behavior," Dalmaijer said.

Nurses who've been in the profession a while will likely say they don't need help from anti-emetics. Brogan recalled working at a hospital in New York City in the early days of the HIV/AIDS epidemic.

"It was a death sentence back then, and it was a particularly ugly way to die, because it affected all your body systems," he said. "But we were very careful to use the human touch with these patients. We let them know, 'At least here, you were not pariahs. We weren't scared of catching AIDS from you. We will give you unconditional love, which is what nursing is at heart.'"

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