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2010年日本宫崎口蹄疫疫情期间及疫情刚结束后现场兽医的身心困扰

Mental and physical distress of field veterinarians during and soon after the 2010 foot and mouth disease outbreak in Miyazaki, Japan.

作者信息

Makita K, Tsuji A, Iki Y, Kurosawa A, Kadowaki H, Tsutsumi A, Nogami T, Watari M

出版信息

Rev Sci Tech. 2015 Dec;34(3):699-712. doi: 10.20506/rst.34.3.2387.

Abstract

An outbreak of foot and mouth disease occurred in Miyazaki, Japan, in April 2010, and nearly 290,000 animals were culled to control the disease. This study was conducted to demonstrate the causes and intensity of mental distress felt by the field veterinarians participating in the control programme. A focus group discussion was conducted with ten veterinarians to understand their distress during the outbreak, and a questionnaire to quantify the degree of distress experienced each week was administered to 16 veterinarians. A detailed questionnaire was separately administered to 70 veterinarians six months after the outbreak was controlled, to assess mental distress status and to identify the risk factors for serious mental illness (SMI) using the six-item Kessler scale (K6). Overall, mental distress (mean 3.1) was significantly greater than physical distress (mean 1.9, p < 0.001). The risk factors for mental distress were categorised into three groups: culling, communication with farmers, and gender; each category was qualitatively described. Only two respondents (2.9%) had high K6 scores suggesting SMI. In the final generalised linear models with quasi-Poisson errors, the riskfactorsfor SMI that remained were: disinfecting vehicles (p = 0.01), distress (p <0.001), and increased alcohol consumption (p = 0.057), and a protective factor: participation in culling (p = 0.07), which suggested healthy worker bias. Sensitive individuals had been allocated to non-culling activities during disease control. In conclusion, human resource management was adequate during the outbreak from a public-health perspective. However, monitoring delayed symptoms of post-traumatic stress disorder is recommended.

摘要

2010年4月,日本宫崎县爆发了口蹄疫,为控制疫情,近29万头牲畜被扑杀。本研究旨在揭示参与防控计划的现场兽医所感受到的精神痛苦的原因及程度。我们与10名兽医进行了焦点小组讨论,以了解他们在疫情期间的痛苦,并向16名兽医发放了问卷,以量化他们每周所经历的痛苦程度。在疫情得到控制6个月后,我们又向70名兽医单独发放了一份详细问卷,以评估他们的精神痛苦状况,并使用6项凯斯勒量表(K6)来确定严重精神疾病(SMI)的风险因素。总体而言,精神痛苦(平均3.1)显著高于身体痛苦(平均1.9,p<0.001)。精神痛苦的风险因素分为三类:扑杀、与养殖户的沟通以及性别;并对每一类进行了定性描述。只有两名受访者(2.9%)K6得分较高,提示患有严重精神疾病。在最终的具有拟泊松误差的广义线性模型中,仍存在的严重精神疾病风险因素为:对车辆进行消毒(p=0.01)、痛苦(p<0.001)以及酒精摄入量增加(p=0.057),还有一个保护因素:参与扑杀(p=0.07),这表明存在健康工人偏倚。在疾病控制期间,敏感个体被分配到非扑杀活动中。总之,从公共卫生角度来看,疫情期间的人力资源管理是充分的。然而,建议监测创伤后应激障碍的延迟症状。

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