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武汉市某三级急症医院 COVID-19 感染医护人员对感染传播途径的认知、感染控制措施、心理社会变化及管理:一项横断面调查。

Perceived infection transmission routes, infection control practices, psychosocial changes, and management of COVID-19 infected healthcare workers in a tertiary acute care hospital in Wuhan: a cross-sectional survey.

机构信息

Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China.

Department of Evidence-Based Medicine and Clinical Epidemiology, The Second Clinical College, Wuhan University, Wuhan, 430071, Hubei, China.

出版信息

Mil Med Res. 2020 May 11;7(1):24. doi: 10.1186/s40779-020-00254-8.

Abstract

BACKGROUND

Many healthcare workers were infected by coronavirus disease 2019 (COVID-19) early in the epidemic posing a big challenge for epidemic control. Hence, this study aims to explore perceived infection routes, influencing factors, psychosocial changes, and management procedures for COVID-19 infected healthcare workers.

METHODS

This is a cross-sectional, single hospital-based study. We recruited all 105 confirmed COVID-19 healthcare workers in the Zhongnan Hospital of Wuhan University from February 15 to 29, 2020. All participants completed a validated questionnaire. Electronic consent was obtained from all participants. Perceived causes of infection, infection prevention, control knowledge and behaviour, psychological changes, symptoms and treatment were measured.

RESULTS

Finally, 103 professional staff with COVID-19 finished the questionnaire and was included (response rate: 98.1%). Of them, 87 cases (84.5%) thought they were infected in working environment in hospital, one (1.0%) thought their infection was due to the laboratory environment, and 5 (4.9%) thought they were infected in daily life or community environment. Swab of throat collection and physical examination were the procedures perceived as most likely causing their infection by nurses and doctors respectively. Forty-three (41.8%) thought their infection was related to protective equipment, utilization of common equipment (masks and gloves). The top three first symptoms displayed before diagnosis were fever (41.8%), lethargy (33.0%) and muscle aches (30.1%). After diagnosis, 88.3% staff experienced psychological stress or emotional changes during their isolation period, only 11.7% had almost no emotional changes. Arbidol (Umifenovir; an anti-influza drug; 69.2%) was the drug most commonly used to target infection in mild and moderate symptoms.

CONCLUSION

The main perceived mode of transmission was not maintaining protection when working at a close distance and having intimate contact with infected cases. Positive psychological intervention is necessary.

摘要

背景

许多医护人员在疫情早期感染了 2019 年冠状病毒病(COVID-19),这对疫情防控构成了巨大挑战。因此,本研究旨在探讨 COVID-19 感染医护人员的感染途径、影响因素、心理社会变化和管理程序。

方法

这是一项横断面、单中心的研究。我们于 2020 年 2 月 15 日至 29 日招募了武汉大学中南医院的 105 例确诊 COVID-19 医护人员。所有参与者均完成了一份经过验证的问卷。所有参与者均获得电子同意。测量了感染的感知原因、感染预防、控制知识和行为、心理变化、症状和治疗。

结果

最终,103 名感染 COVID-19 的专业人员完成了问卷并被纳入(应答率:98.1%)。其中,87 例(84.5%)认为他们在医院工作环境中感染,1 例(1.0%)认为他们的感染是由于实验室环境造成的,5 例(4.9%)认为他们在日常生活或社区环境中感染。护士和医生分别认为咽拭子采集和体格检查是最有可能导致他们感染的程序。43 例(41.8%)认为他们的感染与防护设备有关,与使用常见设备(口罩和手套)有关。诊断前出现的前三种主要症状是发热(41.8%)、乏力(33.0%)和肌肉疼痛(30.1%)。诊断后,88.3%的工作人员在隔离期间经历了心理压力或情绪变化,只有 11.7%的工作人员几乎没有情绪变化。阿比多尔(盐酸阿比多尔;一种抗流感病毒药物;69.2%)是针对轻度和中度症状感染最常用的药物。

结论

主要的感知传播模式是在近距离工作时未能保持保护以及与感染病例进行密切接触。有必要进行积极的心理干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1a6/7212578/5b1d74c562e5/40779_2020_254_Fig1_HTML.jpg

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