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中国不同岗位医务人员在 2019 冠状病毒病(COVID-19)疫情中的心理影响:一项多中心研究。

Psychological impact of coronavirus disease (2019) (COVID-19) epidemic on medical staff in different posts in China: A multicenter study.

机构信息

Department of Infection, Jinan Infectious Disease Hospital, Cheeloo College of Medicine, Shandong University, China.

Department of Infectious Disease and Hepatology, The Second Hospital, Cheeloo College of Medicine, Shandong University, China.

出版信息

J Psychiatr Res. 2020 Oct;129:198-205. doi: 10.1016/j.jpsychires.2020.07.008. Epub 2020 Jul 14.

Abstract

OBJECTIVE

An outbreak of coronavirus disease 2019 (COVID-19) is a public health emergency of international concern and poses a big challenge to medical staff and general public. The aim is to investigate psychological impact of COVID-19 epidemic on medical staff in different working posts in China, and to explore the correlation between psychological disorder and the exposure to COVID-19.

METHODS

A multicenter WeChat-based online survey was conducted among medical staff in China between 26 February and 3 March 2020. Medical staff deployed to Hubei province from other provinces and medical staffs in different posts outside Hubei were selected to represent diverse exposure intensities to the threat of COVID-19. Anxiety, depression, sleep quality, stress and resilience were evaluated using scales including GAD-7, PHQ-9, PSQI, PSS-14, and CD-RISC-10. Latent class analysis was performed to identify potential staff requiring psychological support.

RESULTS

A total of 274 respondents were included, who serving at 4 posts as follows, staff backing Hubei province, isolation wards outside Hubei, fever clinic and infectious disease department, and other departments outside Hubei. The total scores of anxiety, depression, sleep quality and stress were statistically different among groups, meanwhile an increasing tendency of anxiety, depression and sleep quality scores with increasing risk of exposure to COVID-19 was found (p < 0.05). Subsequent post-hoc analysis indicated that the staff backing Hubei had higher scores of anxiety, depression, sleep quality and perceived stress (adjusted p < 0.05). The combined prevalence of anxiety, depression and insomnia of staff backing Hubei reached as high as 38%. Four-class latent class analysis showed 3 categories of population (69.4%) may need psychological support.

CONCLUSIONS

High prevalence of anxiety, depression and insomnia exist in medical staff related to COVID-19. The higher the probability and intensity of exposure to COVID-19 patients, the greater the risk that medical staff will suffer from mental disorders, suggesting continuous and proper psychiatric intervention are needed.

摘要

目的

2019 年冠状病毒病(COVID-19)疫情是国际关注的突发公共卫生事件,给医护人员和公众带来了巨大挑战。本研究旨在调查 COVID-19 疫情对中国不同岗位医护人员的心理影响,并探讨心理障碍与接触 COVID-19 的相关性。

方法

本研究采用多中心微信在线调查的方式,于 2020 年 2 月 26 日至 3 月 3 日期间对中国医护人员进行调查。选择从外省支援湖北和未支援湖北的不同岗位医护人员来代表不同的 COVID-19 威胁暴露强度。采用 GAD-7、PHQ-9、PSQI、PSS-14 和 CD-RISC-10 量表评估焦虑、抑郁、睡眠质量、压力和韧性。采用潜在类别分析识别需要心理支持的潜在人群。

结果

共纳入 274 名受访者,他们分别在以下 4 个岗位工作:支援湖北的人员、非湖北的隔离病房、发热门诊和传染病科以及非湖北的其他科室。各组焦虑、抑郁、睡眠质量和压力总分存在统计学差异,且随着接触 COVID-19 风险的增加,焦虑、抑郁和睡眠质量评分呈上升趋势(p<0.05)。随后的事后分析表明,支援湖北的人员焦虑、抑郁、睡眠质量和感知压力得分更高(调整后 p<0.05)。支援湖北人员的焦虑、抑郁、睡眠质量和失眠综合患病率高达 38%。4 类潜在类别分析显示,有 3 类人群(69.4%)可能需要心理支持。

结论

与 COVID-19 相关的医护人员中存在较高的焦虑、抑郁和失眠患病率。接触 COVID-19 患者的概率和强度越高,医护人员出现精神障碍的风险越大,提示需要持续和适当的精神科干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3dd6/7834267/cd9075f70a24/gr1_lrg.jpg

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