Department of Neurology, The Third Affiliated Hospital of Chongqing Medical University, 1 Shuanghu Road, Chongqing 401120, China.
Department of Cardiology, General Hospital of Chongqing Group, Chongqing 400000, China.
Compr Psychiatry. 2020 Nov;103:152198. doi: 10.1016/j.comppsych.2020.152198. Epub 2020 Aug 12.
Hospital staff are vulnerable and at high risk of novel coronavirus disease (COVID-19) infection. The aim of this study was to monitor the psychological distress in hospital staff and examine the relationship between the psychological distress and possible causes during the COVID-19 epidemic.
An online survey was conducted from February 1 to February 14, 2020. Hospital staff from five national COVID-19 designated hospitals in Chongqing participated. Data collected included demographics and stress responses to COVID-19: 1) the impact of event scale to measure psychological stress reactions; 2) generalizedanxietydisorder 7 to measure anxiety symptoms; 3) Patient Health Questionnaire 9 to measure depression symptoms; 4) Yale-Brown Obsessive-Compulsive Scale to measure obsessive-compulsive symptoms (OCS); and 5) Patient Health Questionnaire 15 to measure somatization symptoms. Multiple logistic regression analysis was used to identify factors that were correlated with psychological distress.
Hospital staff that participated in this study were identified as either doctors or nurses. A total of 456 respondents completed the questionnaires with a response rate of 91.2%. The mean age was 30.67 ± 7.48 years (range, 17 to 64 years). Of all respondents, 29.4% were men. Of the staff surveyed, 43.2% had stress reaction syndrome. The highest prevalence of psychological distress was OCS (37.5%), followed by somatization symptoms (33.3%), anxiety symptoms (31.6%), and depression symptoms (29.6%). Univariate analyses indicated that female subjects, middle aged subjects, subjects in the low income group, and subjects working in isolation wards were prone to experience psychological distress. Multiple logistic regression analysis showed "Reluctant to work or considered resignation" (odds ratio [OR], 5.192; 95%CI, 2.396-11.250; P < .001), "Afraid to go home because of fear of infecting family" (OR, 2.099; 95%CI, 1.299-3.391; P = .002) "Uncertainty about frequent modification of infection and control procedures" (OR, 1.583; 95%CI, 1.061-2.363; P = .025), and"Social support" (OR, 1.754; 95%CI, 1.041-2.956; P = .035) were correlated with psychological reactions. "Reluctant to work or considered resignation" and "Afraid to go home because of fear of infecting family" were associated with a higher risk of symptoms of Anxiety (OR, 3.622; 95% CI, 1.882-6.973; P < .001; OR, 1.803; 95% CI, 1.069-3.039; P = .027), OCS (OR, 5.241; 95% CI, 2.545-10.793; P < .001; OR, 1.999; 95% CI, 1.217-3.282; P = .006) and somatization (OR, 5.177; 95% CI, 2.595-10.329; P < .001; OR, 1.749; 95% CI, 1.051-2.91; P = .031). "Stigmatization and rejection in neighborhood because of hospital work", "Reluctant to work or considered resignation" and "Uncertainty about frequent modification of infection and control procedures" were associated with a higher risk of symptoms of Depression(OR, 2.297; 95% CI, 1.138-4.637; P = .020; OR, 3.134; 95% CI, 1.635-6.006; P = .001; OR, 1.645; 95% CI, 1.075-2.517; P = .022).
Hospital staff showed different prevalence of psychological distress during the COVID-19 epidemic. Our study confirmed the severity of negative psychological distress on hospital staff and identified factors associated with negative psychological distress that can be used to provide valuable information for psychological interventions to improve the mental health of vulnerable groups during the COVID-19 epidemic.
医院工作人员易感染新型冠状病毒病(COVID-19),且属于高危人群。本研究旨在监测 COVID-19 流行期间医院工作人员的心理困扰,并探讨其与可能原因之间的关系。
于 2020 年 2 月 1 日至 2 月 14 日开展在线调查,参与的医院为重庆市 5 家国家 COVID-19 定点医院。收集的数据包括人口统计学信息和对 COVID-19 的应激反应:1)事件影响量表评估心理应激反应;2)广泛性焦虑障碍 7 项量表评估焦虑症状;3)患者健康问卷 9 项量表评估抑郁症状;4)耶鲁-布朗强迫症量表评估强迫症状;5)患者健康问卷 15 项量表评估躯体化症状。采用多因素逻辑回归分析确定与心理困扰相关的因素。
参与研究的医院工作人员包括医生和护士。共有 456 名受访者完成了问卷调查,应答率为 91.2%。平均年龄为 30.67±7.48 岁(范围 17 至 64 岁),其中 29.4%为男性。43.2%的医护人员出现应激反应综合征。心理困扰中强迫症的患病率最高(37.5%),其次是躯体化症状(33.3%)、焦虑症状(31.6%)和抑郁症状(29.6%)。单因素分析表明,女性、中年、低收入和隔离病房工作的医护人员更容易出现心理困扰。多因素逻辑回归分析显示,“不愿意工作或考虑辞职”(比值比[OR],5.192;95%置信区间[CI],2.396-11.250;P<0.001)、“因担心感染家人而不敢回家”(OR,2.099;95%CI,1.299-3.391;P=0.002)、“对频繁修改感染防控程序感到不确定”(OR,1.583;95%CI,1.061-2.363;P=0.025)和“社会支持”(OR,1.754;95%CI,1.041-2.956;P=0.035)与心理反应相关。“不愿意工作或考虑辞职”和“因担心感染家人而不敢回家”与焦虑症状(OR,3.622;95%CI,1.882-6.973;P<0.001;OR,1.803;95%CI,1.069-3.039;P=0.027)、强迫症(OR,5.241;95%CI,2.545-10.793;P<0.001;OR,1.999;95%CI,1.217-3.282;P=0.006)和躯体化症状(OR,5.177;95%CI,2.595-10.329;P<0.001;OR,1.749;95%CI,1.051-2.91;P=0.031)的风险较高相关。“因医院工作而受到邻里的污名化和排斥”、“不愿意工作或考虑辞职”和“对频繁修改感染防控程序感到不确定”与抑郁症状的风险较高相关(OR,2.297;95%CI,1.138-4.637;P=0.020;OR,3.134;95%CI,1.635-6.006;P=0.001;OR,1.645;95%CI,1.075-2.517;P=0.022)。
COVID-19 流行期间,医院工作人员出现不同程度的心理困扰。本研究证实了 COVID-19 流行期间医护人员的负面心理困扰的严重程度,并确定了与负面心理困扰相关的因素,这些因素可以为 COVID-19 流行期间弱势群体的心理干预提供有价值的信息。