Columbia-WHO Center for Global Mental Health, Department of Psychiatry, Columbia University Irving Medical Center, New York.
Psychiatr Serv. 2020 Dec 1;71(12):1260-1269. doi: 10.1176/appi.ps.202000274. Epub 2020 Oct 6.
This rapid review addresses two key questions posed by the COVID-19 pandemic: What are the anticipated mental health sequelae for frontline health workers? and What are best practices during health emergencies to address the mental health needs of these workers?
This review synthesized the literature on the mental health sequelae for health workers during major pandemics and epidemics that occurred in the 21st century (severe acute respiratory syndrome, Middle East respiratory syndrome, Ebola virus disease, and swine flu) and interventions used to address related mental health sequelae. PubMed, MEDLINE, and PsycINFO were searched with terms related to these epidemics/pandemics.
Of 3,876 articles retrieved, 94 were included in this review. Across these studies, most health workers exhibited some adverse psychological experiences during outbreaks, with stress and anxiety being most common. Psychological distress decreased over time. Some studies reported insomnia, burnout, and posttraumatic stress for a subset of individuals up to 3 years after the disease outbreak. Few interventions have been implemented to address providers' mental health needs, and these strategies have not been evaluated systematically.
Systems-level interventions may alleviate distress for most providers without the need for specialized mental health intervention. Psychotherapeutic support and referral to specialty care should be available to health workers with severe and intense adverse psychological outcomes during and beyond the COVID-19 pandemic. Evidence-based interventions are urgently needed to better serve health workers both during and following epidemics/pandemics.
本快速综述旨在探讨 COVID-19 大流行提出的两个关键问题：一线卫生工作者可能会出现哪些预期的心理健康后果？在卫生应急期间，有哪些最佳实践可以满足这些工作人员的心理健康需求？
本综述综合了 21 世纪发生的重大大流行和流行病（严重急性呼吸系统综合征、中东呼吸系统综合征、埃博拉病毒病和猪流感）中卫生工作者心理健康后果的文献以及用于解决相关心理健康后果的干预措施。使用与这些流行病/大流行相关的术语在 PubMed、MEDLINE 和 PsycINFO 上进行了搜索。
在检索到的 3876 篇文章中，有 94 篇被纳入本综述。在这些研究中，大多数卫生工作者在疫情爆发期间表现出一些不良心理体验，最常见的是压力和焦虑。心理困扰随着时间的推移而减少。一些研究报告称，在疾病爆发后长达 3 年的时间里，一部分人会出现失眠、倦怠和创伤后应激。很少有干预措施被用来满足提供者的心理健康需求，并且这些策略尚未得到系统评估。
系统层面的干预措施可能会减轻大多数卫生工作者的痛苦，而无需专门的心理健康干预。在 COVID-19 大流行期间和之后，应向有严重和强烈不良心理后果的卫生工作者提供心理治疗支持和转介至专业护理。迫切需要制定循证干预措施，以更好地为卫生工作者提供服务，无论是在疫情/大流行期间还是之后。
