Zandifar Atefeh, Badrfam Rahim, Mohammadian Khonsari Nami, Mohammadi Mohammad Reza, Asayesh Hamid, Qorbani Mostafa
Cardiovascular Research Center, Shahid Rajaei Educational and Medical Center, Alborz University of Medical Sciences, Karaj, Iran.
Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran.
Iran J Psychiatry. 2020 Oct;15(4):340-350. doi: 10.18502/ijps.v15i4.4303.
The global spread of COVID-19 has caused great psychological stress in health care workers (HCWs). This study aims to assess the prevalence and associated factors of posttraumatic stress symptoms (PTSS) and stigma among health care workers (HCWs) who are involved in treating COVID-19 patients. This study was conducted as part of studies related to assessing the mental health status of HCWs in Iran during the COVID-19 pandemic. Overall, in this cross sectional study, 894 HCWs working in 9 general hospitals in Alborz province, Iran, in the field of diagnostic and treatment care of patients with COVID-19 were selected using multistage sampling method. PTSS and its subscales, including intrusion, avoidance, and hyper vigilance were obtained based on the Posttraumatic Stress Disorder-8 Item validated questionnaire. Information on Stigma's perception among HCWs was also obtained based on a questionnaire adopted from the HIV Stigma Scale. Predictors of PTSS and Stigma's perception among HCWs were assessed using multivariate logistic regression analysis. Overall, 71.4% of the participants were women and 46.9% were front line staff. The prevalence of intrusion, avoidance, and hyper vigilance symptoms was 44.2% (95% CI: 40.8-47.6), 31. 8% (95% CI: 28.8-35.0), and 37.7% (95% CI: 34.5-41.0), respectively. A strong and positive significant correlation was found between stigma score with PTSD total score (coefficient: 0.83) and its components. In multivariate logistic regression model, female gender was associated with intrusion (OR: 1.46, 95% CI: 1.03-2.06) and avoidance (OR: 1.66, 95% CI: 1.147-2.417) and working in frontline increased the odds of intrusion (OR: 1.45, 95% CI: 1.06-1.97) and hyper vigilance (OR: 1.41, 95% CI: 1.03-1.91). The prevalence of PTSS is high among HCWs during COVID-19 pandemic and it is associated with some demographic characteristics of HCWs. This situation should be considered by health policymakers so that while trying to control the disease, the mental health status of this group of personnel should be given much attention.
新冠病毒病（COVID-19）的全球传播给医护人员带来了巨大的心理压力。本研究旨在评估参与治疗COVID-19患者的医护人员创伤后应激症状（PTSS）和污名化的患病率及相关因素。本研究是伊朗在COVID-19大流行期间评估医护人员心理健康状况相关研究的一部分。总体而言，在这项横断面研究中，采用多阶段抽样方法，选取了伊朗阿尔伯兹省9家综合医院中从事COVID-19患者诊断和治疗护理工作的894名医护人员。基于经过验证的创伤后应激障碍8项问卷获得PTSS及其分量表，包括侵入性、回避性和过度警觉性。还基于从艾滋病污名量表采用的问卷获取医护人员对污名化的认知信息。使用多变量逻辑回归分析评估医护人员中PTSS和污名化认知的预测因素。总体而言，71.4%的参与者为女性，46.9%为一线工作人员。侵入性、回避性和过度警觉性症状的患病率分别为44.2%（95%置信区间：40.8 - 47.6）、31.8%（95%置信区间：28.8 - 35.0）和37.7%（95%置信区间：34.5 - 41.0）。发现污名化得分与创伤后应激障碍总分（系数：0.83）及其各成分之间存在强正相关。在多变量逻辑回归模型中，女性性别与侵入性（比值比：1.46，95%置信区间：1.03 - 2.06）和回避性（比值比：1.66，95%置信区间：1.147 - 2.417）相关，在一线工作会增加侵入性（比值比：1.45，95%置信区间：1.06 - 1.97）和过度警觉性（比值比：1.41，95%置信区间：1.03 - 1.91）的几率。在COVID-19大流行期间，医护人员中PTSS的患病率很高，且与医护人员的一些人口统计学特征相关。卫生政策制定者应考虑这种情况，以便在努力控制疾病的同时，应高度关注这组人员的心理健康状况。
