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COVID-19 大流行对意大利东北部高负担地区医护人员的心理影响。

Psychological impact of COVID-19 pandemic on healthcare workers in a highly burdened area of north-east Italy.

机构信息

UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy.

Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

出版信息

Epidemiol Psychiatr Sci. 2020 Dec 17;30:e1. doi: 10.1017/S2045796020001158.

Abstract

AIMS

Healthcare workers exposed to coronavirus 2019 (COVID-19) patients could be psychologically distressed. This study aims to assess the magnitude of psychological distress and associated factors among hospital staff during the COVID-19 pandemic in a large tertiary hospital located in north-east Italy.

METHODS

All healthcare and administrative staff working in the Verona University Hospital (Veneto, Italy) during the COVID-19 pandemic were asked to complete a web-based survey from 21 April to 6 May 2020. Symptoms of post-traumatic distress, anxiety and depression were assessed, respectively, using the Impact of Event Scale (IES-R), the Self-rating Anxiety Scale (SAS) and the Patient Health Questionnaire (PHQ-9). Personal socio-demographic information and job characteristics were also collected, including gender, age, living condition, having pre-existing psychological problems, occupation, length of working experience, hospital unit (ICUs and sub-intensive COVID-19 units vs. non-COVID-19 units). A multivariable logistic regression analysis was performed to identify factors associated with each of the three mental health outcomes.

RESULTS

A total of 2195 healthcare workers (36.9% of the overall hospital staff) participated in the study. Of the participants, 35.7% were nurses, 24.3% other healthcare staff, 16.4% residents, 13.9% physicians and 9.7% administrative staff. Nine per cent of healthcare staff worked in ICUs, 8% in sub-intensive COVID-19 units and 7.6% in other front-line services, while the remaining staff worked in hospital units not directly engaged with COVID-19 patients. Overall, 63.2% of participants reported COVID-related traumatic experiences at work and 53.8% (95% CI 51.0%-56.6%) showed symptoms of post-traumatic distress; moreover, 50.1% (95% CI 47.9%-52.3%) showed symptoms of clinically relevant anxiety and 26.6% (95% CI 24.7%-28.5%) symptoms of at least moderate depression. Multivariable logistic regressions showed that women, nurses, healthcare workers directly engaged with COVID-19 patients and those with pre-existing psychological problems were at increased risk of psychopathological consequences of the pandemic.

CONCLUSIONS

The psychological impact of the COVID-19 pandemic on healthcare staff working in a highly burdened geographical of north-east Italy is relevant and to some extent greater than that reported in China. The study provides solid grounds to elaborate and implement interventions pertaining to psychology and occupational health.

摘要

目的

接触 2019 年冠状病毒(COVID-19)患者的医护人员可能会出现心理困扰。本研究旨在评估意大利东北部一家大型教学医院在 COVID-19 大流行期间医院工作人员的心理困扰程度及其相关因素。

方法

从 2020 年 4 月 21 日至 5 月 6 日,要求在 COVID-19 大流行期间在维罗纳大学医院(意大利威尼托大区)工作的所有医护和行政人员完成一项基于网络的调查。分别使用创伤后应激障碍影响量表(IES-R)、焦虑自评量表(SAS)和患者健康问卷(PHQ-9)评估创伤后应激、焦虑和抑郁症状。还收集了个人社会人口统计学信息和工作特征,包括性别、年龄、居住条件、是否存在先前存在的心理问题、职业、工作经验年限、医院科室(重症监护室和亚重症 COVID-19 病房与非 COVID-19 病房)。进行多变量逻辑回归分析以确定与三种心理健康结果相关的因素。

结果

共有 2195 名医护人员(占医院总员工的 36.9%)参加了这项研究。参与者中,35.7%为护士,24.3%为其他医护人员,16.4%为住院医师,13.9%为医生,9.7%为行政人员。9%的医护人员在重症监护室工作,8%在亚重症 COVID-19 病房工作,16.4%在其他一线服务部门工作,其余人员在不直接接触 COVID-19 患者的医院科室工作。总体而言,63.2%的参与者报告在工作中经历过与 COVID-19 相关的创伤性事件,53.8%(95%CI 51.0%-56.6%)出现创伤后应激症状;此外,50.1%(95%CI 47.9%-52.3%)出现明显焦虑症状,26.6%(95%CI 24.7%-28.5%)出现至少中度抑郁症状。多变量逻辑回归显示,女性、护士、直接接触 COVID-19 患者的医护人员和有先前存在的心理问题的医护人员发生大流行相关精神病理后果的风险增加。

结论

COVID-19 大流行对在意大利东北部负担过重地区工作的医护人员的心理影响是显著的,在某种程度上比在中国报告的更为严重。该研究为制定和实施与心理学和职业健康相关的干预措施提供了有力依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3541/7804082/16d2717e1c42/S2045796020001158_fig1.jpg

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