一线医护人员在照顾 COVID-19 患者时的压力、焦虑和抑郁患病率：系统评价和荟萃回归分析。

BACKGROUND: Stress, anxiety, and depression are some of the most important research and practice challenges for psychologists, psychiatrists, and behavioral scientists. Due to the importance of issue and the lack of general statistics on these disorders among the Hospital staff treating the COVID-19 patients, this study aims to systematically review and determine the prevalence of stress, anxiety and depression within front-line healthcare workers caring for COVID-19 patients. METHODS: In this research work, the systematic review, meta-analysis and meta-regression approaches are used to approximate the prevalence of stress, anxiety and depression within front-line healthcare workers caring for COVID-19 patients. The keywords of prevalence, anxiety, stress, depression, psychopathy, mental illness, mental disorder, doctor, physician, nurse, hospital staff, 2019-nCoV, COVID-19, SARS-CoV-2 and Coronaviruses were used for searching the SID, MagIran, IranMedex, IranDoc, ScienceDirect, Embase, Scopus, PubMed, Web of Science (ISI) and Google Scholar databases. The search process was conducted in December 2019 to June 2020. In order to amalgamate and analyze the reported results within the collected studies, the random effects model is used. The heterogeneity of the studies is assessed using the I index. Lastly, the data analysis is performed within the Comprehensive Meta-Analysis software. RESULTS: Of the 29 studies with a total sample size of 22,380, 21 papers have reported the prevalence of depression, 23 have reported the prevalence of anxiety, and 9 studies have reported the prevalence of stress. The prevalence of depression is 24.3% (18% CI 18.2-31.6%), the prevalence of anxiety is 25.8% (95% CI 20.5-31.9%), and the prevalence of stress is 45% (95% CI 24.3-67.5%) among the hospitals' Hospital staff caring for the COVID-19 patients. According to the results of meta-regression analysis, with increasing the sample size, the prevalence of depression and anxiety decreased, and this was statistically significant (P < 0.05), however, the prevalence of stress increased with increasing the sample size, yet this was not statistically significant (P = 0.829). CONCLUSION: The results of this study clearly demonstrate that the prevalence of stress, anxiety and depression within front-line healthcare workers caring for COVID-19 patients is high. Therefore, the health policy-makers should take measures to control and prevent mental disorders in the Hospital staff.

背景：压力、焦虑和抑郁是心理学家、精神科医生和行为科学家面临的一些最重要的研究和实践挑战。由于这些问题的重要性以及缺乏针对治疗 COVID-19 患者的医院工作人员的这些障碍的一般统计数据，本研究旨在系统地回顾和确定照顾 COVID-19 患者的一线医护人员中压力、焦虑和抑郁的患病率。

方法：在这项研究工作中，使用系统评价、荟萃分析和荟萃回归方法来近似照顾 COVID-19 患者的一线医护人员中压力、焦虑和抑郁的患病率。使用患病率、焦虑、压力、抑郁、精神病理学、精神疾病、精神障碍、医生、医师、护士、医院工作人员、2019-nCoV、COVID-19、SARS-CoV-2 和冠状病毒等关键词搜索 SID、MagIran、IranMedex、IranDoc、ScienceDirect、Embase、Scopus、PubMed、Web of Science（ISI）和 Google Scholar 数据库。搜索过程于 2019 年 12 月至 2020 年 6 月进行。为了合并和分析所收集研究报告的结果，使用随机效应模型。使用 I 指数评估研究的异质性。最后，在 Comprehensive Meta-Analysis 软件中进行数据分析。

结果：在总共 22380 名样本量的 29 项研究中，有 21 项研究报告了抑郁的患病率，23 项研究报告了焦虑的患病率，9 项研究报告了压力的患病率。照顾 COVID-19 患者的医院工作人员中抑郁的患病率为 24.3%（18%CI 18.2-31.6%），焦虑的患病率为 25.8%（95%CI 20.5-31.9%），压力的患病率为 45%（95%CI 24.3-67.5%）。根据荟萃回归分析的结果，随着样本量的增加，抑郁和焦虑的患病率下降，且具有统计学意义（P<0.05），然而，压力的患病率随着样本量的增加而增加，但无统计学意义（P=0.829）。

结论：本研究结果清楚地表明，照顾 COVID-19 患者的一线医护人员中压力、焦虑和抑郁的患病率很高。因此，卫生政策制定者应采取措施控制和预防医院工作人员的精神障碍。