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2019年冠状病毒病疫情早期为患者提供护理的加拿大重症监护护士心理健康受到的影响:一项混合方法研究。

The effect of COVID-19 pandemic on the mental health of Canadian critical care nurses providing patient care during the early phase pandemic: A mixed method study.

作者信息

Crowe Sarah, Howard A Fuchsia, Vanderspank-Wright Brandi, Gillis Paula, McLeod Fiona, Penner Caroline, Haljan Gregory

机构信息

Fraser Health, 13750 96th Avenue, Surrey, BC V3V 1Z2, Canada; University of British Colombia, Faculty of Applied Sciences, School of Nursing, T201 - 2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada.

University of British Colombia, Faculty of Applied Sciences, School of Nursing, T201 - 2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada.

出版信息

Intensive Crit Care Nurs. 2021 Apr;63:102999. doi: 10.1016/j.iccn.2020.102999. Epub 2020 Dec 11.

Abstract

BACKGROUND

Healthcare workers have historically experienced symptoms of post-traumatic stress disorder, depression and anxiety with previous infectious outbreaks. It is unknown if critical care nurses have similar experiences.

OBJECTIVES

The study aimed to examine the mental health of Critical Care Registered Nurses providing direct patient care during the initial phase of the COVID-19 pandemic in Canada.

DESIGN

This was a convergent parallel mixed method study utilizing validated questionnaires and semi-structured qualitative interviews.

SETTING

Critical care units in a single large 650 bed academic teaching hospital in western Canada. The critical care units serve a general mixed medical - surgical adult patient population.

PARTICIPANTS

Critical Care Registered Nurses providing direct patient care in the intensive care and high acuity units at the designated site.

METHODS

109 participants completed two self-reported validated surveys, the Impact of Events Scale - Revised and the Depression, Anxiety and Stress Scale. 15 participants completed one-on-one semi-structured interviews that were analyzed using inductive thematic analysis.

RESULTS

In the surveys, the participants reported clinical concern for (23%), probable (13%) and significant (38%) symptoms of post-traumatic stress disorder, as well as mild to severe depression (57%), anxiety (67%) and stress (54%). In the interviews, psychological distress was described as anxiety, worry, distress and fear related to: 1) rapidly changing policy and information, 2) overwhelming and unclear communication, 3) meeting patient care needs in new ways while staying safe, and 4) managing home and personal commitments to self and family.

CONCLUSIONS

Critical care nurses experienced psychological distress associated with providing care to COVID-19 patients during the early phases of the pandemic.

摘要

背景

在以往的传染病暴发期间,医护人员曾经历过创伤后应激障碍、抑郁和焦虑症状。目前尚不清楚重症监护护士是否有类似经历。

目的

本研究旨在调查在加拿大新冠疫情初期为患者提供直接护理的重症监护注册护士的心理健康状况。

设计

这是一项采用经过验证的问卷和半结构化定性访谈的收敛平行混合方法研究。

地点

加拿大西部一家拥有650张床位的大型学术教学医院的重症监护病房。这些重症监护病房服务于成年内科和外科混合的普通患者群体。

参与者

在指定地点的重症监护病房和高 acuity 病房为患者提供直接护理的重症监护注册护士。

方法

109名参与者完成了两项自我报告的经过验证的调查,即事件影响量表修订版和抑郁、焦虑和压力量表。15名参与者完成了一对一的半结构化访谈,并采用归纳主题分析法进行分析。

结果

在调查中,参与者报告有临床担忧的创伤后应激障碍症状比例为23%,可能有症状的比例为13%,有显著症状的比例为38%,同时还报告有轻度至重度抑郁(57%)、焦虑(67%)和压力(54%)。在访谈中,心理困扰被描述为与以下方面相关的焦虑、担忧、苦恼和恐惧:1)迅速变化的政策和信息,2)压倒性且不清晰的沟通,3)在确保安全的同时以新方式满足患者护理需求,4)处理家庭以及对自己和家人的个人承诺。

结论

在疫情初期,重症监护护士在为新冠患者提供护理时经历了心理困扰。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ea6/7832945/3f0bcc6dfe32/gr1_lrg.jpg

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