COVID-19 对医护人员心理健康影响的快速综述:对支持心理健康的启示。

A rapid review of the impact of COVID-19 on the mental health of healthcare workers: implications for supporting psychological well-being.

机构信息

University of the Highlands and Islands, Institute for Health Research and Innovation, University of the Highlands and Islands, Old Perth Road, Inverness, IV2 3JH, UK.

NHS Highland, Department of Clinical Psychology, New Craigs Hospital, Inverness, IV3 8NP, UK.

出版信息

BMC Public Health. 2021 Jan 9;21(1):104. doi: 10.1186/s12889-020-10070-3.

Abstract

BACKGROUND

Health and social care workers (HSCWs) have carried a heavy burden during the COVID-19 crisis and, in the challenge to control the virus, have directly faced its consequences. Supporting their psychological wellbeing continues, therefore, to be a priority. This rapid review was carried out to establish whether there are any identifiable risk factors for adverse mental health outcomes amongst HSCWs during the COVID-19 crisis.

METHODS

We undertook a rapid review of the literature following guidelines by the WHO and the Cochrane Collaboration's recommendations. We searched across 14 databases, executing the search at two different time points. We included published, observational and experimental studies that reported the psychological effects on HSCWs during the COVID-19 pandemic.

RESULTS

The 24 studies included in this review reported data predominantly from China (18 out of 24 included studies) and most sampled urban hospital staff. Our study indicates that COVID-19 has a considerable impact on the psychological wellbeing of front-line hospital staff. Results suggest that nurses may be at higher risk of adverse mental health outcomes during this pandemic, but no studies compare this group with the primary care workforce. Furthermore, no studies investigated the psychological impact of the COVID-19 pandemic on social care staff. Other risk factors identified were underlying organic illness, gender (female), concern about family, fear of infection, lack of personal protective equipment (PPE) and close contact with COVID-19. Systemic support, adequate knowledge and resilience were identified as factors protecting against adverse mental health outcomes.

CONCLUSIONS

The evidence to date suggests that female nurses with close contact with COVID-19 patients may have the most to gain from efforts aimed at supporting psychological well-being. However, inconsistencies in findings and a lack of data collected outside of hospital settings, suggest that we should not exclude any groups when addressing psychological well-being in health and social care workers. Whilst psychological interventions aimed at enhancing resilience in the individual may be of benefit, it is evident that to build a resilient workforce, occupational and environmental factors must be addressed. Further research including social care workers and analysis of wider societal structural factors is recommended.

摘要

背景

在 COVID-19 危机期间,卫生和社会保健工作者(HSCWs)承担了沉重的负担,为了控制病毒,他们直接面临着病毒的后果。因此,继续支持他们的心理健康仍然是当务之急。 因此,进行了这项快速审查,以确定在 COVID-19 危机期间,HSCWs 是否存在任何可识别的不良心理健康结果的危险因素。

方法

我们按照世界卫生组织和 Cochrane 协作组的建议进行了文献快速审查。我们在 14 个数据库中进行了搜索,并在两个不同的时间点执行了搜索。我们纳入了在 COVID-19 大流行期间报告 HSCWs 心理影响的已发表、观察性和实验性研究。

结果

本综述纳入的 24 项研究主要报告了来自中国(24 项纳入研究中有 18 项)和大多数城市医院工作人员的数据。我们的研究表明,COVID-19 对一线医院工作人员的心理健康有相当大的影响。结果表明,在这场大流行中,护士可能面临更高的不良心理健康结果风险,但没有研究将这一组与初级保健人员进行比较。此外,没有研究调查 COVID-19 大流行对社会护理人员的心理影响。其他确定的危险因素包括潜在的器质性疾病、性别(女性)、对家庭的关注、对感染的恐惧、缺乏个人防护设备(PPE)和与 COVID-19 的密切接触。系统支持、充足的知识和适应力被确定为预防不良心理健康结果的因素。

结论

迄今为止的证据表明,与 COVID-19 患者密切接触的女性护士可能最需要努力支持心理健康。然而,由于发现不一致以及缺乏在医院环境之外收集的数据,这表明我们在解决卫生和社会保健工作者的心理健康问题时不应排除任何群体。虽然旨在增强个体适应力的心理干预可能会有所帮助,但显然,要建立一个有适应力的劳动力,必须解决职业和环境因素。建议进一步研究包括社会护理人员和分析更广泛的社会结构性因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f98c/7796556/45db264eff91/12889_2020_10070_Fig1_HTML.jpg

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