The Chaim Sheba Medical Center, Ramat Gan, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Depress Anxiety. 2021 Apr;38(4):468-479. doi: 10.1002/da.23140. Epub 2021 Feb 5.
Healthcare workers (HCW) treating coronavirus disease 2019 (COVID-19) patients face high levels of psychological stress. We aimed to compare mental health outcomes, risk and protective factors for posttraumatic stress symptoms (PTSS), probable depression, and anxiety between HCW working in COVID-19 and non-COVID-19 wards.
A self-report survey, administered in a large tertiary hospital in Israel during the peak of the COVID-19 outbreak was completed by 828 HCW (42.2% physicians, 57.8% nurses. Patient-Reported Outcomes Measurement Information System; the Patient Health Questionnaire-9; the Primary Care-Post Traumatic Stress Disorder Screen for DSM-5 (PC-PTSD-5) were used for assessing anxiety, depression, and PTSS, respectively. Pandemic-related stress factors, negative experiences, and potential protective factors were also assessed.
Median PC-PTSD scores differed significantly between study teams (χ [5] = 17.24; p = .004). Prevalence of probable depression and anxiety were similar in both groups. Risk factors for mental health outcomes included mental exhaustion, anxiety about being infected and infecting family. Overall, higher proportion of the COVID-19 team witnessed patient deaths as compared to the non-COVID-19 team (50.2% vs. 24.7%). Witnessing patient death at the COVID-19 wards was associated with a four-fold increased likelihood of PTSS (odds ratio [OR] = 3.97; 95% confidence interval [CI], 1.58-9.99; p = .0007), compared with the non-COVID-19 wards (OR 0.91; 95% CI, 0.51-1.61; p = .43).
Witnessing patient death appears to be a risk factor for PTSS unique to HCW directly engaged in treating patients with COVID-19. Our findings suggest that helping HCW cope with COVID-19 related deaths might reduce their risk of posttraumatic stress.
治疗 2019 年冠状病毒病（COVID-19）患者的医护人员（HCW）面临着较高水平的心理压力。我们旨在比较 COVID-19 病房和非 COVID-19 病房工作的 HCW 的心理健康结果、创伤后应激症状（PTSS）、抑郁和焦虑的风险和保护因素。
在 COVID-19 爆发高峰期，在以色列的一家大型三级医院进行了一项自我报告调查，共有 828 名 HCW（42.2%为医生，57.8%为护士）完成了这项调查。使用患者报告的结果测量信息系统（Patient-Reported Outcomes Measurement Information System）、患者健康问卷-9（Patient Health Questionnaire-9）、DSM-5 初级保健创伤后应激障碍筛查（Primary Care-Post Traumatic Stress Disorder Screen for DSM-5，PC-PTSD-5）分别评估焦虑、抑郁和创伤后应激症状。还评估了与大流行相关的应激因素、负面经历和潜在的保护因素。
研究小组之间的 PC-PTSD 评分中位数差异显著（χ[5]=17.24，p=0.004）。两组的抑郁和焦虑患病率相似。心理健康结果的风险因素包括精神疲惫、对感染和感染家人的焦虑。总体而言，与非 COVID-19 病房相比，COVID-19 病房的医护人员目睹的患者死亡人数更多（50.2%比 24.7%）。与非 COVID-19 病房相比，在 COVID-19 病房目睹患者死亡与 PTSD 发生的可能性增加四倍相关（优势比[OR]=3.97；95%置信区间[CI]，1.58-9.99；p=0.0007），与非 COVID-19 病房相比（OR=0.91；95%CI，0.51-1.61；p=0.43）。
目睹患者死亡似乎是 COVID-19 直接治疗患者的 HCW 发生 PTSD 的一个风险因素。我们的研究结果表明，帮助 HCW 应对 COVID-19 相关死亡可能会降低他们发生创伤后应激的风险。
