Critical Care Division, The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Sydney, Australia; Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital, Sydney, Australia.
The University of Queensland, Australia; Queensland Children's Hospital, Brisbane, Australia.
Aust Crit Care. 2021 Mar;34(2):146-154. doi: 10.1016/j.aucc.2020.12.004. Epub 2020 Dec 26.
The aim of the study was to determine levels of depression, anxiety, and stress symptoms and factors associated with psychological burden amongst critical care healthcare workers in the early stages of the coronavirus disease 2019 pandemic.
An anonymous Web-based survey distributed in April 2020. All healthcare workers employed in a critical care setting were eligible to participate. Invitations to the survey were distributed through Australian and New Zealand critical care societies and social media platforms. The primary outcome was the proportion of healthcare workers who reported moderate to extremely severe scores on the Depression, Anxiety, and Stress Scale-21 (DASS-21).
Of the 3770 complete responses, 3039 (80.6%) were from Australia. A total of 2871 respondents (76.2%) were women; the median age was 41 years. Nurses made up 2269 (60.2%) of respondents, with most (2029 [53.8%]) working in intensive care units. Overall, 813 (21.6%) respondents reported moderate to extremely severe depression, 1078 (28.6%) reported moderate to extremely severe anxiety, and 1057 (28.0%) reported moderate to extremely severe stress scores. Mean ± standard deviation values of DASS-21 depression, anxiety, and stress scores amongst woman vs men was as follows: 8.0 ± 8.2 vs 7.1 ± 8.2 (p = 0.003), 7.2 ± 7.5 vs 5.0 ± 6.7 (p < 0.001), and 14.4 ± 9.6 vs 12.5 ± 9.4 (p < 0.001), respectively. After adjusting for significant confounders, clinical concerns associated with higher DASS-21 scores included not being clinically prepared (β = 4.2, p < 0.001), an inadequate workforce (β = 2.4, p = 0.001), having to triage patients owing to lack of beds and/or equipment (β = 2.6, p = 0.001), virus transmission to friends and family (β = 2.1, p = 0.009), contracting coronavirus disease 2019 (β = 2.8, p = 0.011), being responsible for other staff members (β = 3.1, p < 0.001), and being asked to work in an area that was not in the respondents' expertise (β = 5.7, p < 0.001).
In this survey of critical care healthcare workers, between 22 and 29% of respondents reported moderate to extremely severe depression, anxiety, and stress symptoms, with women reporting higher scores than men. Although female gender appears to play a role, modifiable factors also contribute to psychological burden and should be studied further.
本研究旨在确定在 2019 年冠状病毒病大流行早期，重症监护医护人员的抑郁、焦虑和压力症状水平，以及与心理负担相关的因素。
这是一项于 2020 年 4 月进行的匿名网络调查。所有在重症监护环境中工作的医护人员都有资格参加。调查邀请通过澳大利亚和新西兰重症监护学会以及社交媒体平台发布。主要结局是报告抑郁、焦虑和压力量表 21 项（DASS-21）中度至极重度评分的医护人员比例。
在 3770 份完整回复中，3039 份（80.6%）来自澳大利亚。共有 2871 名受访者（76.2%）为女性；中位年龄为 41 岁。护士占 2269 名（60.2%）受访者，其中大多数（2029 名 [53.8%]）在重症监护病房工作。总体而言，813 名（21.6%）受访者报告中度至极重度抑郁，1078 名（28.6%）报告中度至极重度焦虑，1057 名（28.0%）报告中度至极重度压力评分。女性与男性相比，DASS-21 抑郁、焦虑和压力评分的均值±标准差分别为：8.0±8.2 比 7.1±8.2（p=0.003）、7.2±7.5 比 5.0±6.7（p<0.001）和 14.4±9.6 比 12.5±9.4（p<0.001）。在调整了显著混杂因素后，与 DASS-21 评分较高相关的临床问题包括：临床准备不足（β=4.2，p<0.001）、劳动力不足（β=2.4，p=0.001）、因床位和/或设备短缺而必须对患者进行分诊（β=2.6，p=0.001）、病毒传播给朋友和家人（β=2.1，p=0.009）、感染 2019 年冠状病毒病（β=2.8，p=0.011）、对其他员工负责（β=3.1，p<0.001）以及被要求在不属于受访者专业领域的区域工作（β=5.7，p<0.001）。
在这项对重症监护医护人员的调查中，22%至 29%的受访者报告中度至极重度抑郁、焦虑和压力症状，女性报告的评分高于男性。尽管女性性别似乎起了一定作用，但可改变的因素也会导致心理负担，应进一步研究。
