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新冠疫情第一波的经验教训:瑞士医护人员的工作相关后果、临床知识、情绪困扰及安全意识行为

Lessons From the First Wave of COVID-19: Work-Related Consequences, Clinical Knowledge, Emotional Distress, and Safety-Conscious Behavior in Healthcare Workers in Switzerland.

作者信息

Riguzzi Marco, Gashi Shkumbin

机构信息

Careum School of Health, Zürich, Switzerland.

出版信息

Front Psychol. 2021 Feb 9;12:628033. doi: 10.3389/fpsyg.2021.628033. eCollection 2021.

Abstract

The coronavirus disease (COVID-19) imposes an unusual risk to the physical and mental health of healthcare workers and thereby to the functioning of healthcare systems during the crisis. This study investigates the clinical knowledge of healthcare workers about COVID-19, their ways of acquiring information, their emotional distress and risk perception, their adherence to preventive guidelines, their changed work situation due to the pandemic, and their perception of how the healthcare system has coped with the pandemic. It is based on a quantitative cross-sectional survey of 185 Swiss healthcare workers directly attending to patients during the pandemic, with 22% ( = 40) of them being assigned to COVID-19-infected patients. The participants answered between 16th June and 15th July 2020, shortly after the first wave of COVID-19 had been overcome and the national government had relaxed its preventive regulations to a great extent. The questionnaire incorporated parts of the "Standard questionnaire on risk perception of an infectious disease outbreak" (version 2015), which were adapted to the case of COVID-19. Clinical knowledge was lowest regarding the effectiveness of standard hygiene ( < 0.05). Knowledge of infectiousness, incubation time, and life-threatening disease progression was higher, however still significantly lower than regarding asymptomatic cases and transmission without physical contact ( < 0.001). 70% (95%-confidence interval: 64-77%) of the healthcare workers reported considerable emotional distress on at least one of the measured dimensions. They worried significantly more strongly about patients, elderly people, and family members, than about their own health ( < 0.001). Adherence to (not legally binding) preventive guidelines by the government displayed patterns such that not all guidelines were followed equally. Most of the participants were faced with a lack of protective materials, personnel, structures, processes, and contingency plans. An increase in stress level was the most prevalent among the diverse effects the pandemic had on their work situation. Better medical equipment (including drugs), better protection for their own mental and physical health, more (assigned) personnel, more comprehensive information about the symptoms of the disease, and a system of earlier warning were the primary lessons to be learned in view of upcoming waves of the pandemic.

摘要

冠状病毒病(COVID-19)给医护人员的身心健康带来了特殊风险,进而在危机期间对医疗系统的运转造成影响。本研究调查了医护人员对COVID-19的临床知识、获取信息的方式、情绪困扰和风险认知、对预防指南的遵守情况、因疫情导致的工作状况变化,以及他们对医疗系统应对疫情方式的看法。该研究基于对185名在疫情期间直接照料患者的瑞士医护人员进行的定量横断面调查,其中22%(n = 40)被分配照料COVID-19感染患者。参与者于2020年6月16日至7月15日期间作答,此时第一波COVID-19疫情刚过去不久,国家政府已在很大程度上放宽了预防规定。问卷纳入了“传染病暴发风险认知标准问卷”(2015年版)的部分内容,并针对COVID-19的情况进行了调整。关于标准卫生措施有效性的临床知识水平最低(p < 0.05)。关于传染性、潜伏期和危及生命的疾病进展的知识水平较高,但仍显著低于关于无症状病例和无身体接触传播的知识水平(p < 0.001)。70%(95%置信区间:64 - 77%)的医护人员报告在至少一个测量维度上有相当程度的情绪困扰。他们对患者、老年人和家庭成员的担忧明显比对自己健康的担忧强烈得多(p < 0.001)。政府(无法律约束力的)预防指南的遵守情况呈现出并非所有指南都得到同等遵循的模式。大多数参与者面临防护物资、人员、结构、流程和应急预案短缺的问题。压力水平上升是疫情对他们工作状况产生的各种影响中最普遍的。鉴于未来可能出现的疫情浪潮,应吸取的主要经验教训包括更好的医疗设备(包括药品)、对自身身心健康更好的保护、更多(分配的)人员、关于疾病症状更全面的信息以及早期预警系统。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d511/7899962/87c68c44188f/fpsyg-12-628033-g001.jpg

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