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新型冠状病毒肺炎疫情期间中国医护人员的心理和职业影响及其相关因素。

Psychological and occupational impact on healthcare workers and its associated factors during the COVID-19 outbreak in China.

机构信息

Department of Neurology, HwaMei Hospital, University of Chinese Academy of Sciences, Xibei Rd#41, Ningbo, 315010, Zhejiang, China.

Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Xibei Rd#41, Ningbo, 315010, Zhejiang, China.

出版信息

Int Arch Occup Environ Health. 2021 Aug;94(6):1441-1453. doi: 10.1007/s00420-021-01657-3. Epub 2021 Mar 3.

DOI:10.1007/s00420-021-01657-3
PMID:33656572
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7926194/
Abstract

PURPOSE

China was affected by an outbreak of coronavirus disease 2019 (COVID-19) in 2019-2020. Research data are needed to develop evidence-driven strategies to reduce the adverse psychological and occupational impacts on healthcare workers (HCWs).

METHODS

From March 1, 2020, to March 8, 2020, 946 HCWs in China completed a survey consist of sociodemographic data, precautionary measures against COVID-19, and concerns about COVID-19. Self-administered questionnaire were collected to assess psychological and occupational adverse outcomes of HCWs. Multivariable logistic regression analysis was performed to identify factors associated with the outcomes.

RESULTS

A total of 55.0%, 56.0% and 48.3% of the HCWs experienced burnout, psychological distress and posttraumatic stress, respectively. A total of seven factors were independently associated with burnout: good health status (OR 0.51, 95% CI 0.36-0.71), fear of contagion (OR 1.31, 95% CI 1.003-1.79), avoiding contact with children (OR 1.40, 95% CI 1.03-1.91), enough staff support at the workplace (OR 0.59, 95% CI 0.38-0.92), having to work overtime (OR 1.37, 95% CI 1.03-1.83), maladaptive coping (OR 3.28, 95% CI 2.42-4.45) and adaptive coping (OR 0.47, 95% CI 0.35-0.62). A total of 11 factors were independently associated with high psychological distress: having one child (OR 0.54, 95% CI 0.38-0.77), good health status (OR 0.57, 95% CI 0.39-0.83), alcohol abuse (OR 1.51, 95% CI 1.02-2.25), thinking the epidemic would continue for quite a long time (OR 1.59, 95% CI 1.08-2.34), wearing extra-work clothes (OR 1.51, 95% CI 1.06-2.15),effective protective equipment (OR 0.45, 95% CI 0.22-0.90), enough staff support at the workplace (OR 0.55, 95% CI 0.34-0.89), unable to take care of families (OR 1.99, 95% CI 1.42-2.78), economic losses (OR 1.62, 95% CI 1.14-2.31), maladaptive coping (OR 6.88, 95% CI 4.75-9.97),and adaptive coping (OR 0.29, 95% CI 0.21-0.41). These factors were independently associated with posttraumatic stress: living with the elderly (OR 1.46, 95% CI 1.04-2.05), alcohol abuse (OR 1.41, 95% CI 1.002-1.98), working at a 3A hospital(OR 0.66, 95% CI 0.49-0.88), acquaintances confirmed COVID-19 (OR 2.14, 95% CI 1.20-3.84), fear of contagion (OR 1.87, 95% CI 1.40-2.50), believing they would survive if infected (OR 0.63, 95% CI 0.46-0.86), self-disinfected after arriving home (OR 1.43, 95% CI 1.01-2.02), interpersonal isolation (OR 1.65, 95% CI 1.21-2.26), unable to take care of families (OR 1.41, 95% CI 1.05-1.88) and maladaptive coping (OR 3.09, 95% CI 2.32-4.11).

CONCLUSION

The variance in adverse outcomes was explained by the effect of various factors, which will help policymakers better prepare for subsequent potential outbreaks of COVID-19.

摘要

目的

2019-2020 年中国爆发了新型冠状病毒病(COVID-19)疫情。需要研究数据来制定循证策略,以减轻对医护人员(HCWs)的不良心理和职业影响。

方法

2020 年 3 月 1 日至 3 月 8 日,中国的 946 名 HCWs 完成了一项包括社会人口统计学数据、COVID-19 预防措施和对 COVID-19 的担忧的调查。采用自填式问卷评估 HCWs 的不良心理和职业结局。采用多变量逻辑回归分析确定与结局相关的因素。

结果

共有 55.0%、56.0%和 48.3%的 HCWs 经历了倦怠、心理困扰和创伤后应激障碍。共有 7 个因素与倦怠独立相关:健康状况良好(OR 0.51,95%CI 0.36-0.71)、担心感染(OR 1.31,95%CI 1.003-1.79)、避免接触儿童(OR 1.40,95%CI 1.03-1.91)、工作场所有足够的员工支持(OR 0.59,95%CI 0.38-0.92)、需要加班(OR 1.37,95%CI 1.03-1.83)、适应不良应对(OR 3.28,95%CI 2.42-4.45)和适应良好应对(OR 0.47,95%CI 0.35-0.62)。共有 11 个因素与较高的心理困扰独立相关:有一个孩子(OR 0.54,95%CI 0.38-0.77)、健康状况良好(OR 0.57,95%CI 0.39-0.83)、酗酒(OR 1.51,95%CI 1.02-2.25)、认为疫情会持续相当长一段时间(OR 1.59,95%CI 1.08-2.34)、穿着额外的工作服(OR 1.51,95%CI 1.06-2.15)、有效防护设备(OR 0.45,95%CI 0.22-0.90)、工作场所有足够的员工支持(OR 0.55,95%CI 0.34-0.89)、无法照顾家庭(OR 1.99,95%CI 1.42-2.78)、经济损失(OR 1.62,95%CI 1.14-2.31)、适应不良应对(OR 6.88,95%CI 4.75-9.97)和适应良好应对(OR 0.29,95%CI 0.21-0.41)。这些因素与创伤后应激障碍独立相关:与老年人一起生活(OR 1.46,95%CI 1.04-2.05)、酗酒(OR 1.41,95%CI 1.002-1.98)、在 3A 医院工作(OR 0.66,95%CI 0.49-0.88)、熟人确诊 COVID-19(OR 2.14,95%CI 1.20-3.84)、担心感染(OR 1.87,95%CI 1.40-2.50)、相信自己感染后会幸存(OR 0.63,95%CI 0.46-0.86)、回家后自行消毒(OR 1.43,95%CI 1.01-2.02)、人际隔离(OR 1.65,95%CI 1.21-2.26)、无法照顾家庭(OR 1.41,95%CI 1.05-1.88)和适应不良应对(OR 3.09,95%CI 2.32-4.11)。

结论

不良结局的差异可由各种因素的影响来解释,这将有助于决策者更好地为随后可能发生的 COVID-19 疫情做好准备。