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