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新冠疫情期间医护人员的创伤后应激症状:消极应对与疲劳的作用

Posttraumatic stress symptoms among health care workers during the COVID-19 epidemic: The roles of negative coping and fatigue.

作者信息

Hou Tianya, Yin Qianlan, Cai Wenpeng, Song Xiangrui, Deng Wenxi, Zhang Jianguo, Deng Guanghui

机构信息

Faculty of Psychology, Naval Medical University, Shanghai, China.

出版信息

Psychol Health Med. 2022 Feb;27(2):367-378. doi: 10.1080/13548506.2021.1921228. Epub 2021 Apr 27.

Abstract

Healthcare workers (HCWs) exposed to Coronavirus disease 2019 (COVID-19) are not immune to stressors. This study aimed to explore the prevalence of posttraumatic stress symptoms (PTSS) among HCWs during the COVID-19 epidemic and investigate the associations among negative coping, fatigue and PTSS. A total of 507 HCWs from Anhui province enrolled in the study and completed the cross-sectional survey including demographic data, Simplified Coping Style Questionnaire (SCSQ), 14-item Fatigue Scale (FS-14), and PTSD Checklist-civilian Version (PCL-C). Univariate linear regression, Pearson correlation and Mackinnon's four-step procedure were performed in the statistical analysis. Results indicated that the prevalence of PTSS among HCWs during the pandemic was 24%. Univariate linear regression showed HCWs aged 31-40 years exhibited significantly higher scores of PTSS than those aged 51-60 ( = 0.20, 95% : 0.59 to 9.41). Having at least one child was associated with a higher risk of developing PTSS ( = 0.01, 95% : 0.36 to 5.45). Negative coping and fatigue were positively correlated with all three PTSS (all < 0.001), including re-experiencing, avoidance and hyper-arousal. Fatigue has mediated the association between negative coping and PTSS among HCWs during the pandemic (ab = 0.09, SE = 0.03, bootstrap 95% : 0.04 to 0.14). A considerable proportion of HCWs was traumatized during the COVID-19 outbreak. Hence, the institutions should screen out and pay close attention to HCWs who tend to use negative coping (e.g., withdrawal thinking, distraction and blaming others) and arrange work scientifically to avoid overfatigue and PTSS amid the public health crisis.

摘要

接触2019冠状病毒病(COVID-19)的医护人员也难免会受到压力源的影响。本研究旨在探讨COVID-19疫情期间医护人员创伤后应激症状(PTSS)的患病率,并调查消极应对、疲劳与PTSS之间的关联。安徽省共有507名医护人员参与了本研究,并完成了横断面调查,内容包括人口统计学数据、简易应对方式问卷(SCSQ)、14项疲劳量表(FS-14)和创伤后应激障碍检查表平民版(PCL-C)。统计分析采用单因素线性回归、Pearson相关性分析和麦金农四步法。结果表明,疫情期间医护人员PTSS的患病率为24%。单因素线性回归显示,31-40岁的医护人员PTSS得分显著高于51-60岁的医护人员(β = 0.20,95%CI:0.59至9.41)。育有至少一个孩子与发生PTSS的较高风险相关(β = 0.01,95%CI:0.36至5.45)。消极应对和疲劳与所有三种PTSS均呈正相关(均P < 0.001),包括再体验、回避和过度警觉。在疫情期间,疲劳在医护人员消极应对与PTSS之间的关联中起中介作用(ab = 0.09,SE = 0.03,自抽样95%CI:0.04至0.14)。在COVID-19疫情期间,相当一部分医护人员受到了创伤。因此,各机构应筛查并密切关注倾向于采用消极应对方式(如退缩思维、分心和指责他人)的医护人员,并科学安排工作,以避免在公共卫生危机期间出现过度疲劳和PTSS。

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