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中国新冠疫情期间医护人员的不良心理反应及心理援助

Adverse Psychological Reactions and Psychological Aids for Medical Staff During the COVID-19 Outbreak in China.

作者信息

Su Qinji, Ma Xiaoyun, Liu Shun, Liu Shaogang, Goodman Bernard A, Yu Miaoyu, Guo Wenbin

机构信息

Mental Health Center, The Second Affiliated Hospital, Guangxi Medical University, Nanning, China.

Department of Epidemiology, School of Public Health, Guangxi Medical University, Nanning, China.

出版信息

Front Psychiatry. 2021 Apr 15;12:580067. doi: 10.3389/fpsyt.2021.580067. eCollection 2021.

Abstract

The outbreak of the novel coronavirus disease COVID-19 caused panic and psychological stress throughout the World. We investigated the extent of adverse psychological reactions in two medical staff groups in China, and explored the importance of online psychological assistance for them. A cross-sectional online survey including Hospital Anxiety and Depression Scale (HADS) and Insomnia Severity Index (ISI) was utilized to assess anxiety, depression, and insomnia. Propensity score matching (PSM) was applied to match sex and age between the two groups. Differences in the prevalence of adverse psychological reactions between the two groups were compared by a Chi-square test. A multivariate logistic regression analysis was utilized to search for associated adverse psychological reaction factors of two groups. A total of 2,920 medical staff took part in the survey, including 470 frontline and 2,450 non-frontline medical staff. The risk of the frontline group experiencing anxiety, depression, insomnia-early, insomnia-middle, and insomnia-late were 1.16, 1.28, 1.26, 1.22, 1.28 times those of the non-frontline group after PSM. For frontline medical staff, the spinsterhood state (OR = 1.23, 95% CI: 1.00-1.51; = 0.05) was a risk factor for anxiety. Bachelor or college degree (OR = 2.23, 95% CI: 1.24-4.02, = 0.01) and a contact history with COVID-19 patients (OR = 1.62, 95% CI: 1.10-2.40; = 0.02) were risk factors for insomnia. For non-frontline medical staff, being a woman (OR = 1.49, 95% CI: 1.08-2.06, = 0.01) was a risk factor for anxiety, whilst being in a middle age group was a protective factor for anxiety (OR = 0.70, 95% CI: 0.50-0.99, = 0.04) and depression (OR = 0.65, 95% CI: 0.45-0.93, = 0.02). Being a woman (OR = 1.47, 95% CI: 1.14-1.89, = 0.003) and working in a COVID-19 unit (OR = 1.31, 95% CI: 1.11-1.54, = 0.001) were risk factors for insomnia, whilst the spinsterhood state (OR = 0.80, 95% CI: 0.67-0.95; = 0.01) was a protective factor for insomnia. Online forms of psychological aid were all popular with medical staff. The prevalence of anxiety, depression, and insomnia in frontline medical staff was significantly higher than in the non-frontline group. Appropriate intervention methods should be adopted according to the different influencing factors of the two groups. Online psychological aid was the preferred mechanism for relieving psychological problems.

摘要

新型冠状病毒病COVID-19的爆发在全球范围内引起了恐慌和心理压力。我们调查了中国两组医务人员的不良心理反应程度,并探讨了在线心理援助对他们的重要性。采用横断面在线调查,包括医院焦虑抑郁量表(HADS)和失眠严重程度指数(ISI)来评估焦虑、抑郁和失眠情况。应用倾向得分匹配(PSM)来匹配两组之间的性别和年龄。通过卡方检验比较两组不良心理反应患病率的差异。采用多因素逻辑回归分析来寻找两组相关的不良心理反应因素。共有2920名医务人员参与了调查,其中包括470名一线医务人员和2450名非一线医务人员。PSM后,一线组出现焦虑、抑郁、早期失眠、中期失眠和晚期失眠的风险分别是非一线组的1.16倍、1.28倍、1.26倍、1.22倍、1.28倍。对于一线医务人员,未婚状态(OR = 1.23,95%CI:1.00 - 1.51;P = 0.05)是焦虑的一个风险因素。本科或大专学历(OR = 2.23,95%CI:1.24 - 4.02,P = 0.01)以及与COVID-19患者的接触史(OR = 1.62,95%CI:1.10 - 2.40;P = 0.02)是失眠的风险因素。对于非一线医务人员,女性(OR = 1.49,95%CI:1.08 - 2.06,P = 0.01)是焦虑的一个风险因素,而处于中年组是焦虑(OR = 0.70,95%CI:0.50 - 0.99,P = 0.04)和抑郁(OR = 0.65,95%CI:0.45 - 0.93,P = 0.02)的一个保护因素。女性(OR = 1.47,95%CI:1.14 - 1.89,P = 0.003)以及在COVID-19科室工作(OR = 1.31,95%CI:1.11 - 1.54,P = 0.001)是非一线医务人员失眠的风险因素,而未婚状态(OR = 0.80,95%CI:0.67 - 0.95;P = 0.01)是失眠的一个保护因素。在线形式的心理援助在医务人员中都很受欢迎。一线医务人员中焦虑、抑郁和失眠的患病率显著高于非一线组。应根据两组不同的影响因素采取适当的干预方法。在线心理援助是缓解心理问题的首选机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/163d/8082095/5d9653a953e1/fpsyt-12-580067-g0001.jpg

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