重症监护医师在应对第二波 COVID-19 期间的心理健康障碍症状:一项横断面研究。

Symptoms of Mental Health Disorders in Critical Care Physicians Facing the Second COVID-19 Wave: A Cross-Sectional Study.

机构信息

Medical Intensive Care Unit, AP-HP, Saint Louis University Hospital, Paris, France.

Medical Intensive Care Unit, AP-HP, Saint Louis University Hospital, Paris, France.

出版信息

Chest. 2021 Sep;160(3):944-955. doi: 10.1016/j.chest.2021.05.023. Epub 2021 May 21.

Abstract

BACKGROUND

Working in the ICU during the first COVID-19 wave was associated with high levels of mental health disorders.

RESEARCH QUESTION

What are the mental health symptoms in health care providers (HCPs) facing the second wave?

STUDY DESIGN AND METHODS

A cross-sectional study (October 30-December 1, 2020) was conducted in 16 ICUs during the second wave in France. HCPs completed the Hospital Anxiety and Depression Scale, the Impact of Event Scale-Revised (for post-traumatic stress disorder), and the Maslach Burnout Inventory.

RESULTS

Of 1,203 HCPs, 845 responded (70%) (66% nursing staff, 32% medical staff, 2% other professionals); 487 (57.6%) had treated more than 10 new patients with COVID-19 in the previous week. Insomnia affected 320 (37.9%), and 7.7% were taking a psychotropic drug daily. Symptoms of anxiety, depression, post-traumatic stress disorder, and burnout were reported in 60.0% (95% CI, 56.6%-63.3%), 36.1% (95% CI, 32.9%-39.5%), 28.4% (95% CI, 25.4%-31.6%), and 45.1% (95% CI, 41.7%-48.5%) of respondents, respectively. Independent predictors of such symptoms included respondent characteristics (sex, profession, experience, personality traits), work organization (ability to rest and to care for family), and self-perceptions (fear of becoming infected or of infecting family and friends, feeling pressure related to the surge, intention to leave the ICU, lassitude, working conditions, feeling they had a high-risk profession, and "missing the clapping"). The number of patients with COVID-19 treated in the first wave or over the last week was not associated with symptoms of mental health disorders.

INTERPRETATION

The prevalence of symptoms of mental health disorders is high in ICU HCPs managing the second COVID-19 surge. The highest tiers of hospital management urgently need to provide psychological support, peer-support groups, and a communication structure that ensure the well-being of HCPs.

摘要

背景

在 COVID-19 第一波疫情期间在 ICU 工作与心理健康障碍的高发有关。

研究问题

在面对第二波疫情时,医护人员(HCPs)有哪些心理健康症状?

研究设计和方法

这是一项在法国第二波疫情期间(2020 年 10 月 30 日至 12 月 1 日)在 16 个 ICU 进行的横断面研究。HCPs 完成了医院焦虑和抑郁量表、修订后的事件影响量表(用于创伤后应激障碍)和马斯拉赫倦怠量表。

结果

在 1203 名 HCPs 中,有 845 名(70%)做出了回应(66%护理人员,32%医疗人员,2%其他专业人员);487 名(57.6%)在过去一周内治疗了超过 10 名新的 COVID-19 患者。320 名(37.9%)有失眠症状,7.7%每天服用精神药物。60.0%(95%CI,56.6%-63.3%)、36.1%(95%CI,32.9%-39.5%)、28.4%(95%CI,25.4%-31.6%)和 45.1%(95%CI,41.7%-48.5%)的受访者分别报告了焦虑、抑郁、创伤后应激障碍和倦怠症状。这些症状的独立预测因素包括受访者特征(性别、职业、经验、性格特征)、工作组织(休息和照顾家庭的能力)以及自我认知(担心感染或感染家人和朋友、感到与疫情高峰相关的压力、离开 ICU 的意愿、倦怠、工作条件、感觉自己从事高风险职业以及“怀念鼓掌”)。在第一波疫情或过去一周内治疗的 COVID-19 患者人数与心理健康障碍症状无关。

解释

在应对第二波 COVID-19 疫情的 ICU HCPs 中,心理健康障碍症状的患病率很高。医院高层急需提供心理支持、同伴支持小组以及沟通结构,以确保 HCPs 的福祉。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/375e/8137352/d9ad81511a85/gr1_lrg.jpg

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