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孟买一家三甲医院的新冠康复住院医师和实习医生的精神后遗症和新冠经历。

Psychiatric Sequelae and COVID Experiences of Post COVID -19 Recovered Resident Doctors and Interns of a Tertiary General Hospital in Mumbai.

机构信息

Professor & HOU, Department of Psychiatry, Corresponding Author.

PGY-3 Resident, Department of Medicine.

出版信息

J Assoc Physicians India. 2021 Apr;69(4):22-26. doi: 10.0104/japi.2021.03.

Abstract

BACKGROUND

The wide and profound psychological impact of the COVID pandemic on people has been demonstrated by several studies. A survey from the Indian Medical Association (IMA) showed that at least 500 doctors have been infected across Maharashtra, with Mumbai doctors making it to the top of the list. The most infected are the resident doctors working in government hospitals. A few doctors also have lost their lives while working in this pandemic. The delicate balance between duty, altruism and fear for oneself and others often causes conflict and feelings of helplessness and dissonance in many health care personnel with a fear to resume back the duty, especially after being a COVID victim. There have been hardly any studies yet, related to understanding the emotional and general well being of COVID-19 positive health care workers who have recovered and resumed their duties.

AIMS AND OBJECTIVES

To study in post COVID-19 recovered resident doctors and interns the presence of anxiety and depressive symptoms, sleep changes, general well-being, perceptions of their COVID experience and association of general wellbeing with anxiety, depression and sleep changes.

METHODS

The study was conducted after institutional ethics committee permission and online informed consent from the participants which included medical interns and resident doctors of our institute. A Google form with questions and scales pertaining to the aims of the study (Patient Health Questionnaire, Zung Self Rating Anxiety Scale, Warwick Edinburgh Mental Well Being Scale and Insomnia Symptom Questionnaire) was sent on the Google link to the 150 interns and resident doctors via whatsapp who had recovered from COVID 19 infection. Their details were taken from hospital database with Dean permission.

RESULTS

79 responded to the link with the mean duration of COVID infection being 16.1 ± 8.59 days. 64 participants were hospitalized and 18 participants had lung parenchymal involvement. 28 participants had depressive symptoms on the patient health questionnaire. Only 4 participants experienced anxiety as per Zung self rating anxiety scale. 69 participants had greater well being with scores higher than 40 on the Warwick Edinburgh mental well being scale. 8 participants had sleep related issues affecting their work. A negative correlation of general well being was seen with depression, anxiety and insomnia which was highly significant. The most distressing of COVID experiences were being isolated in a room, transmitting disease to near and dear ones and possibility of a serious complication. Re infection, workload followed by use of PPE was the major concern.Many described their COVID experience as boring, depressing with feelings of loneliness.

CONCLUSIONS

Our study is the first of its kind to evaluate the psychiatric sequelae and COVID experiences of post COVID-19 recovered resident doctors and interns. Psychosocial and institutional support will definitely help in improving the post COVID sequelae in the resident doctors and interns.

摘要

背景

多项研究表明,COVID 大流行对人们产生了广泛而深远的心理影响。印度医学协会(IMA)的一项调查显示,马哈拉施特拉邦至少有 500 名医生感染了 COVID-19,孟买的医生感染人数最多。感染人数最多的是在政府医院工作的住院医生。少数医生在这场大流行中也失去了生命。在许多医护人员中,责任、利他主义以及对自己和他人的恐惧之间的微妙平衡常常导致冲突和无助感,使他们不愿恢复工作,尤其是在成为 COVID 受害者之后。然而,几乎没有任何研究涉及到了解已经康复并恢复工作的 COVID-19 阳性医护人员的情绪和整体健康状况。

目的和目标

研究 COVID-19 康复后的住院医生和实习医生是否存在焦虑和抑郁症状、睡眠变化、整体健康状况、对 COVID 经历的看法,以及整体健康状况与焦虑、抑郁和睡眠变化的关系。

方法

本研究获得了机构伦理委员会的许可,并获得了参与者的在线知情同意,参与者包括我们研究所的医学实习生和住院医生。一份包含与研究目的相关问题和量表的谷歌表单(患者健康问卷、Zung 自评焦虑量表、沃里克-爱丁堡心理健康量表和失眠症状问卷)通过 whatsapp 发送给了 150 名从 COVID-19 感染中康复的住院医生和实习医生。他们的详细信息是通过院长的许可从医院数据库中获取的。

结果

79 人回复了链接,COVID 感染的平均持续时间为 16.1 ± 8.59 天。64 名患者住院,18 名患者肺部实质受累。28 名患者在患者健康问卷上有抑郁症状。只有 4 名患者根据 Zung 自评焦虑量表出现焦虑。69 名患者的沃里克-爱丁堡心理健康量表得分高于 40,表明他们的整体健康状况更好。8 名患者的睡眠问题影响了他们的工作。整体健康状况与抑郁、焦虑和失眠呈负相关,具有统计学意义。COVID 经历中最痛苦的是被隔离在一个房间里、将疾病传播给亲朋好友,以及可能出现严重并发症。再次感染、工作量以及随后的个人防护设备的使用是主要关注点。许多人描述他们的 COVID 经历很无聊、沮丧,感到孤独。

结论

我们的研究是评估 COVID-19 康复后住院医生和实习医生的精神后遗症和 COVID 经历的首例研究。社会心理和机构支持肯定会有助于改善住院医生和实习医生的 COVID 后遗症。

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