TERN, The Royal College of Emergency Medicine, London, UK
Emergency Department, Bristol Royal Hospital for Children, Bristol, UK.
BMJ Open. 2021 Jul 9;11(7):e049680. doi: 10.1136/bmjopen-2021-049680.
The psychological impact of the COVID-19 pandemic on doctors is a significant concern. Due to the emergence of multiple pandemic waves, longitudinal data on the impact of COVID-19 are vital to ensure an adequate psychological care response. The primary aim was to assess the prevalence and degree of psychological distress and trauma in frontline doctors during the acceleration, peak and deceleration of the COVID-19 first wave. Personal and professional factors associated with psychological distress are also reported.
A prospective online three-part longitudinal survey.
Acute hospitals in the UK and Ireland.
Frontline doctors working in emergency medicine, anaesthetics and intensive care medicine during the first wave of the COVID-19 pandemic in March 2020.
Psychological distress and trauma measured using the General Health Questionnaire-12 and the Impact of Events-Revised.
The initial acceleration survey distributed across networks generated a sample of 5440 doctors. Peak and deceleration response rates from the original sample were 71.6% (n=3896) and 56.6% (n=3079), respectively. Prevalence of psychological distress was 44.7% (n=1334) during the acceleration, 36.9% (n=1098) at peak and 31.5% (n=918) at the deceleration phase. The prevalence of trauma was 23.7% (n=647) at peak and 17.7% (n=484) at deceleration. The prevalence of probable post-traumatic stress disorder was 12.6% (n=343) at peak and 10.1% (n=276) at deceleration. Worry of family infection due to clinical work was the factor most strongly associated with both distress (R=0.06) and trauma (R=0.10).
Findings reflect a pattern of elevated distress at acceleration and peak, with some natural recovery. It is essential that policymakers seek to prevent future adverse effects through (a) provision of vital equipment to mitigate physical and psychological harm, (b) increased awareness and recognition of signs of psychological distress and (c) the development of clear pathways to effective psychological care.
ISRCTN10666798.
COVID-19 大流行对医生的心理影响是一个重大关注点。由于出现了多波大流行，有关 COVID-19 影响的纵向数据对于确保提供足够的心理保健应对至关重要。主要目的是评估在 COVID-19 第一波加速、高峰和减速期间，一线医生的心理困扰和创伤程度。还报告了与心理困扰相关的个人和职业因素。
前瞻性在线三部分纵向调查。
英国和爱尔兰的急症医院。
在 2020 年 3 月 COVID-19 大流行第一波期间，在急诊医学、麻醉和重症监护医学中工作的一线医生。
使用一般健康问卷-12 和事件影响修订版测量心理困扰和创伤。
最初在网络中分发的加速调查生成了 5440 名医生的样本。来自原始样本的高峰和减速响应率分别为 71.6%（n=3896）和 56.6%（n=3079）。在加速阶段，心理困扰的患病率为 44.7%（n=1334），高峰时为 36.9%（n=1098），减速时为 31.5%（n=918）。创伤的患病率为高峰时 23.7%（n=647），减速时 17.7%（n=484）。高峰时可能患有创伤后应激障碍的患病率为 12.6%（n=343），减速时为 10.1%（n=276）。由于临床工作而担心家人感染是与困扰（R=0.06）和创伤（R=0.10）最密切相关的因素。
研究结果反映了加速和高峰时困扰程度升高的模式，随后有所恢复。政策制定者必须通过（a）提供重要设备来减轻身体和心理伤害，（b）提高对心理困扰迹象的认识和认识，以及（c）制定明确的途径来获得有效的心理保健，来努力防止未来的不利影响。
ISRCTN83453555。
