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与新冠肺炎相关的心理困扰、恐惧及应对:孟加拉国高危群体的识别

COVID-19 Related Psychological Distress, Fear and Coping: Identification of High-Risk Groups in Bangladesh.

作者信息

Rahman Muhammad Aziz, Rahman Shaila, Wazib Amit, Arafat S M Yasir, Chowdhury Zulfia Zinat, Uddin Bhuiyan Mohammad Mahtab, Rahman Mufti Munsurar, Bahar Moni Ahmed Suparno, Alif Sheikh M, Sultana Farhana, Salehin Masudus, Islam Sheikh Mohammed Shariful, Cross Wendy, Bahar Tamanna

机构信息

School of Health, Federation University Australia, Berwick, VIC, Australia.

Australian Institute for Primary Care and Ageing, La Trobe University, Melbourne, VIC, Australia.

出版信息

Front Psychiatry. 2021 Aug 13;12:718654. doi: 10.3389/fpsyt.2021.718654. eCollection 2021.

Abstract

The COVID-19 pandemic has imposed psychological distress and fear across the globe; however, factors associated with those issues or the ways people cope may vary by country or context. This study aimed to investigate the factors associated with psychological distress, fear, and coping strategies for people living in Bangladesh during the COVID-19 pandemic. A cross-sectional study conducted in August-September 2020 using online platforms in Bangladesh. People residing in Bangladesh, aged ≥18 years, who were proficient in English and able to respond to online questionnaire. The Kessler Psychological Distress Scale was used to assess the psychological stress. Level of fear was assessed using the Fear of COVID-19 Scale, and strategies to cope were assessed using the Brief Resilient Coping Scale. Of the 962 participants, half of them were aged between 30 and 59 years. Being born in Bangladesh, having graduate education, perceived distress due to employment change, effect of COVID-19 on financial situation, having multiple comorbidities, and visiting a healthcare provider in the last 4 weeks were associated with higher levels of both psychological distress and fear of COVID-19. Furthermore, higher psychological distress was associated with being a female (AOR 1.81, 95% CI 1.33-2.47, < 0.001), being a frontline worker (AOR 1.50, 95% CI 1.04-2.15, < 0.05), having pre-existing psychiatric problems (AOR 4.03, 95% CI 1.19-13.7, < 0.05), being a smoker (AOR 2.02, 95% CI 1.32-3.09, < 0.01), providing care to a known/suspected COVID-19 patient (AOR 1.96, 95% CI 1.40-2.72, < 0.001), having a recent overseas travel history and being in self-quarantine (AOR 4.59, 95% CI 1.23-17.2, < 0.05), self-isolation without COVID-19 (AOR 2.63, 95% CI 1.68-4.13, < 0.001) or being COVID-19 positive (AOR 2.53, 95% CI 1.19-5.34, < 0.05), and having high levels of fear of COVID-19 (AOR 3.27, 95% CI 2.29-4.66, < 0.001). A higher level of fear was associated with moderate to high levels of psychological distress (AOR 3.29, 95% CI 2.31-4.69, < 0.001). People with pre-existing mental health problems were less likely to be resilient (AOR 0.25, 95% CI 0.11-0.54, < 0.01), whereas those with having an income were more likely to be resilient (AOR 1.46, 95% CI 1.02-2.11, < 0.05). Effective interventions to support the vulnerable groups including improved access to mental health services are of utmost importance during the pandemic.

摘要

新冠疫情在全球范围内造成了心理困扰和恐惧;然而,与这些问题相关的因素或人们的应对方式可能因国家或背景而异。本研究旨在调查新冠疫情期间孟加拉国居民心理困扰、恐惧及应对策略的相关因素。2020年8月至9月在孟加拉国利用在线平台进行了一项横断面研究。研究对象为居住在孟加拉国、年龄≥18岁、精通英语且能够回答在线问卷的人群。使用凯斯勒心理困扰量表评估心理压力。使用新冠恐惧量表评估恐惧程度,使用简短复原力应对量表评估应对策略。在962名参与者中,一半年龄在30至59岁之间。出生在孟加拉国、拥有研究生学历、因就业变化感到困扰、新冠疫情对财务状况的影响、患有多种合并症以及在过去4周内看过医疗服务提供者,均与较高水平的心理困扰和对新冠的恐惧有关。此外,较高的心理困扰与女性(调整后比值比1.81,95%置信区间1.33 - 2.47,P < 0.001)、一线工作者(调整后比值比1.50,95%置信区间1.04 - 2.15,P < 0.05)、有既往精神疾病问题(调整后比值比4.03,95%置信区间1.19 - 13.7,P < 0.05)、吸烟者(调整后比值比2.02,95%置信区间1.32 - 3.09,P < 0.01)、照顾已知/疑似新冠患者(调整后比值比1.96,95%置信区间1.40 - 2.72,P < 0.001)、近期有海外旅行史且正在自我隔离(调整后比值比4.59,95%置信区间1.23 - 17.2,P < 0.05)、无新冠自我隔离(调整后比值比2.63,95%置信区间1.68 - 4.13,P < 0.001)或新冠检测呈阳性(调整后比值比2.53,95%置信区间1.19 - 5.34,P < 0.05)以及对新冠有高度恐惧(调整后比值比3.27,95%置信区间2.29 - 4.66,P < 0.001)有关。较高程度的恐惧与中度至高度的心理困扰有关(调整后比值比3.29,95%置信区间2. — 4.69,P < 0.001)。有既往心理健康问题的人复原力较低(调整后比值比0.25,95%置信区间0.11 - 0.54,P < 0.01),而有收入的人复原力较高(调整后比值比1.46,95%置信区间1.02 - 2.11,P < 0.05)。在疫情期间,采取有效干预措施以支持弱势群体,包括改善获得心理健康服务的机会,至关重要。

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