Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
School of Nursing, the University of Nevada Las Vegas, Las Vegas, NV, USA.
Ann Work Expo Health. 2022 Mar 15;66(3):312-333. doi: 10.1093/annweh/wxab085.
Anxiety and depression among physicians and nurses during the COVID-19 pandemic in the USA are not well described and their modifiable causes are poorly understood.
We conducted a cross-sectional survey of symptoms of anxiety and depression (Hospital Anxiety and Depression Scale) among physicians and nurses in two US healthcare systems in June through September 2020; participation rate was 5-10%. We described features of work as well as their perceptions and associated concerns in relation to the risk of anxiety and depression, while controlling for health history via regression and path analyses.
About a third of 684 nurses and 185 physicians surveyed showed symptoms of anxiety or depression, and the excess of symptoms of mood disorders was particularly prominent in nurses. The belief that one was infected was a dominant correlate of both anxiety and depression. This belief was more associated with history of symptoms of pneumonia than the contact with COVID-19 diagnosed patients. Factors found to be associated with reduced anxiety and depression in this working environment were having confidence in the competent use of and access to personal protective equipment, maintaining usual working hours, being surrounded by colleagues who were both sufficient in numbers and not stressed, and the support of immediate family and religious communities. Involvement in aerosol-generating procedures with infected patients was linked with lower depression in nurses but higher among physicians. Likewise, the setting of recent patient encounters affected risk of anxiety and depression differently for physicians and nurses.
Our findings may help develop mitigation measures and underscore the need to help nurses and physicians bear the psychological burden of the COVID-19 pandemic and similar events in the future.
美国 COVID-19 大流行期间，医生和护士的焦虑和抑郁状况并未得到充分描述，其可改变的病因也知之甚少。
我们于 2020 年 6 月至 9 月期间，在美国的两个医疗保健系统中对医生和护士进行了一项横断面调查，以了解他们的焦虑和抑郁症状（医院焦虑和抑郁量表）；参与率为 5%-10%。我们描述了工作特点以及他们对焦虑和抑郁风险的看法和相关担忧，同时通过回归和路径分析控制健康史的影响。
在接受调查的 684 名护士和 185 名医生中，约有三分之一的人表现出焦虑或抑郁症状，而护士的情绪障碍症状明显更为突出。感染的信念是焦虑和抑郁的主要相关因素。这种信念与肺炎史的相关性强于与 COVID-19 确诊患者的接触。在这种工作环境中，与焦虑和抑郁减少相关的因素包括对个人防护设备的熟练使用和获取的信心、保持正常工作时间、有足够数量且压力不大的同事的支持，以及直系亲属和宗教社区的支持。与感染患者进行气溶胶生成操作与护士的抑郁程度降低有关，但与医生的抑郁程度升高有关。同样，最近的患者接触情况对医生和护士的焦虑和抑郁风险的影响也不同。
我们的研究结果可能有助于制定缓解措施，并强调需要帮助护士和医生承担 COVID-19 大流行和未来类似事件的心理负担。
