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帮助患者与亲人远程联系可调节医护人员的痛苦:针对新冠疫情一线工作者的照料与结盟假说

Helping patients connect remotely with their loved ones modulates distress in healthcare workers: a tend-and-befriend hypothesis for COVID-19 front liners.

作者信息

Fino Edita, Fino Viola, Bonfrate Ismaela, Russo Paolo Maria, Mazzetti Michela

机构信息

Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum-Bologna University School of Medicine, S.Orsola's University Hospital, Bologna, Italy.

COVID-19 Unit, IRCCS Ospedale Sacro Cuore/don Calabria di Negrar, Verona, Italy.

出版信息

Eur J Psychotraumatol. 2021 Oct 12;12(1):1968141. doi: 10.1080/20008198.2021.1968141. eCollection 2021.

Abstract

The no-visitor policies endorsed by healthcare organizations to limit COVID-19 virus risk exposure have unfortunately contributed to the isolation of patients further exacerbating distress in relatives and frontline healthcare workers. To contrast such effects, many healthcare institutions have adopted technology-based solutions helping patients and families communicate online through the aid of virtual devices. To date, no study has investigated whether facilitating patient-family videocalls would mitigate distress levels in frontline healthcare professionals. Caring for emotional needs of patients by re-establishing affiliative connections interrupted by the pandemic through patient-family videocalls is expected to mitigate distress in engaged healthcare workers as an example of a tend-and-befriend response to stress caused by the pandemic. We tested this hypothesis in a cross-sectional study conducted during 1-30 June 2020, involving 209 healthcare workers (nurses = 146; physicians = 63) engaged in the COVID-19 frontline in Italy. Half of participants in our sample ( = 107) had assisted efforts aimed at connecting patients remotely with families through videocalls. Psychological distress measures included symptoms of burnout, post-traumatic stress, anxiety, depression, and difficulty in sleep and wakefulness. Partially in line with our expectations we found a modulation effect specific for professional category: nurses assisting patient-family videocalls reported significantly lower levels of distress and a better quality of wakefulness compared to those who did not, whereas physicians reported higher levels of distress during such virtual communications. We interpret these findings from the perspective of patient-family communication and differences in skills and training between nurses and physicians. These findings highlight that technology-based solutions aimed at reducing barriers and alleviating distress in healthcare settings should be promoted in concert with skill enhancement training for healthcare professionals especially in terms of communicating online and communicating difficult topics with patients and families.

摘要

医疗机构为限制新冠病毒风险暴露而批准的禁止探视政策,不幸地导致了患者的隔离,进一步加剧了亲属和一线医护人员的痛苦。为了抵消这种影响,许多医疗机构采用了基于技术的解决方案,借助虚拟设备帮助患者和家属进行在线沟通。迄今为止,尚无研究调查促进患者与家属视频通话是否会减轻一线医护人员的痛苦程度。通过患者与家属视频通话重新建立因疫情而中断的亲密联系,从而照顾患者的情感需求,有望减轻参与其中的医护人员的痛苦,这是对应对疫情压力的“照料与结盟”反应的一个例证。我们在2020年6月1日至30日进行的一项横断面研究中检验了这一假设,该研究涉及意大利209名参与新冠疫情一线工作的医护人员(护士 = 146名;医生 = 63名)。我们样本中的一半参与者(n = 107)曾协助通过视频通话让患者与家属远程联系。心理痛苦测量指标包括倦怠、创伤后应激、焦虑、抑郁以及睡眠和觉醒困难的症状。部分符合我们的预期,我们发现了一种特定于专业类别的调节效应:协助患者与家属视频通话的护士报告的痛苦程度明显低于未协助的护士,且觉醒质量更好,而医生在这种虚拟沟通期间报告的痛苦程度更高。我们从患者与家属沟通以及护士和医生在技能与培训方面的差异角度来解读这些发现。这些发现凸显出,应在促进医护人员技能提升培训的同时,推广旨在减少医疗环境中的障碍并减轻痛苦的基于技术的解决方案,尤其是在在线沟通以及与患者和家属沟通困难话题方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04b1/8519556/1a910b0cf962/ZEPT_A_1968141_F0001_B.jpg

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