从 SARS 幸存和 COVID-19 中挺过来：医护人员心理健康结果及应对见解。
Surviving SARS and living through COVID-19: Healthcare worker mental health outcomes and insights for coping.
机构信息
Centre for Mental Health, University Health Network, Toronto, Ontario, Canada.
Intensive Care Medicine, University Health Network, Toronto, Ontario, Canada.
出版信息
PLoS One. 2021 Nov 10;16(11):e0258893. doi: 10.1371/journal.pone.0258893. eCollection 2021.
OBJECTIVE
Explore how previous work during the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak affects the psychological response of clinical and non-clinical healthcare workers (HCWs) to the current COVID-19 pandemic.
METHODS
A cross-sectional, multi-centered hospital online survey of HCWs in the Greater Toronto Area, Canada. Mental health outcomes of HCWs who worked during the COVID-19 pandemic and the SARS outbreak were assessed using Impact of Events-Revised scale (IES-R), Generalized Anxiety Disorder scale (GAD-7), and Patient Health Questionnaire (PHQ-9).
RESULTS
Among 3852 participants, moderate/severe scores for symptoms of post- traumatic stress disorder (PTSD) (50.2%), anxiety (24.6%), and depression (31.5%) were observed among HCWs. Work during the 2003 SARS outbreak was reported by 1116 respondents (29.1%), who had lower scores for symptoms of PTSD (P = .002), anxiety (P < .001), and depression (P < .001) compared to those who had not worked during the SARS outbreak. Multivariable logistic regression analysis showed non-clinical HCWs during this pandemic were at higher risk of anxiety (OR, 1.68; 95% CI, 1.19-2.15, P = .01) and depressive symptoms (OR, 2.03; 95% CI, 1.34-3.07, P < .001). HCWs using sedatives (OR, 2.55; 95% CI, 1.61-4.03, P < .001), those who cared for only 2-5 patients with COVID-19 (OR, 1.59; 95% CI, 1.06-2.38, P = .01), and those who had been in isolation for COVID-19 (OR, 1.36; 95% CI, 0.96-1.93, P = .05), were at higher risk of moderate/severe symptoms of PTSD. In addition, deterioration in sleep was associated with symptoms of PTSD (OR, 4.68, 95% CI, 3.74-6.30, P < .001), anxiety (OR, 3.09, 95% CI, 2.11-4.53, P < .001), and depression (OR 5.07, 95% CI, 3.48-7.39, P < .001).
CONCLUSION
Psychological distress was observed in both clinical and non-clinical HCWs, with no impact from previous SARS work experience. As the pandemic continues, increasing psychological and team support may decrease the mental health impacts.
目的
探讨 2003 年严重急性呼吸综合征（SARS）疫情期间的既往工作如何影响临床和非临床医护人员（HCWs）对当前 COVID-19 大流行的心理反应。
方法
这是一项在加拿大大多伦多地区医院进行的横断面、多中心的 HCWs 在线调查。使用修订后的事件影响量表（IES-R）、广泛性焦虑症量表（GAD-7）和患者健康问卷（PHQ-9）评估在 COVID-19 大流行期间和 SARS 爆发期间工作的 HCWs 的心理健康结果。
结果
在 3852 名参与者中，观察到 HCWs 中创伤后应激障碍（PTSD）症状（50.2%）、焦虑（24.6%）和抑郁（31.5%）的中度/重度评分。1116 名受访者（29.1%）报告曾在 2003 年 SARS 爆发期间工作，他们的 PTSD（P =.002）、焦虑（P <.001）和抑郁（P <.001）症状评分均低于未在 SARS 爆发期间工作的人员。多变量逻辑回归分析显示，在本次大流行期间，非临床 HCWs 患焦虑症（OR，1.68；95%CI，1.19-2.15，P =.01）和抑郁症（OR，2.03；95%CI，1.34-3.07，P <.001）的风险更高。使用镇静剂的 HCWs（OR，2.55；95%CI，1.61-4.03，P <.001）、仅照顾 2-5 名 COVID-19 患者的 HCWs（OR，1.59；95%CI，1.06-2.38，P =.01）和因 COVID-19 而被隔离的 HCWs（OR，1.36；95%CI，0.96-1.93，P =.05），患 PTSD 中度/重度症状的风险更高。此外，睡眠恶化与 PTSD（OR，4.68，95%CI，3.74-6.30，P <.001）、焦虑（OR，3.09，95%CI，2.11-4.53，P <.001）和抑郁（OR 5.07，95%CI，3.48-7.39，P <.001）的症状有关。
结论
临床和非临床 HCWs 均观察到心理困扰，既往 SARS 工作经历无影响。随着大流行的持续，增加心理和团队支持可能会降低心理健康的影响。
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