Centre for Mental Health, University Health Network, Toronto, Ontario, Canada.
Intensive Care Medicine, University Health Network, Toronto, Ontario, Canada.
PLoS One. 2021 Nov 10;16(11):e0258893. doi: 10.1371/journal.pone.0258893. eCollection 2021.
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.
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).
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).
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.
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。
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。
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。
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。
