Hammami Ahmed Sami, Jellazi Mohamed, Mahjoub Lobna, Fedhila Maya, Ouali Sonia
Department of Internal Medicine, CHU F Bourguiba Monastir, Monastir, Tunisia.
Biochemistry Laboratory, LR12ES05 LR-NAFS "Nutrition - Functional Food and Vascular Health", Faculty of Medicine, University of Monastir, Monastir, Tunisia.
Front Psychol. 2021 Dec 14;12:754047. doi: 10.3389/fpsyg.2021.754047. eCollection 2021.
Our study aimed to evaluate the magnitude of different psychological outcomes among Tunisian healthcare professionals (HCPs) during the first wave of the coronavirus disease 2019 (COVID-19) pandemic, and to identify the associated factors. Healthcare professionals completed a cross-sectional questionnaire during a 3-week period in the first wave of the COVID-19 pandemic in Tunisia. The survey collected demographic information, factors that may interfere with the psychological outcomes, behavioral changes, and mental health measures. Mental health was assessed using three scales: the Seven-Item Insomnia Severity Index, the Two-Item Patient Health Questionnaire, and the Two-Item Generalized Anxiety Disorder instrument. Multivariable logistic regression was conducted to identify factors associated with psychological outcomes. A total of 503 HCPs successfully completed the survey, and 493 agreed to enroll in the study: 411 (83.4%) physicians, 323 (64.2%) women, and 271 (55%) with a second-line work position. A significant proportion of HCPs had anxiety (35.7%), depression (35.1%), and insomnia (23.7%). Women, those with a psychiatric history, and those using public transportation had higher proportions for overall symptoms compared with other groups, for example, depression in 44.9% of female participants vs. 18.2% of male participants ( = 0.00). Those with a previous medical history and nurses had more anxiety and insomnia compared with other groups, for example, anxiety in 45.1% of nurses, 36.1% of interns/residents, and 27.5% of attending physicians ( = 0.04). Multivariable logistic regression showed that female gender was a risk factor for all psychological outcomes, whereas psychiatric history was a risk factor for both anxiety and insomnia [odds ratio (OR) = 2.86, 95% CI 1.78-4.60, = 0.00 for insomnia]. Using protective equipment was associated with a lower risk for depression (OR = 0.41, 95% CI 0.27-0.62, = 0.00) and anxiety. Physical activity was also protective against depression and anxiety (OR = 0.41, 95% CI 0.25-0.67, = 0.00). Psychological symptoms are usually overlooked or dismissed by HCPs, although the COVID-19 pandemic played a major role in exacerbating this burden. Prompt psychological support should be endorsed and simple measures, such as physical activity and ensuring the availability of personal protective equipment, are paramount to improve mental health outcomes and the quality of care provided to patients.
我们的研究旨在评估2019年冠状病毒病（COVID-19）大流行第一波期间突尼斯医疗保健专业人员（HCPs）不同心理结果的严重程度，并确定相关因素。在突尼斯COVID-19大流行第一波期间的3周内，医疗保健专业人员完成了一份横断面调查问卷。该调查收集了人口统计学信息、可能干扰心理结果的因素、行为变化和心理健康指标。使用三个量表评估心理健康：七项失眠严重指数、两项患者健康问卷和两项广泛性焦虑症量表。进行多变量逻辑回归以确定与心理结果相关的因素。共有503名HCPs成功完成了调查，493人同意参与研究：411名（83.4%）医生，323名（64.2%）女性，271名（55%）处于二线工作岗位。相当一部分HCPs有焦虑（35.7%）、抑郁（35.1%）和失眠（23.7%）。与其他组相比，女性、有精神病史的人和使用公共交通工具的人总体症状比例更高，例如，44.9%的女性参与者有抑郁，而男性参与者为18.2%（P = 0.00）。与其他组相比，有既往病史的人和护士有更多焦虑和失眠，例如，45.1%的护士、36.1%的实习生/住院医师和27.5%的主治医师有焦虑（P = 0.04）。多变量逻辑回归显示，女性是所有心理结果的危险因素，而精神病史是焦虑和失眠的危险因素[失眠的优势比（OR）= 2.86，95%置信区间1.78 - 4.60，P = 0.00]。使用防护设备与较低的抑郁风险（OR = 0.41，95%置信区间0.27 - 0.62，P = 0.00）和焦虑相关。体育活动也对抑郁和焦虑有预防作用（OR = 0.41，95%置信区间0.25 - 0.67，P = 0.00）。尽管COVID-19大流行在加重这种负担方面起了主要作用，但HCPs通常会忽视或忽略心理症状。应认可及时的心理支持，诸如体育活动和确保提供个人防护设备等简单措施对于改善心理健康结果和为患者提供的护理质量至关重要。
