Department of Health Policy, Health Management College, Harbin Medical University, Harbin, Heilongjiang, China.
Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China.
BMJ Open. 2022 Jan 11;12(1):e047753. doi: 10.1136/bmjopen-2020-047753.
This study aimed to examine the prevalence of peritraumatic stress symptoms (PTSSs), perceived threat, social support and factors contributing to clinically significant PTSS among frontline COVID-19 healthcare workers (HCWs) in China.
An online survey through self-administered questionnaires was conducted from 18 February to 4 March 2020, during the outbreak of COVID-19.
PTSS was assessed using the post-traumatic stress disorder (PTSD) self-rating scale. Demographic and socioeconomic characteristics, self-reported health, physical/psychological symptoms, perceived threat from frontline work and perceived social support were investigated. Multivariable line regression analysis distinguished factors associated with HCWs' PTSS scores.
A total of 676 (58.1%) HCWs have shown clinically significant high levels of PTSS. Only 441 (37.9%) self-reported good health. Most had physical symptom(s) (915 (78.7%)), psychological symptom(s) (906 (77.9%)), inability to vent emotions (284 (24.4%)), emotional exhaustion (666 (57.3%)) and 1037 (89.2%) needed professional respect. Moreover, social support received was less than expected, and the receipt of psychological services/help scored the lowest (3.11±1.73). Combined psychological and physical symptoms, difficulty in releasing tension and venting emotions timely, fear of infection, emotional exhaustion and depersonalisation are significantly associated with PTSS scores among frontline HCWs. Working ≥8 hours, having the senior professional title, self-reported health, enjoying perfect protection and control measures, economic subsidy and control policy on reducing discriminatory practices are negatively correlated with PTSS scores.
During the outbreak of COVID-19, frontline HCWs experienced clinically significant high levels of PTSS and heavy workload, and the emergency resulted in their inadequate psychosocial support. If this is left unchecked, HCWs have a higher risk of developing PTSD. Early detection, identification and person-directed, targeted multidisciplinary interventions should be undertaken to address various influencing factors. Comprehensive measures, including setting up emotional release channels, as well as providing psychological and social support intervention for HCWs globally, are highly recommended.
本研究旨在调查中国新冠肺炎一线医护人员(HCWs)创伤后应激症状(PTSSs)、感知威胁、社会支持以及导致临床显著 PTSS 的因素的流行情况。
2020 年 2 月 18 日至 3 月 4 日期间,在新冠肺炎疫情爆发期间,通过在线自我管理问卷进行了一项调查。
共有 676 名(58.1%)医护人员表现出明显的创伤后应激障碍(PTSD)水平。只有 441 人(37.9%)自我报告健康状况良好。大多数人存在身体症状(915 人,78.7%)、心理症状(906 人,77.9%)、无法宣泄情绪(284 人,24.4%)、情绪疲惫(666 人,57.3%)和 1037 人(89.2%)需要专业尊重。此外,他们得到的社会支持低于预期,而获得心理服务/帮助的得分最低(3.11±1.73)。一线 HCWs 的综合心理和身体症状、及时释放紧张和宣泄情绪的困难、对感染的恐惧、情绪疲惫和去人性化与 PTSD 评分显著相关。工作时间≥8 小时、具有高级职称、自我报告健康状况、享受完善的保护和控制措施、经济补贴和减少歧视性做法的控制政策与 PTSD 评分呈负相关。
在新冠肺炎疫情期间,一线 HCWs 经历了明显的创伤后应激障碍和繁重的工作量,紧急情况导致他们获得的心理社会支持不足。如果不加以控制,HCWs 患创伤后应激障碍的风险更高。应早期发现、识别并针对个人进行有针对性的多学科干预,以解决各种影响因素。强烈建议采取全面措施,包括为 HCWs 建立情绪释放渠道,以及为他们提供心理和社会支持干预。