Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands.
Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States of America.
PLoS One. 2022 Feb 7;17(2):e0245182. doi: 10.1371/journal.pone.0245182. eCollection 2022.
Working under pandemic conditions exposes health care workers (HCWs) to infection risk and psychological strain. A better understanding of HCWs' experiences of following local infection prevention and control (IPC) procedures during COVID-19 is urgently needed to inform strategies for protecting the psychical and psychological health of HCWs. The objective of this study was therefore to capture the perceptions of hospital HCWs on local IPC procedures and the impact on their emotional wellbeing during the first wave of the COVID-19 pandemic in Europe.
Participants were recruited in two sampling rounds of an international cross-sectional survey. Sampling took place between 31 March and 17 April 2020 via existing research networks and between 14 May and 31 August 2020 via online convenience sampling. Main outcome measures were behavioural determinants of HCWs' adherence to IPC guidelines and the WHO-5 Well-Being Index, a validated scale of 0-100 reflecting emotional wellbeing. The WHO-5 was interpreted as a score below or above 50 points, a cut-off score used in previous literature to screen for depression.
2289 HCWs from 40 countries in Europe participated. Mean age was 42 (±11) years, 66% were female, 47% and 39% were medical doctors and nurses, respectively. 74% (n = 1699) of HCWs were directly treating patients with COVID-19, of which 32% (n = 527) reported they were fearful of caring for these patients. HCWs reported high levels of concern about COVID-19 infection risk to themselves (71%) and their family (82%) as a result of their job. 40% of HCWs considered that getting infected with COVID-19 was not within their control. This feeling was more common among junior than senior HCWs (46% versus 38%, P value < .01). Sufficient COVID-19-specific IPC training, confidence in PPE use and institutional trust were positively associated with the feeling that becoming infected with COVID-19 was within their control. Female HCWs were more likely than males to report a WHO-5 score below 50 points (aOR 1.5 (95% confidence interval (CI) 1.2-1.8).
In Europe, the COVID-19 pandemic has had a differential impact on those providing direct COVID-19 patient care, junior staff and women. Health facilities must be aware of these differential impacts, build trust and provide tailored support for this vital workforce during the current COVID-19 pandemic.
在大流行期间工作会使医护人员（HCWs）面临感染风险和心理压力。迫切需要更好地了解 HCWs 在 COVID-19 期间遵循当地感染预防和控制（IPC）程序的经验，以为保护 HCWs 的身心健康提供策略。因此，本研究的目的是了解医院 HCWs 对当地 IPC 程序的看法以及这些程序对他们在欧洲 COVID-19 大流行第一波期间情绪健康的影响。
参与者是通过两轮国际横断面调查招募的。第一轮调查于 2020 年 3 月 31 日至 4 月 17 日通过现有的研究网络进行，第二轮调查于 2020 年 5 月 14 日至 8 月 31 日通过在线便利抽样进行。主要结局指标是 HCWs 遵守 IPC 指南的行为决定因素和世界卫生组织（WHO）-5 幸福感指数，这是一个 0-100 的得分，反映了情绪健康。WHO-5 的得分低于或高于 50 分，这是以前文献中用于筛查抑郁的一个临界值。
来自欧洲 40 个国家的 2289 名 HCWs 参与了这项研究。参与者的平均年龄为 42（±11）岁，66%为女性，47%和 39%分别为医生和护士。74%（n = 1699）的 HCWs 直接治疗 COVID-19 患者，其中 32%（n = 527）表示他们害怕照顾这些患者。由于工作原因，HCWs 对自己（71%）和家人（82%）感染 COVID-19 的风险表示高度关注。40%的 HCWs 认为感染 COVID-19 不在他们的控制范围内。这种感觉在初级 HCWs 中比在高级 HCWs 中更为常见（46%比 38%，P 值<.01）。有足够的 COVID-19 特定 IPC 培训、对 PPE 使用的信心和机构信任与认为感染 COVID-19 在自己的控制范围内呈正相关。女性 HCWs 比男性更有可能报告 WHO-5 得分低于 50 分（优势比 1.5（95%置信区间（CI）1.2-1.8）。
在欧洲，COVID-19 大流行对直接提供 COVID-19 患者护理的人员、初级工作人员和女性产生了不同的影响。卫生机构必须意识到这些不同的影响，建立信任，并在当前的 COVID-19 大流行期间为这一重要的劳动力提供有针对性的支持。
