Bates Andrew, Ottaway Julia, Moyses Helen, Perrrow Marcie, Rushbrook Sophie, Cusack Rebecca
University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Dorset HealthCare, NHS Foundation Trust Poole, Poole, UK.
J Intensive Care Soc. 2021 Nov;22(4):312-318. doi: 10.1177/1751143720965109. Epub 2020 Oct 14.
Reports of significant psychological stress among frontline healthcare workers are emerging from the Covid-19 outbreak in China. Concerningly, these match findings from previous infective outbreaks, which resulted in long-term psychological pathology.
During the Covid-19 pandemic, a multi-disciplinary cohort of Intensive Care staff completed an online survey of psychological well-being and rated the perceived usefulness of supportive interventions.
Sixty per cent of invited staff responded. Seventy-seven per cent reported normal/high level of resilience. Thirty-two staff (35%) reported anxiety of a level at which formal psychological assessment is recommended. Sixteen (14%) staff members reported symptomology suggestive of post-traumatic stress disorder (PTSD). Multiple regression analysis revealed a significant relationship between job-related well-being, anxiety (p = 0.003) and PTSD (p = 0.005). Nurses were seven times more likely than doctors to score higher anxiety (OR = 6.8; p = 0.01). Preferred supportive interventions were adequate personal protective equipment, rest facilities and regular breaks. In the subgroup with high anxiety, psychological support was perceived as significantly more useful, with significant reductions reported for rest facilities and PPE.
We report concerning levels of anxiety and post-traumatic stress symptomology among intensive care staff during the Covid-19 crisis, significantly impacting job-related well-being. Nurses are disproportionately affected. Overall, physiologically protective supportive interventions were preferred by staff; however, staff with established anxiety desire professional psychological help. Our findings match reports from SARS 2003 and China 2019. To mitigate long-term psychological consequences of caring for patients during a pandemic, easily deliverable protective strategies should be instigated, supported by formal and longer-term psychological support. Particular attention should be paid to developing strategies which support nursing staff.
在中国新冠疫情爆发期间，一线医护人员出现严重心理压力的报道不断涌现。令人担忧的是，这些情况与以往感染性疫情的调查结果相符，而以往疫情导致了长期的心理疾病。
在新冠疫情期间，一组多学科的重症监护室工作人员完成了一项关于心理健康的在线调查，并对支持性干预措施的感知有用性进行了评分。
60%受邀工作人员做出了回应。77%的人报告称恢复力处于正常/较高水平。32名工作人员（35%）报告的焦虑程度达到建议进行正式心理评估的水平。16名（14%）工作人员报告有创伤后应激障碍（PTSD）的症状。多元回归分析显示，工作幸福感与焦虑（p = 0.003）和创伤后应激障碍（p = 0.005）之间存在显著关系。护士出现较高焦虑的可能性是医生的7倍（比值比=6.8；p = 0.01）。首选的支持性干预措施是充足的个人防护装备、休息设施和定期休息。在高焦虑亚组中，心理支持被认为明显更有用，同时报告称休息设施和个人防护装备的需求显著减少。
我们报告了新冠疫情危机期间重症监护室工作人员中令人担忧的焦虑水平和创伤后应激症状，这对工作幸福感产生了重大影响。护士受到的影响尤为严重。总体而言，工作人员更倾向于生理保护性支持干预措施；然而，已有焦虑症状的工作人员需要专业心理帮助。我们的研究结果与2003年非典和2019年中国的报告相符。为减轻疫情期间照顾患者带来的长期心理影响，应实施易于提供的保护策略，并辅以正式的长期心理支持。应特别关注制定支持护理人员的策略。
