Osório Flávia L, Zuardi Antonio Waldo, Silveira Isabella L M, Crippa José Alexandre S, Hallak Jaime Eduardo Cecílio, Pereira-Lima Karina, Loureiro Sonia R
Medical School of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.
Front Psychiatry. 2022 Apr 8;13:852157. doi: 10.3389/fpsyt.2022.852157. eCollection 2022.
Few longitudinal studies assessed the less immediate consequences of the COVID-19 pandemic on health workers' mental health, especially in less developed countries. The objective was to assess the evolution of mental health indicators of Brazilian health workers providing care to COVID-19 patients, considering the beginning and first wave of the pandemic, identifying risk and protective factors. A non-probabilistic sample of health professionals was assessed for 6 months at seven different points in time using standardized instruments to measure anxiety, depression, insomnia, posttraumatic stress, and burnout symptoms. Risk and protective factors were assessed using a questionnaire addressing socio-demographic, clinical, occupational variables, and COVID-19 risk perception. The results indicate high rates for all the indicators (>30%) throughout the follow-up; only anxiety symptoms decreased in the different phases compared to the baseline. Depression and insomnia symptoms showed a significant drop in isolated points of the assessment, which were not maintained at the final follow-up. Burnout indicators concerning emotional exhaustion and depersonalization remained stable (40 and 20%), while professional achievement decreased by approximately 19%. Occupational and personal characteristics (profession and work setting), perceptions regarding protective measures imposed by the institutions, and future professional prospects stood out as risk/protective factors in mental health. Unlike European and Asian countries, where mental distress symptoms tended to decrease over the pandemic, this study's results suggest alarming indicators of mental health problems remaining stable with burnout symptoms on the rise. Hence, the different contexts across countries, with different management resources and investments in health actions, seem to influence workers' mental health differently, demanding constant attention and monitoring and measures to minimize the impacts on individuals and collectives, especially in less developed countries like Brazil.
很少有纵向研究评估新冠疫情对医护人员心理健康的较长期影响，尤其是在欠发达国家。本研究旨在评估为新冠患者提供护理的巴西医护人员心理健康指标的变化情况，考虑到疫情的开始和第一波高峰，识别风险和保护因素。使用标准化工具在七个不同时间点对一个非概率抽样的卫生专业人员进行为期6个月的评估，以测量焦虑、抑郁、失眠、创伤后应激和职业倦怠症状。使用一份涉及社会人口统计学、临床、职业变量以及对新冠风险认知的问卷来评估风险和保护因素。结果表明，在整个随访期间所有指标的发生率都很高（>30%）；与基线相比，只有焦虑症状在不同阶段有所下降。抑郁和失眠症状在评估的个别时间点有显著下降，但在最终随访时并未持续。关于情感耗竭和去个性化的职业倦怠指标保持稳定（分别为40%和20%），而专业成就感下降了约19%。职业和个人特征（职业和工作环境）、对机构实施的保护措施的认知以及未来职业前景是心理健康方面的风险/保护因素。与欧洲和亚洲国家不同，在这些国家心理困扰症状在疫情期间往往有所下降，本研究结果表明心理健康问题的警示指标保持稳定，职业倦怠症状呈上升趋势。因此，不同国家的不同背景，以及在卫生行动方面不同的管理资源和投入，似乎对工作人员的心理健康有不同影响，需要持续关注和监测，并采取措施尽量减少对个人和集体的影响，尤其是在像巴西这样的欠发达国家。
