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新冠疫情对妇产科医护人员心理健康的影响:在一家顶尖机构的观察性研究

The Impact of the COVID-19 Pandemic on the Psychological Well-being of Healthcare Workers in Obstetrics and Gynaecology: An Observational Study at an Apex Institute.

作者信息

Meena Jyoti, Dhiman Soniya, Sharma Renu, Kumari Kamlesh, Singhal Seema, Kulshrestha Vidushi, Vatsa Richa, Perumal Vanamail

机构信息

Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, New Delhi, IND.

Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, New Delhi, IND.

出版信息

Cureus. 2022 Apr 11;14(4):e24040. doi: 10.7759/cureus.24040. eCollection 2022 Apr.

Abstract

Background and objective The coronavirus disease 2019 (COVID-19) pandemic has affected the health, social, and economic sectors all over the world. With a view to assessing the impact of COVID-19 on the mental health of healthcare workers (HCWs), we conducted a study to find out the incidence and severity of depression, anxiety, and post-traumatic stress disorder (PTSD) among HCWs. Material and methods This was an observational cross-sectional study conducted in the Department of Obstetrics and Gynaecology in collaboration with the Department of Psychiatry at AIIMS, New Delhi from March 2021 to June 2021. One hundred HCWs working in the Department of Obstetrics and Gynaecology were surveyed using a set of semi-structured interview schedules and structured questionnaires distributed via email or manually. The structured questionnaire included the demographic profile; other baseline information; the 42-item Depression, Anxiety, and Stress Scale (DASS-42); and the Impact of Event Scale-Revised (IES-R) instrument. Data analysis was carried out using the statistical package STATA version 14.0 (StataCorp LLC, College Station, TX). Results A total of 100 HCWs participated in the study, out of which 39 (39%), 45 (45%), and 16 (16%) were doctors, nursing staff, and supporting staff, respectively. Overall, 92 (92%) of the participants were women, and the mean age of the participants was 29.87 ±4.85 years. Out of the 100 participants, 17 (17%), 25 (25%), 13 (13%), and two (2%) participants had depression, anxiety, stress, and PTSD, respectively. Occupation-wise, among the nursing staff, doctors, and supporting staff, the incidence of depression was 24.4%, 15.4%, 0.0%, respectively; the anxiety rate was 33.3%, 25.6%, and 0.0%, respectively; and the rate of stress was 17.8%, 12.8%, and 0.0%, respectively. The IES-R score was significantly higher among unmarried as compared to married participants (2.70 ±7.935 vs. 1.60 ±3.583, p=0.000). Participants living in joint families had a higher DASS-42 score (DASS-D: 4.00 ±5.299 vs. 3.77 ±7.727, p=0.889; DASS-A: 4.31 ±4.398 vs. 4.12 ±7.496, p=0.905; DASS-S: 4.08 ±4.816 vs. 3.88 ±7.567, p=0.016) and lower IES-R score (1.31 ±4.922 vs. 2.66 ±9.947, p=0.752) as compared to those living in nuclear families. Depression (4.86 ±8.165 vs. 2.00 ±4.388, p=0.054), anxiety (5.31 ±7.538 vs. 2.14 ±4.704, p=0.024), stress (5.20 ±7.651 vs. 1.67 ±4.733, p=0.014) and PTSD (3.61 ±10.900 vs. 1.44 ±2.634, p=0.245) were all higher among HCWs having exposure to COVID-19 more than 10 hours per week compared to participants with an exposure of less than 10 hours per week. The participants having psychiatric illness in the family showed significantly higher mean values for DASS-42 (DASS-D: 20.00 ±26.870 vs. 3.50 ±6.264, p=0.001; DASS-A: 18.50 ±20.506 vs. 3.88 ±6.215, p=0.002; DASS-S: 18.00 ±21.213 vs. 3.64 ±6.346, p=0.003) as compared to those without any psychiatric illness in the family. Conclusion Based on our findings, occupational and environmental factors at the workplace play a key role in mental health outcomes, and COVID-19 has had a significant impact on the mental health of HCWs. Furthermore, we have also observed that effective planning can significantly reduce mental stress.

摘要

背景与目的 2019年冠状病毒病(COVID-19)大流行已影响到全球的健康、社会和经济领域。为评估COVID-19对医护人员心理健康的影响,我们开展了一项研究,以了解医护人员中抑郁症、焦虑症和创伤后应激障碍(PTSD)的发病率及严重程度。

材料与方法 这是一项于2021年3月至2021年6月在新德里全印医学科学研究所妇产科与精神科合作开展的观察性横断面研究。采用一套半结构化访谈提纲和通过电子邮件或人工发放的结构化问卷,对100名在妇产科工作的医护人员进行了调查。结构化问卷包括人口统计学资料;其他基线信息;42项抑郁、焦虑和压力量表(DASS-42);以及事件影响量表修订版(IES-R)工具。使用统计软件包STATA 14.0(StataCorp有限责任公司,德克萨斯州大学站)进行数据分析。

结果 共有100名医护人员参与了本研究,其中医生、护理人员和辅助人员分别有39名(39%)、45名(45%)和16名(16%)。总体而言,92名(92%)参与者为女性,参与者的平均年龄为29.87±4.85岁。在100名参与者中,分别有17名(17%)、25名(25%)、13名(13%)和2名(2%)参与者患有抑郁症、焦虑症、压力症和创伤后应激障碍。按职业划分,护理人员、医生和辅助人员中抑郁症的发病率分别为24.4%、15.4%、0.0%;焦虑症发生率分别为33.3%、25.6%、0.0%;压力症发生率分别为17.8%、12.8%、0.0%。未婚参与者的IES-R得分显著高于已婚参与者(2.70±7.935对1.60±3.583,p=0.000)。与核心家庭的参与者相比,生活在大家庭中的参与者DASS-42得分更高(DASS-D:平均值4.00±5.299对3.77±7.727,p=0.889;DASS-A:4.31±4.398对4.12±7.496,p=0.905;DASS-S:4.08±4.816对3.88±7.567,p=0.016),IES-R得分更低(1.31±4.922对2.66±9.947,p=0.752)。与每周接触COVID-19少于10小时的参与者相比,每周接触COVID-19超过10小时的医护人员的抑郁症(4.86±8.165对2.00±4.388,p=0.054)、焦虑症(5.31±7.538对2.14±4.704,p=0.024)、压力症(5.20±7.651对1.67±4.733,p=0.014)和创伤后应激障碍(3.61±10.900对1.44±2.634,p=0.245)水平均更高。与家庭中无精神疾病的参与者相比,家庭中有精神疾病的参与者DASS-42的平均值显著更高(DASS-D:20.00±26.870对3.50±6.264,p=0.001;DASS-A:18.50±20.506对3.88±6.215,p=0.002;DASS-S:18.00±21.213对3.64±6.346,p=0.003)。

结论 根据我们的研究结果,工作场所的职业和环境因素在心理健康结果中起关键作用,COVID-19对医护人员的心理健康产生了重大影响。此外,我们还观察到有效的规划可以显著减轻精神压力。

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