探索 COVID-19 大流行对日本居家医护人员心理健康的影响：一项多中心横断面网络调查。
Exploration of the impact of the COVID-19 pandemic on the mental health of home health care workers in Japan: a multicenter cross-sectional web-based survey.
机构信息
Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan.
Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
出版信息
BMC Prim Care. 2022 May 26;23(1):129. doi: 10.1186/s12875-022-01745-4.
BACKGROUND
The COVID-19 pandemic has caused home health care workers (home-HCWs) to experience anxiety. The mental health of home-HCWs and related factors during the COVID-19 pandemic have not been clarified; therefore, we aimed to investigate the status and associated factors of fear of COVID-19 infection, anxiety, and depression among home-HCWs in Japan.
METHODS
We conducted a multicenter cross-sectional web-based anonymous survey of home-HCWs in August 2021, during the fifth wave of the pandemic in Japan. We surveyed members of facilities that provided home visit services during the COVID-19 pandemic. We measured the Japanese version of the Fear of COVID-19 scale (FCV-19S-J) and the Hospital Anxiety and Depression scale (HADS) as objective variables, and the Japanese version of the Assessment of Interprofessional Team Collaboration Scale-II (J-AITCS-II) as an explanatory variable.
RESULTS
A total of 328 members of 37 facilities responded to the survey, and we ultimately analyzed 311 participants. The most frequent occupation was nurse (32.8%), followed by doctor (24.8%) and medical office staff (18.0%). The mean score of the FCV-19S-J was 16.5 ± 5.0 (7.0 - 31.0), and the prevalences of definitive anxiety and depression were 7.4% and 15.7%, respectively. Multivariate regression analysis revealed that the J-AITCS-II teamwork subscale was significantly negatively associated with FCV-19S-J, HADS-anxiety, and HADS-depression (β = -0.171, p = 0.004; β = -0.151, p = 0.012; β = -0.225, p < 0.001, respectively). Medical office staff showed significant positive associations with FCV-19S-J and HADS-depression (β = 0.219, p = 0.005; β = 0.201, p = 0.009, respectively), and medical social workers with HADS-anxiety and HADS-depression (β = -0.166, p = 0.011; β = -0.214, p < 0.001, respectively) compared with doctors. The unmet support need for expert lectures on COVID-19 was significantly positively associated with FCV-19S-J (β = 0.131, p = 0.048), and the unmet support need for support systems for psychological stress and emotional exhaustion was significantly positively associated with HADS-anxiety (β = 0.141, p = 0.022).
CONCLUSIONS
Fear of COVID-19 infection and depression of nurses, medical office staff, and other occupations was significantly higher than those of doctors. These findings suggest that non-physicians were more likely to be fearful and depressed during the COVID-19 pandemic; thus, it is necessary to tailor mental health support based on occupation in the home care setting.
背景
新冠疫情大流行导致家庭保健工作者（家庭保健工作者）感到焦虑。家庭保健工作者在新冠疫情期间的心理健康及其相关因素尚不清楚；因此，我们旨在调查日本家庭保健工作者对新冠病毒感染的恐惧、焦虑和抑郁的状况及相关因素。
方法
我们于 2021 年 8 月在日本第五波疫情期间对家庭保健工作者进行了一项多中心、横断面、网络匿名调查。我们调查了在新冠疫情期间提供上门服务的机构的成员。我们以日本版新冠恐惧量表（FCV-19S-J）和医院焦虑和抑郁量表（HADS）为客观变量，以评估专业间团队合作量表-II（J-AITCS-II）为解释变量。
结果
共有 37 个机构的 328 名成员对调查做出了回应，我们最终分析了 311 名参与者。最常见的职业是护士（32.8%），其次是医生（24.8%）和医疗办公室工作人员（18.0%）。FCV-19S-J 的平均得分为 16.5±5.0（7.0-31.0），明确焦虑和抑郁的患病率分别为 7.4%和 15.7%。多变量回归分析显示，J-AITCS-II 团队合作子量表与 FCV-19S-J、HADS 焦虑和 HADS 抑郁呈显著负相关（β=-0.171，p=0.004；β=-0.151，p=0.012；β=-0.225，p<0.001）。医疗办公室工作人员与 FCV-19S-J 和 HADS 抑郁呈显著正相关（β=0.219，p=0.005；β=0.201，p=0.009），医疗社会工作者与 HADS 焦虑和 HADS 抑郁呈显著负相关（β=-0.166，p=0.011；β=-0.214，p<0.001），而与医生相比。对新冠病毒专家讲座的未满足支持需求与 FCV-19S-J 呈显著正相关（β=0.131，p=0.048），对心理压力和情绪疲惫支持系统的未满足支持需求与 HADS 焦虑呈显著正相关（β=0.141，p=0.022）。
结论
与医生相比，护士、医疗办公室工作人员和其他职业对新冠病毒感染的恐惧和抑郁程度明显更高。这些发现表明，非医生在新冠疫情期间更容易感到恐惧和抑郁；因此，有必要根据家庭保健环境中的职业调整心理健康支持。
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