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应对 COVID-19 时医护人员的心理健康:系统评价和荟萃分析。

Health care workers' mental health in the face of COVID-19: a systematic review and meta-analysis.

机构信息

Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.

Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Int J Psychiatry Clin Pract. 2023 Jun;27(2):208-217. doi: 10.1080/13651501.2022.2101927. Epub 2022 Jul 23.

Abstract

BACKGROUND

Healthcare workers are leading the way in treating patients with coronavirus disease 2019 (COVID-19). Due to the high levels of psychological stress, this group is more likely to experience psychological issues. These psychological problems in healthcare providers include depression, anxiety, insomnia, stress and post-traumatic stress disorder (PTSD). The goal of this systematic review and meta-analysis was to find out how common these problems were in the face of COVID-19.

METHODS

On 20 February 2022, systematic searches were conducted in the PubMed, Cochrane Library, Scopus, EMBASE, Science Direct, Web of Science and ProQuest databases. Two authors selected articles based on search keywords. As a last step, articles about the prevalence of psychological problems among healthcare workers in the face of COVID-19 were looked at and analysed for five different outcomes.

RESULTS

The initial search yielded 18,609 articles. After reviewing the titles, abstracts and full texts of the articles, 44 were chosen for the final analysis and 29 were subjected to a meta-analysis. Insomnia, anxiety, depression, PTSD and stress are among the psychological issues faced by healthcare workers. Furthermore, the highest pooled prevalence of depression, anxiety, insomnia, PTSD and stress was 36% (95% confidence interval (CI) 24-50%), 47% (95% CI 22-74%), 49% (95% CI 28-70%), 37% (95% CI 19-59%) and 27% (95% CI 6-69%).

CONCLUSIONS

In this meta-analysis, insomnia was found to be the most common mental health problem, followed by anxiety, PTSD, depression and stress in healthcare workers in the face of the COVID-19 pandemic. Generally, the pooled prevalence of these mental health problems was higher among physicians, nurses and older staff in the subgroup analysis. As a result, health policymakers and managers of the health care system should think about effective interventions to promote mental health, paying particular attention to these two groups.Key pointsStudies conducted in China reported more mental problems than in other countries.Health policymakers and health system managers should hold training programs to promote healthcare workers' mental health with a particular focus on more vulnerable groups.The prevalence of PTSD, stress, anxiety, depression and insomnia were higher among physicians, nurses and older staff.Health systems at both national and local levels have to take older physicians, nurses and healthcare providers into consideration while designing interventions.

摘要

背景

医护人员在治疗 2019 年冠状病毒病(COVID-19)患者方面发挥了主导作用。由于心理压力水平较高,这群人更容易出现心理问题。医护人员的这些心理问题包括抑郁、焦虑、失眠、压力和创伤后应激障碍(PTSD)。本系统评价和荟萃分析的目的是找出在 COVID-19 面前这些问题有多普遍。

方法

2022 年 2 月 20 日,在 PubMed、Cochrane 图书馆、Scopus、EMBASE、Science Direct、Web of Science 和 ProQuest 数据库中进行了系统搜索。两位作者根据搜索关键词选择了文章。最后一步是查看并分析了 44 篇关于 COVID-19 期间医护人员心理问题发生率的文章,并对五个不同的结果进行了分析。

结果

最初的搜索产生了 18609 篇文章。在审查了文章的标题、摘要和全文后,选择了 44 篇进行最终分析,其中 29 篇进行了荟萃分析。失眠、焦虑、抑郁、PTSD 和压力是医护人员面临的心理问题。此外,抑郁、焦虑、失眠、PTSD 和压力的最高 pooled 患病率为 36%(95%置信区间[CI]24-50%)、47%(95%CI 22-74%)、49%(95%CI 28-70%)、37%(95%CI 19-59%)和 27%(95%CI 6-69%)。

结论

在这项荟萃分析中,失眠是医护人员在 COVID-19 大流行期间最常见的心理健康问题,其次是焦虑、PTSD、抑郁和压力。一般来说,在亚组分析中,这些心理健康问题的 pooled 患病率在医生、护士和年龄较大的工作人员中更高。因此,卫生政策制定者和卫生系统管理者应考虑采取有效的干预措施来促进心理健康,特别关注这两个群体。

关键点

在中国进行的研究报告的心理问题比其他国家多。

卫生政策制定者和卫生系统管理者应举办培训计划,以促进医护人员的心理健康,特别关注更脆弱的群体。

PTSD、压力、焦虑、抑郁和失眠在医生、护士和年龄较大的工作人员中更为常见。

在设计干预措施时,国家和地方各级卫生系统必须考虑到年龄较大的医生、护士和医疗保健提供者。

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