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COVID-19 大流行期间医护人员心理健康的长期轨迹和影响因素:一项长达 24 个月的纵向队列研究。

Long-Term Trajectory and Risk Factors of Healthcare Workers' Mental Health during COVID-19 Pandemic: A 24 Month Longitudinal Cohort Study.

机构信息

Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.

Occupational Medicine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.

出版信息

Int J Environ Res Public Health. 2023 Mar 4;20(5):4586. doi: 10.3390/ijerph20054586.

Abstract

BACKGROUND

Research has shown the substantial impact of the COVID-19 pandemic on healthcare workers' (HCWs) mental health, however, it mostly relies on data collected during the early stages of COVID-19. The aim of this study is to assess the long-term trajectory of HCWs' mental health and the associated risk factors.

METHODS

a longitudinal cohort study was carried out in an Italian hospital. At Time 1 (July 2020-July 2021), 990 HCWs took part in the study and completed the General Health Questionnaire (GHQ-12), the Impact of Event Scale (IES-R), and the General Anxiety Disorder (GAD-7)questionnaire. McNemar's test measured changes in symptoms' trajectories, and random effects models evaluated risk factors associated with scores above the cut-off.

RESULTS

310 HCWs participated to the follow-up evaluation (Time 2; July 2021-July 2022). At Time 2, scores above cut-offs were significantly lower ( < 0.001) than at Time 1 for all scales (23% vs. 48% for GHQ-12; 11% vs. 25% for IES-R; 15% vs. 23% for GAD-7). Risk factors for psychological impairment were being a nurse (IES-R: OR 4.72, 95% CI 1.71-13.0; GAD-7: OR 2.82, 95% CI 1.44-7.17), a health assistant (IES-R: OR 6.76, 95% CI 1.30-35.1), or having had an infected family member (GHQ-12: OR 1.95, 95% CI 1.01-3.83). Compared to Time 1, gender and experience in COVID-19 units lost significance with psychological symptoms.

CONCLUSIONS

data over more than 24 months from the pandemic onset showed improvement of HCWs' mental health; our findings suggested the need to tailor and prioritize preventive actions towards healthcare workforce.

摘要

背景

研究表明,COVID-19 大流行对医护人员(HCWs)的心理健康产生了重大影响,但这些研究主要依赖于 COVID-19 早期阶段收集的数据。本研究旨在评估 HCWs 心理健康的长期轨迹及其相关的危险因素。

方法

在意大利的一家医院进行了一项纵向队列研究。在时间 1(2020 年 7 月至 2021 年 7 月),990 名 HCWs 参与了研究,并完成了一般健康问卷(GHQ-12)、事件影响量表(IES-R)和广泛性焦虑障碍(GAD-7)问卷。McNemar 检验测量了症状轨迹的变化,随机效应模型评估了与得分超过临界值相关的危险因素。

结果

310 名 HCWs 参加了随访评估(时间 2;2021 年 7 月至 2022 年 7 月)。在时间 2,所有量表的得分高于临界值的比例显著低于时间 1(GHQ-12:23%比 48%;IES-R:11%比 25%;GAD-7:15%比 23%)。心理障碍的危险因素包括护士(IES-R:OR 4.72,95%CI 1.71-13.0;GAD-7:OR 2.82,95%CI 1.44-7.17)、卫生助理(IES-R:OR 6.76,95%CI 1.30-35.1)或有感染的家庭成员(GHQ-12:OR 1.95,95%CI 1.01-3.83)。与时间 1 相比,性别和 COVID-19 病房工作经验与心理症状失去了相关性。

结论

自大流行开始以来超过 24 个月的数据显示,HCWs 的心理健康状况有所改善;我们的研究结果表明,需要针对医疗保健劳动力制定和优先考虑预防措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f286/10002366/03ab8d13d868/ijerph-20-04586-g001.jpg

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