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新型冠状病毒肺炎患者与医护人员的心理社会危机干预。

Psychosocial crisis intervention for coronavirus disease 2019 patients and healthcare workers.

机构信息

Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China.

Department of Behavioral Medicine and Psychiatry, School of Medicine, West Virginia University, Morgantown 26505, WV, United States.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2023 Jan 28;48(1):92-105. doi: 10.11817/j.issn.1672-7347.2023.210803.

Abstract

OBJECTIVES

Shelter hospital was an alternative way to provide large-scale medical isolation and treatment for people with mild coronavirus disease 2019 (COVID-19). Due to various reasons, patients admitted to the large shelter hospital was reported high level of psychological distress, so did the healthcare workers. This study aims to introduce a comprehensive and multifaceted psychosocial crisis intervention model.

METHODS

The psychosocial crisis intervention model was provided to 200 patients and 240 healthcare workers in Wuhan Wuchang shelter hospital. Patient volunteers and organized peer support, client-centered culturally sensitive supportive care, timely delivery of scientific information about COVID-19 and its complications, mental health knowledge acquisition of non-psychiatric healthcare workers, group activities, counseling and education, virtualization of psychological intervention, consultation and liaison were exhibited respectively in the model. Pre-service survey was done in 38 patients and 49 healthcare workers using the Generalized Anxiety Disorder 7-item (GAD-7) scale, the Patient Health Questionnaire 2-item (PHQ-2) scale, and the Primary Care PTSD screen for the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (PC-PTSD-5). Forty-eight healthcare workers gave feedback after the intervention.

RESULTS

The psychosocial crisis intervention model was successfully implemented by 10 mental health professionals and was well-accepted by both patients and healthcare workers in the shelter hospital. In pre-service survey, 15.8% of 38 patients were with anxiety, 55.3% were with stress, and 15.8% were with depression; 16.3% of 49 healthcare workers were with anxiety, 26.5% were with stress, and 22.4% were with depression. In post-service survey, 62.5% of 48 healthcare workers thought it was very practical, 37.5% thought more practical; 37.5% of them thought it was very helpful to relief anxiety and insomnia, and 27.1% thought much helpful; 37.5% of them thought it was very helpful to recognize patients with anxiety and insomnia, and 29.2% thought much helpful; 35.4% of them thought it was very helpful to deal with patients' anxiety and insomnia, and 37.5% thought much helpful.

CONCLUSIONS

Psychological crisis intervention is feasible, acceptable, and associated with positive outcomes. Future tastings of this model in larger population and different settings are warranted.

摘要

目的

收容医院是为轻症 2019 冠状病毒病(COVID-19)患者提供大规模医学隔离和治疗的一种替代方式。由于各种原因,收容医院的住院患者和医护人员都报告存在较高水平的心理困扰。本研究旨在介绍一种全面、多方面的心理社会危机干预模式。

方法

将心理社会危机干预模式提供给武汉武昌收容医院的 200 名患者和 240 名医护人员。患者志愿者和组织同伴支持、以患者为中心的文化敏感的支持性护理、及时提供关于 COVID-19 及其并发症的科学信息、非精神科医护人员获得心理健康知识、小组活动、咨询和教育、心理干预的虚拟化、咨询和联络分别在该模型中得到了体现。在服务前,使用广泛性焦虑障碍 7 项量表(GAD-7)、患者健康问卷 2 项量表(PHQ-2)和精神障碍诊断与统计手册第 5 版的初级保健创伤后应激障碍筛查量表(PC-PTSD-5)对 38 名患者和 49 名医护人员进行了预服务调查。干预结束后,有 48 名医护人员提供了反馈。

结果

该心理社会危机干预模式由 10 名心理健康专业人员成功实施,在收容医院的患者和医护人员中得到了很好的接受。在服务前调查中,38 名患者中有 15.8%存在焦虑,55.3%存在压力,15.8%存在抑郁;49 名医护人员中有 16.3%存在焦虑,26.5%存在压力,22.4%存在抑郁。在服务后调查中,48 名医护人员中有 62.5%认为非常实用,37.5%认为更实用;37.5%认为对缓解焦虑和失眠很有帮助,27.1%认为帮助很大;37.5%认为对识别焦虑和失眠患者很有帮助,29.2%认为帮助很大;35.4%认为对处理患者的焦虑和失眠很有帮助,37.5%认为帮助很大。

结论

心理危机干预是可行的、可接受的,并与积极的结果相关。需要在更大的人群和不同的环境中进一步测试该模型。

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