新冠疫情的另一面：对意大利护士样本在第二波疫情期间心理健康状况的横断面研究
The other side of COVID-19: A cross-sectional study on mental health in a sample of Italian nurses during the second wave.
作者信息
Renzi Erika, Imeshtari Valentin, Masud Dima, Baccolini Valentina, Migliara Giuseppe, Gasperini Giulia, De Vito Corrado, Marzuillo Carolina, Villari Paolo, Massimi Azzurra
机构信息
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
Emergency Department, Sandro Pertini Hospital, Rome, Italy.
出版信息
Front Psychiatry. 2023 Mar 1;14:1083693. doi: 10.3389/fpsyt.2023.1083693. eCollection 2023.
INTRODUCTION
The COVID-19 pandemic has led to a drastic increase in the workload of healthcare professionals, particularly nurses, with serious consequences for their psychological well-being. Our study aimed to identify demographic and work-related factors, as well as clinical predictors of post-traumatic stress disorder (PTSD) and generalized anxiety disorder (GAD), in nurses employed during the COVID-19 pandemic.
METHODS
We carried out a cross-sectional study between December 2020 and April 2021 on nurses employed during the COVID-19 second wave (October - December 2020). We evaluated PTSD and GAD using two validated questionnaires: i) the Impact of Event Scale - Revised (IES-R); and ii) General Anxiety Disorder -7 (GAD-7).
RESULTS
Overall, 400 nurses, whose mean age was 34.3 years (SD ± 11.7), were included in the study. Most were female (78.5%), unmarried (58.5%) and employed in the central (61.5%) regions of Italy. A total of 56.8% of all participants had clinical predictors of PTSD, recording a median IES-R score (IQR) of 37.0 (22.0, 51.0) (range 1-84; cut-off >33 for PTSD). Furthermore, 50% of respondents reported moderate-to-severe symptoms consistent with GAD, recording a median GAD-7 score (IQR) of 9.5 (6.0,14.0) (range 0-21; cut-off >10 for GAD). Multivariable analysis showed that moderate-to-severe GAD (aOR = 4.54, 95% CI: 2.93 - 7.05), being employed in the critical care area (aOR = 1.74, 95% CI: 1.01 - 3.00) and being female (aOR= 1.88, 95% CI: 1.09 - 3.22) were significantly associated with the presence of clinical predictors of PTSD.
DISCUSSION
The levels of PTSD symptoms and anxiety among nurses were high during the pandemic. PTSD and GAD represent a public health problem that should be addressed in the post-pandemic period. Healthcare organizations need to activate specific support and rehabilitation networks and programs for healthcare professionals employed during the COVID-19 pandemic.
引言
新冠疫情导致医护人员，尤其是护士的工作量急剧增加，对他们的心理健康产生了严重影响。我们的研究旨在确定在新冠疫情期间工作的护士中，与创伤后应激障碍（PTSD）和广泛性焦虑障碍（GAD）相关的人口统计学因素、工作相关因素以及临床预测指标。
方法
我们在2020年12月至2021年4月期间，对在新冠疫情第二波（2020年10月至12月）工作的护士进行了一项横断面研究。我们使用两份经过验证的问卷评估创伤后应激障碍和广泛性焦虑障碍：i）事件影响量表修订版（IES-R）；ii）广泛性焦虑障碍-7（GAD-7）。
结果
总体而言，400名护士纳入了研究，他们的平均年龄为34.3岁（标准差±11.7）。大多数为女性（78.5%），未婚（58.5%），在意大利中部地区工作（61.5%）。所有参与者中，共有56.8%具有创伤后应激障碍的临床预测指标，事件影响量表修订版的中位数得分（四分位间距）为37.0（22.0，51.0）（范围1-84；创伤后应激障碍临界值>33）。此外，50%的受访者报告有与广泛性焦虑障碍相符的中度至重度症状，广泛性焦虑障碍-7的中位数得分（四分位间距）为9.5（6.0，14.0）（范围0-2）；广泛性焦虑障碍临界值>10）。多变量分析显示，中度至重度广泛性焦虑障碍（调整后比值比=4.54，95%置信区间：2.93-7.05）、在重症监护区工作（调整后比值比=1.74，95%置信区间：1.01-3.00）以及女性（调整后比值比=1.88，95%置信区间：1.09-3.22）与创伤后应激障碍临床预测指标的存在显著相关。
讨论
疫情期间护士的创伤后应激障碍症状和焦虑水平较高。创伤后应激障碍和广泛性焦虑障碍是一个公共卫生问题，在疫情后时期应予以解决。医疗机构需要为在新冠疫情期间工作的医护人员启动特定的支持和康复网络及项目。
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