At the University of Texas, Southwestern Medical Center in Dallas, Tex., Keri Draganic is an acute care nurse practitioner, Linda Denke is a nurse scientist, Corey Kershaw is the medical director of the Medical ICU, Kandace Williams is an adult gerontology acute care nurse practitioner, and Folefac D. Atem is the lead statistician. Victoria England is a retired associate CNO.
Nursing. 2023 Apr 1;53(4):54-61. doi: 10.1097/01.NURSE.0000920444.46279.2c.
To evaluate the severity and longitudinal trends of depression in critical care nurses caring for patients with COVID-19 in the US during a global pandemic.
The study employed longitudinal mixed methods. Using the Patient Health Questionnaire (PHQ-9), nurses were sent electronic surveys at baseline, 1 month, and between 3 and 6 months to measure the severity and trends of depression during the prevaccination stage of the COVID-19 pandemic. One-on-one interviews were conducted with critical care nurses to evaluate their depressive symptoms.
Forty-eight nurses completed the questionnaire at baseline, 40 completed 1-month surveys, and 20 completed the 3 to 6 month surveys. The mean PHQ-9 score was 5.85, 6.20, and 8.30 at baseline, at 1 month, and at 3 to 6 months, respectively. PHQ-9 scores increased significantly over time (estimate = 1.120, P = .037). The probability of participants being moderately to severely depressed was 0.980 (P = .049) at baseline, 0.990 (P = .013) at 1 month, and 1.0 (P = .002) at 3 to 6 months. Fourteen nurses were included in a single, one-on-one interview. Eight major themes were found in qualitative analyses. For example, nurses expressed fear of spreading COVID-19 to their loved one and community. Common themes identified within the interviews included uncertainty, limited human interaction, fluctuations in mood, life is in my hands, a threat to others, positive and negative coping, nurses as scapegoats, and emerging vulnerability to COVID-19 exposure. All 14 nurses who were interviewed denied accessing any mental health services.
More research is needed to evaluate critical care nurses who care for patients with COVID-19 and their levels of depression to improve practice at the bedside further and develop policies to promote their well-being.
评估美国 COVID-19 大流行期间护理 COVID-19 患者的重症监护护士的严重程度和纵向趋势。
该研究采用纵向混合方法。使用患者健康问卷（PHQ-9），在疫苗接种前的 COVID-19 大流行阶段，在基线、1 个月和 3 至 6 个月时向护士发送电子调查，以衡量他们的抑郁严重程度和趋势。对重症监护护士进行一对一访谈，以评估他们的抑郁症状。
48 名护士在基线时完成了问卷，40 名护士在 1 个月时完成了调查，20 名护士在 3 至 6 个月时完成了调查。PHQ-9 评分分别在基线、1 个月和 3 至 6 个月时为 5.85、6.20 和 8.30。PHQ-9 评分随时间显著增加（估计值=1.120，P=.037）。参与者处于中度至重度抑郁的概率在基线时为 0.980（P=.049），在 1 个月时为 0.990（P=.013），在 3 至 6 个月时为 1.0（P=.002）。14 名护士接受了一次一对一的访谈。在定性分析中发现了 14 个主要主题。例如，护士们表达了对将 COVID-19 传播给亲人的恐惧和对社区的恐惧。访谈中确定的共同主题包括不确定性、有限的人际互动、情绪波动、我的生命掌握在我手中、对他人的威胁、积极和消极的应对、护士成为替罪羊，以及对 COVID-19 暴露的新脆弱性。所有接受访谈的 14 名护士都否认接受任何心理健康服务。
需要进一步研究护理 COVID-19 患者的重症监护护士及其抑郁程度，以进一步改善床边护理实践，并制定促进其福祉的政策。
