Fond Guillaume, Lucas Guillaume, Boyer Laurent
Assistance Publique des Hôpitaux de Marseille, CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France.
Fondation FondaMental, Créteil, France.
J Clin Nurs. 2023 Nov;32(21-22):7765-7772. doi: 10.1111/jocn.16673. Epub 2023 Mar 22.
Recent studies have suggested increased rates of depression in healthcare workers (HCWs), with direct impact on care quality and productivity. The objective was to determine the proportion of HCWs adequately treated for their major depression in a nationwide survey, the proportion of lifestyle risk factors for depression, and to determine if working in psychiatry department or professional status may modulate these outcomes.
The method followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement guidelines. A survey comprising the Center for Epidemiologic Studies-Depression Scale was sent to public and private national healthcare facilities.
Overall, 10,325 participants were recruited; 3438 (33.3%) [95% confidence interval 32.4-34.2] met likely diagnostic criteria for clinical depression. Almost 80% of them declared that they had a history of major depressive episode. However, only approximately 23% of them were treated with antidepressants and approximately 13% had a psychiatric follow-up. Depressed HCWs working in psychiatry departments received slightly better care for their depression, but they also consumed more anxiolytics and hypnotics and had more risk factors for depression (including smoking and hazardous drinking). We found specificities according to professions, physicians reported higher rates of hazardous drinking while nurses, nurse assistants, and health executives had higher rates of smoking and twice as much obesity as physicians.
Disseminating tools to detect major depression, programs destigmatizing depression and antidepressants, promoting physical activity, weight loss, tobacco cessation and reduced alcohol consumption are promising strategies to improve the care of major depression in HCWs.
Reducing depression in healthcare workers is necessary to improve the quality of care, to limit burnout, medical errors, absenteeism and turn-over and globally to improve the wellbeing at work.
近期研究表明医护人员（HCW）中抑郁症发病率有所上升，这对护理质量和工作效率有直接影响。本研究的目的是通过一项全国性调查确定接受充分治疗的患有重度抑郁症的医护人员比例、抑郁症生活方式风险因素比例，并确定在精神科工作或职业状态是否会影响这些结果。
本方法遵循《加强流行病学观察性研究报告（STROBE）声明》指南。向公立和私立国家医疗保健机构发送了一份包含流行病学研究中心抑郁量表的调查问卷。
总体而言，共招募了10325名参与者；3438人（33.3%）[95%置信区间32.4 - 34.2]符合临床抑郁症的可能诊断标准。其中近80%的人宣称有重度抑郁发作史。然而，只有约23%的人接受了抗抑郁药物治疗，约13%的人接受了精神科随访。在精神科工作的抑郁医护人员在抑郁症治疗方面得到的护理稍好一些，但他们服用的抗焦虑药和催眠药也更多，且有更多抑郁症风险因素（包括吸烟和有害饮酒）。我们发现了职业特异性，医生报告的有害饮酒率较高，而护士、护士助理和卫生管理人员的吸烟率较高，肥胖率是医生的两倍。
推广检测重度抑郁症的工具、消除抑郁症和抗抑郁药物污名化的项目、促进体育锻炼、减肥、戒烟和减少酒精消费是改善医护人员重度抑郁症护理的有前景的策略。
减少医护人员的抑郁症对于提高护理质量、限制职业倦怠、医疗差错、旷工和人员流动以及全面改善工作幸福感是必要的。
