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评估 COVID-19 管理及其对医疗保健专业人员的影响:来自孟加拉国的一项横断面研究。

Assessment of COVID-19 management and its consequences on healthcare professionals: a cross-sectional study from Bangladesh.

机构信息

Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh.

Institute of Health Economics, University of Dhaka, Dhaka, Bangladesh.

出版信息

BMJ Open. 2023 Jul 31;13(7):e068633. doi: 10.1136/bmjopen-2022-068633.

Abstract

OBJECTIVE

This explorative study aims to identify the gaps in COVID-19 management and their consequences on physicians in terms of contracting infection and psychological well-being during the early phase of the pandemic.

DESIGN, SETTINGS AND PARTICIPANTS: We conducted a nationwide cross-sectional online study to collect information from 420 intern doctors who were at their internship in government medical colleges from February to August 2020.

METHODS

We performed univariate and bivariate analyses to assess COVID-19 management. We investigated the consequences of COVID-19 management on infection risk, experiencing stress, developing anxiety, depression and sleep disturbance using five sets of multivariable logistic regression analyses.

RESULTS

Findings indicate a delay in first-case detection and identify people's tendency to hide COVID-19 symptoms as one of the possible causes of that delay. About 56% of the intern doctors experienced that patients were trying to hide COVID-19 symptoms in the earlier phase of the pandemic. More than half of the respondents did not get any training on COVID-19 from their working institutions. About 30% and 20% of the respondents did not use personal protective equipment (PPE) and masks while treating patients. Respondents who treated patients without PPE, masks, face shields and gloves were almost two times as likely to be infected by COVID-19. The odds of experiencing COVID-19-related stress was almost twofold among respondents who treated patients without wearing PPE and masks. Experiencing COVID-19-related stress was further associated with an increased risk of developing anxiety and depression that led to sleep disturbance.

CONCLUSION

Ensuring the maximum utilization of limited resources during any public health crisis such as COVID-19 needs developing coping mechanisms by projecting future demand. Ensuring proper training and safety measures can reduce physical and psychological hazards among physicians.

摘要

目的

本探索性研究旨在确定 COVID-19 管理中的差距,以及这些差距对医生在大流行早期感染风险和心理健康方面的影响。

设计、地点和参与者:我们进行了一项全国性的横断面在线研究,从 2020 年 2 月至 8 月在政府医学院实习的 420 名实习医生那里收集信息。

方法

我们进行了单变量和双变量分析,以评估 COVID-19 的管理。我们使用五组多变量逻辑回归分析来评估 COVID-19 管理对感染风险、经历压力、出现焦虑、抑郁和睡眠障碍的影响。

结果

研究结果表明,首次发现病例的时间延迟,并发现人们隐瞒 COVID-19 症状的倾向是导致这种延迟的原因之一。大约 56%的实习医生在大流行早期经历过患者试图隐瞒 COVID-19 症状的情况。超过一半的受访者没有从工作单位获得任何关于 COVID-19 的培训。约 30%和 20%的受访者在治疗患者时没有使用个人防护设备(PPE)和口罩。在治疗患者时没有使用 PPE、口罩、面罩和手套的受访者感染 COVID-19 的可能性几乎是两倍。在治疗患者时没有使用 PPE 和口罩的受访者,经历 COVID-19 相关压力的几率几乎是两倍。经历 COVID-19 相关压力与出现焦虑和抑郁的风险增加有关,进而导致睡眠障碍。

结论

在 COVID-19 等任何公共卫生危机期间,确保最大限度地利用有限的资源需要通过预测未来的需求来制定应对机制。确保适当的培训和安全措施可以减少医生的身心危害。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b146/10391835/74d70f564c7f/bmjopen-2022-068633f01.jpg

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