Dong Qiangli, Yang Yumeng, Ma Mohan, Ou Wenwen, Lv Guanyi, Huang Mei, Li Yunjing, Lu Yimei, Fan Ajiao, Ju Yumeng, Zhang Yan
Department of Psychiatry, Lanzhou University Second Hospital, Lanzhou, China.
Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China; China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan, China.
Psychiatry Res. 2023 Sep;327:115406. doi: 10.1016/j.psychres.2023.115406. Epub 2023 Aug 6.
Posttraumatic stress symptoms of healthcare workers have become a significant public concern in the healthcare system that have long COVID-19. It is less known how the pandemic impacts the HCWs' PTSS longitudinally and long-term risk factors for it.
Four consecutive surveys were conducted among healthcare workers in China from 2019 to 2023 COVID-19 outbreaks. Multilevel mixed-effect models were used to examine longitudinal changes and risk factors. Network analysis was utilized to explore network centrality changes in PTSS symptoms.
HCWs' PTSS symptoms were increased over time during the COVID-19 pandemic. Being female, being nurse, working in the emergency department, working longer hours, less frequently going back home and having COVID-19 infection are risk factors of PTSS for HCWs; unmarried is the protective factor. Significant interaction between symptom changes and profession exists. PTSS networks showed that Avoidance of thoughts, Emotional-cue activity, Exaggerated startle response and Hypervigilance were the central symptoms during four waves. The global strength of the PTSS network grows over time, and nodal strength of Avoidance of thoughts, Loss of interest and Negative beliefs increased by COVID-19.
The pandemic's impacts on healthcare workers vary by professions. PTSS symptoms exacerbate, reinforce each other, and persists with recurring waves.
在长期存在新冠疫情的医疗系统中，医护人员的创伤后应激症状已成为一个重大的公众关切问题。对于疫情如何纵向影响医护人员的创伤后应激症状以及其长期风险因素，人们了解较少。
在2019年至2023年新冠疫情爆发期间，对中国的医护人员进行了连续四次调查。采用多层次混合效应模型来研究纵向变化和风险因素。利用网络分析来探索创伤后应激症状的网络中心性变化。
在新冠疫情期间，医护人员的创伤后应激症状随时间增加。女性、护士、在急诊科工作、工作时间较长、回家频率较低以及感染新冠病毒是医护人员创伤后应激症状的风险因素；未婚是保护因素。症状变化与职业之间存在显著交互作用。创伤后应激症状网络显示，在四波疫情期间，回避想法、情绪线索活动、夸张的惊吓反应和过度警觉是核心症状。创伤后应激症状网络的全局强度随时间增长，回避想法、兴趣丧失和消极信念的节点强度因新冠疫情而增加。
疫情对医护人员的影响因职业而异。创伤后应激症状会加剧、相互强化，并随着疫情反复出现而持续存在。
