SAMBE-Instituto de Saúde Mental Baseada em Evidências, Department of Mental Health, Universidade Federal de Minas Gerais, Brazil; Post Graduation Department in Molecular Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Departamento de Ensino e Pesquisa (DENPE), Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil; Clinical Neuroscience Lab (LINC), Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
SAMBE-Instituto de Saúde Mental Baseada em Evidências, Department of Mental Health, Universidade Federal de Minas Gerais, Brazil; SCNLab, Centro de Ciências Biológicas e da Saúde e do Programa de Pós-Graduação em Distúrbios do Desenvolvimento, Universidade Presbiteriana Mackenzie, São Paulo, Brazil.
J Psychiatr Res. 2023 Dec;168:230-239. doi: 10.1016/j.jpsychires.2023.10.031. Epub 2023 Oct 25.
Pandemics have the potential to be considered traumatic event, increasing the risk of developing post-traumatic stress symptoms (PTSS) in HealthCare Workers (HCW). However, few longitudinal studies have evaluated the impact of prolonged exposure to the risk imposed by COVID-19. Our aim was to identify subgroups of HCW with profiles of PTSS, how this profile changed during the pandemic and which variables were related to these changes.
We evaluated the levels of PTSS and psychological distress in a Brazilian HealthCare Workers' sample (n = 1398) in three waves of assessment: from May to June 2020 (Wave 1), December 2020 to February 2021 (Wave 2) and May to August 2021 (Wave 3), using Latent Profile Analysis (LPA) to identify subgroups with different profiles of symptms, and then, Latent Transition Analysis (LTA) was applied to examine changes in symptom profiles over time, including gender, psychiatric diagnosis history, and pandemic-related fears as covariates.
two profiles were identified: high-PTSS profile (Wave 1-23%; Wave 2-64% and Wave 3-73%) and a low-PTSS (Wave 1-77%; Wave 2-36% and Wave 3-27%). Being female, fear of contamination, and fearing financial problems were strong predictors of changes in the profile. In addition, the participants had a high probability of being in the high-PTSS in the long run.
These results suggests that targeted interventions can mitigate the impact of pandemic. Providing financial support, and psychological support can be beneficial for those with psychiatric diagnoses and experiencing bereavement.
大流行有可能被视为创伤性事件，增加医护人员（HCW）出现创伤后应激症状（PTSS）的风险。然而，很少有纵向研究评估长时间接触 COVID-19 风险对其产生的影响。我们的目的是确定具有 PTSS 特征的 HCW 亚组，这些特征在大流行期间如何变化，以及哪些变量与这些变化相关。
我们在三个评估阶段评估了巴西医护人员样本（n=1398）的 PTSS 水平和心理困扰：2020 年 5 月至 6 月（第 1 波）、2020 年 12 月至 2021 年 2 月（第 2 波）和 2021 年 5 月至 8 月（第 3 波），使用潜在剖面分析（LPA）来识别具有不同症状特征的亚组，然后，应用潜在转变分析（LTA）来检查随时间推移症状特征的变化，包括性别、精神科诊断史和与大流行相关的恐惧作为协变量。
确定了两个特征：高 PTSS 特征（第 1 波-23%；第 2 波-64%和第 3 波-73%）和低 PTSS 特征（第 1 波-77%；第 2 波-36%和第 3 波-27%）。女性、对污染的恐惧和对财务问题的恐惧是特征变化的强有力预测因素。此外，参与者长期处于高 PTSS 的可能性很高。
这些结果表明，有针对性的干预措施可以减轻大流行的影响。提供经济支持和心理支持对有精神科诊断和经历丧亲之痛的人是有益的。
