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部署相关隔离——德国军人的风险因素还是恢复因素?在 COVID-19 第三至第五波期间的前瞻性分析。

Deployment-related quarantining-a risk or resilience factor for German military service members? A prospective analysis during the third-fifth waves of COVID-19.

机构信息

Bundeswehr Center for Military Mental Health, Military Hospital Berlin, Berlin, Germany.

出版信息

Front Public Health. 2023 Dec 13;11:1267581. doi: 10.3389/fpubh.2023.1267581. eCollection 2023.

Abstract

BACKGROUND

Mandatory deployment-related quarantining added further constraints on soldiers during the pandemic. Contrary to overwhelming research documenting an adverse impact of quarantining on mental health, no adverse short-term mental health effects of pre-deployment quarantining for German soldiers were identified. Therefore, we are interested in a potentially delayed onset, the impact of an additional post-deployment quarantine, and quarantine-associated risk and resilience factors predicting mental health post-deployment.

METHODS

In a prospective research design, 928 German soldiers enrolled in the study at the in-processing of pre-deployment quarantine between February 2021 and March 2022. Every German military service member undergoing pre-deployment quarantine could participate. The soldiers were between 18 and 64 years old; 87.5% identified as male and 12.5% as female. Self-reported mental health (Mini-SCL), perceived social support (FSozU-K22), and perceived unit cohesion were assessed three to five times: at the beginning and the end of pre-deployment quarantine ( = 928,  = 907), if still mandatory-at the beginning and the end of post-deployment quarantine ( = 143 and  = 132), and 3 months post-deployment, on average 7 to 8 months later than pre-deployment quarantine ( = 308). The analyzed quarantine-associated risk and resilience factors were informedness about COVID-19, infection risk, quarantine benefit, clarity of quarantine protocol, need for intimacy/bonding, norms, stigma, practicality, financial disadvantages, boredom, and health-promoting leadership.

RESULTS

Despite four different mental health trajectories identified, repeated measures ANOVAs revealed a significant improvement in mental health post-deployment ([2,265] = 21.54,  < 0.001), a small decrease in social support ([2,266] = 16.85,  < 0.001), and no significant changes in unit cohesion ([2,264] = 0.482,  = 0.618) 3 months post-deployment. Using stepwise regression, 24% of variance in mental health symptomatology post-deployment is predicted pre-deployment by a clear quarantine protocol, unit cohesion, intimacy/bonding, and social support ([4,263] = 22.23,  < 0.001). In total, 30% of mental health at the end of post-deployment quarantine is predicted by stigma and a clear quarantine protocol ([2,99] = 22.22,  < 0.001).

CONCLUSION

Although no overall adverse impact of quarantining on mental health was found, it is recommended to address perceived stigma and clearly communicate the quarantine protocol, and to further follow up on the perceived decrease in social support.

摘要

背景

在疫情期间,强制性部署相关隔离给士兵带来了进一步的限制。与压倒性的研究记录隔离对心理健康的不利影响形成鲜明对比的是,没有发现德国士兵部署前隔离对短期心理健康的不利影响。因此,我们对可能的延迟发作、额外的部署后隔离的影响以及与隔离相关的预测部署后心理健康的风险和适应因素感兴趣。

方法

在一项前瞻性研究设计中,928 名德国士兵在 2021 年 2 月至 2022 年 3 月期间的部署前隔离期间入组研究。每一位接受部署前隔离的德国军人都可以参加。士兵年龄在 18 至 64 岁之间;87.5%为男性,12.5%为女性。使用迷你 SCL 评估三次至五次自我报告的心理健康状况:在部署前隔离的开始和结束时(=928,=907),如果仍然是强制性的-在部署后隔离的开始和结束时(=143 和=132),以及部署后 3 个月,平均比部署前隔离晚 7 至 8 个月(=308)。分析的与隔离相关的风险和适应因素包括对 COVID-19 的了解、感染风险、隔离益处、隔离协议的清晰度、亲密/联系的需求、规范、耻辱感、实用性、经济劣势、无聊和促进健康的领导力。

结果

尽管确定了四个不同的心理健康轨迹,但重复测量方差分析显示,部署后心理健康显著改善([2,265]=21.54,<0.001),社会支持略有下降([2,266]=16.85,<0.001),部署后 3 个月时单位凝聚力没有明显变化([2,264]=0.482,=0.618)。使用逐步回归,部署后心理健康症状的 24%的方差可以由明确的隔离协议、单位凝聚力、亲密/联系和社会支持来预测([4,263]=22.23,<0.001)。总的来说,部署后隔离结束时 30%的心理健康可以由耻辱感和明确的隔离协议来预测([2,99]=22.22,<0.001)。

结论

尽管没有发现隔离对心理健康的总体不利影响,但建议解决感知到的耻辱感,明确沟通隔离协议,并进一步关注社会支持的下降。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15c8/10751356/dbdea5069183/fpubh-11-1267581-g001.jpg

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