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在反复面临 COVID-19 浪潮的 ICU 医护人员中的韧性和心理健康症状。

Resilience and Mental-Health Symptoms in ICU Healthcare Professionals Facing Repeated COVID-19 Waves.

机构信息

Medical Intensive Care Unit, Saint Louis University Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Cité University, Paris, France; FAMIREA study group.

Medical Intensive Care Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.

出版信息

Am J Respir Crit Care Med. 2024 Mar 1;209(5):573-583. doi: 10.1164/rccm.202305-0806OC.

Abstract

Psychological resilience (the ability to thrive in adversity) may protect against mental-health symptoms in healthcare professionals during coronavirus disease (COVID-19) waves. To identify determinants of resilience in ICU staff members. In this cross-sectional survey in 21 French ICUs, staff members completed the 10-item Connor-Davidson Resilience Scale, Hospital Anxiety and Depression Scale, and Impact of Event Scale-Revised (for post-traumatic stress disorder [PTSD]). Factors independently associated with resilience were identified. The response rate was 73.1% (950 of 1,300). The median 10-item Connor-Davidson Resilience Scale score was 29 (interquartile range, 25-32). Symptoms of anxiety, depression, and PTSD were present in 61%, 39%, and 36% of staff members, respectively. Distress associated with the COVID-19 infodemic was correlated with symptoms of depression and PTSD. More resilient respondents less often had symptoms of anxiety, depression, and PTSD. Greater resilience was independently associated with male sex, having provided intensive care during the early waves, having managed more than 50 patients with COVID-19, and, compared with earlier waves, working longer hours, having greater motivation, and more often involving families in end-of-life decisions. Independent risk factors for lower resilience were having managed more than 10 patients who died of COVID-19, having felt frightened or isolated, and greater distress from the COVID-19 infodemic. This study identifies modifiable determinants of resilience among ICU staff members. Longitudinal studies are needed to determine whether prior resilience decreases the risk of mental ill health during subsequent challenges. Hospital and ICU managers, for whom preserving mental well-being among staff members is a key duty, should pay careful attention to resilience.

摘要

心理弹性(逆境中茁壮成长的能力)可能有助于保护医护人员在冠状病毒病(COVID-19)浪潮期间免受心理健康症状的影响。为了确定 ICU 工作人员弹性的决定因素。在这项针对 21 家法国 ICU 的横断面调查中,工作人员完成了 10 项 Connor-Davidson 弹性量表、医院焦虑和抑郁量表以及修订后的事件影响量表(用于创伤后应激障碍 [PTSD])。确定了与弹性独立相关的因素。回复率为 73.1%(1300 人中的 950 人)。中位数 10 项 Connor-Davidson 弹性量表得分为 29(四分位距,25-32)。分别有 61%、39%和 36%的工作人员出现焦虑、抑郁和 PTSD 症状。与 COVID-19 信息疫情相关的困扰与抑郁和 PTSD 症状相关。更有弹性的受访者出现焦虑、抑郁和 PTSD 症状的频率较低。更大的弹性与男性、在早期浪潮中提供重症监护、管理超过 50 名 COVID-19 患者、与早期浪潮相比工作时间更长、动力更大以及更经常让家人参与临终决策独立相关。弹性较低的独立风险因素包括管理超过 10 名死于 COVID-19 的患者、感到恐惧或孤立以及 COVID-19 信息疫情造成的更大困扰。这项研究确定了 ICU 工作人员弹性的可改变决定因素。需要进行纵向研究以确定先前的弹性是否会降低随后挑战中心理健康不良的风险。医院和 ICU 管理人员有责任保护员工的心理健康,应密切关注弹性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bdf7/10919111/cce89f6ab90c/rccm.202305-0806OCf1.jpg

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