新冠疫情对医疗服务提供者心理健康的影响：肯尼亚肯雅塔国家医院的经历
The Effects of the COVID-19 Pandemic on Healthcare Providers' Mental Health: Experiences at Kenyatta National Hospital, Kenya.
作者信息
Ogello Vallery, Thuo Nicholas, Okello Phelix, Wairimu Njeri, Mwangi Paul, Maina Gakuo, Mwenda Harrison, Mutua Paul, Kinuthia John, Ongeri Linnet, Mugo Nelly, Ngure Kenneth
机构信息
Partners in Health Research and Development, Centre for Clinical Research, Kenya Medical Research Institute, Nairobi 19865-00202, Kenya.
Kenyatta National Hospital, Nairobi 20723-00202, Kenya.
出版信息
Behav Sci (Basel). 2024 Apr 23;14(5):351. doi: 10.3390/bs14050351.
BACKGROUND
In 2020, healthcare providers were expected to provide care to individuals with coronavirus disease 2019 (COVID-19), putting them at risk of acquiring COVID-19. The possibility of acquiring poorly understood infectious diseases while providing care may have an impact on the mental health of providers. We conducted a study to explore the effects of COVID-19 on the mental health of healthcare providers.
METHODS
Between April and August 2021, we conducted in-depth interviews with 60 healthcare providers in the infectious disease unit (IDU) and other units of the hospital (non-IDU). The healthcare providers completed an online self-administered survey form with demographic data (age, sex, average income, and known contact with a COVID-19 patient). We used semi-structured interview guides to understand the healthcare providers' lived experiences of stress, anxiety, depression, and their associated factors. We transcribed the interviews verbatim and coded and analyzed the transcripts to derive thematic concepts related to mental health experiences.
RESULTS
The healthcare providers had a median age of 37 years [IQR 20.0-58.0], and 56.7% were female, 30.0% nurses, 18.3% medical doctors, and 11.7% laboratory technologists. The healthcare providers reported increased stress during the pandemic, attributed to the high demand for patient care, changes in social life, and fear of COVID-19 infection. They also reported experiences of anxiety and depression as a result of limited knowledge at the beginning of the pandemic and the perception that "COVID-19 resulted in death". Testing positive for COVID-19, high exposure to COVID-19 risks, and the death of patients and colleagues reportedly affected the healthcare providers' mental health. Additionally, the healthcare providers reported mental health support through debriefing meetings, peer-to-peer support, and psychological counseling, with privacy and confidentiality concerns.
CONCLUSIONS
Healthcare providers faced mental health issues such as stress and anxiety while taking care of COVID-19 patients. An effective mental health response requires institutional practices that address context-specific challenges such as privacy and confidentiality.
背景
2020年，医疗服务提供者被期望为2019冠状病毒病（COVID-19）患者提供护理，这使他们面临感染COVID-19的风险。在提供护理时感染了解甚少的传染病的可能性可能会对医疗服务提供者的心理健康产生影响。我们开展了一项研究，以探讨COVID-19对医疗服务提供者心理健康的影响。
方法
2021年4月至8月期间，我们对医院传染病科（IDU）和其他科室（非IDU）的60名医疗服务提供者进行了深入访谈。这些医疗服务提供者完成了一份包含人口统计学数据（年龄、性别、平均收入以及与COVID-19患者的已知接触情况）的在线自填式调查问卷。我们使用半结构化访谈指南来了解医疗服务提供者在压力、焦虑、抑郁方面的生活经历及其相关因素。我们逐字转录访谈内容，并对转录文本进行编码和分析，以得出与心理健康经历相关的主题概念。
结果
医疗服务提供者的年龄中位数为37岁[四分位距20.0 - 58.0]，56.7%为女性，30.0%为护士，18.3%为医生，11.7%为实验室技术人员。医疗服务提供者报告称，在疫情期间压力增加，这归因于对患者护理的高需求、社会生活的变化以及对COVID-19感染的恐惧。他们还报告说，由于疫情初期知识有限以及“COVID-19会导致死亡”的认知，出现了焦虑和抑郁情绪。据报告，COVID-19检测呈阳性、高暴露于COVID-19风险以及患者和同事的死亡影响了医疗服务提供者的心理健康。此外，医疗服务提供者报告通过汇报会、同伴支持和心理咨询获得了心理健康支持，但存在对隐私和保密性的担忧。
结论
医疗服务提供者在照顾COVID-19患者时面临压力和焦虑等心理健康问题。有效的心理健康应对措施需要机构采取措施应对诸如隐私和保密性等特定背景下的挑战。
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