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加拿大医护人员在 COVID-19 大流行期间的患者接触水平和事件影响评分。

Level of patient contact and Impact of Event scores among Canadian healthcare providers during the COVID-19 pandemic.

机构信息

Sinai Health System, 600 University Ave, Toronto, ON, M5G 1X5, Canada.

University of Toronto, 27 King's College Circle, Toronto, ON, M5S 1A1, Canada.

出版信息

BMC Health Serv Res. 2024 Aug 20;24(1):947. doi: 10.1186/s12913-024-11426-w.

Abstract

BACKGROUND

Healthcare providers (HCP) continue to provide patient care during the COVID-19 pandemic despite the known risks for transmission. Studies conducted early in the pandemic showed that factors associated with higher levels of distress among HCP included being of younger age, female, in close contact with people with COVID-19, and lower levels of education. The goal of this study was to determine if level of patient contact was associated with concern for post-traumatic stress disorder (PTSD) as measured by the Impact of Event Scale-Revised (IES-R).

METHODS

This cross-sectional study, embedded within a prospective cohort study, recruited HCP working in hospitals in four Canadian provinces from June 2020 to June 2023. Data were collected at enrolment and annually from baseline surveys with the IES-R scale completed at withdrawal/study completion. Modified Poisson regression was used to determine the association between level of patient contact and concern for PTSD (i.e., IES-R scores ≥24).

RESULTS

The adjusted rate ratio (RR) associated with concern for PTSD among HCP with physical contact/direct patient care was 1.19 (95% confidence interval (CI) 1.03, 1.38) times higher than for HCP with no direct contact. In fully adjusted linear regression models, physical care/contact was associated with higher avoidance and hyperarousal scores, but not intrusion scores.

CONCLUSIONS

Administrators and planners need to consider the impact of heightened and ongoing stress among HCP by providing early screening for adverse emotional outcomes and delivery of tailored preventive strategies to ensure immediate and long-term HCP health.

摘要

背景

医护人员(HCP)在 COVID-19 大流行期间继续为患者提供护理,尽管已知存在传播风险。在大流行早期进行的研究表明,与 HCP 中更高水平的压力相关的因素包括年龄较小、女性、与 COVID-19 患者密切接触以及教育程度较低。本研究的目的是确定与患者接触程度是否与通过修订后的事件影响量表(IES-R)测量的创伤后应激障碍(PTSD)的担忧相关。

方法

这项横断面研究嵌入在一项前瞻性队列研究中,从 2020 年 6 月至 2023 年 6 月,在加拿大四个省的医院招募 HCP。在入组时和基线调查中每年收集数据,使用 IES-R 量表完成。使用修正泊松回归来确定与患者接触程度与 PTSD 担忧(即 IES-R 得分≥24)之间的关联。

结果

与没有直接接触的 HCP 相比,有身体接触/直接患者护理的 HCP 发生 PTSD 担忧的调整后比率比(RR)为 1.19(95%置信区间(CI)为 1.03,1.38)倍更高。在完全调整的线性回归模型中,身体护理/接触与更高的回避和过度警觉评分相关,但与入侵评分无关。

结论

管理人员和规划人员需要通过对不良情绪结果进行早期筛查,并提供量身定制的预防策略,考虑到 HCP 压力的加剧和持续存在,以确保 HCP 的即时和长期健康。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2984/11334392/d971c7cc232a/12913_2024_11426_Fig1_HTML.jpg

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