Coleman Brenda L, Gutmanis Iris, Maunder Robert, McGeer Allison
School of Public Health, University of Toronto, Toronto, ON, Canada.
Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Front Psychol. 2025 Jul 17;16:1628884. doi: 10.3389/fpsyg.2025.1628884. eCollection 2025.
During the COVID-19 pandemic, approximately 25% of healthcare providers (HCP) worldwide were reported to have experienced symptoms associated with post-traumatic stress disorder (PTSD). While longitudinal studies have identified factors associated with PTSD in this group of essential workers, associations with psychological distress trajectories have not been studied.
Healthcare providers who participated in the prospective Canadian COVID-19 Cohort Study were eligible. Baseline data were collected at enrolment with time-varying measures updated by participants every 12 months. Kessler Psychological Distress Scale (K10) questionnaires were completed in March 2021 or upon their recruitment (whichever came first) and every 6 months thereafter. Impact of Event Scale-Revised (IES-R) questionnaires were completed within two weeks of their withdrawal from the study or study termination date (December 2023). Modified Poisson regression was used to assess the association between PTSD symptoms (i.e., IES-R scores of < 24 vs. ≥ 24) and score trajectories of the first four K10 questionnaires that were completed 180 (± 60) days apart.
Of 441 participants, 105 (24.0%) had IES-R scores indicative of concern for PTSD (i.e., ≥ 24). Five trajectories of K10 scores were identified including: resilient ( = 111, 25.2%), chronically distressed (131, 29.7%), delayed onset of distress (43, 9.8%), recovery (83, 18.8%), and mutable (73, 16.6%). HCP whose K10 score trajectories were classified as chronically distressed (i.e., all ≥ 16) had rates of IES-R scores indicative of PTSD that were 6.9 times [95% confidence interval (CI) 3.7, 13.0] higher than HCP with resilient score trajectories (i.e., all < 16). Participants with scores in the other three K10 trajectories also had higher rates of IES-R scores of ≥ 24 when compared to those with resilient scores, with adjusted incident rate ratios of 2.6 (delayed onset; CI 1.3, 5.1), 3.1 (recovery; CI 1.4, 7.2), and 4.0 (mutable; CI 2.2, 7.3).
Early and repeated assessment of HCP distress levels will help identify those who are distressed so that evidence-based mitigation strategies can be provided.
在新冠疫情期间，据报道全球约25%的医疗保健提供者（HCP）出现了与创伤后应激障碍（PTSD）相关的症状。虽然纵向研究已经确定了这一关键工作者群体中与创伤后应激障碍相关的因素，但尚未研究与心理困扰轨迹的关联。
参与前瞻性加拿大新冠队列研究的医疗保健提供者符合条件。在入组时收集基线数据，参与者每12个月更新一次随时间变化的测量数据。凯斯勒心理困扰量表（K10）问卷于2021年3月或招募时（以先到者为准）完成，此后每6个月完成一次。事件影响量表修订版（IES-R）问卷在退出研究或研究终止日期（2023年12月）的两周内完成。采用修正泊松回归评估创伤后应激障碍症状（即IES-R评分<24与≥24）与相隔180（±60）天完成的前四份K10问卷的评分轨迹之间的关联。
在441名参与者中，105名（24.0%）的IES-R评分表明存在创伤后应激障碍担忧（即≥24）。确定了K10评分的五种轨迹，包括：恢复力强（n = 111，25.2%）、长期困扰（131，29.7%）、困扰延迟发作（43，9.8%）、恢复（83，18.8%）和可变（73，16.6%）。K10评分轨迹被归类为长期困扰（即所有评分≥16）的HCP中，IES-R评分表明存在创伤后应激障碍的比例是恢复力强评分轨迹（即所有评分<16）的HCP的6.9倍[95%置信区间（CI）3.7，13.0]。与恢复力强评分的参与者相比，其他三种K10轨迹评分的参与者IES-R评分≥24的比例也更高，调整后的发病率比分别为2.6（延迟发作；CI 1.3，5.1）、3.1（恢复；CI 1.4，7.2）和4.0（可变；CI 2.2，7.3）。
对HCP困扰水平进行早期和重复评估将有助于识别那些处于困扰中的人，以便提供基于证据的缓解策略。
