Psychosocial distress amongst Canadian intensive care unit healthcare workers during the acceleration phase of the COVID-19 pandemic.
Psychosocial distress amongst Canadian intensive care unit healthcare workers during the acceleration phase of the COVID-19 pandemic.
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DOI：
10.1371/journal.pone.0254708
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Tsang JLY
中科院分区：
文献类型：
--
作者：
Binnie A;Moura K;Moura C;D'Aragon F;Tsang JLY
在新发疾病爆发期间，重症监护病房医护人员 (ICU HCW) 面临着出现心理健康问题的风险。法国 ICU 医护人员的一项研究显示，在第一波疫情高峰期，50.4% 和 30.4% 的医护人员出现焦虑和抑郁症状。这些 ICU 医护人员的 COVID-19 暴露水平非常高。在加拿大，ICU 医护人员在第一波大流行期间经历了不同程度的 COVID-19 暴露，一些医院收治了大量患者，而另一些医院则收治很少或根本没有收治患者。在这项研究中，我们研究了加拿大 ICU 医护人员的 COVID-19 暴露与心理健康之间的关系。 2020 年 4 月，在第一波大流行的加速阶段，我们对加拿大 ICU 医护人员进行了一项横断面队列研究。使用 12 项一般健康问卷 (GHQ-12) 评估社会心理困扰。参与者被问及压力来源、与 COVID-19 患者的接触情况以及个人防护装备 (PPE) 的可用性。确定了与临床相关社会心理困扰相关的因素。我们收到了来自 30 多家机构的 310 名加拿大 ICU 医护人员的回复。其中，64.5% 的人在 GHQ-12 问卷中得分≥3分，表明存在临床相关的社会心理困扰。注册护士中出现心理社会困扰的频率最高（75.7%），而医生中出现社会心理困扰的频率最低（49.4%）。女性（64.9%）的比例也高于男性（47.6%）。尽管 PPE 的可用性良好（> 80% 的参与者报告有足够的可用性），但人们对 PPE 的可用性、感染 COVID-19 的风险以及将 COVID-19 传播给他人的风险存在严重焦虑。在多变量回归分析中，对感染 COVID-19 的焦虑（OR 1.53，CI 1.31-1.81）是临床相关心理社会困扰的最强阳性预测因子，而接触 COVID-19 的轮班次数（OR 0.86，CI 0.75-0.95）是最强的阴性预测因子。总之，在第一波 COVID-19 大流行的加速阶段，大多数 ICU 医护人员都存在临床相关的社会心理困扰，包括那些很少接触或没有接触过 COVID-19 的人。整个医疗保健系统都需要制定支持 ICU 医护人员心理健康的策略。
Intensive care unit healthcare workers (ICU HCW) are at risk of mental health issues during emerging disease outbreaks. A study of ICU HCW from France revealed symptoms of anxiety and depression in 50.4% and 30.4% of workers at the peak of the first wave of the pandemic. The level of COVID-19 exposure of these ICU HCW was very high. In Canada, ICU HCW experienced variable exposure to COVID-19 during the first wave of the pandemic, with some hospitals seeing large numbers of patients while others saw few or none. In this study we examined the relationship between COVID-19 exposure and mental health in Canadian ICU HCW. We conducted a cross-sectional cohort study of Canadian ICU HCW in April 2020, during the acceleration phase of the first wave of the pandemic. Psychosocial distress was assessed using the 12-item General Health Questionnaire (GHQ-12). Participants were asked about sources of stress as well as about exposure to COVID-19 patients and availability of personal protective equipment (PPE). Factors associated with clinically-relevant psychosocial distress were identified. Responses were received from 310 Canadian ICU HCW affiliated with more than 30 institutions. Of these, 64.5% scored ≥ 3 points on the GHQ-12 questionnaire, indicating clinically-relevant psychosocial distress. The frequency of psychosocial distress was highest amongst registered nurses (75.7%) and lowest amongst physicians (49.4%). It was also higher amongst females (64.9%) than males (47.6%). Although PPE availability was good (> 80% of participants reported adequate availability), there was significant anxiety with respect to PPE availability, with respect to the risk of being infected with COVID-19, and with respect to the risk of transmitting COVID-19 to others. In multivariable regression analysis, Anxiety with respect to being infected with COVID-19 (OR 1.53, CI 1.31–1.81) was the strongest positive predictor of clinically-relevant psychosocial distress while the Number of shifts with COVID-19 exposure (OR 0.86, CI 0.75–0.95) was the strongest negative predictor. In summary, clinically-relevant psychosocial distress was identified amongst a majority of ICU HCW during the acceleration phase of the first wave of the COVID-19 pandemic, including those with minimal or no exposure to COVID-19. Strategies to support mental health amongst ICU HCW are required across the entire healthcare system.
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