Health professionals facing the coronavirus disease 2019 (COVID-19) pandemic: What are the mental health risks?
Health professionals facing the coronavirus disease 2019 (COVID-19) pandemic: What are the mental health risks?
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DOI：
10.1016/j.encep.2020.04.008
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发表时间：
2020-06-01
影响因子：
2.7
通讯作者：
Aouizerate, B.
中科院分区：
文献类型：
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作者：
El-Hage, W.;Hingray, C.;Aouizerate, B.
目标. - 2019冠状病毒病（COVID-19）大流行在全球范围内引发重大卫生危机。半个世界都被隔离了。在法国，这一大规模的健康危机紧急引发了保健服务提供的结构调整和重组，以支持紧急服务、医疗重症监护室和持续护理室。卫生专业人员调动了所有资源，在不确定的大环境下提供紧急援助。人们对治疗和护理COVID-19患者的医护人员的心理健康、心理调整和康复的担忧正在上升。本文的目的是提供与卫生专业人员暴露于COVID-19大流行相关的潜在心理健康风险的最新信息。- 作者进行了叙述性综述，确定了科学和医学文献中的相关结果，考虑了2003年（SARS-CoV-1）和2009年（H1N1）的既往流行病以及关于COVID-19大流行病的最新数据。我们强调了最相关的数据有关的疾病特征，组织因素和个人因素，可能有助于发展心理困扰和其他心理健康问题。- 当前COVID-19大流行的疾病特征引发了普遍的警惕和不确定性，尤其是在卫生专业人员中，这是由于一系列原因，例如COVID-19的快速传播、其可能在一部分感染者中引起的症状的严重性、缺乏对该疾病的知识以及卫生专业人员的死亡。组织因素也可能造成压力，例如个人防护设备耗尽、担心部署到新地区后无法提供合格的护理、担心信息迅速变化、无法获得最新信息和通信、缺乏特效药物、缺乏护理激增的重症病人所需的呼吸机和重症监护病房床位，他们的日常社会和家庭生活发生了重大变化。已确定了其他风险因素，包括感觉得不到充分的支持、担心自己的健康、害怕将家庭感染带给家人或其他人、在需要时无法通过职业健康快速获得检测、被隔离、感觉不确定和社会耻辱、工作量过大或不安全的依恋。此外，我们还讨论了有助于增强应对疫情的复原力的积极社会和组织因素。有一个共识，在所有相关文献中，医疗保健专业人员的高水平的压力，焦虑，抑郁，倦怠，成瘾和创伤后应激障碍，这可能有长期的心理影响的风险增加。- 从长远来看，这场悲剧性的健康危机应该会大大提高我们对面临COVID-19大流行的医疗保健专业人员的心理健康风险因素的理解。报告此类信息对于规划未来的预防战略至关重要。保护医护人员确实是应对大规模健康危机的公共卫生措施的重要组成部分。因此，需要立即实施干预措施，以促进接触COVID-19的卫生保健专业人员的心理健康，并通过培训卫生保健专业人员进行心理帮助和危机管理来加强预防和应对策略。(C)2020 L 'Encephale，巴黎。
Objectives. - The coronavirus disease 2019 (COVID-19) pandemic has caused major sanitary crisis worldwide. Half of the world has been placed in quarantine. In France, this large-scale health crisis urgently triggered the restructuring and reorganization of health service delivery to support emergency services, medical intensive care units and continuing care units. Health professionals mobilized all their resources to provide emergency aid in a general climate of uncertainty. Concerns about the mental health, psychological adjustment, and recovery of health care workers treating and caring for patients with COVID-19 are now arising. The goal of the present article is to provide up-to-date information on potential mental health risks associated with exposure of health professionals to the COVID-19 pandemic.Methods. - Authors performed a narrative review identifying relevant results in the scientific and medical literature considering previous epidemics of 2003 (SARS-CoV-1) and 2009 (H1N1) with the more recent data about the COVID-19 pandemic. We highlighted most relevant data concerning the disease characteristics, the organizational factors and personal factors that may contribute to developing psychological distress and other mental health symptoms.Results. - The disease characteristics of the current COVID-19 pandemic provoked a generalized climate of wariness and uncertainty, particularly among health professionals, due to a range of causes such as the rapid spread of COVID-19, the severity of symptoms it can cause in a segment of infected individuals, the lack of knowledge of the disease, and deaths among health professionals. Stress may also be caused by organizational factors, such as depletion of personal protection equipment, concerns about not being able to provide competent care if deployed to new area, concerns about rapidly changing information, lack of access to up-to-date information and communication, lack of specific drugs, the shortage of ventilators and intensive care unit beds necessary to care for the surge of critically ill patients, and significant change in their daily social and family life. Further risk factors have been identified, including feelings of being inadequately supported, concerns about health of self, fear of taking home infection to family members or others, and not having rapid access to testing through occupational health if needed, being isolated, feelings of uncertainty and social stigmatization, overwhelming workload, or insecure attachment. Additionally, we discussed positive social and organizational factors that contribute to enhance resilience in the face of the pandemic. There is a consensus in all the relevant literature that health care professionals are at an increased risk of high levels of stress, anxiety, depression, burnout, addiction and post-traumatic stress disorder, which could have long-term psychological implications.Conclusions. - In the long run, this tragic health crisis should significantly enhance our understanding of the mental health risk factors among the health care professionals facing the COVID-19 pandemic. Reporting information such as this is essential to plan future prevention strategies. Protecting health care professionals is indeed an important component of public health measures to address large-scale health crisis. Thus, interventions to promote mental well-being in health care professionals exposed to COVID-19 need to be immediately implemented, and to strengthen prevention and response strategies by training health care professionals on mental help and crisis management. (C) 2020 L'Encephale, Paris.