The association between witnessing patient death and mental health outcomes in frontline COVID-19 healthcare workers
The association between witnessing patient death and mental health outcomes in frontline COVID-19 healthcare workers
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DOI：
10.1002/da.23140
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发表时间：
2021-02-05
影响因子：
7.4
通讯作者：
Pessach, Itai M.
中科院分区：
文献类型：
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作者：
Mosheva, Mariela;Gross, Raz;Pessach, Itai M.
背景 治疗 2019 年冠状病毒病 (COVID-19) 患者的医护人员 (HCW) 面临着高度的心理压力。我们的目的是比较在 COVID-19 病房和非 COVID-19 病房工作的医护人员之间的心理健康结果、创伤后应激症状 (PTSS)、可能的抑郁和焦虑的风险和保护因素。方法 在 COVID-19 爆发高峰期，以色列一家大型三级医院进行了一项自我报告调查，由 828 名医护人员（42.2% 是医生，57.8% 是护士）完成。患者报告结果测量信息系统；患者健康问卷-9；DSM-5 初级护理创伤后应激障碍筛查 (PC-PTSD-5) 分别用于评估与大流行相关的应激因素、负面经历和潜在的保护因素。 结果 研究团队之间的 PC-PTSD 中位数分数存在显着差异 (chi(2) [5] = 17.24；p = .004）。两组中可能出现抑郁和焦虑的风险因素包括精神疲惫、对感染和感染家人的焦虑。总体而言，与非 COVID-19 团队相比，目睹患者死亡的比例较高（50.2% 与 24.7%），与 PTSS 的可能性增加四倍相关（比值比 [OR] =）。与非 COVID-19 病房相比（OR 0.91；95% CI，0.51-1.61；p = 0.43）。结论 目睹患者死亡似乎是直接参与治疗 COVID-19 患者的 PTSS 的一个危险因素。建议帮助医护人员应对与 COVID-19 相关的死亡可能会降低他们遭受创伤后应激的风险。
Background Healthcare workers (HCW) treating coronavirus disease 2019 (COVID-19) patients face high levels of psychological stress. We aimed to compare mental health outcomes, risk and protective factors for posttraumatic stress symptoms (PTSS), probable depression, and anxiety between HCW working in COVID-19 and non-COVID-19 wards.Methods A self-report survey, administered in a large tertiary hospital in Israel during the peak of the COVID-19 outbreak was completed by 828 HCW (42.2% physicians, 57.8% nurses. Patient-Reported Outcomes Measurement Information System; the Patient Health Questionnaire-9; the Primary Care-Post Traumatic Stress Disorder Screen for DSM-5 (PC-PTSD-5) were used for assessing anxiety, depression, and PTSS, respectively. Pandemic-related stress factors, negative experiences, and potential protective factors were also assessed.Results Median PC-PTSD scores differed significantly between study teams (chi(2) [5] = 17.24; p = .004). Prevalence of probable depression and anxiety were similar in both groups. Risk factors for mental health outcomes included mental exhaustion, anxiety about being infected and infecting family. Overall, higher proportion of the COVID-19 team witnessed patient deaths as compared to the non-COVID-19 team (50.2% vs. 24.7%). Witnessing patient death at the COVID-19 wards was associated with a four-fold increased likelihood of PTSS (odds ratio [OR] = 3.97; 95% confidence interval [CI], 1.58-9.99; p = .0007), compared with the non-COVID-19 wards (OR 0.91; 95% CI, 0.51-1.61; p = .43).Conclusions Witnessing patient death appears to be a risk factor for PTSS unique to HCW directly engaged in treating patients with COVID-19. Our findings suggest that helping HCW cope with COVID-19 related deaths might reduce their risk of posttraumatic stress.