The experience of the 2003 SARS outbreak as a traumatic stress among frontline healthcare workers in Toronto: lessons learned
The experience of the 2003 SARS outbreak as a traumatic stress among frontline healthcare workers in Toronto: lessons learned
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DOI：
10.1098/rstb.2004.1483
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发表时间：
2004-07-29
影响因子：
6.3
通讯作者：
Maunder, R
中科院分区：
文献类型：
--
作者：
Maunder, R
2003年上半年加拿大爆发的严重急性呼吸系统综合症在几个方面都是史无前例的。了解疫情对医护人员，特别是医院医护人员的心理影响，对于规划未来新发传染病的暴发非常重要。本综述基于对多伦多SARS疫情的定性和定量研究，概述了导致医护人员将疫情视为心理创伤的因素。总体而言，据估计，29%-35%的医院工作人员经历了高度的痛苦。确定了三类促成因素。相关的环境因素有当护士、接触过SARS患者和有孩子。导致态度的因素和过程是经历工作压力，感受到污名，通过避开人群和同事来应对，以及感觉被仔细审查。先前存在的特质因素也是造成脆弱性的原因之一。从疫情中吸取的经验教训包括：(1)需要努力减轻感染控制程序的心理影响，特别是这些程序促进的人际隔离；(2)有效的风险沟通是疫情早期的优先事项；(3)医护人员可能在影响媒体报道模式方面发挥作用，从而提高或降低士气；(4)医护人员受益于有助于反思异常应激源的影响的资源；(5)医护人员受益于表明机构提供切实支持的实际干预措施。
The outbreak of severe acute respiratory syndrome (SARS) in the first half of 2003 in Canada was unprecedented in several respects. Understanding the psychological impact of the outbreak on healthcare workers, especially those in hospitals, is important in planning for future outbreaks of emerging infectious diseases. This review draws upon qualitative and quantitative studies of the SARS outbreak in Toronto to outline the factors that contributed to healthcare workers' experiencing the outbreak as a psychological trauma. Overall, it is estimated that a high degree of distress was experienced by 29-35% of hospital workers. Three categories of contributory factors were identified. Relevant contextual factors were being a nurse, having contact with SARS patients and having children. Contributing attitudinal factors and processes were experiencing job stress, perceiving stigmatization, coping by avoiding crowds and colleagues, and feeling scrutinized. Pre-existing trait factors also contributed to vulnerability. Lessons learned from the outbreak include: (i) that effort is required to mitigate the psychological impact of infection control procedures, especially the interpersonal isolation that these procedures promote, (ii) that effective risk communication is a priority early in an outbreak, (iii) that healthcare workers may have a role in influencing patterns of media coverage that increase or decrease morale; (iv) that healthcare workers benefit from resources that facilitate reflection on the effects of extraordinary stressors; and (v) that healthcare workers benefit from practical interventions that demonstrate tangible support from institutions.