新型冠状病毒肺炎疫情早期对北京协和医院发热门诊医务人员心理支持特点分析  

Psychological service to medical workers in fever clinic of Peking Union Medical College Hospital in Beijing during early months of COVID-19 outbreak

作　　者：耿文奇 曹锦亚 段艳平[1] 魏镜[1] 蒋静 赵晓晖 Wenqi Geng;Jinya Cao;Yanping Duan;Jing Wei;Jing Jiang;Xiaohui Zhao(Department of Psychological Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences/Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院、北京协和医学院、北京协和医院心理医学科,北京100730

出　　处：《中华卫生应急电子杂志》2022年第5期293-299,共7页Chinese Journal of Hygiene Rescue(Electronic Edition)

基　　金：北京协和医院院内基金(ZC201902261);首都医学发展科研基金(2022-2-4012)。

摘　　要：目的分析新型冠状病毒肺炎疫情早期对北京协和医院发热门诊医务人员的心理支持情况,探索如何为一线医务人员提供更好的心理支持。方法收集并分析在疫情早期(2020年1月23日至4月27日)对北京协和医院发热门诊医务人员的心理热线工作中所收集的定性及定量资料:基础信息、定性访谈、综合生理-心理-社会评估问卷(UPPSAQ-70),、事件影响量表修订版(IES-R)及职业耗竭问卷(MBI)。结果共有120名医务人员完成了上述研究(应答率为96.0%)。绝大部分医务人员认为个体防护督导和调整工作时间及强度等措施是重要的和有帮助的。其中,5.0%有显著应激反应,41.7%有职业耗竭,10.8%有显著抑郁,8.3%存在综合生理-心理-社会功能不良;心理健康状况优于其他类似研究发现。抑郁评分与高警觉(b=0.812,P<0.001)及情感耗竭(b=0.072,P=0.020)有关。结论最早开始支持性心理工作等综合干预能有效减少和缓冲心理应激,减少负面心理状况的发生。高警觉、情感耗竭与抑郁存在相关性。未来类似工作中应尽早提供支持性的整体干预,尤其是纳入降低高警觉的干预模块。ObjectiveTo analyse our early-on psychological service to medical workers as part of CL-service in fever clinic of PUMCH during the outbreak of COVID-19, so as to explore better psychological help to frontline medical workers.MethodsWe offered a resource-oriented supportive psychological hotline service to all medical workers in fever clinic of PUMCH. Following data from January 23 to April 27 were acquired and analysed, including basic information, qualitative interview, Union Physio-Psycho-Social Assessment Questionnaire(UPPSAQ-70), Impact of Event Scale-Revised (IES-R), and Maslach Burn-out Inventory (MBI).ResultsA total of 120 participants completed the evaluation (response rate of 96.0%). Most medical workers found personal protection supervision, adjusting work time and work load, and some other measures important and helpful. Of all the participants, 5.0% had significant stress reactions, 47.1% showed professional burnout, and 10.8% had significant depression. In bio-psycho-social wholistic evaluation, 8.3% showed a poor status. In general, the participants showed a better psychological state than in other similar studies. Depression was associated with hyperarousal (b=0.832, P<0.001)and emotional exhaustion(b=0.081, P=0.020).ConclusionIntegral interventions including providing medical security, adjusting work load continuously, and early supportive psychological service could cushion stress in medical workers and reduce negative psychological outcomes. Hyperarousal, emotional exhaustion and depression are closely related. Therefore, we call for early-on integral interventions in similar situations, with special modalities focusing on decreasing hyperarousal.

关 键 词：抑郁 职业耗竭 医务人员心理健康 COVID-19 心理干预 

分 类 号：R192[医药卫生—卫生事业管理] R563.1[医药卫生—公共卫生与预防医学]