新冠肺炎疫情期间医务人员抑郁焦虑情绪和失眠现况及其影响因素
Prevalence and related factors of depression, anxiety, and insomnia among medical staff during COVID-19 pandemic
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摘要:
背景 新型冠状病毒肺炎（简称：新冠肺炎）疫情严重影响直接面对疾病危险的医务人员的心理状况。
目的 了解新冠肺炎疫情期间医务人员抑郁情绪、焦虑情绪和失眠问题发生现况及相关影响因素。
方法 于2020年2月13日—3月1日，采用方便抽样对482名医务人员进行网络问卷调查，使用自编问卷调查基本人口学信息和新冠肺炎相关问题，使用患者健康问卷抑郁量表（PHQ-9）、广泛性焦虑障碍量表（GAD-7）和失眠严重指数量表（ISI）调查医务人员抑郁情绪、焦虑情绪和失眠问题发生现况。以PHQ-9得分、GAD-7得分和ISI得分为应变量做多重线性回归分析（逐步法），以有无抑郁情绪、焦虑情绪和失眠问题为应变量做多因素logistic回归分析（向前-条件法），将基本人口学信息和新冠肺炎相关问题作为自变量同时纳入回归方程进行筛选，分析最终进入回归方程的自变量与应变量的关系以探索相关影响因素。
结果 医务人员抑郁情绪、焦虑情绪和失眠问题的发生比率分别为14.3%、11.2%和23.2%，不同年龄、性别、所在地疫情分级、职业类别及是否支援湖北人群中的发生率差异无统计学意义。直接接触发热或确诊患者的医务人员抑郁（
b =1.73，95%CI ：0.79~2.66）和失眠（b =2.43，95%CI ：1.48~3.39）程度更严重且出现失眠问题的风险更高（OR =1.89，95%CI ：1.21~2.96）。认为目前防护措施不可避免感染新冠肺炎的医务人员抑郁（b =1.72，95%CI ：0.65~2.80）、焦虑（b =1.75，95%CI ：0.76~2.75）及失眠（b =1.73，95%CI ：0.63~2.82）程度更严重且更有可能出现抑郁情绪（OR =1.97，95%CI ：1.11~3.49）、焦虑情绪（OR =3.00，95%CI ：1.64~5.46）及失眠问题（OR =1.79，95%CI ：1.08~2.96）。结论 新冠肺炎疫情期间医务人员抑郁情绪、焦虑情绪和失眠问题的发生风险较非疫情期间升高，工作是否接触高危人群和防护措施是否得当会影响医务人员的心理。
Abstract:Background The epidemic of coronavirus disease 2019 (COVID-19) seriously affects the psychological status of medical staff who directly face the risk of the disease.
Objective This study investigates the prevalence and related factors of depression, anxiety, and insomnia among medical staff during the COVID-19 pandemic.
Methods From February 13 to March 1, 2020, a network questionnaire survey was conducted among 482 medical staff selected by convenience sampling. A self-designed questionnaire was used to investigate the basic demographic information and COVID-19-related questions. The Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Insomnia Severity Index (ISI) were used to estimate the prevalence of depression, anxiety, and insomnia among the medical staff. Stepwise multiple linear regression analysis was performed with PHQ-9 score, GAD-7 score, and ISI score as dependent variables. Multivariate logistic regression analysis (forward-conditional method) on depression, anxiety, and insomnia as dependent variables was performed with basic demographic information and COVID-19-related questions as independent variables.
Results Among the surveyed medical staff, the prevalence rates of depression, anxiety, and insomnia were 14.3%, 11.2%, and 23.2%, respectively. There were no significant differences in the prevalence rates among different age, gender, local risk level, and occupation groups and those aiding Hubei Province or not. The medical staff who directly contacted fever or diagnosed patients had more serious depression (
b =1.73, 95%CI : 0.79-2.66) and insomnia (b =2.43, 95%CI : 1.48-3.39) and a higher risk of insomnia (OR =1.89, 95%CI : 1.21-2.96). The medical staff whose current protective measures cannot prevent infection had more serious depression (b =1.72, 95%CI : 0.65-2.80), anxiety (b =1.75, 95%CI : 0.76-2.75), and insomnia (b =1.73, 95%CI : 0.63-2.82), and had a higher risk of depression (OR =1.97, 95%CI : 1.11-3.49), anxiety (OR =3.00, 95%CI : 1.64-5.46), and insomnia (OR =1.79, 95%CI : 1.08-2.96).Conclusion During the COVID-19 epidemic, the risks of depression, anxiety, and insomnia among selected medical staff are increased compared with the non-epidemic period. Occupational exposure to high-risk groups and protective measures would significantly affect mental health of medical staff.
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