新冠肺炎疫情下医务人员压力、焦虑、抑郁状况及影响因素研究

目的 分析新型冠状病毒肺炎 (COVID-19) 流行期间上海医务人员的心理健康状况并探讨其影响因素，为建立心理健康服务政策提供依据。方法 采用自编问卷和压力知觉量表（PSS-10），焦虑项症状（GAD-7）和健康自评量表（PHD-9），通过问卷星开展调查。结果 压力应激阳性率为27.9%,焦虑症状阳性率为30.0%，抑郁症状阳性率为27.0%。女性（OR:0.68，95%CI:0.547~0.846）、30岁以下青年（OR:0.761，95%CI:0.605~0.958；OR:0.561，95%CI:0.408~0.771）、周工作时长超过60h和80h者（OR:1.877，95%CI:1.345~2.619；OR:2.759，95%CI:1.570~4.847）、家庭支持较差（OR:1.515，95%CI:1.183~1.941）、工作风险高（OR:1.354，95%CI:1.128~1.625），有发热门诊的综合医院（OR:1.456，95%CI:1.151~1.843；OR:1.540，95%CI:1.225~1.936）更易发生压力应激；女性（OR:0.758，95%CI:0.612~0.939）、其他婚姻状态（OR:0.678，95%CI:0.527~0.872）、工龄长（OR:1.884，95%CI:1.273~2.789;OR:2.087，95%CI:1.258~3.465）、周工作时长超过60h和80h者（OR:2.092，95%CI:1.519~2.882），OR:3.879，95%CI:2.223~6.759）、高工作风险（OR:1.568，95%CI:1.320~1.862），预期疫情时长不确定（OR:1.437，95%CI:1.076~1.920）更易发生焦虑症状；有发热门诊的综合医院（OR:1.408，95%CI:1.126~1.762）、30岁以下青年（OR:0.652，95%CI:0.474~0.896）、周工作时长超过60h者（OR:1.791，95%CI:1.288~2.488）、预期疫情时长不确定（OR:1.679，95%CI:1.254~2.248）、高工作风险（OR:1.364，95%CI:1.136~1.636）更易发生抑郁症状。结论 COVID-19防控期间,医务人员的心理健康状况都受到一定影响,应当合理安排医务人员的工作时长，关注家庭支持，高风险岗位人员，分层完善心理干预措施。

Stress,anxiety,depressionand relevant factors of health staff during COVID- 19 epidemic period

Objective To analyze mental health status of heath staff and explore the influencing factors during the coronavirus disease (COVID-19) epidemic period, provide evidence for establishing mental health service policy. Methods Besides demographics, three mental health problems including psychological distress, anxious symptoms, and depressive symptoms were evaluated by Perceived Stress Scale (PSS-10), generalized anxiety disorder scale (GAD-7) and Patients Health Questionnaire (PHQ-9) in the questionnaire online. Results The overall prevalence of stress, anxiety and depression was 27.9%, 30.0% and 27.0%, respectively. Female (OR: 0.68, 95%CI:0.547-0.846), youth under 30 years old (OR: 0.761, 95%CI:0.605-0.958; OR: 0.561, 95%CI:0.408-0.771), weekly work time more than 60h and 80h (OR: 1. 877,95%CI:1.345-2.619;OR: 2.759, 95%CI:1.570-4.847), poor family support(OR:1.515,95%CI:1.183-1.941), high infection risk (OR:1.354,95%CI:1.128-1.625), general hospitals with fever clinic (OR:1.456, 95%CI:1.151-1.843;OR:1.540,95%CI:1.225-1.936) have a higher risk of stress positive. Female(OR:0.758,95%CI:0.612-0.939), other marital status (OR:0.678,95%CI:0.527-0.872), length of service (OR:1.884,95%CI:1.273-2.789;OR:2.087,95%CI:1.258-3.465),weekly work time more than 60h and 80h(OR:2.092,95%CI:1.519-2.882),OR:3.879,95%CI:2.223-6.759), high infection risk (OR:1.568,95%CI:1.320-1.862), uncertain expected epidemic duration (OR:1.437,95%CI:1.076-1.920), have a higher risk of anxiety positive.General hospitals with fever clinic (OR: 1.408,95%CI:1.126-1.762, youth under 30 years old (OR:0.652,95%CI:0.474-0.896), weekly work time more than 60h and 80h(OR:1.791,95%CI:1.288-2.488), uncertain expected epidemic duration (OR:1.679,95%CI:1.254-2.248), high infection risk (OR:1.364,95%CI:1.136-1.636) have a higher risk of depression positive .Conclusion During the prevention and control period of COVID-19, the mental health status of medical staff is affected to a certain extent. We should reasonably arrange the working hours of medical staff, pay attention to family support, medical institutional personnel in high-risk positions, and improve the psychological intervention measures in different levels.