突发公共卫生事件对公众心理的影响:2019冠状病毒病疫情期间浙江省心理援助热线来电分析

目的: 总结2019冠状病毒病疫情期间心理援助热线服务需求及公众心理状态的变化特点。方法: 采用量化统计与质性分析相结合的方法对2020年1月25日至2月29日浙江省心理援助热线（简称“热线”）来电进行分析。将疫情相关来电分为医学、心理、资讯、其他四类,采用文本分析法确定心理类来电的二级类别;按周统计来电数量并分析各类来电数量随时间变化情况;采用分层随机抽样法在各类疫情相关来电中抽取600人次进行语义分析,通过标记新增、同类合并的方式形成特征集,归纳各阶段的来电内容特征;对200名来电者进行回访,从等待时间、通话时长、解决问题的程度和结束通话的方式四方面了解其对来电过程的感受。结果: 全省热线累计接到来电13 764人次,8978人次（65.23%）为COVID-19疫情相关来电,其中医学类占12.59%（1130/8978）、心理类占26.50%（2379/8978）、资讯类占27.18%（2440/8978）、其他占33.74%（3029/8978）。各类来电数量随时间呈非线性变化,每日各类来电数量受到每日疫情情况、新增相关政策情况、热线宣传力度等因素的影响（P < 0.05或P < 0.01）;各类来电数量在不同性别和身份的来电者中的分布差异有统计学意义（均P < 0.05）。181名来电者自愿接受回访,其中51.38%（93/181）的来电者认为热线占线等待时间偏长,33.15%（60/181）的来电者认为热线通话时间不足,80.66%（146/181）的来电者认为通过拨打热线能部分/完全解决问题,39.23%（71/181）的来电者认为是由接线员单方面提出结束通话。结论: 心理援助热线来电数量和内容的变化反映出疫情期间公众心理大致经历盲目期、恐慌期、烦闷期和调整期四个阶段,各个时期呈现不同的特征。应进一步加强心理援助热线的“专线”特性,提高服务效率,针对不同阶段公众的心理特征采取相应的心理干预策略。

Impact of public health emergency on public psychology: analysis of mental health assistance hotlines during COVID-19 in Zhejiang province

Objective: To analyze the usage of mental health assistance hotline during COVID-19 in Zhejiang province from January 25th to February 29th 2020, and summarize the characteristics of the demand for mental health services and the dynamic changes of public mental health status during COVID-19 pandemic. Methods: Both quantitative and qualitative methods were used. The calls related to pandemic were divided into four categories: medical, psychological, information and the others. The secondary categories of psychological calls were determined by text analysis. The number of calls were calculated weekly and the number of various types of calls over time were analyzed. We used stratified random sampling method to extract 600 cases of all kinds of calls related to pandemic and conducted a semantic analysis, through marking new, similar combination to form a feature set, then summed up the call content characteristics of each stage. Two hundred callers were followed up to understand how they felt about the call process in four aspects: the waiting time, call duration, the degree of problem-solving and the way to end the call. Results: In a total of 13 746 calls, 8978 were related to pandemic, among which 12.59%(1130/8978) were about medical issues, 26.50%(2379/8978) were about mental health, 27.18%(2440/8978) were about information regarding the pandemic and 33.74%(3029/8978) were about other pandemic related issues. Pandemic situation, relevant policy release, frequency of advertising campaigns were predictors of the number of calls per day during the pandemic (P < 0.05 or P < 0.01). The number of calls differed by gender and identities of callers (both P < 0.05). Finally 181 callers accepted telephone follow-up. Among them, 51.38%(93/181) of the callers thought that the waiting time was too long, 33.15%(60/181) of the callers thought that the call time was insufficient, 80.66%(146/181) of callers believed that the hotline could partially or completely resolve their concerns, and 39.23%(71/181) of the callers said the operator proposed to end the call. Conclusions: The changes of the number and content of the mental health assistance hotline calls reflected that the public mental health status experienced four stages during the pandemic: confusion, panic, boredom, and adjustment. The specialized mental health assistance hotlines should be further strengthened, and the efficiency should be improved. Mental health interventions should be tailored and adopted according to the characteristics of the public mental health status at different stages of the pandemic.