Investigation on the Mental Health Status of ICU Practitioners and Analysis of Influencing Factors During the Stable Stage of COVID-19 Epidemic in China

Psychological symptoms and correlates of Chinese healthcare professionals in the intensive care unit before and after the COVID-19 outbreak: A comparison of two cross-sectional studies

BACKGROUND

The outbreak of COVID-19 disarranged lives across mainland China. No study has examined changes in psychological symptoms of healthcare professionals in the intensive care unit (ICU) before and after the outbreak of COVID-19. The aim of this study was to estimate changes in psychological symptoms of ICU healthcare professionals before and after the COVID-19 outbreak, and to analyze factors related to psychological symptoms.

METHODS

Two waves' administrations were implemented between December 13 and December 14, 2018, and between April 5 and April 7, 2020, respectively. The symptom checklist-90 (SCL-90) were used to evaluate psychological symptoms. Multiple logistical regression was used to reveal the risk of psychological symptoms.

RESULTS

A total of 3902 and 3908 ICU healthcare professionals took part in the first and second surveys. The mean total score of the SCL-90 was 179.27 (70.02) at wave 1 and 147.75 (58.40) at wave 2, respectively. The proportion of psychological symptoms was 55.6 % (95%CI = 54.0-57.1) at wave 1. But rates of psychological symptoms decreased to 36.6 % (95%CI = 35.1-38.2) at wave 2. ICU healthcare professionals with western economic belt and 6-10 years of work were more likely to develop psychological symptoms, while ICU healthcare professionals with the later survey and doctoral degree were less likely to develop psychological symptoms.

CONCLUSION

Although COVID-19 period benefited psychological symptoms of ICU healthcare professionals, psychological symptoms still had a related high prevalence. Regular screening and appropriate interventions should still be implemented to decrease the risk for psychological symptoms among Chinese ICU healthcare professionals.

Assessment of Psychological and Social Fitness in Healthy Adults Permanently Living at Very High Altitude

BACKGROUND

Environmental factors of high altitude, especially hypobaric hypoxia, may directly and persistently affect human physical and mental health. Our study was designed to assess the psychological and social fitness in healthy adults permanently living at very high altitude, i.e., an average elevation of 3650 m.

METHODS

In our observational study, 320 participants were included, among which 218 (68.1%) had resided in such a setting for more than 20 years. Participants underwent 138 assessments, including the Self-Rating Anxiety Scale (SAS), Symptom Check List 90 (SCL-90) and the Evaluation Scale of Human Adaptation Capability (ESHAC). SAS (20 items) and SCL-90 (90 items) were used to assess psychological fitness, and the ESHAC (28 items) was used to assess social fitness. Pearson analysis was used to assess correlations and Logistic regression analysis was performed to determine independent influencing factors.

RESULTS

The highest SAS score was 80 and the mean score was 43.26 ± 8.88, which was higher than the norm in China (p < 0.001). Sixty (18.8%) participants showed anxiety symptoms and 14 (4.4%) had moderate or severe anxiety. The average score of SCL-90 was 140.88 ± 44.77, and 96 (30.0%) participants showed SCL-90 scores ≥160. Compared with the norm, significant differences were shown in eight of the nine SCL-90 factor scores, i.e., somatization, obsessive-compulsive, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. The average score of ESHAC was 19.92 ± 4.54, and 114 (35.6%) participants did not reach the qualifying standard. Significant correlations were observed between the SAS score, SCL-90 total and factor scores, and ESHAC scores. The Logistic regression analysis showed that being born at very high altitude was an independent influencing factor (AOR = 2.619; 95% CI, 1.629-4.211; p < 0.001) after controlling for other factors.

CONCLUSION

Permanently living at very high altitude can influence the psychological and social fitness of healthy adults.

Advocating for in-center hemodialysis patients via anonymous survey

We conducted an anonymous survey in 9 of our university affiliated outpatient dialysis units to address the concern that many in-center hemodialysis patients may not feel comfortable sharing their experiences. Major goals of this study: Investigating level of patient satisfaction with their care; Evaluating the subjective perception of the level of understanding of patients regarding pertinent issues of their disease and its management; Identifying potential avenues for care improvement. Survey was conducted in English, paper-based, with answer choices to individual questions for patient satisfaction and education graded using a 5-point Likert scale. Regarding potential areas of improvement, patients were asked to choose as many areas as deemed appropriate. To ensure anonymity, the completed surveys were folded and dropped into a box. Overall, 253 out of 516 (49%) screened patients were eligible and completed the survey. Patients expressed favorable responses regarding satisfaction (mean rating > 4 in each of 14 questions) and education (mean rating > 4 in 8 questions, > 3.5 in 2 questions) regarding hemodialysis. About 62% of overall study participants identified at least one area where they felt additional information would result in improvement of care. Our results indicate that patients undergoing outpatient hemodialysis were overall satisfied and had a good perceptive understanding about their health. Based on the patients' input, strategies focused on addressing pain and discomfort, privacy, providing information about palliative care/hospice, mental health resources, and the process of kidney transplantation may promote improvement in overall quality of care.