全科医生在社区防控新型冠状病毒肺炎中的困难和需求及心理状况调查研究

Survey on the difficulties,requirements and psychological status of general practitioners in community-based prevention and control of the COVID-19 epidemic

目的探讨社区全科医生对新型冠状病毒肺炎(COVID-19)的诊疗及防控指南的认识度,以及在社区疫情防控中的困难、需求及心理健康状况。方法对上海市参加社区防控COVID-19的一线全科医生进行问卷调查。通过微信群及同事分享的方式对参加疫情防控的社区全科医生发放问卷。结果共发放问卷210份,回收210份,有效问卷209份,有效回收率为99.50%。209例全科医生对COVID-19的认知程度:了解70例(33.49%)、熟悉70例(33.49%)、掌握50例(23.93%)、非常了解19例(9.09%);在社区防控COVID-19中的主要困难前三位是:医疗物资紧缺199例(95.22%)、医务人员短缺150例(71.77%)、疑似患者不配合92例(44.02%);在社区防控COVID-19中的主要需求前三位是:医疗物资197例(94.26%)、医务人员(全科、公卫、护士)158例(75.60%)、专家指导104例(49.76%);209例全科医生中,184例自感有压力(88.04%),209例全科医生对COVID-19和普通肺炎的心理状态比较,差异有统计学意义(χ2=98.06,P<0.05)。184例自感有压力的全科医生中,63例(34.24%)全科医生在此次疫情防控中可能存在抑郁症,69例(37.50%)全科医生在此次疫情防控中可能存在焦虑症。结论社区全科医生在防控COVID-19中存在不同程度的心理健康问题,少数全科医生有不同程度的焦虑和抑郁。困难多为医疗物资及医务工作者的不足,所需要的帮助除了以上困难外尚需专家指导社区防控。因此,政府及社会在关注社区全科医生在COVID-19疫情防控中出现的心理问题时,应以社区全科医生需求为导向,积极干预并缓解其心理压力,从而使其更好的服务于社区居民,做好健康的守门人。

ObjectiveTo investigate the awareness level of management,and prevention and control guidelines of the COVID-19 infection in community general practitioners,and investigate their difficulties,requirements and mental health status in community-based prevention and control of the COVID-19 epidemic.MethodsWe conducted an online questionnaire survey among the frontline general practitioners who participating in the community-based prevention and control of the COVID-19 epidemic in Shanghai.Through the WeChat group and sharing between colleagues,questionnaires were sent to community general practitioners.ResultsAmong 210 questionnaires,totally 209 valid questionnaires were recovered. The effective rate of the questionnaire was99.50%.The cognition degree of 209 general practitioners to COVID-19:70 cases of understanding(33.49%),70 cases of familiarizing(33.49%),50 cases of well knowing(23.93%),and 19 cases of quite understanding(9.09%).The top three difficulties encountered in the prevention and control of the epidemic are: shortage of medical supplies(95.22%),shortage of medical workers(71.77%),and non-cooperation of the suspected patients(44.02%).The top three requirements are:medical supplies(94.26%),medical workers(general practitioners,public health physicians and nurses)(75.60%),and expert guidance(49.76%).Among the 209 general practitioners,184 cases(88.04%)felt stressed.It showed significantly different attitudes of general practitioners toward the COVID-19 and the common pneumonia(χ2=98.06,P<0.05).Of the 184 cases who felt stressed,63(34.24%)may had depression,and 69(37.50%)may had anxiety in COVID-19 epidemic prevention and control.Conclusion Community general practitioners have mental health problems on different extent in the prevention and control of the COVID-19 epidemic,especially a few of them may have anxiety and depression on different extent.The shortage of medical materials and medical workers are the main difficulties. And experts are also needed to guide community prevention and control.Therefore,the government and society pay attention to the psychological problems of community general practitioners in the prevention and control of COVID-19 epidemic,reduce their psychological pressure based on their requirements,so that they can better serve the community residents as good health gatekeepers.