新型冠状病毒肺炎疫情背景下医院隔离观察病房内感染性疾病患者的心理评估及干预对策

Psychological Evaluation and Intervention Strategies of Patients with Infectious Diseases in Isolation Observation Ward of a Hospital during COVID-19 Pandemic

目的:分析与评估新型冠状病毒肺炎(COVID-19)疫情期间医院隔离观察病房内感染性疾病患者的心理状态,以及经心理干预后的改善情况及干预效果。方法:选取2020年1月—11月转入太仓市第一人民医院感染科隔离观察与治疗的126例患者病历,分析14 d内来自COVID-19高风险区的流调情况、隔离观察期间发热、呼吸道症状,以及入院时按焦虑自评量表(self-rating anxiety scale,SAS)评估患者的心理状态,比较患者入院时、入院1 h和入院24 h的SAS评分值的变化情况,并做好心理访谈与疏导工作。结果:126例患者中,其中入院时焦虑患者74例(占57.94%),经心理访谈及疏导后SAS评分值明显低于入院时(P<0.05);不同性别、年龄以及是(否)有与COVID-19患者接触史的患者SAS评分值之间均无统计学差异(P>0.05);按4月8日武汉解封日为截点,4月8日前期入院患者的焦虑程度明显重于后期(P<0.05);不同学历的患者SAS评分值之间也存在一定的差异,初级与中级、高级学历患者之间SAS评分值也均有显著差异(P<0.05);心理访谈疏导后,高学历者在短时间内SAS评分值明显低于低学历者(P<0.05)。结论:COVID-19疫情期间,隔离病房患者易产生焦虑情绪,尤其是高学历患者,经心理访谈疏导后有效缓解了患者的焦虑情绪。

Objective: To analyze and evaluate the psychological status of patients with infectious diseases in the isolation observation ward of hospitals during the COVID-19 outbreak, as well as the improvement and effects after psychological intervention. Methods: The medical records of 126 patients who were transferred to the infection Department of The First People’s Hospital of Taicang for isolation observation and treatment from January to November2020 were selected to analyze the flow pattern, fever and respiratory symptoms during isolation observation from high-risk areas of COVID-19 within 14 days. And the psychological states of the patients were assessed according to the SAS self-rating anxiety scale when they were admitted, and the changes of the SAS scores when they were admitted,1 h after admission and 24 h after admission were compared, and the psychological interview and counseling work were done well. Results: Among the 126 patients, 74 patients(57.94%) were anxious at admission. After psychological interview and counseling, the SAS score was significantly lower than that at admission(P<0.05). There were no significant differences in SAS scores among patients with different gender, age and yes(no) contact history with COVID-19 patients(P>0.05). Based on the cut-off point of Wuhan release date on April 8, the anxiety level of patients admitted before April 8 was significantly higher than that in the later period(P<0.05);There were also some differences in SAS score values among the patients with different educational backgrounds, and there were significant differences among primary, intermediate and advanced educational backgrounds(P<0.05). After the psychological interview, the SAS score of the students with high academic experience was significantly lower than that of the students with low academic experience in a short time(P<0.05). Conclusion: Based on the COVID-19 outbreak, patients in isolation wards are prone to anxiety, especially those with high education. Psychological interviews have effectively alleviated patients’ anxiety.