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意大利新冠疫情期间血液学患者的心理健康、疾病管理及社会经济变化所受影响

Impact on mental health, disease management, and socioeconomic modifications in hematological patients during the COVID-19 pandemic in Italy.

作者信息

De Muro Marianna, Janssen Annelot Julia, Amadori Sergio, de Fabritiis Paolo, Sabatino Dante, Niscola Pasquale, Torti Lorenza, Trawinska Malgorzata Monika, Tesei Cristiano, Bombaci Felice, Tarricone Mario, Bocchia Monica, Fava Carmen, Galimberti Sara, Iurlo Alessandra, Luciano Luigia, Abruzzese Elisabetta

机构信息

Department of Hematology and Stem Cell Transplantation, Campus Bio-Medico University Hospital, Rome, Italy.

Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

出版信息

Ther Adv Hematol. 2023 Sep 6;14:20406207231190683. doi: 10.1177/20406207231190683. eCollection 2023.

Abstract

BACKGROUND

Hematological patients are a highly vulnerable population with an increased risk of developing severe COVID-19 symptoms due to their immunocompromised status. COVID-19 has proven to cause serious mental health issues, such as stress, anxiety, and depression in the general population. However, data on the psycho-social impact of COVID-19 on hematological patients are lacking.

OBJECTIVES

This study aims to examine the psychological well-being of hematological patients in Italy during the initial period of the COVID-19 pandemic. Furthermore, it seeks to explore the association between modifications in the management of hematological diseases and employment status of these patients during the COVID-19 pandemic and the resulting mental health outcomes.

DESIGN AND METHODS

A survey using the DASS-21 questionnaire was administered to 1105 hematological patients. Data analysis was conducted using the R software, and logistic regression analysis was performed to predict the association between hematological patient/general population and employment status with DASS scores.

RESULTS

The hematological patient population reported significantly higher levels of depression (OR 0.947, 95% CI 0.966-0.982,  < 0.001), anxiety (OR 0.948, 95% CI 0.939-0.958,  < 0.001), and stress (OR 0.984, 95% CI 0.977-0.992,  < 0.001) compared with the general population. A significant relationship has been found in stress between employed and unemployed patients (OR 1.015, 95% CI 1.000-1.030,  = 0.044), as well as in the control group (OR 1.024, 95% CI 1.010-1.039,  = 0.001). In addition, employment status is significantly related to depression, anxiety, and stress in both the hematological patient group and the general population.

CONCLUSION

During the initial phase of the COVID-19 pandemic, hematological patients had elevated levels of depression, anxiety, and stress compared with the general population. The delay in their treatment and employment status played a role in their mental health outcomes. These findings emphasize the importance of further research to gain deeper insight into the long-term psychological effects and explore effective strategies for managing mental health in similar crises.

摘要

背景

血液学患者是一个高度脆弱的群体,由于其免疫功能低下的状态,感染新冠病毒后出现严重症状的风险增加。事实证明,新冠病毒会引发严重的心理健康问题,如普通人群中的压力、焦虑和抑郁。然而,关于新冠病毒对血液学患者心理社会影响的数据却很缺乏。

目的

本研究旨在调查意大利新冠疫情初期血液学患者的心理健康状况。此外,还试图探讨新冠疫情期间血液学疾病管理方式的改变与这些患者就业状况之间的关联,以及由此产生的心理健康结果。

设计与方法

使用DASS - 21问卷对1105名血液学患者进行了调查。使用R软件进行数据分析,并进行逻辑回归分析,以预测血液学患者/普通人群与就业状况与DASS评分之间的关联。

结果

与普通人群相比,血液学患者群体的抑郁水平(比值比0.947,95%置信区间0.966 - 0.982,<0.001)、焦虑水平(比值比0.948,95%置信区间0.939 - 0.958,<0.001)和压力水平(比值比0.984,95%置信区间0.977 - 0.992,<0.001)显著更高。已发现就业和未就业患者之间在压力方面存在显著关系(比值比1.015,95%置信区间1.000 - 1.030,P = 0.044),对照组中也是如此(比值比1.024,95%置信区间1.010 - 1.039,P = 0.001)。此外,就业状况在血液学患者组和普通人群中均与抑郁、焦虑和压力显著相关。

结论

在新冠疫情初期,血液学患者的抑郁、焦虑和压力水平高于普通人群。他们治疗的延迟和就业状况对其心理健康结果产生了影响。这些发现强调了进一步研究的重要性,以便更深入地了解长期心理影响,并探索在类似危机中管理心理健康的有效策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b32b/10483981/f34bd00ebad1/10.1177_20406207231190683-fig1.jpg

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