COVID-19 Pandemisinin İntörn Hekim ve Hekimlerin Yalnızlık, Umutsuzluk ve Anksiyete Belirti Düzeylerine Etkisi
Öz
Giriş: Bu çalışmada, halen devam eden COVID-19 pandemisinde ön sıralarda çalışan intörn hekim ve hekimlerin hissettikleri yalnızlık, umutsuzluk, durumluk ve sürekli anksiyete belirti düzeylerinin belirlenmesi amaçlandı. Yöntem: Kesitsel tipte tanımlayıcı bir çalışma olan bu araştırma, 01.05.2020-30.05.2020 tarihleri arasında sosyal medya üzerinden ulaşılan ve katılmayı kabul eden 212 imtörn hekim ve hekimler ile tamamlandı. Katılımcılara Google forms üzerinden ulaştırılan anket linkinde sosyodemografik bilgi formu, Beck Umutsuzluk Ölçeği (BUÖ), UCLA Yalnızlık Ölçeği (UCLA-LS) ile Durumluk (STAI-1) ve Sürekli Anksiyete (STAI-2) Envanterinden oluşan sorular yeraldı. Bulgular: Katılımcıların %54,7’si (n=116) erkek, %17,7’si (n=36) intörn hekim ve %37,7’si (n=80) uzman hekimdi. Asistan ve uzman hekimlerin %83,1’i (n=102) dahili bilimlere bağlıydı. Hekimlerin %54,2’si (n=115) “O anda” yaşadığı şehirden memnun olduğunu ve %16’sı (n=34) tekrar seçme şansı olsa tıp eğitimini asla seçmeyeceğini belirtmişti. Grubun BUÖ puan ortalaması 7,35±4,8 (0-20) puan ve UCLA-LS puan ortalaması 41,32±9,8 (24-65) puandı. Ölçeklerden alınan puanlar ile yaş, cinsiyet ve akademik eğitim düzeyleri arasında ilişki saptanmadı (p>0,05). COVID-19 hastasına bakım hizmeti veren, hastayla yüz yüze temas eden hekimlerin, umutsuzluk (8,41±4,1; 8,92±4,5) ve yalnızlık (44,61±8,9; 44,37±9,7) puanları daha yüksekti (p=0,05; p=0,001). Hekimlerin tamamının (%100) durumluk anksiyete belirti düzeyi, %86,7’sinin ise sürekli anksiyete belirti düzeyi yüksekti. Çalıştıkları kurumlarda ayrı triyaj alanı oluşturulmayanların ve COVID-19 tanısı alanların sırasıyla durumluk anksiyete (p=0,011; p=0,013) ve sürekli anksiyete belirti düzeyleri anlamlı olarak yüksek tespit edildi (p=0,018; p=0,009). Ayrıca COVID-19 hastası ile yüz yüze temas edenlerin durumluk anksiyete belirtileri artmıştı (p=0,020). Sonuç: Bu çalışma, bir kez daha COVID-19 pandemi döneminde büyük bir özveri ile çalışan hekimlerin gelecekten umutsuz, yalnız ve oluşan durumdan kaygılı olduğunu göstermiştir. Bu dönemde risk altındaki hekimlerin psikolojik durumlarının takibi ile gerekli önlemlerin erken dönemde alınması hem kendi sağlıkları, hem de toplum sağlığı açısından çok önemlidir.
Anahtar Kelimeler
Teşekkür
Bu zorlu süreçte zaman ayırıp çalışma anketini dolduran, dolduramayan tüm hekimlere teşekkür ediyoruz.
Kaynakça
- 1-World Health Organisation. WHO Coronavirus Disease (COVID-19) Dashboard. https://covid19.who.int/. Erişim tarihi: 24.9.2020
- 2-TC. Sağlık Bakanlığı 2020 COVID-19-New Coronavirus Disease [Internet]. Erişim adresi: https://covid19bilgi.saglik.gov.tr/tr/ Erişim tarihi: 24.9.2020
- 3-Breillat R, Birtus M. Is the COVID-19 outbreak severely affecting the psychological well-being of frontline respiratory and ıntensive care physicians and nurses? Psychosociological Issues in Human Resource Management 2020; 8(1): 49-54.
- 4-Chew NWS, Lee GKH, Tan BYQ, Jing M, Goh Y, Ngiam NJH, et al. A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain Behav Immun. 2020 Aug; 88: 559-65.
- 5- Preti E, Di Mattei V, Perego G, Ferrari F, Mazzetti M, Taranto P, et al. The psychological ımpact of epidemic and pandemic outbreaks on healthcare workers: rapid review of the evidence. Curr Psychiatry Rep 2020 Jul 10; 22(8):43.
- 6-Zerbini G, Ebigbo A, Reicherts P, Kunz M, Messman H. Psychosocial burden of healthcare professionals in times of COVID-19 - a survey conducted at the University Hospital Augsburg. Ger Med Sci. 2020 Jun 22;18: Doc05.
- 7-Sutter A, Llor C, Maier M, Mallen C, Tatsioni A, van Weert H, et al. Family medicine in times of ‘COVID-19’: A generalists' voice. Eur J Gen Pract 2020; 26(1): 58–60.
- 8-Twenge JM, Joiner TE. U.S. Census Bureau-assessed prevalence of anxiety and depressive symptoms in 2019 and during the 2020 COVID-19 pandemic. Depress Anxiety 2020 Jul 15; 10.1002/da.23077.
- 9-Erdoğdu Y, Koçoğlu F, Sevim C. COVID-19 pandemisi sürecinde anksiyete ile umutsuzluk düzeylerinin psikososyal ve demografik değişkenlere göre incelenmesi J Clin Psy 2020; 23(Ek 1): 24-37.
- 10-Spoorthy MS, Pratapa SK, Mahant S. Mental health problems faced by healthcare workers due to the COVID-19 pandemic-A review. Asian J Psychiatr 2020 Jun; 51: 102119.
- 11-Elhadi M, Msherghi A, Elgzairi M, Alhashimi A, Bouhuwaish A, Biala M, et al. Psychological status of healthcare workers during the civil war and COVID-19 pandemic: A cross-sectional study. J Psychosom Res 2020; 137: 110221.
- 12-Monterrosa-Castro A, Redondo-Mendoza V, Mercado-Lara M. Psychosocial factors associated with symptoms of generalized anxiety disorder in general practitioners during the COVID-19 pandemic. J Investig Med 2020; 68(7):1228-34.
- 13-Heinrich LM, Gullone E. The clinical significance of loneliness: A literature review. Clin Psychol Rev 2006; 26: 695–718.
- 14-Karaoğlu N, Avşaroğlu S, Deniz ME. Yalnız mısın? Selçuk Üniversitesi öğrencilerinde yalnızlık düzeyi ile ilgili bir çalışma. Marmara Medical Journal 2009; 22(1): 19-26.
- 15-Lauder W, Mummery K, Jones M, Caperchione C. A comparison of health behaviours in lonely and non-lonely populations. Psychol Health Med 2006; 11(2): 233–245.
- 16-Cudjoe TKM, Kotwal AA. “Social distancing” amid a crisis in social ısolation and loneliness. J Am Geriatr Soc 2020; 15: 10.1111/jgs.16527.
- 17-Steptoe A, Owen N, Kunz-Ebrecht S, Brydon L. Loneliness and neuroendocrine, cardiovascular, and inflammatory stres responses in middle-aged men and women. Psychoneuroendocrino 2004; 29: 593– 611.
- 18-Nausheen B, Gidron Y, Gregg A, Tissarchondou H S, Peveler R. Loneliness, social support and cardiovascular reactivity to laboratory stress. Stress 2007; 10(1): 37–44.
- 19-Güler M, Demirci K, Karakuş K, Kişioğlu AN, Zengin E, Yozgat Z, ve ark. Süleyman Demirel Üniversitesi Tıp Fakültesi öğrencilerinde umutsuzluk- depresyon sıklığı ve sosyodemografik özellikler arasındaki ilişkinin belirlenmesi. Int J Basic Clin Med 2014;2(1):32-37.
- 20-Hacimusalar Y, Kahve AC, Yasar AB, Aydin MS. Anxiety and hopelessness levels in COVID-19 pandemic: A comparative study of healthcare professionals and other community sample in Turkey. J Psychiatr Res 2020 Oct; 129: 181-8.
- 21-Durak A, Palabıyıkoğlu R. Beck Umutsuzluk Ölçeği geçerlilik çalışması. Kriz Dergisi 1994; 2(2): 311-9.
- 22-Beck AT, Weissman A, Lester D, Trexler L. The Hopelessness Scale. Journal of Consulting and Clinical Psychology 1974; 42 (6): 861-5.
- 23-Spielberger CD, Gorsuch RL, Lusahene RE. Manual for State and Anxiety Inventory. California, Consulting Psychologists Press, 1970.
- 24-Oner N, LeCompte A. Durumluk-Sürekli Kaygı Envanteri El Kitabı. Boğazici Üniversitesi Yayınları, No 333. İstanbul. 1982.
- 25-Karaoglu N, Seker M. Anxiety and depression in medical students related to desire for and expectations from a medical career. West Indian Medical Journal 2010; 59(2): 196-202.
- 26-Karaoğlu N, Bulut S, Baydar A, Carelli F. Aile hekimlerinde durumluk ve sürekli anksiyete düzeyi: Bir vaka kontrol çalışması. Türkiye Aile Hekimliği Dergisi 2009; 13(3): 119–26.
- 27-Seber G, Dilbaz N, Kaptanoğlu C, Tekin D. Umutsuzluk Ölçeği: Geçerlilik ve güvenirliği. Kriz Dergisi 1993; 1: 139-42.
- 28-Russell D, Peplau LA, Cutrona CE. The revised UCLA Loneliness Scale: Concurrent and discriminant validity evidence. J Pers Soc Psychol 1980; 39: 472–80.
- 29-Demir A. UCLA Yalnızlık ölçeğinin geçerlik ve güvenirliliği. Psikoloji Dergisi 1989; 7: 14–8.
- 30-Salopek-Žiha D, Hlavati M, Gvozdanovi Z, Gaši M, Placento H, Jaki H, et al. Differences in distress and coping with the COVID-19 stressor in nurses and physicians. Psychiatria Danubina 2020; 32(2): 287-93.
- 31-Elbay RY, Kurtulmuş A, Arpacıoğlu S, Karadere E. Depression, anxiety, stress levels of physicians and associated factors in Covid-19 pandemics. Psychiatry Res 2020 Aug; 290:113130.
- 32-Lai J, Ma S, Wang Y, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open 2020; 3(3): e203976.
- 33-Imran N, Masood HMU, Ayub M, Gondal KM. Psychological impact of COVID-19 pandemic on postgraduate trainees: a cross-sectional survey. Postgrad Med J 2020; postgradmedj-2020-138364.
- 34-Shanafelt T, Ripp J, Trockel M. Understanding and addressing sources of anxiety among health care professionals during the COVID-19 Pandemic. JAMA 2020; 10. 1001/jama. 2020. 5893.
- 35-Shah K, Chaudhari G, Kamrai D, Lail A, Patel RS. How essential is to focus on physician's health and burnout in coronavirus (COVID-19) pandemic? Cureus 2020; 12(4): e7538.
The Effect of the COVID-19 Pandemic on Interns’ and Physicians' Loneliness, Hopelessness and Anxiety Symptom Levels
Öz
Introduction: This study aimed to determine the levels of loneliness, hopelessness, state and trait anxiety of physicians and interns working at the forefront of the COVID-19 pandemic that is still ongoing. Method: This cross-sectional, descriptive study was completed with voluntary 212 physicians those were reached via social media between 01.05.2020-30.05.2020. The questionnaire link delivered in Google forms and consisted sociodemographic information form, the Beck Hopelessness Scale (BHS), the UCLA Loneliness Scale (UCLA-LS), and the State (STAI-1) and Trait Anxiety (STAI-2) Inventory. Results: The 54.7 percent (n=116) of the participants were male, 17.7% (n=36) were interns and 37.7% (n=80) were specialists. The residents and specialists were mainly (83.1%; n=102) from internal sciences. Above the half (54.2%; n=115) stated that they were happy with the city they are living and 16% (n=34) noted that they would not select medical education if they had a chance again. The mean BHS score was 7.35±4.8 (0-20) and the mean UCLA-LS score was 41.32±9.8 (24-65) points. No relationship was found between these scores and age, gender, and education level (p>0.05). The physicians who provided care to the COVID-19 patients and had face to face contact were more hopeless (8.41±4.1; 8.92±4.5; p=0.05) and more lonely (44.61±8.9; 44.37±9.7; p=0.001). State (100%) and trait anxiety symptom (86.7%) of the group were high. The state anxiety symptom of those who did not have a separate triage area in their institutions and diagnosed with COVID-19 were significantly high, respectively (p=0.011; p=0.013) and trait anxiety symptom levels as well (p=0.018; p=0.009). In addition, state anxiety symptoms of those who had face to face contact with COVID-19 patients were evident (p = 0.020). Conclusion: This study once again showed that physicians working with great devotion during the COVID-19 pandemic are hopeless, lonely and worried about the situation that occurs. In this period, it is very important to monitor the psychological conditions of the physicians at risk and to take the necessary precautions earlier, both for their own and for public health.
Anahtar Kelimeler
Kaynakça
- 1-World Health Organisation. WHO Coronavirus Disease (COVID-19) Dashboard. https://covid19.who.int/. Erişim tarihi: 24.9.2020
- 2-TC. Sağlık Bakanlığı 2020 COVID-19-New Coronavirus Disease [Internet]. Erişim adresi: https://covid19bilgi.saglik.gov.tr/tr/ Erişim tarihi: 24.9.2020
- 3-Breillat R, Birtus M. Is the COVID-19 outbreak severely affecting the psychological well-being of frontline respiratory and ıntensive care physicians and nurses? Psychosociological Issues in Human Resource Management 2020; 8(1): 49-54.
- 4-Chew NWS, Lee GKH, Tan BYQ, Jing M, Goh Y, Ngiam NJH, et al. A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain Behav Immun. 2020 Aug; 88: 559-65.
- 5- Preti E, Di Mattei V, Perego G, Ferrari F, Mazzetti M, Taranto P, et al. The psychological ımpact of epidemic and pandemic outbreaks on healthcare workers: rapid review of the evidence. Curr Psychiatry Rep 2020 Jul 10; 22(8):43.
- 6-Zerbini G, Ebigbo A, Reicherts P, Kunz M, Messman H. Psychosocial burden of healthcare professionals in times of COVID-19 - a survey conducted at the University Hospital Augsburg. Ger Med Sci. 2020 Jun 22;18: Doc05.
- 7-Sutter A, Llor C, Maier M, Mallen C, Tatsioni A, van Weert H, et al. Family medicine in times of ‘COVID-19’: A generalists' voice. Eur J Gen Pract 2020; 26(1): 58–60.
- 8-Twenge JM, Joiner TE. U.S. Census Bureau-assessed prevalence of anxiety and depressive symptoms in 2019 and during the 2020 COVID-19 pandemic. Depress Anxiety 2020 Jul 15; 10.1002/da.23077.
- 9-Erdoğdu Y, Koçoğlu F, Sevim C. COVID-19 pandemisi sürecinde anksiyete ile umutsuzluk düzeylerinin psikososyal ve demografik değişkenlere göre incelenmesi J Clin Psy 2020; 23(Ek 1): 24-37.
- 10-Spoorthy MS, Pratapa SK, Mahant S. Mental health problems faced by healthcare workers due to the COVID-19 pandemic-A review. Asian J Psychiatr 2020 Jun; 51: 102119.
- 11-Elhadi M, Msherghi A, Elgzairi M, Alhashimi A, Bouhuwaish A, Biala M, et al. Psychological status of healthcare workers during the civil war and COVID-19 pandemic: A cross-sectional study. J Psychosom Res 2020; 137: 110221.
- 12-Monterrosa-Castro A, Redondo-Mendoza V, Mercado-Lara M. Psychosocial factors associated with symptoms of generalized anxiety disorder in general practitioners during the COVID-19 pandemic. J Investig Med 2020; 68(7):1228-34.
- 13-Heinrich LM, Gullone E. The clinical significance of loneliness: A literature review. Clin Psychol Rev 2006; 26: 695–718.
- 14-Karaoğlu N, Avşaroğlu S, Deniz ME. Yalnız mısın? Selçuk Üniversitesi öğrencilerinde yalnızlık düzeyi ile ilgili bir çalışma. Marmara Medical Journal 2009; 22(1): 19-26.
- 15-Lauder W, Mummery K, Jones M, Caperchione C. A comparison of health behaviours in lonely and non-lonely populations. Psychol Health Med 2006; 11(2): 233–245.
- 16-Cudjoe TKM, Kotwal AA. “Social distancing” amid a crisis in social ısolation and loneliness. J Am Geriatr Soc 2020; 15: 10.1111/jgs.16527.
- 17-Steptoe A, Owen N, Kunz-Ebrecht S, Brydon L. Loneliness and neuroendocrine, cardiovascular, and inflammatory stres responses in middle-aged men and women. Psychoneuroendocrino 2004; 29: 593– 611.
- 18-Nausheen B, Gidron Y, Gregg A, Tissarchondou H S, Peveler R. Loneliness, social support and cardiovascular reactivity to laboratory stress. Stress 2007; 10(1): 37–44.
- 19-Güler M, Demirci K, Karakuş K, Kişioğlu AN, Zengin E, Yozgat Z, ve ark. Süleyman Demirel Üniversitesi Tıp Fakültesi öğrencilerinde umutsuzluk- depresyon sıklığı ve sosyodemografik özellikler arasındaki ilişkinin belirlenmesi. Int J Basic Clin Med 2014;2(1):32-37.
- 20-Hacimusalar Y, Kahve AC, Yasar AB, Aydin MS. Anxiety and hopelessness levels in COVID-19 pandemic: A comparative study of healthcare professionals and other community sample in Turkey. J Psychiatr Res 2020 Oct; 129: 181-8.
- 21-Durak A, Palabıyıkoğlu R. Beck Umutsuzluk Ölçeği geçerlilik çalışması. Kriz Dergisi 1994; 2(2): 311-9.
- 22-Beck AT, Weissman A, Lester D, Trexler L. The Hopelessness Scale. Journal of Consulting and Clinical Psychology 1974; 42 (6): 861-5.
- 23-Spielberger CD, Gorsuch RL, Lusahene RE. Manual for State and Anxiety Inventory. California, Consulting Psychologists Press, 1970.
- 24-Oner N, LeCompte A. Durumluk-Sürekli Kaygı Envanteri El Kitabı. Boğazici Üniversitesi Yayınları, No 333. İstanbul. 1982.
- 25-Karaoglu N, Seker M. Anxiety and depression in medical students related to desire for and expectations from a medical career. West Indian Medical Journal 2010; 59(2): 196-202.
- 26-Karaoğlu N, Bulut S, Baydar A, Carelli F. Aile hekimlerinde durumluk ve sürekli anksiyete düzeyi: Bir vaka kontrol çalışması. Türkiye Aile Hekimliği Dergisi 2009; 13(3): 119–26.
- 27-Seber G, Dilbaz N, Kaptanoğlu C, Tekin D. Umutsuzluk Ölçeği: Geçerlilik ve güvenirliği. Kriz Dergisi 1993; 1: 139-42.
- 28-Russell D, Peplau LA, Cutrona CE. The revised UCLA Loneliness Scale: Concurrent and discriminant validity evidence. J Pers Soc Psychol 1980; 39: 472–80.
- 29-Demir A. UCLA Yalnızlık ölçeğinin geçerlik ve güvenirliliği. Psikoloji Dergisi 1989; 7: 14–8.
- 30-Salopek-Žiha D, Hlavati M, Gvozdanovi Z, Gaši M, Placento H, Jaki H, et al. Differences in distress and coping with the COVID-19 stressor in nurses and physicians. Psychiatria Danubina 2020; 32(2): 287-93.
- 31-Elbay RY, Kurtulmuş A, Arpacıoğlu S, Karadere E. Depression, anxiety, stress levels of physicians and associated factors in Covid-19 pandemics. Psychiatry Res 2020 Aug; 290:113130.
- 32-Lai J, Ma S, Wang Y, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open 2020; 3(3): e203976.
- 33-Imran N, Masood HMU, Ayub M, Gondal KM. Psychological impact of COVID-19 pandemic on postgraduate trainees: a cross-sectional survey. Postgrad Med J 2020; postgradmedj-2020-138364.
- 34-Shanafelt T, Ripp J, Trockel M. Understanding and addressing sources of anxiety among health care professionals during the COVID-19 Pandemic. JAMA 2020; 10. 1001/jama. 2020. 5893.
- 35-Shah K, Chaudhari G, Kamrai D, Lail A, Patel RS. How essential is to focus on physician's health and burnout in coronavirus (COVID-19) pandemic? Cureus 2020; 12(4): e7538.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | İç Hastalıkları |
| Bölüm | Orijinal Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 20 Haziran 2021 |
| Gönderilme Tarihi | 9 Aralık 2020 |
| Yayımlandığı Sayı | Yıl 2021 Cilt: 15 Sayı: 2 |
Cited By
Sağlığın ve birinci basamak bakımın anlaşılmasına ve geliştirilmesine katkıda bulunacak yeni bilgilere sahip yazarların İngilizce veya Türkçe makaleleri memnuniyetle karşılanmaktadır.