新研究突出了大流行对一线护士的影响

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Journal of Clinical Nursing publishes study on mental and emotional toll of COVID-19

COLUMBUS – A team of nurse scientists, evidence-based practice professionals and an ethicist from The Ohio State University College of Nursing have published their findings from their multi-site study with first-hand accounts of the psychological and emotional toll that the COVID-19 pandemic has taken on front-line nurses in the U.S.

Focus groups engaging 43 staff nurses at four sites across the country (California, New York, Ohio and Pennsylvania) informed the study, which identified four central themes:

1. The challenges the nurses faced in their work;

2. The feelings that dominated their emotional and mental health;

3. Coping mechanisms with varying levels of success in dealing with the pandemic; and

4. Ethical issues they were forced to wrestle with in real time as they treated the sickest COVID-19 patients.

“We were asked to perform this study by staff RNs themselves not only to capture the history and emotions of the pandemic as it was happening, but also to learn where there were gaps that must be filled,” said Esther Chipps, PhD, clinical nurse scientist and professor of clinical nursing at The Ohio State University College of Nursing who was the lead principal investigator. “Our front-line nurses are inspirations and heroes for how they have served during the pandemic, and it is incumbent upon healthcare organizations to understand and course-correct where possible to better support them.”

Many of the nurses interviewed for this study consistently echoed similar concerns regarding internal communication issues, ever-changing protocols as the pandemic evolved, overwhelming fatigue, growing stress and anxiety among the nursing population and the ethical dilemmas associated with the magnitude of the illness and death that they witnessed among their patients.

The study, published by the international nursing journal Journal of Clinical Nursing, spotlighted the urgent need for several evidence-based approaches to mitigate the situation that hampered the front-line response to the pandemic, including:

Consistent disaster preparation and management guidelines that front-line clinicians can count on.

Interventions to build coping and resiliency skills in front-line clinicians who are trying to handle elevated levels of stress, anxiety and burnout as they care for patients such as The Ohio State University Wexner Medical Center’s Mindfulness in Motion, STAR mental health and Buckeye Paws programs, as well as Ohio State’s MINDSTRONG™/MINDBODYSTRONG™ cognitive-behavioral skills-building program.

Opportunities to reflect on the current experience and document successes and failures to build a bank of institutional knowledge and memory that includes innovative practices, surge staffing plans, personal anecdotes and other documentation so that future crises of this kind can be met from a better-informed perspective to improve organizational preparedness.

“We cannot afford to repeat the tragedy of this pandemic ever again,” Chipps said. “Part of what we can control is the support infrastructure put into place for clinicians so that they have clarity, consistency and resources available that allow them to focus on: caring for patients and optimizing their own self-care.”

Investigators for this study include leaders from The Ohio State University College of Nursing Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare, (Donal O’Mathuna, PhD; Haley Roberts, BS; Sharon Tucker, PhD; Inga Zadvinskis, PhD; Cindy Zellefrow, DNP), The Ohio State University College of Nursing and The Ohio State University Wexner Medical Center (Esther Chipps, PhD), The Ohio State University College of Nursing (Marjorie Kelley, PhD; Julia Smith, EdM), UCLA Health (Pamela Miller, PhD), Columbia University College of Nursing (Allison Norfull, PhD) and Chester County Hospital, Penn Medicine (Cindy Brockway, MSN; Cheryl Monturo, PhD).

全文翻译（仅供参考）

《临床护理杂志》发表了关于 COVID-19 的精神和情绪损失的研究

哥伦布——来自俄亥俄州立大学护理学院的一个由护士科学家、循证实践专业人员和伦理学家组成的团队发表了他们多站点研究的发现，并提供了 COVID-19 对心理和情感造成的损失的第一手资料大流行已经席卷了美国的一线护士

由全国四个地点（加利福尼亚、纽约、俄亥俄和宾夕法尼亚）的 43 名护士组成的焦点小组为这项研究提供了信息，该研究确定了四个中心主题：

1. 护士在工作中面临的挑战；

2. 支配他们情绪和心理健康的感觉；

3. 在应对大流行方面取得不同程度成功的应对机制；和他们在治疗病情最严重的 COVID-19 患者时被迫实时解决道德问题。

临床护士埃丝特·奇普斯 (Esther Chipps) 博士说：“我们被要求由注册护士自己进行这项研究，不仅是为了在大流行发生时捕捉它的历史和情绪，还要了解哪些地方必须填补空白，”俄亥俄州立大学护理学院的科学家和临床护理教授，他是首席首席研究员。“我们的一线护士是他们在大流行期间服务的灵感和英雄，医疗机构有责任在可能的情况下理解并纠正路线以更好地支持他们。”

本研究采访的许多护士一致回应了类似的担忧，包括内部沟通问题、随着大流行的发展而不断变化的协议、压倒性的疲劳、护理人员中日益增加的压力和焦虑以及与疾病和死亡严重程度相关的道德困境他们在病人中亲眼目睹。

这项由国际护理杂志《临床护理杂志》发表的研究强调了迫切需要几种循证方法来缓解阻碍一线应对大流行的情况，包括：

一线临床医生可以信赖的一致的灾难准备和管理指南。

旨在帮助一线临床医生建立应对和恢复能力技能的干预措施，这些医生在照顾患者时试图应对压力、焦虑和倦怠的情况，例如俄亥俄州立大学韦克斯纳医学中心的运动正念、STAR 心理健康和七叶树爪计划，以及俄亥俄州立大学的MINDSTRONG™/MINDBODYSTRONG™认知行为技能培养计划。

有机会反思当前的经验并记录成功和失败，以建立机构知识和记忆库，其中包括创新实践、人员激增计划、个人轶事和其他文件，以便可以通过更明智的方式应对未来的此类危机提高组织准备的观点。

奇普斯说：“我们承受不起再次重演这种流行病的悲剧。” “我们可以控制的部分内容是为临床医生建立的支持基础设施，以便他们拥有清晰、一致和可用的资源，使他们能够专注于：照顾患者并优化他们自己的自我护理。”

这项研究的研究人员包括来自俄亥俄州立大学护理学院 Helene Fuld Health Trust 国家护理和医疗保健循证实践研究所的领导（Donal O'Mathuna，博士；Haley Roberts，BS；Sharon Tucker，博士；Inga Zadvinskis , 博士; Cindy Zellefrow, DNP), 俄亥俄州立大学护理学院和俄亥俄州立大学韦克斯纳医学中心 (Esther Chipps, PhD), 俄亥俄州立大学护理学院 (Marjorie Kelley, PhD; Julia Smith, EdM), UCLA Health (Pamela Miller, PhD), 哥伦比亚大学护理学院 (Allison Norfull, PhD) 和 Chester County Hospital, Penn Medicine (Cindy Brockway, MSN; Cheryl Monturo, PhD)。

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