探索COVID-19疫情對難治型憂鬱症病人健康與因應行為之影響

The Impact of the COVID-19 Pandemic on the Health and Coping Behaviors of Patients With Treatment-Resistant Depression

背景：COVID-19新冠肺炎帶來全球性災難，對一般民眾或精神疾病病人而言都可能造成身心壓力與生活衝擊。目的：本研究旨在探討難治型憂鬱症病人在經歷COVID-19疫情爆發後的生活轉變暨身心影響。方法：本研究為團隊於2018年針對難治型憂鬱症病人進行長期追蹤研究的一部分，受訪者來自兩家教學醫院，由精神科專科醫師確診重鬱症且符合收入條件之病人，研究者於2020年1–5月期間以結構化訪談指引收集COVID-19疫情爆發後身心變化之資料，並以錄音或重點記錄方式彙整，採主題分析法進行主題歸納與分類及單元架構分析。結果：116位受訪者因COVID-19疫情導致生理、心理、社會三個健康層面受到明顯的衝擊，個案陳述中浮現出三大主題：憂鬱症病人的全人健康恆定性受到威脅、生理、心理及社會面向之交互作用、以及個體的正向成長。受訪者表達對政府防疫措施有信心，但觀看過多疫情報導會造成苦惱與不安。結論／實務應用：COVID-19對憂鬱症病人產生多重健康影響及正向轉變|政府防疫策略帶來保護作用，然仍須注意長期暴露於疫情報導下的負向影響。

Background: The COVID-19 pandemic has had a disastrous impact globally. For the general public and for people with mental illnesses, this pandemic may cause mental/physical stress and major life impacts. Purpose: This study was designed to explore the related changes in daily life and impacts on the well-being of a group of patients with chronic treatment-resistant depression (TRD) during the COVID-19 pandemic. Methods: This study was a part of a long-term, follow-up study of a cohort of patients with TRD collected in 2018. All of the subjects who were diagnosed with major depression and fit the inclusion criteria were referred by the psychiatrists from two teaching hospitals. Structured interviews were used to collect data on physical and psychological changes during the pandemic period between January and May 2020. The researchers organized the key points by recording or note taking. Thematic analysis was used to summarize and classify themes and units. Results: The 116 respondents revealed that the COVID-19 pandemic affected their health in the biological, psychological, and social dimensions. The three emerging themes included: The threatening of homogeneity in the whole person’s health, the interaction between bio-psycho-social aspects, and positive growth of individuals with TRD. Although the participants had confidence in the prevention strategies of the government related to COVID-19, they expressed feelings of distress and restlessness with regard to COVID-19-related news reports. Conclusions/ Implications for Practice: The COVID-19 pandemic has affected the health of patients with TRD in both positive and negative ways. As the goal of government preventive strategies is to protect and promote public health, regular attention should be paid to the negative effects of long-term exposure to pandemic-related news on this vulnerable population.