台灣公民面對新冠肺炎疫情初期之焦慮症狀與防疫作為之趨勢

Trends of anxiety and performance of preventive measures among Taiwanese citizens during COVID-19 pandemic

目標：面對新冠肺炎疫情，民眾若覺知有病毒感染的嚴重性與易感性，可能引發過度焦慮，導致出現過度反應或不理性行為。本研究是分析台灣在新冠肺炎疫情發展初期，成年公民面對疫情威脅時的焦慮症狀與採取防疫作為之趨勢。方法：本研究採用匿名網路調查台灣成年公民面對疫情之焦慮症狀及採取之防疫作為。焦慮症狀是採用STAI-6量表，詢問民眾因為疫情經驗到的緊張、沮喪、擔心、平靜、放輕鬆及滿足，共計6種情緒；防疫行為包含三個構面：洗手與戴口罩之個人防護、咳嗽禮儀、保持社交距離與自願檢疫，共計12題。資料分成三個期間，分別為中國武漢實施封城（1月23日至2月7日）、台灣實施強化邊境防疫、口罩購買實名制與首例無症狀高病毒感染者（2月8日至2月16日宣布第一位死亡案例）以及台灣發生第1例新冠肺炎死亡案例10天後（2月27日至3月9日）。統計方法使用Cochran-Armitage Trend Test及Jonckheere's Trend Test檢視疫情發展不同時段之民眾焦慮程度，以及採取防疫作為之趨勢變化，並進一步檢視性別、年齡、教育程度與收入在焦慮程度與防疫行為關聯性之差異。不同時期之焦慮程度均與防疫行為關聯程度是採用共變數分析。結果：分析結果顯示，研究參與者出現高度焦慮程度之比率在三個時段分別為45%、50%及55%，上升趨勢達統計顯著。能經常或總是落實防疫作為者之比率在三個時段分別為46%、58%及66%，上升趨勢達統計顯著，但與性別、年齡、教育程度與收入之相關未達顯著，表示不同時期之焦慮程度與防疫行為關聯性斜率均一致。共變數分析顯示不同時期之焦慮程度均與防疫行為有顯著關聯。結論：本研究結果顯示隨著COVID-19疫情發展，民眾焦慮症狀及防疫作為，不分性別、年齡與教育程度，都呈現上升趨勢。（台灣衛誌2021；40(1)：83-96）

Objectives: Citizens who perceive SARS-CoV-2 as a threat may experience heightened anxiety of the severe illness caused by COVID-19. This study investigated the trends in anxiety and performance of preventive measures among Taiwanese citizens during the early stages of the COVID-19 pandemic. Methods: This study employed an anonymous online survey to investigate anxiety and preventive behavior practice in adults during the early stages of the COVID-19 pandemic. The 6-item state version of the State-Trait Anxiety Inventory (STAI-6) was used to measure symptoms of anxiety. The preventive measures consisted of 12 items divided into three categories: personal protection, cough etiquette, and social distance and voluntary quarantine. The three time periods studied were the lockdown in Wuhan, China (from January 23 to February 7), the week when enhanced border protections and in-person mask purchase systems were introduced and the first citizen tested positive for SARS-CoV-2 without symptoms (from February 8 to February 16), and the 10 days following the first death from COVID-19 in Taiwan (from February 27 to March 9). The Cochran-Armitage trend test and the Jonckheere trend test were used to analyze changes in the degree of anxiety and the adoption of preventive measures in the early stages of the epidemic. An analysis of covariance was performed to examine the relationship between changes in anxiety and engagement in preventive behaviors after control for sex, age, education, and income. Results: The percentages of the participants with moderate to high levels of anxiety during the three time periods were 45%, 50%, and 55%, respectively. The percentages of those who practiced preventive measures often or always during the three time periods were 46%, 58%, and 66%, respectively. Significant increases were found both in levels of anxiety and in performance of preventive measures over the three time periods, but no differences across sex, age, education, or income groups were found. Changes in anxiety and performance of preventive behaviors were significantly associated during the three periods. Conclusions: The results revealed that as the pandemic spread, citizens'anxiety, and performance of preventive measures increased significantly for each sex, age, education level, and income group. (Taiwan J Public Health. 2021;40(1):83-96)