新冠肺炎疫情期間消防人員創傷壓力、睡眠品質對憂鬱及焦慮之影響探討

The Effects of Covid-19-Related Traumatic Stress and Sleep Quality on Depression and Anxiety among Firefighters during the COVID-19 Pandemic

研究目的：自2019年始新冠肺炎病毒迅速擴散全球，臺灣疫情亦快速升溫，導致第一線消防人員除了工作負荷量增加以外，亦承受更多心理壓力。因此，本研究針對前線之消防人員，評估其可能發展為情緒疾患的相關因素，提出因應對策，期望能降低消防人員出現身心失衡的困境。研究方法：本研究進行壓力問卷調查，為橫斷性研究，探討T市消防員於新冠疫情時創傷反應、主觀壓力感受、睡眠品質對憂鬱及焦慮情緒之影響，共計有效樣本200位。研究結果：本研究在變項相關性上發現，消防人員新冠創傷壓力反應、強迫性檢查和尋求保證行為與對危險與汙染恐懼感、睡眠品質以及自覺壓力評分對於憂鬱和焦慮的診斷皆有顯著相關。在羅吉斯迴歸分析結果顯示，新冠創傷壓力反應、自覺壓力評分、睡眠品質及婚姻狀態，對於消防人員增加罹患憂鬱症及焦慮症有顯著預測力。研究結論：本研究提出下列相關建議：1.建立本土化之消防人員心理健康資料庫，以建構適用消防人員之健康促進模型；2.全面檢視救護勤務項目及制定適用於特殊傳染病時期之人力調整；3.設定專責之心理衛生單位，聘僱專責專業的心理輔導人員。

Objective: The 2019 coronavirus (COVID-19) outbreak and its rapid spread around the world resulted in an increased workload and greater psychological stress for frontline paramedics. To address the physical and mental burdens of paramedics in Taiwan, we assessed factors related to mood disorders and proposed measures to mitigate these issues. Methods: Using a cross-sectional design, we administered a questionnaire to 200 paramedics to examine the associations among stress, the extent of Covid-19 related traumatic response, perceived stress, sleep quality, depression, and anxiety. Results: The correlation analyses revealed significant relationships between traumatic responses such as compulsive examination with assurance-seeking behavior and a fear of danger and contamination with both depression and anxiety. Both sleep quality and perceived COVID- 19-related stress were also significantly correlated with depression and anxiety. Logistic regression analysis results showed that the degree of COVID-19 traumatic stress response, perceived stress, low sleep quality and marriage status are all significant predictors of increased depression and anxiety symptoms in paramedics. Conclusions: We propose the following recommendations: 1. Construct a paramedic stress scale and a health promotion model suitable for Taiwanese paramedics; 2. Identify the ambulance service items and manpower requirements that need to be adjusted to suit special infectious disease periods; 3. Set up a dedicated mental health department staffed by professional psychological counsellors with expertise in depression and anxiety to serve medical professionals during a pandemic.