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浙江大学学报(医学版)  2020, Vol. 49 Issue (4): 409-418    DOI: 10.3785/j.issn.1008-9292.2020.08.05
医学与社会     
突发公共卫生事件对公众心理的影响:2019冠状病毒病疫情期间浙江省心理援助热线来电分析
王维丹1(),徐方忠1,徐松泉1,章健民1,张宁2,3,*()
1. 浙江省立同德医院 浙江省精神卫生中心 浙江省精神卫生工作办公室, 浙江 杭州 310012
2. 浙江大学医学院公共卫生学院, 浙江 杭州 310058
3. 浙江大学医学院附属第二医院统计、生物信息和大数据中心, 浙江 杭州 310009
Impact of public health emergency on public psychology: analysis of mental health assistance hotlines during COVID-19 in Zhejiang province
WANG Weidan1(),XU Fangzhong1,XU Songquan1,ZHANG Jianmin1,ZHANG Ning2,3,*()
1. Tongde Hospital, Zhejiang Province and Zhejiang Mental Health Center, Hangzhou 310012, China
2. School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China
3. Statistics, Bio-informatics and Big Data Center, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
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摘要:

目的: 总结2019冠状病毒病疫情期间心理援助热线服务需求及公众心理状态的变化特点。方法: 采用量化统计与质性分析相结合的方法对2020年1月25日至2月29日浙江省心理援助热线(简称“热线”)来电进行分析。将疫情相关来电分为医学、心理、资讯、其他四类,采用文本分析法确定心理类来电的二级类别;按周统计来电数量并分析各类来电数量随时间变化情况;采用分层随机抽样法在各类疫情相关来电中抽取600人次进行语义分析,通过标记新增、同类合并的方式形成特征集,归纳各阶段的来电内容特征;对200名来电者进行回访,从等待时间、通话时长、解决问题的程度和结束通话的方式四方面了解其对来电过程的感受。结果: 全省热线累计接到来电13 764人次,8978人次(65.23%)为COVID-19疫情相关来电,其中医学类占12.59%(1130/8978)、心理类占26.50%(2379/8978)、资讯类占27.18%(2440/8978)、其他占33.74%(3029/8978)。各类来电数量随时间呈非线性变化,每日各类来电数量受到每日疫情情况、新增相关政策情况、热线宣传力度等因素的影响(P < 0.05或P < 0.01);各类来电数量在不同性别和身份的来电者中的分布差异有统计学意义(均P < 0.05)。181名来电者自愿接受回访,其中51.38%(93/181)的来电者认为热线占线等待时间偏长,33.15%(60/181)的来电者认为热线通话时间不足,80.66%(146/181)的来电者认为通过拨打热线能部分/完全解决问题,39.23%(71/181)的来电者认为是由接线员单方面提出结束通话。结论: 心理援助热线来电数量和内容的变化反映出疫情期间公众心理大致经历盲目期、恐慌期、烦闷期和调整期四个阶段,各个时期呈现不同的特征。应进一步加强心理援助热线的“专线”特性,提高服务效率,针对不同阶段公众的心理特征采取相应的心理干预策略。

关键词: 2019冠状病毒病公共卫生心理学    
Abstract:

Objective: To analyze the usage of mental health assistance hotline during COVID-19 in Zhejiang province from January 25th to February 29th 2020, and summarize the characteristics of the demand for mental health services and the dynamic changes of public mental health status during COVID-19 pandemic. Methods: Both quantitative and qualitative methods were used. The calls related to pandemic were divided into four categories: medical, psychological, information and the others. The secondary categories of psychological calls were determined by text analysis. The number of calls were calculated weekly and the number of various types of calls over time were analyzed. We used stratified random sampling method to extract 600 cases of all kinds of calls related to pandemic and conducted a semantic analysis, through marking new, similar combination to form a feature set, then summed up the call content characteristics of each stage. Two hundred callers were followed up to understand how they felt about the call process in four aspects: the waiting time, call duration, the degree of problem-solving and the way to end the call. Results: In a total of 13 746 calls, 8978 were related to pandemic, among which 12.59%(1130/8978) were about medical issues, 26.50%(2379/8978) were about mental health, 27.18%(2440/8978) were about information regarding the pandemic and 33.74%(3029/8978) were about other pandemic related issues. Pandemic situation, relevant policy release, frequency of advertising campaigns were predictors of the number of calls per day during the pandemic (P < 0.05 or P < 0.01). The number of calls differed by gender and identities of callers (both P < 0.05). Finally 181 callers accepted telephone follow-up. Among them, 51.38%(93/181) of the callers thought that the waiting time was too long, 33.15%(60/181) of the callers thought that the call time was insufficient, 80.66%(146/181) of callers believed that the hotline could partially or completely resolve their concerns, and 39.23%(71/181) of the callers said the operator proposed to end the call. Conclusions: The changes of the number and content of the mental health assistance hotline calls reflected that the public mental health status experienced four stages during the pandemic: confusion, panic, boredom, and adjustment. The specialized mental health assistance hotlines should be further strengthened, and the efficiency should be improved. Mental health interventions should be tailored and adopted according to the characteristics of the public mental health status at different stages of the pandemic.

Key words: Coronavirus disease 2019    Public health    Psychology
收稿日期: 2020-05-08 出版日期: 2020-09-27
:  B849  
基金资助: 浙江省软科学研究计划(2019C35058);浙江大学新型冠状病毒(2019-nCoV);肺炎应急科研专项(2020XGZX046)
通讯作者: 张宁     E-mail: wang_weidan@163.com;zhangning2019@zju.edu.cn
作者简介: 王维丹(1983-), 女, 硕士, 心理治疗师, 主要从事重点人群心理干预与心理卫生政策研究; E-mail:wang_weidan@163.com; https://orcid.org/0000-0003-2737-5593
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引用本文:

王维丹,徐方忠,徐松泉,章健民,张宁. 突发公共卫生事件对公众心理的影响:2019冠状病毒病疫情期间浙江省心理援助热线来电分析[J]. 浙江大学学报(医学版), 2020, 49(4): 409-418.

WANG Weidan,XU Fangzhong,XU Songquan,ZHANG Jianmin,ZHANG Ning. Impact of public health emergency on public psychology: analysis of mental health assistance hotlines during COVID-19 in Zhejiang province. J Zhejiang Univ (Med Sci), 2020, 49(4): 409-418.

链接本文:

http://www.zjujournals.com/med/CN/10.3785/j.issn.1008-9292.2020.08.05        http://www.zjujournals.com/med/CN/Y2020/V49/I4/409

图 1  2020年1月25日—2月29日浙江省心理援助热线来电数量变化曲线
来电类别 第1周
(1月25—31日)
第2周
(2月1—7日)
第3周
(2月8—14日)
第4周
(2月15—21日)
第5周
(2月22—29日)
合计
与第1周比较,*P<0.05;与第2周比较,#P<0.05;与第3周比较,P<0.05;与医学类比较,P<0.05;与心理类比较,P<0.05.
医学类 314 454* 183*# 101*# 78*# 1130
心理类 282 687 462* 536*#▲ 412*#▲ 2379
资讯类 216 759*▲ 899*#▲ 342 224 2440
其他 238 746*▲ 1104*#▲ 496*#△ 445*#▲ 3029
合计 1050 2646 2648 1475 1159 8978
表 1  2020年1月25日—2月29日浙江省2019冠状病毒病疫情相关各类来电数量变化
图 2  2020年1月25日—2月29日浙江省2019冠状病毒病疫情相关心理类来电数量随时间变化趋势
来电者特征 合计 医学类 心理类 资讯类 其他 P
性别  男性 4448 625 1107 1308 1408 <0.01
         女性 4493 565 1271 1139 1518
年龄(岁)   < 18 682 57 103 287 235 >0.05
               18~<36 3539 501 1008 890 1140
               36~<60 3748 426 1114 974 1284
               ≥60 887 136 153 285 333
身份  医务人员 55 2 21 9 13 <0.01
         疑似患者 73 20 19 13 21
         密切接触人员 84 27 18 9 31
         隔离人员家属 104 12 20 29 43
         严重精神障碍患者及家属 21 3 8 5 5
         普通人群 176 47 36 53 40
表 2  2020年1月25日—2月29日浙江省2019冠状病毒病疫情相关来电数量在不同来电者中的差异
因素 疫情相关 医学类 心理类 资讯类 其他
*P < 0.05,**P < 0.01.
全省每日累计确诊患者数(r值) 0.389* 0.520** 0.333* 0.166 0.439**
全省每日新增确诊患者数(r值) 0.059 0.661** 0.167 0.077 -0.190
全省每日新增追踪密切接触者数(r值) 0.618** 0.481** 0.319* 0.571** 0.514**
每日新增国家疫情相关政策情况(有/无)(χ2值) 0.25 11.06** 4.56* 0.07 0.00
每日新增省级疫情相关政策情况(有/无)(χ2值) 0.29 15.23** 1.09 12.42** 0.22
每日省、市、县(市、区)发布心理热线相关宣传报道或推文情况(r值) 0.373* 0.402* 0.411* 0.470* 0.321
表 3  2020年1月25日—2月29日浙江省2019冠状病毒病疫情相关来电数量影响因素分析
来电类别 等待时长* 通话时长* 问题解决程度 结束通话方式**
偏长 正常 充足 一般 不足 完全解决 部分解决 尚未解决 接线员提出 其他
*P < 0.05,**P < 0.01.
医学类 19 26 19 18 8 17 20 8 9 38
心理类 31 15 8 15 23 19 15 12 30 16
资讯类 18 27 15 18 12 14 26 5 13 32
其他 25 20 16 13 16 15 20 10 19 26
表 4  2020年1月25日—2月29日浙江省2019冠状病毒病疫情相关各类来电者对热线的评价
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