| 其他摘要 | In the early stage of the outbreak of COVID-19 epidemic, due to partial suspension of non-infectious diseases health services in the hospitals and the fear of being infected, the group with potential medical needs had to turn to online diagnosis and treatment offered by online hospitals. Although the number of patients in domestic online hospitals is quite large, there is a lack of research on their negative emotion status during the epidemic. Therefore, this paper first investigated the anxiety and depression of online hospital visitors with potential medical needs, and observed the relationship between these two emotions and the severity of the epidemic. Among the groups with potential medical needs affected by the epidemic, patients with fever symptoms who went to the hospitals and then were quarantined for observation (“quarantined fever patients”) are a high-risk group of emotional disorders. Therefore, it is necessary to explore possible targets to alleviate the emotional distress of quarantined fever patients, so as to reduce their emotional response of anxiety and depression. As the core intervention goal of Acceptance and Commitment Therapy (ACT), psychological flexibility has been proved to be closely related to negative emotions. It is a high-order psychological capacity that may be used to predict individual psychological distress during the epidemic and buffer the adverse effects thereof. Therefore, this paper also investigated the relationship between the psychological flexibility and each of anxiety and depression of the quarantined fever patients in a general hospital in Beijing, further developed a short online self-help intervention protocol based on ACT technologies and tested the intervention effect of this protocol on anxiety and depression of quarantined fever patients. Study 1 of this paper investigated the anxiety status of online hospital visitors during the epidemic, and took as subjects (N=1378) those who participated in the evaluation of Generalized Anxiety Scale (GAD-7) released by WeDoctor online hospital diagnosis and treatment platform ("WeDoctor platform") in February 2020. The results showed that the participants’ anxiety was serious with an average score of 10.32±5.31, and a positive detection rate (GAD-7 score≥5) of 88.46%. After the participants were classified into five risk areas according to the severity of the epidemic of their residence, it was found that there was significant difference in anxiety scores among the participants in different risk areas. The anxiety score of participants in medium-low risk area, medium risk area and medium-high risk area respectively was significantly higher than that in low risk area, showing an inverted U-shape with high in the middle and low at both ends. Study 2 investigated the depression status of online hospital visitors during the epidemic, and took as subjects (N=2724) those who participated in the evaluation of Patient Health Questionnaire (PHQ-9) released by the WeDoctor platform from January to February 2020. The results showed that the participants’ depression was serious, with an average score of 10.35±6.36 and the positive detection rate (PHQ-9 score≥5) of 80.07%. The difference of depression score of participants among different risk areas was also statistically significant. With the weakening of the impact of the epidemic, the participants’ depression generally showed a gradually increasing trend. The depression score of the high risk area was significantly lower than that of the low risk area and the medium-low risk area. Study 3 investigated the relationship between psychological flexibility and each of anxiety and depression of the quarantined fever patients. From March to May 2020, 106 effective subjects were recruited from the fever clinic of a hospital in Beijing and administered the anxiety subscale of the Depression Anxiety Stress Scale-21 (DASS-21-Anxiety), the depression subscale of the Depression Anxiety Stress Scale-21 (DASS-21-Depression), the Acceptance and Action Questionnaire-2nd Edition (AAQ-Ⅱ) and the Cognitive Fusion Questionnaire (CFQ). The results showed that there was a significant positive correlation between anxiety, depression and each of experiential avoidance and cognitive fusion. Experiential avoidance and cognitive fusion may positively predict anxiety and depression of quarantined fever patients. Study 4 applied the online self-help audio based on ACT technologies on quarantined fever patients. Adopting the semi-experimental design, 59 subjects were recruited from the fever clinic of a hospital in Beijing from March to May 2020, with 20 in the psychological intervention group and 39 in the control group. All subjects were administered pre-test half an hour after being quarantined and post-test before discharge. The measures of pre-test and post-test were the same as those in Study 3. The results showed that the post-test score of depression of the psychological intervention group was significantly lower than the pre-test score, and there was no significant difference between the pre and post scores for all the observed variables of the control group. The interaction effects of time and group and the main effects of group of all the observed variables were not significant. The main effect of time of depression was significant while those of all the other observed variables were not significant. In general, each of the anxiety and depression of online hospital visitors during the epidemic were not consistent with the severity of the epidemic: the anxiety of the participants showed an inverted U-shaped middle zone effect, and the anxiety of the participants located in the middle risk area was the most serious, higher than that in the mild risk area, while the depression of the participants showed a gradually increasing trend with the weakening of the impact of the epidemic. During the epidemic, the anxiety and depression of quarantined fever patients were significantly correlated with their psychological flexibility, and psychological flexibility may predict their anxiety and depression. Short online self-help audio based on ACT technologies might reduce the depression of quarantined fever patients to some extent, but it has no effects on their anxiety and psychological flexibility. |
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