Wuhan Psychiatric Experts Said: How To Win The New Crown Fight Psychological Warfare

"Psychological support is very important in the face of diseases without specific effects." In March 9th, in an interview with the twenty-first Century economic report reporter, Yang Yuan, director of psychiatry at Tongji Hospital Affiliated to Huazhong University of Science and Technology, described this.

Since the outbreak of the new crown pneumonia in Wuhan, Yang Yuan has led a team of 5 people in their way to launch a fight against the new crown virus, so far more than 60 days. In the early days, Yang Yuan participated in the psychological support of new crown pneumonia, and launched various psychological support and publicity contents for patients and medical staff. Before January 24th, in order to solve the psychological problems encountered by all parties during the epidemic, Tongji Hospital also launched online psychological counseling outpatient service while launching online clinic. At the moment, she once again devoted herself to the prevention and diagnosis and treatment of PTSD. How did she go through the new crown virus fight psychological warfare?

Yang Yuan. Data map

Intermingled hypochondria and insomnia

In late January, the news of "new crown virus human transmission" was confirmed by experts. Many people were in panic and needed to pour out and treat. The online psychological counseling clinic of Tongji Hospital was put into use. Yang Yuan began to take the first time.

There are various manifestations of panic: unable to sleep at night, feeling chest tightness, shortness of breath, dizziness, suspicion of pneumonia, and frequent body temperature, and then anxiety. The vast majority of online outpatient visits are suspect groups, not all new crown pneumonia patients. For a time, hypochondria became the top of the consultation clinic at that time, and about 80% of them were caused by panic.

The number of online appointments is very popular. It often starts to register and is soon filled. Compared with the past, the psychological pressure of the consultation is several times higher than that of daily visits. Yang Yuan has to reduce the number of registration so as to ensure the quality of consultation for each consultant.

A medical worker's husband and wife went to the front line. He spent the whole day alone at home worrying about his wife's infection. He also worried that his wife might bring the virus back home and sleep all night because of the lack of precaution.

There are also more serious cases of confirmed patients, after entering the hospital, see the same batch of patients have been discharged from hospital, but they can only stay in the ward, he crazy to call their loved ones, and even began to talk about the "last words", and often a few nights do not sleep, afraid of a sleep can not wake up.

"These are all anxiety reactions caused by stress. We intervene in time, teach him some relaxation breathing training methods, and strengthen communication with him, to satisfy his need to talk, slowly guide, the state is much better. Yang Yuan said.

After the construction of the shelter hospital, the situation of treatment and isolation in Wuhan improved and the role of psychological support became more prominent. Yang Yuan's work range is also from online admission, adding psychological treatment to various treatment places in hospitals.

For different patients, Yang Yuan will take a different treatment plan, and slightly alleviate it through verbal counseling. Patients who are unable to sleep all night, have suicidal tendencies, and some patients with depression will be advised to take medicine or visit related departments because of the aggravation of the epidemic.

"In fact, many times, stress does not require excessive intervention, and many patients will pour out their opinions." Yang Yuan had done a questionnaire survey in the early stage of the outbreak, and about 15% of the questionnaires mentioned the need for help. But at that time, considering that the moderate emotional problems under the epidemic were mostly transient stress reactions, there was no need for premature overintervention. Recently, Yang Yuan followed up these people. Most of them said that they had recovered their mentality and did not need any help.

The latest questionnaire shows that the real need is about 10%.

Yang Yuan said, this shows that the epidemic has a normal stress process on people, but people adjust themselves, with the improvement of the epidemic situation, the improvement of the environment and other environmental changes will gradually heal themselves.

Medical personnel need more attention.

In addition to the general public, Yang Yuan's psychological state is also very concerned. They are a group of special groups. They think that their professional knowledge and professional skills should not have psychological problems, so many problems are carried on their own. Precisely because of this, the investigation of medical staff is always a difficult point.

In fact, some of my colleagues and colleagues will have psychological problems, but they rarely seek psychological intervention. Early in the day, the online Bahrain special mode was introduced, that is, the two-dimensional code was dispersed to various departments and departments, and medical staff with mental problems entered the group consultation. However, the initial effect was not good, and only about 100 people entered the group. We plan to strengthen publicity in the later stage.

In fact, Yang Yuan discovered that the early febrile outpatient clinics had a great psychological impact on medical staff because they hoped that everyone could get treatment, so the Bureau of medical resources seriously short of demand at that time caused some trauma to the medical staff. At the same time, some medical workers have family members who are infected or seriously ill, but because they are unable to take care of their families in the front line, there is also a lot of psychological pressure. In addition, the work of medical staff has high risk and high intensity characteristics, especially nurses, in addition to the usual nursing work, they also need to work as nurses in the epidemic treatment. Every patient needs to be treated by nurses, such as eating, drinking, laundering and turning over. Many medical personnel support the front line and even dare not tell the family members. This is the most difference between medical staff and the public.

Therefore, Yang Yuan suggested to the hospital that the branch should be a unit in the whole hospital, so that medical personnel should first communicate actively with the branch staff. If we find problems and arrange counseling, we will find out the psychological problems of medical workers in a more timely manner.

Tracking PTSD

At present, the probability of PTSD (PTSD) can not be accurately predicted. The first thing to consider from the crowd is the local medical staff, because they are the most stressed at the early stage of the outbreak. For example, the family members of the medical staff were diagnosed with new crown pneumonia, but she could only work in the front line. At ordinary times, she worked very hard, behaved with high spirits, like nothing, but at night, she would talk with colleagues about herself and her family.

Yang Yuan said that early PTSD did not necessarily show anything. First of all, we need to see whether it has experienced trauma such as the death of a loved one. Secondly, we should pay attention to the sudden changes in personality whether compared with normal ones. For example, we are very enthusiastic, suddenly become very indifferent, or shrink back, hesitate to do things, and quarrel fiercely.

What patients worry most about is the change of their condition. For patients with familial aggregation infection, they will be worried that their families will live in different places and do not see each other. If the family is in good condition, they are worried that they will be infected with their family members. There will be greater risk for those who are discharged from hospital but whose family structure changes. But at present, the number of medical professionals in China is very small, which can not support such a huge potential demand. Later recommendations can continue to play a grass-roots level. When patients return to the community, the community can conduct regular screening, follow-up and tracking of such people.

On the whole, the online inquiry platform is relatively limited, and there are certain limitations both in the ability of admission and the age distribution of the audience. On the other hand, there are too few psychiatrists in China, and there is a serious shortage of resources.

For this reason, Yang Yuan made a demonstration ward in the court District of Tongji Hospital, and did a scale screening for every patient, such as patients' psychological problems, so that nurses and doctors could pay attention to it and conduct stratified treatment. At the same time, a scientific video about new crown pneumonia was arranged for patients in all hospitals of the hospital. And make an hour of continuous play cure music, regular playback, let patients relax. The whole process has been implemented for nearly two weeks, and the feedback effect obtained is very good. The process is replicable and can be carried out in other hospitals if there are enough medical personnel.

Yang Yuan said that for the psychological problems of the epidemic, the focus of the next stage will be anxiety, depression, insomnia, somatization disorder and PTSD. PTSD patients will have flashbacks in the later stage. They can not help thinking back to the scene before, and then affect their social function or life function, so that they can not go to work or go to school. Some people will appear somatization disorder, appear chest tightness, headache and other body discomfort, go to the various departments of the hospital for help, but can not get effective treatment, and may even produce doctor-patient disputes. Therefore, we need to follow up and follow up and try to find out people with psychological barriers. This requires more social forces to participate in it. Yang Yuan also plans to invite famous psychologists at home and abroad to give collective psychological treatment to the general public, medical staff and patients on line. (Editor: Lin Hong)

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