Data_Sheet_1_Associations between post-traumatic stress symptoms and quality of life among psychiatric healthcare personnel in China during the COVID-19 pandemic: A network approach.pdf

BackgroundPost-traumatic stress symptoms (PTSS) are commonly reported by psychiatric healthcare personnel during the coronavirus disease 2019 (COVID-19) pandemic and negatively affect quality of life (QOL). However, associations between PTSS and QOL at symptom level are not clear. This study examined the network structure of PTSS and its connection with QOL in psychiatric healthcare personnel during the COVID-19 pandemic.
MethodsThis cross-sectional study was carried out between March 15 and March 20, 2020 based on convenience sampling. Self-report measures including the 17-item Post-Traumatic Stress Disorder Checklist – Civilian version (PCL-C) and World Health Organization Quality of Life Questionnaire - Brief Version (WHOQOL-BREF) were used to measure PTSS and global QOL, respectively. Network analysis was used to investigate the central symptoms of PTSS and pattern of connections between PTSS and QOL. An undirected network was constructed using an extended Bayesian Information Criterion (EBIC) model, while a directed network was established based on the Triangulated Maximally Filtered Graph (TMFG) method.
ResultsAltogether, 10,516 psychiatric healthcare personnel completed the assessment. “Avoidance of thoughts” (PTSS-6), “Avoidance of reminders” (PTSS-7), and “emotionally numb” (PTSS-11) were the most central symptoms in the PTSS community, all of which were in the Avoidance and Numbing domain. Key bridge symptoms connecting PTSS and QOL were “Sleep disturbances” (PTSS-13), “Irritability” (PTSS-14) and “Difficulty concentrating” (PTSS-15), all of which were within the Hyperarousal domain.
ConclusionIn this sample, the most prominent PTSS symptoms reflected avoidance while symptoms of hyper-arousal had the strongest links with QOL. As such, these symptom clusters are potentially useful targets for interventions to improve PTSS and QOL among healthcare personnel at work under pandemic conditions.

背景
创伤后应激症状（Post-traumatic stress symptoms, PTSS）在新型冠状病毒肺炎（COVID-19）疫情期间常被精神科医护人员报告，且会对生活质量（Quality of Life, QOL）产生负面影响。然而，在症状层面上PTSS与QOL的关联尚不明确。本研究旨在探讨新冠疫情期间精神科医护人员的PTSS网络结构及其与QOL的关联。

方法
本项横断面研究于2020年3月15日至3月20日通过便利抽样法开展。研究分别采用17条目创伤后应激障碍检查表平民版（Post-Traumatic Stress Disorder Checklist – Civilian version, PCL-C）与世界卫生组织生活质量测定简表（World Health Organization Quality of Life Questionnaire - Brief Version, WHOQOL-BREF）自评量表，用以评估PTSS与总体QOL水平。采用网络分析法探究PTSS的核心症状以及PTSS与QOL的关联模式。本研究使用扩展贝叶斯信息准则（extended Bayesian Information Criterion, EBIC）模型构建无向网络，并基于三角化最大过滤图（Triangulated Maximally Filtered Graph, TMFG）方法构建有向网络。

结果
共计10516名精神科医护人员完成了本次评估。“回避想法”（PTSS-6）、“回避触发线索”（PTSS-7）以及“情感麻木”（PTSS-11）是PTSS网络中最核心的症状，且均归属于回避与麻木症状群。连接PTSS与QOL的关键桥接症状为“睡眠障碍”（PTSS-13）、“易激惹”（PTSS-14）与“注意力困难”（PTSS-15），上述症状均归属于高警觉症状群。

结论
本研究样本中，最突出的PTSS症状表现为回避症状，而高警觉症状与QOL的关联最为紧密。因此，上述症状群可作为疫情期间在职医护人员改善PTSS与QOL的潜在干预靶点。