Kev Koom Tes Nruab Nrab Ntawm Cov Mob Nkeeg Mob Ntsws Thiab Kev Ua Phem Ntawm Cov Neeg Muaj Cuam Tshuam Ntawm Middle East Respiratory Syndrome Tshaj li ib xyoo 2-Lub Sijhawm Ua Raws Li
Mar 21, 2022
So-Hyun Ahn, Jeong Lan Kim, Jang Rae Kim b, So Hee Lee b,*,1, Hyeon Woo Yim c, Hyunsuk Jeong c, Jeong-Ho Chae d, 1,**, Hye Yoon Park e, Jung Jae Lee f, Haewoo Lee g
ib lub Department of Psychiatry, Chungnam National University School of Medicine, Daejeon, Republic of Kauslim
b National Medical Center, Seoul, Republic of Kauslim
c Department of Preventive Medicine, Lub Tsev Kawm Ntawv Qib Siab Catholic ntawm Kaus Lim Kauslim, Tsev Kawm Qib Siab Tshuaj, Seoul, Kaus Lim Qab Teb
d Seoul St. Mary's Tsev Kho Mob, Catholic University of Kauslim, Tsev Kawm Qib Siab Tshuaj, Seoul, Kaus Lim Qab Teb
e Seoul National University Tsev Kho Mob, Seoul, Republic of Kauslim
f Dankook University School of Medicine, Cheonan, Chungnam, koom pheej ntawm Kauslim
g Seoul Medical Center, Seoul, koom pheej ntawm Kauslim
Hu rau:joanna.jia@wecistanche.com/ WhatsApp: 008618081934791
TSAB NTAWV
Kev tua tus kheej yog ib qho teeb meem tseem ceeb rau pej xeem kev noj qab haus huv thaum lub sij hawm muaj kev sib kis ntawm cov kab mob sib kis (EIDs). Hauv EIDs, ntau yam tsos mob tshwm sim txawm tias tom qab rov zoo, thiabmob nkeesyog ntawm cov uas tau tshaj tawm. Lub hom phiaj ntawm txoj kev tshawb no yog los tshuaj xyuas qhov cuam tshuam ntawmmob nkeesSyndrome ntawm kev tua tus kheej thaum lub sijhawm rov qab los ntawm cov neeg muaj sia nyob ntawm Middle East respiratory syndrome (MERS). MERS cov neeg muaj txoj sia nyob tau raug xaiv los ntawm tsib lub chaw thiab yav tom ntej ua raws li 2 xyoos. Nyob rau hauv tag nrho, 63 tus neeg koom tau sau npe ntawm 12 lub hlis (T1), ntawm lawv 53 thiab 50 ua tiav qhov kev ntsuam xyuas ntawm 18 lub hlis (T2) thiab 24 lub hlis (T3), feem. Suicidality thiab qaug zog ntev tau raug soj ntsuam los ntawm kev siv suicidality module ntawm Mini-International Neuropsychiatric Interview (MINI) thiab Fatigue Severity Scale (FSS), feem. Peb tau txheeb xyuas qhov kev sib raug zoo ntawm kev qaug zog ntev thiab kev tua tus kheej thaum lub sijhawm rov qab los siv qhov kev kwv yees dav dav (GEE). Tus nqi suicidality yog 22.2 feem pua (n=14), 15.1 feem pua (n=8), thiab 10.0 feem pua (n=5) ntawm T1–T3, feem. Ntawm 63 tus neeg koom, 29 muajmob nkeesSyndrome ntawm T1. Cov pab pawg uas tau tshaj tawm tias mob nkees nkees ntawm T1 feem ntau muaj feem cuam tshuam txog kev tua tus kheej thaum lub sijhawm 2- xyoo rov qab dua li cov pab pawg uas tau tshaj tawm lwm yam (RR: 7.5, 95 feem pua CI: 2.4–23.1). Lub koom haum no tau tshwm sim txawm tias tom qab hloov kho rau cov muaj peev xwm confounders (RR: 7.6, 95 feem pua CI: 2.2–26.{17}}). Mob nkees nkees thiab muaj kev pheej hmoo tua tus kheej ntawm cov neeg muaj sia nyob (EID) yuav tsum tau lees paub, thiab kev cuam tshuam zoo yuav tsum tau tsim.
Tags: mob hlwb, qaug zog, Suicidality, Emerging kis kab mob, Middle East respiratory syndrome, Survivors
qhov twg yuav cistancherauqaug zog
1. Taw qhia
Cov kab mob sib kis tau tshwm sim (EIDs) yog qhov kev sib tw loj hauv ntiaj teb. Tam sim no peb tab tom muaj kev sib kis ntawm tus kab mob Coronavirus 2019 (COVID-19), tshwm sim los ntawm tus kab mob tshiab coronavirus hu ua mob hnyav ua pa nyuaj ua pa mob coronavirus 2 (SARS-CoV-2). Tus kab mob COVID-19 kis thoob qhov txhia chaw ua rau muaj kev pheej hmoo ntawm teeb meem kev puas siab puas ntsws los ntawm qhov tsis paub tseeb thiab tsis paub tseeb uas nws tau tsim. Raws li kev txheeb xyuas meta-tshaj tawm tsis ntev los no, qhov tshwm sim ntawm kev ntxhov siab, kev ntxhov siab, thiab kev nyuaj siab nyob rau hauv cov pej xeem thaum lub sij hawm COVID-19 muaj thoob qhov txhia chaw, cov tsos mob tsis tu ncua tom qab kis kab mob. Nws zoo nkaus li tias ntau tus neeg mob yuav raug kev txom nyem los ntawm lub sijhawm ntev, ob lub cev thiab lub hlwb (del Rio li al., 2020). Ib qho kev tshwm sim tseem ceeb ntawm Middle East cov kab mob ua pa (MERS), tshwm sim los ntawm lwm tus mob Coronavirus, tshwm sim hauv Kaus Lim Qab Teb xyoo 2015. Hauv 217 hnub, tus kab mob MERS tau ua rau 186 tus neeg uas tau lees paub thiab 36 tus neeg tuag, thiab 16,693 tus neeg tau ntsib kev cais tawm (Cho et al. ., 2016). Kev tshuaj xyuas rov qab los ntawm 24 tus neeg mob MERS uas tau lees paub los ntawm 2015 MERS tshwm sim hauv Kaus Lim Kauslim pom tias lawv tau ntsib cov tsos mob ntawm kev puas siab puas ntsws xws li insomnia, kev nyuaj siab, ntxhov siab, ntxhov siab, tsis nco qab, hnov lus hnov, thiab aggressive outbursts (Kim li al., 2018). . Txoj kev tshawb fawb yav tom ntej tau qhia tias cov neeg muaj sia nyob MERS txuas ntxiv ntsib teeb meem puas siab puas ntsws ib xyoos tom qab rov zoo los ntawm MERS (Shin et al., 2019). Peb yuav tsum tau xyuam xim rau cov kev cuam tshuam ntev rau kev puas siab puas ntsws, raws li EIDs tau tshaj tawm tias muaj feem cuam tshuam nrog kev mob hlwb hnyav hauv ob theem mob thiab tom qab mob (Rogers li al., 2020). Kev tua tus kheej yog ib qho teeb meem tseem ceeb ntawm kev puas hlwb. Cov ntawv ceeb toom yav dhau los tau txheeb xyuas qhov sib koom ua ke ntawm cov kab mob sib kis thiab tua tus kheej (Honigsbaum, 2010; Wasserman, 1992).
Xyoo 2003 SARS kev kis mob tau cuam tshuam nrog kev tua tus kheej ntawm cov poj niam laus hauv Hong Kong (Chan li al., 2006). Tsis tas li ntawd, cov neeg muaj txoj sia nyob ntawm tus kab mob Ebola (Keita li al., 2017) thiab cov neeg mob khaub thuas B seropositivity (Okusaga li al., 2011) ob leeg tau pom tias muaj kev sim tua tus kheej ntau dua. Cov kev tshawb pom no qhia tias kev tua tus kheej yuav nce ntxiv vim yog COVID-19 kev sib kis (Gunnell li al., 2020). Kev qaug zog ntev tau raug tshaj tawm tias muaj kev pheej hmoo siab ntawm kev xav tua tus kheej thiab kev tuag ntxov (Jason et al., 2006), thiab kev ua haujlwm tsis zoo yog ntawm cov kev hloov pauv ntawm lub koom haum no (Johnson li al., 2020). Cov ntawv ceeb toom ntawm kev qaug zog ntev tau tshwm sim hauv kev koom tes nrog EID rov qab thiab tuaj yeem nyob ntev rau cov neeg muaj sia nyob (Tansey li al., 2007; Wing and Leung, 2012). Kev tshawb nrhiav tom qab ntawm Kaus Lim Qab Teb MERS cov neeg muaj sia nyob tau qhia tias kev nyuaj siab tuaj yeem kho qhov mob nkees thiab cov tsos mob ntawm kev ntxhov siab tom qab (Lee li al., 2019). Kev qaug zog kuj yog ib qho kev mob ntev ntev ntawm tus mob Ebola (PES). Ntawm cov kab mob Ebola tus kab mob (EVD) muaj txoj sia nyob hauv Tebchaws Meskas, 75 feem pua tau qhia txog kev nkees txawv txawv (Epstein li al., 2015). Tsis tas li ntawd, hauv kev tshawb nrhiav ntu ntu ntawm EVD cov neeg muaj txoj sia nyob, kev qaug zog txawv txawv yog ib qho ntawm cov tsos mob tshwm sim ntev dua 10 lub hlis (Wilson et al., 2018). Txoj kev tshawb fawb ntawm COVID-19 cov neeg muaj txoj sia nyob kuj tau tshaj tawm tias kev qaug zog yog cov tsos mob feem ntau ntawm kev rov qab los thiab hais txog kev taug qab mus ntev ntawm cov neeg muaj sia nyob (Kamal et al., 2020). Txawm li cas los xij, me ntsis paub txog kev sib raug zoo ntawm kev qaug zog ntev thiab kev tua tus kheej hauv cov ntsiab lus ntawm EIDs, tshwj xeeb tshaj yog cov neeg muaj sia nyob MERS. Tsis tas li ntawd, vim tias qhov tshwm sim ntawm kev puas siab puas ntsws muaj feem yuav tshwm sim dhau qhov kev kis thoob qhov txhia chaw (Gunnell li al., 2020), yuav tsum muaj cov ntaub ntawv soj ntsuam mus sij hawm ntev. Yog li, peb tau tshawb xyuas cov kev puas siab puas ntsws hloov pauv hauv cov neeg muaj sia nyob ntawm MERS tom qab 12 thiab 24 lub hlis, thiab kev sib raug zoo ntawm lawv. Lub hom phiaj ntawm txoj kev tshawb fawb no yog los tshuaj xyuas cov
2. Cov ntaub ntawv thiab txoj kev
2.1. Cov neeg koom nrog
Txoj kev tshawb no tau koom nrog 2- xyoo tom ntej ntawm MERS cov neeg muaj txoj sia nyob ntawm tsib lub chaw hauv tebchaws Kaus Lim Kauslim. Txhua tus neeg koom tau raug kuaj pom tias muaj tus mob MERS thaum xyoo 2015 tau tshwm sim, raug kho, thiab tau zoo lawm. MERS cov neeg muaj txoj sia nyob tau raug xaiv los ntawm National Medical Center, Seoul National University Tsev Kho Mob, Chungnam National University Tsev Kho Mob, Seoul Medical Center, thiab Dankook University, thiab tau taug qab los ntawm e-mail thiab ntawm tus kheej. Nyob rau hauv tag nrho, 63 tus neeg koom tau sau npe thiab tshuaj xyuas ntawm 12 lub hlis (T1). Ntawm cov neeg koom no, 53 thiab 50 ua tiav qhov kev ntsuam xyuas ntawm 18 lub hlis (T2), thiab 24 lub hlis (T3), feem. Txhua tus neeg koom tau pom zoo koom nrog rau kev kawm thiab ua tiav cov lus nug ntawm nws tus kheej. Cov txheej txheem sau cov ntaub ntawv tau ua raws li cov hauv paus ntsiab lus ntawm Kev Tshaj Tawm ntawm Helsinki. Txoj kev tshawb no tau pom zoo los ntawm Institutional Review Boards ntawm Chungnam National University Tsev Kho Mob (2015-08-029-007), Dankook University (2016-02-014), National Medical Center (H-1510- 059-007), Seoul Medical Center ({{ 16}}), thiab Seoul National University Tsev Kho Mob (1511-117-723).
2.2. Kev ntsuas
Socio-demographic cov ntaub ntawv (hnub nyoog, poj niam txiv neej, kev txij nkawm, thiab kev ua hauj lwm) thiab kev siv psychotropics tau sau. Cov kev hloov pauv hauv chaw kho mob hais txog lub sijhawm ntawm tus kab mob MERS suav nrog kev mob ntsws ntsws, muaj cov pa oxygen, lub cev tsis sib haum xeeb, kev cais tawm, xwm txheej, lub sijhawm pw hauv tsev kho mob, thiab lub sijhawm nruab nrab ntawm cov tsos mob thiab kev kuaj pom tseeb. Cov kev hloov pauv tom qab MERS tau soj ntsuam yog kev tua tus kheej, kev qaug zog ntev, kev nyuaj siab, kev ntxhov siab, kev siv cawv, cov tswv yim daws teeb meem, teeb meem hauv lub neej txhua hnub vim kev noj qab haus huv tsis zoo, kev txhawb nqa nyiaj txiag, kev txhawb nqa kev sib raug zoo, thiab kev qias neeg cuam tshuam nrog MERS. Lub suicidality module ntawm Mini-International Neuropsychiatric Interview (MINI) (Lecrubier li al., 1997; Yoo et al., 2006) tau siv los ntsuas kev tua tus kheej. Cov qauv no suav nrog rau 6 pawg ntawm cov khoom hnyav: kev ntshaw rau kev tuag (qhov hnyav ntawm 1), lub siab xav ua phem rau tus kheej (qhov hnyav ntawm 2), kev sim tua tus kheej hauv lub neej (qhov hnyav ntawm 4), kev xav tua tus kheej (qhov hnyav ntawm 6), kev npaj tua tus kheej (qhov hnyav ntawm 10), thiab kev sim tua tus kheej hauv lub hli dhau los (qhov hnyav ntawm 10). Cov qhab nia hnyav tau muab xam los ua tus qhab nia tag nrho; Cov qhab nia Ntau dua lossis sib npaug li 6 yog suav tias yog qhov qhia tau tias muaj kev pheej hmoo nruab nrab-rau-siab. Fatigue Severity Scale (FSS) (Krupp et al., 1989) muaj cuaj yam uas ntsuas qhov hnyav ntawm kev qaug zog ntawm lub lim tiam dhau los, ntsuas ntawm Likert scale li ntawm 1 txog 7. Nws suav nrog cov nqe lus xws li "Kuv lub siab yog qis dua thaum kuv nkees" thiab "Fatigue yog ntawm kuv peb feem ntau cov tsos mob tsis zoo". Qhov qhab nia nruab nrab rau txhua yam khoom tau txais, nrog cov qhab nia siab dua qhia tias muaj kev puas tsuaj ntau dua vim kev qaug zog. Lub Korean version ntawm FSS (Chung thiab Song, 2001), uas muaj cov qhab nia txiav tawm ntawm 3.22, pom qhov rhiab heev ntawm 84.1 feem pua thiab qhov tshwj xeeb ntawm 85.7 feem pua. Kev sib raug zoo ntawm FSS cov qhab nia thiab kev nyuaj siab symptomatology tsis muaj zog (Krupp li al., 1989).
suab puam cistanche cov txiaj ntsig raumob nkees
Txhawm rau ntsuas cov tsos mob tseem ceeb ntawm kev nyuaj siab, Cov Lus Nug Txog Kev Noj Qab Haus Huv Tus Neeg Mob{{{{10}}}} (PHQ-2) (Kroenke et al., 2003; Manea et al. , 2016) tau siv los hloov Cov Lus Nug Txog Kev Noj Qab Haus Huv Tus Neeg Mob-9 (PHQ-9) vim tias qee yam kev nyuaj siab ntawm PHQ-9 tuaj yeem sib tshooj nrog cov tsos mob qaug zog. PHQ-2 muaj ob yam uas sawv cev rau cov tsos mob tseem ceeb ntawm kev nyuaj siab loj uas tau teev tseg hauv Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), txhua qhov tau qhab nia ntawm 0 txog 3. PHQ-2 tau raug txhais thiab siv tau hauv Kaus Lim Kauslim (Shin et al., 2013) thiab tau pom zoo siv tau thiab kev ntseeg tau. Qhov zoo tshaj plaws txiav tawm cov qhab nia rau kev nyuaj siab yog 3. Cov Kev Nyuaj Siab Generalized -7 (GAD-7) scale (Spitzer li al., 2006) yog ib qho kev tshuaj ntsuam uas siv los ntsuas qhov hnyav ntawm kev ntxhov siab nyob rau hauv ua ntej 2 lub lis piam. Qhov ntsuas muaj xya yam khoom ntsuas siv plaub-point Likert-type scale (0 ntsiab lus rau "Tsis yog" thiab 3 ntsiab lus rau "Zoo txhua hnub"). Tag nrho cov qhab nia Ntau dua lossis sib npaug rau 10 yog suav tias yog qhov tseem ceeb hauv kev kho mob. Kev Cuam Tshuam Txog Kev Siv Dej Haus Dej Haus (AUDIT) (Saunders li al., 1993) yog ib qho kev tshuaj ntsuam xyuas yooj yim los soj ntsuam kev haus dej cawv txaus ntshai thiab tsim kev puas tsuaj thiab txheeb xyuas cov xwm txheej ntawm kev vam khom rau xyoo dhau los. Ib qho luv luv (Seong et al., 2009), Kev Cuam Tshuam Txog Kev Siv Dej Haus Dej Haus -Kev Siv Khoom Siv (AUDIT-C), suav nrog peb yam khoom ntsuas qhov zaus thiab qhov haus, thiab haus dej haus cawv, tau siv hauv txoj kev tshawb no. Cov Lus Qhia luv luv (Brief COPE) (Carver, 1997) ntsuas peb lub tswv yim daws teeb meem tseem ceeb: kev xav tsom, teeb meem tsom, thiab tsis ua haujlwm. Daim ntawv nug no suav nrog 28 yam khoom tau qhab nia ntawm plaub-point Likert scale xws li 0 ("Tsis siv tag nrho") txog 3 ("Us nquag").
Lub stigma cuam tshuam nrog tus kab mob MERS raug soj ntsuam los ntawm kev hloov kho ntawm Berger's Human Immunodeficiency Virus (HIV) Stigma Scale (Berger li al., 2001), thiab luv luv version ntawm HIV Stigma Scale (Wiklander li al. ., 2013). Cov lus nug no suav nrog yim yam khoom ntsuas ntawm plaub-point Likert scale thiab ntsuam xyuas plaub pawg ntawm stigma: tus kheej stigma, kev txhawj xeeb tshaj tawm, tsis zoo rau tus kheej, thiab kev txhawj xeeb txog pej xeem tus cwj pwm (Table 1.). Kev Tshawb Fawb Txog Kev Tshawb Fawb Txog Kev Noj Qab Haus Huv Kev Noj Qab Haus Huv (MOS-SSS) (Sherbourne thiab Stewart, 1991) tau siv los ntsuas seb cov neeg koom nrog tau txais kev txhawb nqa los ntawm lwm tus thaum ntsib cov xwm txheej ntxhov siab. Qhov ntsuas no suav nrog 19 yam khoom thiab cov lus qhia thawj zaug: "Yog tias koj xav tau, koj tuaj yeem nyob ntawm qee tus neeg pab?" Muaj tsib txoj kev xaiv teb (tsib-point Likert scale; 0, "Tsis Txhob"; 4, "Txuas"). Cov qhab nias siab dua qhia tau tias muaj kev txhawb nqa ntau dua.
2.3. Kev txheeb cais
Cov neeg koom nrog kev noj qab haus huv-kev noj qab haus huv thiab MERS cov yam ntxwv ntsig txog kev kho mob tau nthuav tawm raws li txhais tau tias ± SD lossis tus lej thiab feem pua. Cov neeg koom tau muab faib ua ob pawg raws li qhov muaj nyob ntawmmob nkeesSyndrome ntawm lub hauv paus. Cov pab pawg sib txawv tau suav los ntawm t-tests rau qhov sib txawv tsis tu ncua lossis Chi-square xeem rau categorical variables. Txhawm rau ntsuas kev sib koom ua ke ntawmmob nkeesSyndrome thiab suicidality ntawm MERS survivors nyob rau lub sijhawm {{0}}} xyoo rov qab, peb tau siv qhov kev kwv yees dav dav (GEE) rau tus qauv binomial regression, nrog rau kev sib txuas logit thiab cov ntaub ntawv tsis sib xws ntawm matrix. Kev tshuaj xyuas Univariate GEE tau siv los txiav txim siab txog cov koom haum ntawm cov mob qaug zog ntev nrog kev tua tus kheej ntawm MERS cov neeg muaj txoj sia nyob rau lub sijhawm 2- xyoo rov qab nyob rau hauv Model I. Hauv kev tshuaj ntsuam GEE ntau yam, peb tau hloov kho hnub nyoog thiab poj niam txiv neej hauv Model II thiab tag nrho cov muaj peev xwm confounders hauv Model III. Cov kev hloov pauv tsis txaus ntseeg rau tus qauv III tsom xam tau raug xaiv los ntawm qhov sib txawv nrog p-tus nqi tsawg dua 0.1 hauv tus qauv I; poj niam txiv neej raug xaiv ntxiv raws li nws tsis tu ncua qhia tau hais tias muaj txiaj ntsig zoo hauv kev tshawb fawb suicidality. Kev tshuaj xyuas tau ua tiav siv SAS software (version 9.4; SAS Institute, Cary, NC, USA). Tag nrho cov nqi yog ob sab.
3. Cov txiaj ntsig
Ntawm 63 tus neeg koom, 29 thiab 34 tau raug cais tawm tias muaj thiab tsis muaj mob nkees nkees ntawm lub hauv paus, feem. Tsis muaj pab pawg sib txawv tau pom nyob rau hauv lub hauv paus kev sib raug zoo-cov pej xeem lossis cov yam ntxwv kho mob thaum lub sijhawm kis tus kabmob MERS (Table 2 thiab Table 3). Lub 12-, 18-, thiab 24-hli kev soj ntsuam kev tua tus kheej tau ua tiav los ntawm 63 (100} feem pua , 53 (81.1 feem pua ), thiab 50 (79.4 feem pua) cov neeg koom, feem. Tus nqi suicidality feem ntau yog 14 (22.2%), 8 (15.1%), thiab 5 (10.0 feem pua) ntawm 12, 18, thiab 24 lub hlis, raws li (Daim duab 1). Piv nrog rau cov pab pawg uas tau tshaj tawm tias tsis muaj tus mob nkees nkees ntawm lub hauv paus, cov neeg uas tau tshaj tawm cov mob qaug zog ntev tau pom tias muaj 7.5- quav (RR: 7.5, 95 feem pua CI: 2.4–23.1) nce suicidality tshaj {{40 }} xyoo tom qab lub sijhawm, raws li Model I. Nyob rau hauv cov qauv sib txawv, cov kab mob ua rau lub cev qaug zog tau ua rau nws tus kheej cuam tshuam nrog kev muaj kev tua tus kheej thoob plaws hauv lub sijhawm 2- xyoo rov qab, tom qab hloov kho hnub nyoog thiab poj niam txiv neej ( Model II, RR: 8.3, 95 feem pua CI: 2.8–24.4), thiab rau tej zaum confounders (Model III, RR: 7.6, 95 feem pua CI: 2.2–26.0) (Table 4).
4. Kev sib tham
Rau qhov zoo tshaj plaws ntawm peb txoj kev paub, peb txoj kev tshawb fawb yog thawj qhov kev tshawb nrhiav yav tom ntej ntawm kev tua tus kheej ntawm cov neeg muaj sia nyob MERS. Peb pom tias qhov muaj feem ntau ntawm kev tua tus kheej hauv MERS cov neeg muaj txoj sia nyob yog 10–22.2 feem pua thaum lub sijhawm 2- xyoo rov qab. Baseline chronic fatigue syndrome yog nws tus kheej cuam tshuam nrog kev muaj suicidality thoob plaws hauv 2- xyoo rov qab. Peb qhov kev tshawb pom tau zoo ib yam nrog cov kev tshawb fawb yav dhau los uas qhia tias kev tua tus kheej tuaj yeem tshwm sim tom qab rov qab los ntawm EIDs (Keita li al., 2017; Secor li al., 2020), txawm hais tias feem ntau ntawm kev tua tus kheej yuav txawv ntawm txoj kev tshawb no thiab yav dhau los vim ntawm qhov sib txawv ntawm lub sijhawm rov qab los thiab cov cuab yeej ntsuas kev tua tus kheej. Kev tshawb nrhiav rov qab los ntawm EVD cov neeg muaj txoj sia nyob pom tau tias 3 xyoos tom qab qhov tshwm sim, EVD cov neeg muaj txoj sia nyob tau tshaj tawm cov kev ntxhov siab tom qab kev ntxhov siab, kev nyuaj siab, kev ntxhov siab, thiab kev tua tus kheej hauv kev sib piv nrog cov neeg tsis muaj sia nyob, nrog 39 tawm ntawm 116 (34 feem pua. ) Cov neeg teb hais qhia txog kev sim tua tus kheej (Niederkrotenthaler li al., 2020). Hauv kev tshawb fawb koom nrog 256 ntawm 1270 EVD cov neeg muaj sia nyob ntawm 2013-2016 kev kis mob, 33 tau raug xa mus rau cov kws kho mob hlwb thaum lub sijhawm rov zoo, ib tus ntawm lawv tau ntsib kev xav tua tus kheej thiab peb tus neeg tau sim tua tus kheej (Keita et al. . Ib qho kev tshawb fawb hla ntu uas tau ua thaum lub sijhawm rov qab los ntawm cov neeg muaj sia nyob hauv peb lub tebchaws cuam tshuam los ntawm EVD tau pom tias 10-20 feem pua ntawm cov neeg teb tau qhia txog kev tsim txom tus kheej lossis kev xav tua tus kheej (Secor li al., 2020). Hauv kev tshawb fawb 4-xyoo tom qab tus kab mob SARS tshwm sim hauv Hong Kong, 42.5 feem pua ntawm cov neeg muaj sia nyob (77/181) tau tshaj tawm tsawg kawg yog ib qho kev kuaj mob hlwb, thiab 40.3 feem pua tau qhia txog kev qaug zog (Lam et al., 2009). Kev tua tus kheej yog ib qho teeb meem tseem ceeb tshaj plaws rau pej xeem kev noj qab haus huv.
cistanche poob teb chaws Ottoman tshuaj ntsuab raumob nkees
Peb hais tias txoj kev tshawb fawb no muaj txiaj ntsig tshwj xeeb rau lub sijhawm no, vim tias qhov xav tau kev tiv thaiv kev tua tus kheej tau raug qhia, thiab qhov kev cia siab tias tus neeg tua tus kheej yuav nce ntxiv (Gunnell li al., 2020) vim yog EID tsis tu ncua los ntawm COVID{ {1}}. Peb pom tias kev qaug zog ntev ntawm cov neeg muaj sia nyob ntawm 12 lub hlis tom qab MERS tau kwv yees kev tua tus kheej hauv 2- xyoo rov qab. Ib qho kev tshawb fawb txog kev noj qab haus huv rau cov neeg laus ua nyob rau hauv ib cheeb tsam nroog hauv Iceland tau tshaj tawm tias kev qaug zog yog cuam tshuam nrog kev xav tua tus kheej (Vilhjalmsson et al., 1998), thaum ib qho kev tshawb fawb hauv Teb Chaws Asmeskas ua ntej tau tshaj tawm txog kev tua tus kheej ntawm cov neeg uas muaj cov tsos mob qaug zog (Smith li al., 2006). Txawm li cas los xij, kev nyuaj siab confounds kev koom tes ntawm suicidality nrog mob nkees. Kev nyuaj siab yog dav paub tias yog ib qho ntawm feem ntau muaj feem cuam tshuam rau kev tua tus kheej hauv cov neeg mob uas muaj mob lub cev (Webb li al., 2012). Kev tshawb fawb txog kev pheej hmoo tua tus kheej hauv cov neeg mob uas lub raum tsis ua haujlwm tau pom ntau dua ntawm kev qaug zog, kev ntxhov siab, thiab kev pheej hmoo tua tus kheej hauv cov neeg mob kev nyuaj siab, thiab qhia txog kev sib raug zoo ntawm kev qaug zog thiab kev nyuaj siab (Chen li al., 2010). Kev tshawb fawb ntawm cov neeg uas muaj ntau yam sclerosis kuj qhia tau tias muaj kev sib koom ua ke ntawm kev qaug zog thiab kev xav tua tus kheej, tab sis tom qab tswj kev nyuaj siab, kev sib raug zoo ploj mus (Mikula li al., 2020). Kev qaug zog yog txhais raws li kev xav ntawm kev qaug zog, tsis muaj zog, thiab nkees; Cov tsos mob no tau sib koom nrog kev nyuaj siab. Yog li, peb siv PHQ-2 nplai, uas ntsuas cov tsos mob tseem ceeb ntawm kev nyuaj siab. Peb cov txiaj ntsig tau pom tias kev qaug zog ntev hauv MERS cov neeg muaj sia nyob tau cuam tshuam nrog kev tua tus kheej, tsis muaj cov tsos mob tseem ceeb ntawm kev nyuaj siab. Tsis tas li ntawd, qhov teeb meem tsom rau kev daws teeb meem yog qhov tsis txaus ntseeg hauv txoj kev tshawb no.
Kev tshawb fawb yav dhau los tau qhia tias kev siv cov tswv yim daws teeb meem txo qis kev pheej hmoo ntawm kev tua tus kheej (Knafo li al., 2015). Cov tswv yim daws teeb meem tau txais kev pom zoo thaum lub sij hawm EID tshwm sim hauv cov pej xeem suav nrog nrhiav lwm txoj kev ntsuas (xws li, qigong thiab cov tshuaj ntxiv), thiab kev koom tes hauv kev coj cwj pwm uas tiv thaiv tus kheej lossis lwm tus (Chew li al., 2020). Txoj kev daws teeb meem no tso cai rau peb ua cov kauj ruam ntawm kev txhawb nqa tus kheej thiab txo cov kev xav tsis meej los ntawm kev muab peb txoj kev tswj hwm kev noj qab haus huv (Siu et al., 2007). Txawm li cas los xij, peb pom tias kev qaug zog ntev hauv MERS cov neeg muaj txoj sia nyob tau cuam tshuam nrog kev tua tus kheej, ntawm nws tus kheej ntawm txhua txoj kev daws teeb meem. Kev koom tes ntawm kev qaug zog ntev thiab kev pheej hmoo tua tus kheej tuaj yeem cuam tshuam nrog kev ua haujlwm tsis zoo thiab cuam tshuam ntawm lub neej txhua hnub (Kapur thiab Webb, 2016). Peb xav tias cov neeg muaj txoj sia nyob ntawm EIDs uas qhia txog kev qaug zog ntev yuav tsum tau soj ntsuam raws li kev pheej hmoo ntawm kev tua tus kheej, kom cov tswv yim kho kom tsim nyog tuaj yeem siv tau. Cov kev txwv ntawm qhov kev tshawb fawb tam sim no muaj raws li hauv qab no. Ua ntej, kev coj tus cwj pwm tsis zoo tuaj yeem tshwm sim, tsuas yog nyob ib ncig ntawm 43 feem pua ntawm MERS cov neeg muaj sia nyob tau koom nrog hauv txoj kev tshawb no. Tsis tas li ntawd, muab 5-15 feem pua ntawm kev tso tawm, nws muaj peev xwm hais tias ib tus neeg uas xav tias lawv muaj teeb meem kev puas siab puas ntsws txuas ntxiv mus koom nrog hauv txoj kev tshawb no. Txawm li cas los xij, peb cov ntaub ntawv tseem ceeb uas peb tau saib xyuas cov neeg muaj sia nyob ntawm EID hais txog kev tua tus kheej ntau dua 2 xyoos. Qhov thib ob, peb tsis tuaj yeem ntsuas lwm qhov sib txawv, xws li lwm yam teeb meem kev ntxhov siab lossis kev ntxhov siab ntawm kev puas siab puas ntsws, raws li kev hloov pauv vim tias cov no tuaj yeem cuam tshuam txog kev tua tus kheej hauv lub sijhawm tom qab kis kab mob. Cov kev tshawb fawb yav tom ntej uas ntsuas ntau lwm yam teeb meem puas siab puas ntsws yuav xav tau los nthuav qhia cov xwm txheej ntawm kev tua tus kheej mus ntev hauv cov neeg muaj sia nyob ntawm EIDs. Qhov thib peb, nws yuav tsum tau muab sau tseg tias peb soj ntsuam kev qaug zog ntev thiab kev tua tus kheej siv kev ntsuas tus kheej nkaus xwb; Txawm hais tias cov kev txwv no, qhov no yog thawj txoj kev tshawb fawb qhia txog kev tua tus kheej ntawm MERS cov neeg muaj txoj sia nyob thiab nws txoj kev koom tes nrog kev qaug zog ntev. Hauv kev xaus, peb txoj kev tshawb nrhiav tom qab ntawm MERS cov neeg muaj sia nyob tau pom tias nyob ib puag ncig 10-20 feem pua tau ntsib kev tua tus kheej tom qab rov zoo los ntawm tus kab mob MERS. Kev qaug zog ntev ntawm 12 lub hlis tom qab MERS tuaj yeem cuam tshuam kev tua tus kheej mus ntev ntawm MERS cov neeg muaj sia nyob. Yog li, EID cov neeg muaj sia nyob yuav tsum tau soj ntsuam rau kev qaug zog ntev; cov kev kho mob zoo los daws qhov teeb meem no.
Tus qauv I: Crude RRs.
Qauv II: Kho rau hnub nyoog thiab poj niam txiv neej.
Qauv III: Kho rau poj niam txiv neej, cov tsos mob ntawm kev nyuaj siab, cov tsos mob ntawm kev ntxhov siab, teeb meem kev daws teeb meem, thiab psychotropic.
Mob nkeesSyndrome tau soj ntsuam los ntawm FSS (Fatigue severity scale) nrog tus qhab nia txiav tawm yog 3.22.
Cov tsos mob ntxhov siab tau raug soj ntsuam los ntawm GAD{{0}} (Generalized Anxiety Disorder-7). Kev txhawb nqa kev sib raug zoo raug soj ntsuam los ntawm MOS-SSS (Kev Tshawb Fawb Txog Kev Kho Mob-Kev Tshawb Fawb Txog Kev Pabcuam Hauv Zej Zog) thiab cov pab pawg siab dua tau txhais raws li qhov saum toj no ntawm cov qhab nia nruab nrab (72). Lub tswv yim daws teeb meem tau soj ntsuam los ntawm cov khoom muag luv luv thiab nws tau txheeb xyuas los ntawm kev faib ua peb lub ntsiab (kev xav tsom, teeb meem tsom, thiab tsis ua haujlwm). Bold qhov tseem ceeb qhia txog qhov tseem ceeb ntawm tus lej ntawm p < 0.1="" qib="" hauv="" kev="" txheeb="" xyuas="" qhov="" tsis="" sib="" xws="" los="" xaiv="" qhov="" sib="" txawv="" ntawm="" qhov="" tsis="" sib="" haum="" xeeb.="" kev="" sib="" deev="" raug="" txiav="" txim="" raws="" li="" kev="" kho="" mob="" muaj="" txiaj="" ntsig="" sib="" txawv="" thiab="" suav="" nrog="" qhov="" sib="" txawv="" ntawm="" qhov="" sib="" txawv="" kom="" raug="" kho.="" asterisk="" (*)="" qhia="" txog="" qhov="" tseem="" ceeb="" ntawm="" qhov="" p=""><0.05>
Nov yog peb cov khoom tiv thaiv kev qaug zog! Nyem rau daim duab kom paub ntau ntxiv!
Cov ntaub ntawv
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