《臨床精神醫學期刊》(The Journal of Clinical Psychiatry )刊登一篇義大利托斯卡尼精神醫療在疫情下的現況,作者所在的西恩那醫學院附設醫院是一座相對大型的綜合醫院,以下整理本文門診、病房、學術活動、醫療人員心理健康的各層面的因應

#門診

▍疫情爆發後立即取消了90%的門診,改用電話遠距醫療。雖然他們對於用電話或遠距醫療幾乎沒有任何經驗,但是這似乎是唯一的選擇。對精神科病患用電話溝通幾乎都是可行的,而有些還可以使用WhatsApp或FaceTime視訊。

▍重新安排會談時的座位,讓兩人的距離至少相距2公尺

#病房

▍只收治絕對需要住院的病患,而病房分艙分流為COVID與非COVID的兩區。收治在COVID區精神科病房的患者,通常他們的精神症狀都是比COVID相關身體症狀還要嚴重的。

▍該院在2019年10月為預防院內感染,就開始禁止握手

▍鼓勵戴口罩,在口罩短缺的情況下,告訴患者如何自製口罩的資訊

▍所有醫院的員工在拿到護目鏡之前,都要戴眼鏡,平常沒帶眼鏡的戴太陽眼鏡也可以

#學術活動:會議、臨床報告都全部取消,改用視訊。

#醫護人員的心理健康:醫護人員長期身著防護裝備,也目睹同事與患者被感染、死亡;因此許多醫護人員都有失眠、焦慮以及心理健康需求,因此醫院也安排各種支持性的團體與方案

這篇第一手報導許多細節的文章,也詳述了這些措施的背景(例如口罩、護目鏡短缺)以及根據(門診座位保持2公尺是因為談話時藉由呼吸飛沫可能傳播達到1.5公尺;若個案打噴嚏則要考量調整為3公尺),值得精神醫療院所參考。

(財團法人國家衛生研究院 林煜軒醫師摘要整理)

On January 31, two Chinese tourists in Rome tested positive for coronavirus disease 2019 (COVID-19). One week later, an Italian man who had returned from Wuhan, China, became the third case in Italy.

These 3 cases were worrisome but felt relatively far from us in Tuscany. By February 21, the situation had worsened, and 16 cases were confirmed in Lombardy. On February 22, 60 additional cases were added. So, the epidemic had begun. As of March 22, a total of 4,826 health care workers in Italy have been infected by COVID-19, which means that some 9% of those infected nationwide by COVID-19 are health care workers. As of March 23, we have reached 63,928 cases and 6,078 deaths, out of a population of about 60 million (ie, less than one fifth of the US population).

…

Author:Andrea Fagiolini, Alessandro Cuomo, Ellen Frank, et al.
原文連結:https://reurl.cc/5l5RDy