Faced with the dilemma of the spread of the novel coronavirus pneumonia epidemic, many people may experience a difficult period of time, including mental and physical confusion. Whether it is the confirmed, suspected and close contacts of novel coronavirus pneumonia, or the front-line medical staff, volunteers and ordinary medical staff for epidemic prevention and control, facing the pressure of this huge event and disaster, they will inevitably have anxiety, panic, depression and other emotional reactions. This is an urgent need for us to actively face and deal with it in a timely manner.
1、 Confirmed, suspected and close contacts of novel coronavirus infected pneumonia
Defeating the disease not only depends on the professional treatment of medical staff, but also requires patients to face the disease with a positive attitude. During treatment, we should not only pay attention to their physiological needs, but also understand their psychological needs and demands, as well as possible emotional, emotional and mental problems.
1. Psychological crisis of the confirmed, suspected and close contacts of novel coronavirus infected pneumonia
Pneumonia diagnosed as novel coronavirus infection can be said to be a huge stress event, and patients may have a series of stress reactions. At the initial stage of isolation treatment, patients may be shocked, at a loss, expressionless and unresponsive; Some patients think they are mistaken and strongly deny it; Some patients become angry, complain, and even send their anger to the medical staff and their families for no reason. Not only do they not cooperate with the treatment, but they even have impulsive destruction behavior; Some patients showed obvious anxiety and fear; Some patients are in sadness and depression, and think that the future is hopeless. They can not sleep all night because of passive treatment. The isolation of patients during the treatment period, the isolation environment and the suffering of illness increase the loneliness of patients and their dependence on the care of medical personnel. The fluctuation of the condition during the treatment period will greatly affect the patients' psychology, become sensitive, suspicious, anxious and fearful, and even give up or do not cooperate with the treatment when they feel hopeless to cure; Some people's condition is slightly relieved, blindly optimistic, and the condition is slightly worse and unbearable; The patient even has respiratory distress, extreme anxiety, panic and chest distress, which are not consistent with the condition of pneumonia and are accompanied by a sense of dying. This panic attack will cause the illusion of urgent rescue. For severe patients, the trachea has been cut because of respiratory distress, but the anxiety and tension caused by dyspnea will aggravate dyspnea and other symptoms, thus falling into a vicious circle. The patients even fall into pessimism, panic and despair, increasing the difficulty of treatment.
Mild patients who are isolated at home do not need to be hospitalized, but their psychological pressure is not small. They may be worried about the sudden aggravation of the disease but can not be cured; they may be worried about improper isolation and infection to relatives and friends; they may feel aggrieved and helpless because of being alienated by others, or even fall into pessimism and depression, and have a sense of shame and suppress their emotions; they may also feel that they have not been valued and become angry; others may feel that the problem is not serious enough and they do not follow the doctor's advice, or even wander around.
The biggest psychological problem of suspected patients is uncertainty, which will make patients feel great anxiety and fear - anxiety about life safety, fear of death, etc. Uncertainty can make people sensitive, suspicious and indecisive. Anxiety and fear will be intensified and magnified by involuntary intrusion into the idea of catastrophic disaster. Especially in the era of information explosion, they will be drowned in the information torrent related to "pneumonia infected by novel coronavirus" consciously or unconsciously. Every few minutes, they will take out their mobile phones to have a look. The more they look at it, the more worried they are, the greater their fear and powerlessness, and even feel angry with others or society. Especially when there are uncomfortable symptoms such as fever and cough, it is more likely to have disastrous thoughts and fear of death, guilt and regret about their own behavior. Anxiety and fear will activate the sympathetic nervous system, which may aggravate the original symptoms, and even panic, chest tightness and shortness of breath, constipation, frequent urination, etc., thus anxiety and fear will be magnified infinitely and fall into a vicious circle.
2. Psychological counseling and effective intervention for patients
In the face of public health and safety emergencies, moderate worry, fear and anxiety are normal emotional reactions. The sympathetic nervous system generated with anxiety is activated. It can help us to increase our awareness of danger, improve people's ability to adapt to and cope with the environment. It is a protective reaction. However, if it is excessive or inappropriate, it is a harmful psychological reaction, which requires appropriate intervention.
Monitoring and evaluation of patients' mental health status is the premise of selecting treatment measures. Problems can be found and severity can be judged through regular measurement with interview method and scale. For mild symptoms and problems, psychological intervention can be carried out. First of all, let the patients learn to acknowledge the reality, understand and accept their own psychological reactions, face up to the epidemic information, allow emotional reactions to occur, and do not reject or deny them. While making full use of positive information and other available resources to create the patient's sense of security, teach the patient to learn the breathing relaxation method and progressive muscle relaxation method, relax the mood through full head to foot muscle relaxation training, and focus on the details of every action at the moment with slow deep breathing and mindfulness meditation, Learn to do any appropriate activities and pay attention to what you are doing. Mindfulness, meditation and seeking for psychological support are all effective ways to relieve stress. They have dual functions of decompression and energy recovery. They encourage patients to keep in touch with the outside world and their relatives and friends through mobile phone information channels every day, so as to obtain psychological support and stimulate their own internal energy.
For suspected patients or potential contacts, urge them to work and rest normally, and ensure diet and sleep. In order to eliminate the anxiety and fear after isolation, first encourage them to face the problem directly and accept the emotion, and teach them to decompress and relax through gymnastics with deep breathing; Divert attention, but think more about the possibility of uncertainty in the future. It is suggested to make full use of the current time to read books that you usually like but have no time to read. Leave the Internet appropriately, but browse more information about the epidemic and listen more to your inner voice.
If patients have these feelings or conditions, such as fear, loss of confidence in themselves or anyone else, loss of self-esteem, hatred of themselves, feeling shame, helplessness, emptiness, feeling dull and numb, becoming withdrawn or isolated, worsening sleep conditions, etc., and last for more than 2 weeks, they need psychological counseling to eliminate fear, control fear, and suppress fear.
For patients who need crisis intervention, if they can sit down face to face or make phone calls, the first thing to do is to listen. Through listening technology, he can understand the crisis through narration, and realize what happened externally and psychologically through narrating the whole crisis process and his inner feelings at that time. While venting his emotions, he can gain psychological support and understanding through communication and companionship with the interveners. This interpersonal connection can also resolve the sense of loneliness and lay a foundation for subsequent intervention. It is the beginning of good treatment effect to listen to and accept patients, try to reach empathy, and win the trust of patients through empathy.
If medical personnel wear protective clothing, goggles and masks at the rescue site, they mainly rely on the use of nonverbal information to provide psychological support to patients. Nonverbal information includes the doctor's facial expression, eyes, body posture, etc. Body posture is a very powerful communication influencing factor. The most powerful communication element of the crisis intervention hotline is also nonverbal information, which conveys concern and support through voice, intonation, tone, speed and other nonverbal information. Cognitive behavior therapy, mindfulness relaxation, Morita therapy, insight therapy and other psychological counseling techniques can be used in the follow-up counseling. In a word, at the beginning of treatment, it is mainly to give listening support and psychological counseling, so as to avoid excessive intervention leading to increased resistance. After that, it is necessary to cooperate with active psychotherapy, adjust the sad and negative mentality, reduce anxiety, depression and fear, so as to help patients build confidence, cooperate with medical staff to overcome the epidemic and win the fight against the epidemic in an all-round way.
In terms of drug treatment, light and medium-sized patients can use a small amount of sedatives every night. In addition to the sedatives, the heavier patients who meet the diagnostic criteria of the disease also need to use anti anxiety and depression drugs, such as droperithiazide melitracen tablets, citalopram, sertraline, escitalopram, duloxetine, etc.
2、 Psychological adjustment for medical staff, epidemic staff and the public
Today, with the increasing prevalence of novel coronavirus, first-line medical personnel at the rescue site face the psychological pressure of high intensity work, separation from their families and worry about their relatives. Excessive tension will lead to fatigue and even exhaustion. All medical staff and related staff are also engaged in epidemic prevention and control. Due to close contact with patients, there is a greater risk of suffering from pneumonia caused by novel coronavirus, so medical staff and related staff have a higher risk of emotional distress and psychological crisis. While everyone in all walks of life responds to the call to do a good job of home isolation, their anxiety about their bodies may become increasingly apparent, and they may also worry about being infected, being overly sensitive to their own body feelings, and having health anxiety that they suspect they have diseases. In a word, in addition to isolation anxiety caused by social stress of patients and stress anxiety caused by overload of doctors, anticipation anxiety and fear will also occur when people stay at home. In addition to anxiety, there will be insomnia, depression, sadness, grievance, helplessness, depression, compulsion, frustration or self blame, which can not ensure your health.
A good psychological state is a prerequisite for better helping others and coping with the epidemic. Therefore, it is necessary to help medical staff and relevant staff to actively carry out psychological self-help and counseling, which is also an important part of winning this war.
First of all, cutting off the route of transmission is the best way to prevent disease and avoid health anxiety. Timely report the epidemic situation of the pneumonia virus epidemic, vigorously carry out popular science publicity, understand the transmission route and clinical symptoms of the novel coronavirus, wear masks when going out, wash hands and disinfect frequently when going home, avoid going to crowded places, strengthen online health consultation, and try to avoid going to hospitals as little as possible. Through protective guidance and psychological intervention, avoid the occurrence of "anxiety, fear, fear, fear, and fear".
Secondly, while working hard, arrange appropriate relaxation and rest to ensure adequate sleep and food; Whenever possible, try to keep in touch and communicate with family members and the outside world. When facing self isolation, take a break for your body and mind, take a short rest, take a rest and meditate, make plans and make plans, do something you usually want to do that you can't do, and make bad things good. The sense of achievement after finishing things can overcome many bad emotions.
Moreover, adjust the mentality, enhance the ability of self psychological adjustment, exercise and avoid unhealthy coping styles (such as smoking and drinking). Try to do what you can and not be responsible for yourself. Relax your mood through muscle relaxation training and breathing adjustment, express your mood through communication and mutual talk, learn Baduanjin to exercise your body and mind, and mindfulness therapy to adjust your mind and body.
Mindfulness is to let you focus on the present moment, so as to achieve the effect of passion, curiosity and wholehearted acceptance. The purpose of mindfulness is to live in the present moment in a more harmonious and happy way. Mindfulness training can be carried out for any action and behavior in the moment, such as eating, drinking, breathing, walking, etc. Deep breathing can lead to deep relaxation. Deep breathing will directly affect the brain stem, slowing down your heart rate and blood pressure, and calming down your heart. When people are stressed, their bodies are also tense. At this time, they should coordinate with deep breathing to adjust at the physical and psychological behavior levels. Through aerobic exercises such as shoulder neck and waist back activities, they can improve immunity and reduce mental stress, so that the body can regain energy and flexibility.
The medical workers who treat critically ill patients also need to spend a few minutes quietly sitting in a chair, closing their eyes, concentrating on breathing and the feelings it brings, slowly taking deep breaths, and feeling self release and relaxation. In addition, we should pay more attention to every medical action and problem in front of us, help the patients one by one, affirm the value of every medical activity we have done, delay fatigue and avoid psychological failure, and strive to ensure good sleep, healthy diet, regular exercise and relaxation.
With the implementation of this resistance war, if we have obvious insomnia, depression and anxiety, we need to seek professional psychological crisis intervention or mental health services. We can call the psychological assistance hotline for online psychological services, and if possible, we can conduct face-to-face psychological crisis intervention and psychological counseling. Those who do not relieve for 2 weeks and affect their normal work and life need to be evaluated by psychological and psychiatric department. Professional doctors will conduct detailed consultation and anxiety, depression, stress disorder and other scale tests, determine the diagnosis through technical methods, and give professional treatment, so as to restore healthy mind and body as soon as possible, and return to work to serve the society.
Friends of medical workers, we are soldiers fighting against the disease, and we need courage and passion; At the same time, it is also a good medicine for curing psychological trauma, which requires calm and tranquility. Let's live in the present and face the epidemic directly; Work at the right time and serve the society and the public with a strong heart!
