新冠肺炎疫情下高风险科室护士的抑郁现状及影响因素分析

摘要/Abstract

摘要： 目的：了解新冠肺炎疫情期间高风险科室护士的抑郁现状及影响因素。方法：横断面调查研究设计，便利抽样抽取门诊、急诊、呼吸科护士作为调查对象，采用自行设计的调查问卷及家庭关怀度指数（Family APGAR Index）、广泛性焦虑量表（GAD-7）、患者健康问卷（PHQ-9）进行调查。结果：回收有效问卷380份，PHQ-9得分（7.08±5.443）分，256（67.4%）名护士存在不同程度抑郁。单因素分析显示，是否独生子女、职称、有无基础疾病、自觉健康状况、突发公共卫生事件的救治经验、对此次疫情的恐惧、对医院培训、应急预案、诊疗方案等的满意度、家庭关怀度指数和焦虑对护士抑郁有影响（P＜0.05），且这些因素之间存在一定的相关性。多因素分析显示，对该病毒可能通过自己传染家人的恐惧、家庭关怀度指数、焦虑为护士抑郁的独立影响因素。结论：高风险科室的护士抑郁发生率高。护理管理者应重视护理人员的情绪及心理状态，及早筛查、干预以提高护理人员的心理健康，并完善应对突发公共卫生事件下护理人员心理应激的管理体系。

关键词: font-size:medium, ">新冠肺炎；护士；抑郁

Abstract: Objective： To investigate the status and influencing factors of depression of nurses from high-risk departments during COVID-19 pandemic period. Methods： By cross-sectional study， the convenient samples consisted by nurses from clinic， emergency and respiratory department were surveyed by questionnaire including basic informantion， Family APGAR Index， anxiety scale(GAD-7) and depression scale (PHQ-9). Results： Valid questionnaires were collected as a total of 380. The average score of PHQ-9 was（7.08±5.443）， and 256（67.4%） nurses were in depression. Univariate analysis showed the status of depression of nurses was associated with several characteristics： the only child， professional title，background disease，perceived health status，experience of treatment in public health emergencies，fear of epidemic， satisifaction to training， emergency response plan and diagnose and treatment plan of the hospital， Family APGAR Index and anxiety(P＜0.05). There were relationships between these characteristics. Multiple linear regression analysis showed that fear of infection of families by themselves， Family APGAR Index and anxiety were the factors affecting nurses′ depression. Conclusion： The status of depression of nurses was serious in this study. Nursing administrators should pay attention to the emotion and psychological health of nurses. Screening and intervention is needed as early as possible and the management system to deal with the psychological problems of nurses under public health emergencies should be improved.

Key words: font-size:medium, ">Corona virus disease 2019(COVID-19)； Nurses； Depression

中图分类号:

赵艺璞, 闫秀文. 新冠肺炎疫情下高风险科室护士的抑郁现状及影响因素分析[J]. 中国医药导刊, 2020, 22(5): 294-300.

ZHAO Yipu, YAN Xiuwen. Status and Influencing Factors of Depression of Nurses from High-risk Departments during COVID-19 Pandemic Period[J]. CHINESE JOURNAL OF MEDICINAL GUIDE, 2020, 22(5): 294-300.

参考文献

[1]国家卫生健康委. 2020第1号中华人民共和国国家卫生健康委员会公告[EB/OL]．(2020-01-20)[2020-03-02]．http://www.nhc.gov.cn/jkj/s7916/202001/44a3b8245e8049d2837a4f27529cd386.shtml．
[2]World Health Organization. Novel coronavirus (2019-nCoV) situation report-12[R]. (2020-03-02)[2020-03-02]．https://www.who.int/docs/default-source/coronaviru
se/situation-reports/20200201-sitrep-12-ncov.pdf?sfvrsn=273c5d35_2．
[3]张立,沙莉,鲁桂兰.突发传染性公共卫生事件中护理人员心理压力的研究现状及前景展望[J].护理实践与研究,2011,8(22):103-105.
[4] 冯杰,杨君.突发公共卫生事件下医务人员情绪变化研究[J].解放军医院管理杂志,2004,11(4):373-375.
[5]胡佳梅. “甲流”爆发期间医务人员心理状况调查与相关因素分析[D].长沙：中南大学,2010:2.
[6] Garrouste-Orgeas M, Perrin M, Soufir L, et al. The Iatroref study:?medical errors?are?associated?with?symptoms of depression?in?ICU?staff?but not burnout or?safety culture[J]. Intensive?Care?Med.?2015,41(2):273-284.?
[7]苑杰,尚翠华,张蒙,等. 2016年唐山市4所医院医护人员焦虑抑郁的影响因素及与心理弹性的关系[J].职业与健康,2017,33(21):2918-2922.
[8] 蒲佳,李桂蓉,曹璐璐,等. 某三甲医院临床护士面对新型冠状病毒肺炎疫情的心理状况调查分析[J/OL].重庆医学:1-6[2020-03-08].http://kns.cnki.net/kcms/detail/50.1097.R.20200219.2121.006.html.
[9] Smilkstein G. The family APGAR: a proposal for a family function test and its use by physicians[J]. J Fam Pract, 1978,6(6):1231-1239.
[10] Spitzer RL, Kroenke K, Williams JB, etc. A brief measure for assessing generalized anxiety disorder: the GAD-7[J]. Archives of internal medicine, 2006, 166 (10): 1092-1097.
[11] Kroenke K, Spitzer RL, Williams JB, etc. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection[J]. Annals of internal medicine, 2007, 146 (5): 317-325.
[12]周麦琳. 合同制护士情绪调节策略与情绪困扰的关系研究[D].济南:山东大学,2019:16.
[13] Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure[J], J Gen Intern Med,2001,16(9):606-613
[14] Mitchell AJ, Yadegarfar M,?Gill J, et al. Case finding and screening clinical utility of the Patient Health Questionnaire (PHQ-9?and?PHQ-2) for depression in primary care: a diagnostic meta-analysis of 40 studies[J]. BJPsych Open, 2016,2(2):127-138.
[15] 王旭,孟宪东,余建英,罗珊霞.华西心情指数量表与病人健康问卷应用于护理人群抑郁筛查的信效度比较[J].成都医学院学报,2018,13(03):359-363.
[16] Smart OL, Tiruvadi VR, Mayberg HS. Multimodal approaches to define network oscillations in depression[J]. Biol Psychiatry,2015,77(12):1061-1670.
[17] Maguen S, Madden E, Cohen B, et al. Association of mental health problems with gastrointestinal disorders in Iraq an Afghanistan veterans[J]. Depress Anxiety, 2014,31(2):160-165.
[18]Gerrits MM, van Marwijk HW, van Oppen P, et al. Longitudinal association between pain, and depression and anxiety over four years[J]. J Psychosom Res, 2015,78(1):64-70.
[19] Levula A, Harre M, Wilson A. The association between social network factors with depression and anxiety at different life stages[J]. Community Ment Health J,2018,54(6):842-854.
[20] Rogers ML, Ringer FB, Joiner TE. The association between suicidal ideation and lifetime suicide attempts is strongest at low levels of depression[J]. Psychiatry Res,2018,270:324-328.
[21]王东博,华明蕊,潘悦达,等.北京市某三甲医院护士抑郁现状和影响因素分析[J].中国卫生统计,2018,35(02):225-227.
[22]汪萍. SARS治疗一线医护人员心理健康状况调查及危机干预模式构建的研究[D].西安:第四军医大学,2005:25.
[23] 贾玉枝,张蕾,杜超,等.首次参与H7N9禽流感救治护士照护体验的质性研究[J].解放军护理杂志,2019,36(03):47-50.
[24] 柏宁培,刘艳,况欢彧,等.成都市某三甲医院护士工作满意度与护理环境和工作压力的中介效应[J].预防医学情报杂志,2020,36(01):110-115.
[25] 徐明川,张悦.首批抗击新型冠状病毒感染肺炎的临床一线支援护士的心理状况调査[J].护理研究,2020,34(03):368-370.
[26]朱美玲.膀胱癌术后病人内在力量、家庭关怀与述情障碍的关系研究[D].延边:延边大学,2019:1-5.
[27] 武海环. 肾移植患者社会支持、家庭功能、心理一致感与生活质量的相关性研宄[D]济南:山东大学,2018:6.
[28] 曾海宽,赵久波,张小远.大一新生生命意义感在其家庭功能与自杀风险之间的中介效应[J].中国全科医学,2018,21(36):4521-4526.
[29] 李艳兰. 防御方式在大学生家庭功能与自杀意念间的中介作用［J］．现代预防医学，2013，40（10）：1888-1892.
[30] HAO JH，WU D，LIU L，et al． Association between work-family conflict and depressive symptoms among Chinese female nurses：The mediating and moderating role of psychological capital［J］． Int J Environ Res Public Health，2015，12（6）：6682－6699．
[31]Vicente B, Kohn R, Rioseco P, et al. DSM-III-R?disorders?in the Chile psychiatric?prevalence study[J]. Am J Psychiatry.?2006 ,163(8):1362-70.
[32] Lam LC,?Wong CS,?Wang MJ, et al. Prevalence, psychosocial correlates and service utilization?of depressive and anxiety disorders in Hong Kong: the Hong Kong Mental Morbidity Survey (HKMMS)[J]. Soc Psychiatry Psychiatr Epidemiol.?2015 Sep;50(9):1379-88.
[33] Pranjic N,?Bajraktarevic A,?Ramic E. DISTRESS AND PTSD IN PATIENTS WITH CANCER: COHORT STUDY?CASE[J]. Mater Sociomed.?2016,28(1):12-16.

快速检索引用检索图表检索高级检索