医护人员血源性职业暴露心理健康状况及应对方式的相关性研究  

Psychological status and coping styles of medical staffs with occupational exposure to blood infectious diseases

作　　者：谷珊珊[1] 宫海燕[2] 何梅[1] 

机构地区：[1]第三军医大学西南医院临床心理科,重庆400038 [2]第三军医大学西南医院预防保健科,重庆400038

出　　处：《第三军医大学学报》2013年第21期2371-2374,共4页Journal of Third Military Medical University

基　　金：重庆市科技攻关计划项目(CSTC2012gg-yyjsB10001)~~

摘　　要：目的了解医务人员血源性职业暴露的心理健康状况、创伤后应激障碍发生率及与应对方式的相关性,探讨其有效的预防模式及心理干预对策。方法采用回顾性问卷调查方式,运用症状自评量表,PTSD自评量表及简易应对方式问卷,调查2011年6月至2012年11月213人血源性职业暴露的医务人员。结果医护人员血源性职业暴露后SCL-90总分、躯体化、人际关系敏感、抑郁、焦虑、恐怖因子分显著高于常模（P〈0.05）;PCL-C总分为14~58（32.69±10.73）分,3类症状再体验、回避、警觉的得分为（10.67±3.78）、（11.56±4.98）、（10.01±5.76）,PTSD阳性率为16.90%。积极应对方式显著高于常模（P〈0.05）。积极应对方式与SCL-90总分、焦虑、抑郁、敌对、偏执呈显著负相关（r分别为-0.138、-0.365、-0.201、-0.188、-0.235,P〈0.05）。消极应对方式与SCL-90总分、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性、PTSD总分、再体验、回避、警觉呈显著正相关（r分别为0.194、0.141、0.401、0.354、0.201、0.436、0.308、0.323、0.269、0.286、0.315、0.287,P〈0.05）。消极应对方式可以预测心理健康水平及PTSD的发生（Beta分别为0.186、0.152）。结论医护人员血源性职业暴露后心理健康状况不容乐观,PTSD的发生率较高,应给予正确指导和心理干预,采取更有效的应对方式。Objective To investigate the psychological status,incidence of post-traumatic stress disorder（PTSD）,and coping styles in medical staff who having occupational exposure to blood infectious diseases in order to explore effective modes of prevention and psychological intervention measures.Methods A total of 213 medical staffs with occupational exposure to blood infectious diseases during June 2011 to November2012 were inquired by questionnaires including self-report symptom checklist 90,PTSD,self-rating and questionnaire on copying styles.Results SCL-90 total score,somatization,interpersonal sensitivity,depression,anxiety,phobic were significantly higher in the medical staffs than the norm（P0.05）.The total score of PCL-C was 14 to 58 points（32.69±10.73）.And the sore of subscales re-experiencing the trauma,avoidance behaviors and hyper-arousal behaviors was 10.67±3.78,11.56±4.98 and 10.01±5.76 respectively,and the positive rate of PTSD was 16.90%.Active coping style was significantly higher than the norm（P0.05）.Positive coping styles had an obvious negative correlation with SCL-90 total score,anxiety,depression,hostility,paranoia（r=-0.138,-0.365,-0.201,-0.188,-0.235,P0.05）.Negative coping style had an obvious positive correlation with SCL-90 total score,interpersonal sensitivity,depression,anxiety,hostility,terror,paranoia,psychosis,total score of PTSD,subscales re-experiencing the trauma,avoidance behaviors and hyper-arousal behaviors（r=0.194,0.141,0.401,0.354,0.201,0.436,0.308,0.323,0.269,0.286,0.315,0.287,P0.05）.Negative coping style predicted the status of mental health and the incidence of PTSD（Beta=0.186,0.152）.Conclusion Mental health status of medical staffs with occupational exposure to blood infectious diseases is not optimistic,with higher incidence of PTSD.Right guidance and psychological intervention should be given to take a more effective coping styles.

关 键 词：医务人员 血源性 职业暴露 心理健康 应对方式 相关 

分 类 号：R135.99[医药卫生—劳动卫生] R192[医药卫生—公共卫生与预防医学]