心理危机管理模式在急重症高风险科室医护人员中的应用  

Application of the psychological crisis intervention on the medical staff in acute and critical care departments

作　　者：王纯玲[1] 李俊凤 朱耘生 

机构地区：[1]河北医科大学第三医院骨伤科, 石家庄050051 [2]神经外科 [3]急诊科

出　　处：《中华现代护理杂志》2014年第10期1130-1133,共4页Chinese Journal of Modern Nursing

基　　金：河北省科技厅指导项目（20130155）

摘　　要：目的：探讨心理危机管理模式在急重症高风险科室医护人员中的应用效果，为维护急重症高风险科室医护人员的身心健康，提高其心理素质和应对能力提供指导。方法以提高社会支持、自助与他助相结合的心理危机管理模式，对急诊科、ICU、神经外科高风险科室96名医护人员应用心理危机干预技术进行为期6个月的心理干预。干预前后采用医务人员压力调查量表、症状自评量表（ SCL-90）、社会支持评定量表进行问卷调查，比较干预前后效果。结果压力调查结果显示，影响急诊科、ICU、神经外科医护人员身心健康的压力因素主要来源于工作、人际关系和学习，其中来自工作时间长、担心差错事故、医疗纠纷、医患纠纷中感到自身安全无保障的压力人数占100％。96名医护人员干预前社会支持总分（37．57±177;7．74）分，干预后（41．52±177;8．19）分，差异有统计学意义（ t＝3．434，P＜0．05）。干预后SCL-90因子分值降低，其中躯体化（1．97±177;0．51）、强迫（1．88±177;0．54）、人际敏感（1．83±177;0．55）、抑郁（1．72±177;0．61）、焦虑（1．69±177;0．49）、敌意（1．28±177;0．48）、恐怖（1．55±177;0．46）、偏执（1．50±177;0．56）、精神病性（1．30±177;0．41）分，与干预前比较差异均有统计学意义（ t 值分别为15．861，9．173，7．989，7．966，9．198，6．311，5．573，1．271，5．828；P＜0．05）；急重症高风险科室医护人员SCL-90各因子得分与院内其他科室及国内常模比较差异均有统计学意义（P＜0．05）。结论急重症高风险科室医护人员存在较严重心理健康问题。采用自助与他助相结合的心理危机管理模式，提高社会支持的利用度，对维护医务人员身心健康，提高心理素质及应对能力有显著作用。Objective To investigate the effect of application of the psychological crisis intervention on the medical staff in acute and critical care departments and to improve the physical and psychological health of medical staff .Methods The psychological crisis intervention of improving the social support and self -and-others assistance was applied on 96 medical staff who worked in the intensive care units （ ICU ） , emergency room （ ER） and the department of neurosurgery for 6 month.The Pressure Scale , the Social Support Rating Scale and the Symptom checklist 90 （SCL-90） were used for data collection.The effects before and after intervention were compared.Results The pressure scale results showed that the source of pressure were from work , interpersonal relationship and study , among which 100% investigators felt the pressure from long working hours , worries of mistakes , medical dispute and lack of security .The score of social support before intervention was （ 37 .57 ±177; 7.74）, which was significantly lower than （41.52 ±177;8.19） after the intervention （t=3.434, P＆lt;0.05）.The score of SCL-90 was lower after the intervention .The score of somatization , obsessive-compulsive , interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism were （1.97 ±177; 0.51）, （1.88 ±177;0.54）, （1.83 ±177;0.55）, （1.72 ±177;0.61）, （1.69 ±177;0.49）, （1.28 ±177;0.48）, （1.55 ±177;0.46）, （1.50 ±177;0.56） and （1.30 ±177;0.41）, respectively, the differences had statistical significances （t =15.861, 9.173, 7.989, 7.966, 9.198, 6.311, 5.573, 1.271, 5.828, respectively; P＆lt;0.05）.Compared with the medical staff in other departments , the medical staff in acute and critical care departments had a significantly lower score of SCL-90 （P＆lt;0.05）.Conclusions The study indicates that the medical staff in acute and critical＆amp;nbsp;care departments has mental problems .Using self-and-others assistance with the ps

关 键 词：医护人员 急重症科室 社会支持 压力 心理危机管理模式 

分 类 号：R472[医药卫生—护理学]