住院患者情绪问题评估的护患一致性研究  

The patient-nurse concordance on the recognition of emotional problems in inpatients

作　　者：余建英[1] 董再全[1] 罗珊霞[1] 刘阳[1] 王建[1] 黄明金[1] 陈靓[1] 郭万军[1] 陈然[1] 王瑜[1] 张岚[1] YU Jian-ying;DONG Zai-quan;LUO Shan-xia;LIU Yang;WANG Jian;HUANG Ming-jin;CHEN Liang;GUO Wan-jun;CHEN Ran;WANG Yu;ZHANG Lan(Mental Health Center,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院心理卫生中心,四川成都610041

出　　处：《实用医院临床杂志》2019年第3期210-213,共4页Practical Journal of Clinical Medicine

摘　　要：调查综合医院住院患者与护理人员对患者情绪问题评估的一致性,并找出相关社会人口学影响因素。方法按照纳入、排除标准,随机选择四川大学华西医院一天的10个科室全部住院患者及其主管护士为研究对象,进行问卷调查。调查内容包括患者和护理人员的社会人口学资料,9条目患者健康问卷(PHQ-9),广泛性焦虑筛查量表(GAD-7),15条目患者健康问卷(PHQ-15),健康焦虑量表(Whiteley-7),以及护理人员对患者情绪问题的判定。结果对比患者的量表自评结果和其主管护士对患者情绪问题的判定,护士正确识别出了52. 5%存在严重情绪问题的患者和62. 09%不存在情绪问题的患者。护士对患者情绪状态判断的总体正确率为56. 96%,护患一致性低(κ=0. 144)。结论针对住院患者的情绪问题,护理人员判定结果和患者自评情绪量表结果存在显著差异,护患一致性低。暂未发现与此种差异相关的社会人口学影响因素。Objective To investigate the recognition concordance between inpatients and nurses on patients’ emotional problems in general hospitals in China and to find out the main socio-demographic influencing factors of the concordance. Methods A cross-section study was performed on one randomly selected day.All the inpatients of the selected departments in the West China Hospital were selected as the potential subjects and recruited by inclusive criteria.A questionnaire survey including socio-demographic data of patients and nurses,Patient Health Questionnaire-9,Generalized Anxiety Disorder 7-Item scale,Patient Health Questionnaire 15-Item,Whiteley-7,and questions concerning the awareness of psychological or emotional problems of nurses.Results Based on the results of patients’ self-rating scales and determination of emotional problems of patients by the supervisor nurse,nurses successfully identified52. 5% patients with emotional problems and 62. 09% patients without emotional problems. In total,the nurses correctly recognized56. 96% patients’ emotional status.The concordance between patients’ ratings and nurses’ recognition was low( κ = 0. 144).Conclusion A significant difference was found between nurses’ detection and patients’ self-rated emotional problems. The patient-nurse concordance on emotional problems was low.The nurse plays an important role in the detection and management of emotional problems.

关 键 词：焦虑 抑郁 护理人员 患者 情绪问题 

分 类 号：R473.5[医药卫生—护理学] R749.72[医药卫生—临床医学]