新型冠状病毒肺炎疫情下医务者压力及应对资源对应激症状的影响  

Effects of occupational stress and coping on posttraumatic stress symptoms among frontier health care workers during COVID-19 pandemic

作　　者：毛芳香 张烜 曹枫林[1] MAO Fangxiang;ZHANG Xuan;CAO Fenglin(School of Nursing and Rehabilitation in Shandong University,Jinan 250012,China)

机构地区：[1]山东大学护理与康复学院,济南250012

出　　处：《中国健康心理学杂志》2021年第7期1060-1066,共7页China Journal of Health Psychology

基　　金：山东大学新冠肺炎应急攻关科研专项(编号:21330082035101)。

摘　　要：目的:探讨新冠疫情下一线医务人员职业压力对创伤后应激症状的影响及内外部应对资源的调节作用。方法:采用台湾版改编的压力源、内部应对策略、外部应对支持问卷和中文版创伤后应激障碍自评量表,对707名武汉一线医务人员展开网络问卷调查。使用Pearson相关性检验,探究新冠疫情下一线医务人员职业压力与创伤后应激症状关系;使用调节效应模型,探究内外部应对资源对职业压力下创伤后应激症状的调节作用。结果:职业压力与创伤后应激症状总分及各个维度均呈显著正相关(r=0.499~0.592,P<0.001);内部回避应对调节职业压力与创伤后应激症状总分(△R^(2)=1.01%,P<0.001)、侵入症状(△R^(2)=0.8%,P=0.003<0.05)、回避症状(△R^(2)=1.3%,P<0.001)、认知和情绪负性改变症状(△R^(2)=2.27%,P<0.001)、过度唤醒症状间关系(△R^(2)=1.40%,P<0.001);外部支持可以调节职业压力与创伤后应激症状总分(△R^(2)=0.49%,P=0.026<0.05)、认知和情绪负性改变症状(△R^(2)=0.072%,P=0.01<0.05)、过度唤醒症状间关系(△R^(2)=0.59%,P=0.018<0.05)。结论:职业压力水平越高,一线医务人员创伤后应激症状水平越高;低水平的内部回避应对和高水平的外界支持可以缓冲职业压力对创伤后应激症状的影响。Objective:To investigate the effects of occupational stress on posttraumatic stress symptoms(PTSS)among frontier health care workers during COVID-19 pandemic and the moderating role of internal and external coping strategies between stress exposure and PTSS.Methods:Adapted Taiwan questionnaire comprising of 3 sub-scales(occupational stress,internal coping strategies and external coping support)and Chinese version of PTSD checklist for DSM-5(PCL-5)were employed among 707 frontier health care workers(HCWs).Pearson correlation test was used in examining the relationship between occupational stress and PTSS.The moderation analysis was used to the moderating role of internal and external coping strategies between occupation stress and PTSS.Results:The severity of occupational stress was positively associated with total scores and all sub-scales of PCL-5(r=0.499~0.592,P<0.001);Internal avoidant coping strategies could moderate the relationship between occupational stress and PTSS total scores(△R^(2)=1.01%,P<0.001),intrusion(△R^(2)=0.8%,P<0.05),avoidance(△R^(2)=1.3%,P<0.001),negative alterations in mood and cognitions(△R^(2)=2.27%,P<0.001),and alterations in reactivity and arousal(△R^(2)=0.59%,P<0.05);External support could moderate the relationship between occupational stress and PTSS total scores(△R^(2)=0.49%,P<0.05),negative alterations in mood and cognitions(△R^(2)=0.072%,P<0.05)and alterations in reactivity and arousal(△R^(2)=0.59%,P<0.05).Conclusion:Occupational stress is positively correlated with PTSS;low levels of internal avoidant coping strategies and high levels of external support could decrease the relationship between occupational stress and PTSS respectively.

关 键 词：职业压力 应对资源 调节模型 一线医务人员 创伤后应激症状 新型冠状病毒肺炎 

分 类 号：R395.9[哲学宗教—心理学]