医务工作者职业暴露后心理应激状况的调查分析及预防措施  

Investigation on psychological stress of 477 medical workers after occupational exposure

作　　者：程涛 韩天勇 刘伯夫[1,2,3] 谷志寒 余海放 周亚雄[1,2,3] CHENG Tao;HAN Tianyong;LIU Bofu;GU Zhihan;YU Haifang;ZHOU Yaxiong(Emergency Department,West China Hospital,Sichuan University,Chengdu 610041,China;Laboratory of Emergency Medicine,West China Hospital,Sichuan University,Chengdu 610041,China;Disaster Medical Center,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院急诊科,四川成都610041 [2]四川大学华西医院急诊医学研究室,四川成都610041 [3]四川大学灾难医学中心,四川成都610041

出　　处：《西部医学》2023年第1期107-110,120,共5页Medical Journal of West China

基　　金：四川省科技厅重点研发项目(2021YFS0023);四川省卫生厅科学基金项目(S15065);成都市科技局重点研发支撑计划技术创新研发项目(2020-YF05-00074-SN);北京医卫健康公益基金会项目(2020YFS0009)。

摘　　要：目的调查分析医务工作者职业暴露后的心理应激情况,早期预防心理应激障碍的发生,并为后续必要的心理危机干预提供依据。方法本研究为前瞻性调查研究,通过对本院2018年11月~2020年10月发生职业暴露的医务工作人员进行网络问卷调查,比较不同性别、学历、岗位、暴露方式及防护情况等人员的(PTSD-SS)评分,进而了解不同医务工作人员职业暴露后的心理应激情况。结果全院共计发生职业暴露447例,男性177例(39.60%),女性270例(60.40%),平均年龄(28.54±7.05)岁,平均工龄(5.06±5.62)年;根据不同职业分类,其中医生286例(63.98%)、护士140例(31.32%),医院行政后勤工作人员21例(4.70%)。447例暴露者的PTSD-SS总分平均为(47.72±21.68)分,其中最高分120分,最低24分,除不同暴露方式(针刺暴露vs黏膜暴露)的暴露者间PTSD-SS评分差异有统计学意义外,其他不同性别、学历、暴露源知晓情况和标准防护与否等各亚组总分差异均无统计学意义(P>0.05)。结论医务人员发生职业暴露后,均可能出现不同程度的心理应激障碍,尤其是发生黏膜暴露者出现心理应激障碍程度可能更重,应该引起足够的重视,做到早预防,早发现,早引导,早干预,避免发生严重心身损害。Objective To investigate the psychological stress of medical workers after occupational exposure.Methods This was a prospective study.Through online questionnaire survey on medical staff with occupational exposure in a tertiary hospital in Sichuan Province from November 1,2018 to October 31,2020,PTSD-SS score of different gender,education background,post,exposure mode and protection situation were compared,so as to understand the psychological trauma stress of different medical staff after occupational exposure.Results During the period from November 1,2018 to October 31,2020,a total of 447 cases of occupational exposure occurred in our hospital,including 177 males(39.60%)and 270 females(60.40%),with an average age of(28.54±7.05)years and an average length of service of(5.06±5.62)years.According to the classification of different occupations,there were 286 doctors(63.98%),140 nurses(31.32%)and 21 administrative and logistic staff(4.70%).The highest PTSD-SS score was 120,the lowest was 24,and the average PTSD-SS score was(47.72±21.68).The average total PTSD-SS score of 447 exposed persons was(47.72±21.68),of which the highest score was 120 and the lowest score was 24.Except that there were significant differences in PTSD-SS scores among exposed persons with different exposure modes(acupuncture exposure vs.mucosal exposure),there were no significant differences in the total scores of other subgroups such as gender,education background,awareness of exposure sources and standard protection(P>0.05).Conclusion After occupational exposure,medical personnel may have psychological stress disorders of different severity,especially those with mucosal exposure.We should pay enough attention to early prevention,early detection,early guidance and intervention to avoid serious psychosomatic damage.

关 键 词：职业暴露 医务工作者 心理应激 PTSD-SS 

分 类 号：R511[医药卫生—内科学] R519.9[医药卫生—临床医学]