护理学员在严重急性呼吸系统综合征流行期间心理应激与心理健康状况调查(英文)

An investigation of response to SARS stress and mental health of nurse students during SARS prevalent period

背景:严重急性呼吸系统综合征(简称SARS)作为一种急性应激源,使不少人出现恐慌、心理反应过敏等症状,也有部分护理学生担心被感染,害怕到临床科室实习,情绪烦躁,影响了护理学生的临床实习工作和身心健康。目的:通过对护理学生应激反应和焦虑症状的调查,以了解护理学生在SARS流行期间心理应激反应程度和焦虑水平。设计:以进入临床实习和见习的护理学生为观察对象的横断面调查。单位:四川大学华西医院精神科。对象:于2003-05选择四川大学华西医院护理学院2～4年级进入临床实习和见习的护理系学生为观察对象,所有调查对象均无精神疾病病史或其他严重疾病,并自愿接受调查。发出问卷305份,回收到有效问卷299份。其中大专生171名(47.2%),本科生128名(42.8%),年龄18～32岁,平均21.51岁,男生占4.6%,女生占93.4%。方法:采用危机反应问卷从认知、情感和行为三方面调查学生对SARS危机的反应程度,反应等级从1～10。该问卷总分范围为3～30分,3分为无损害,3～9分为损害很轻,9～15分为轻度损害,15～21分中度损害,21～27分显著损害,大于27分为严重损害。采用焦虑自评量表评定各项目所定义的症状在所调查学生中出现的频度,包含20个项目,分为4级评分,1表示没有或很少时间有,2表示小部分时间有,3表示相当多时间有,4表示绝大部分或全部时间都有。两问卷都仅调查学生最近一周的实际情况。问卷由学生当场独立填写,填完整后立即回收。主要观察指标:护理学生在行为、情绪和认知上对SARS危机的反应程度和焦虑水平。结果:发出305份,回收有效问卷各299份,回收率为98%。①危机反应程度:在认知、情绪和行为三方面,有21.7%的护理学生无损害,有56.8%的学生损害很轻,有13.8%的学生显示出轻度损害,有5.4%的学生存在中度损害,有1.7%的学生有显著损害,只有0.7%的学生有严重损害。本科护理学生对SARS危机的反应在认知、情感和行为的得分及危机反应总分明显高于大专护理学生(P<0.05)。②焦虑水平:护理学生的焦虑自评结果总分高于全国常模[(39.89±11.98,29.78±0.46),(P<0.05)],其中高于常模水平人数占82.3%。大专与本科护理学生的焦虑自评结果无显著性差异。③危机反应与焦虑水平的关系:护理学生应激反应程度与焦虑水平的关系分析结果显示,二者具有相关性(r=0.685,P<0.01)。结论:面对SARS危机的应激反应,护理学生在认知、情感和行为上存在一定程度的损害,焦虑水平高于全国常模,心理应激反应程度与焦虑水平呈正相关关系。

BACKGROUND： SARS, as a kind of sudden stress source, make quite a few people present symptoms such as panic emotion, psychological allergic reaction, etc. There are also partial nurse students who worry about to be infected, fear to practice in clinical departments and live in an irritable mood, which interferes their clinical practice and affects both body and mind health.OBJECTIVE： Through the investigation of the nurse students＇ stress response and anxiety symptom to understand their psychological stress response scale and anxiety level during the prevailing period of SARS.DESIGN： An intersectional investigation with the nurse students doing clinical practice or probation apprentice as observative objects.SETTING： Department of Psychiatry, West China Hospital, Sichuan Univesity PARTICIPANTS： In May 2003, the nurse students of 2-4 grade doing clinical practice and probation in West China Nursing College of Sichuan University were selected as observative objects, all of whom had no record of mental illness or other severe disease, and volunteered to receive the investigation. 305 questionnaires were sent out and 299 valid questionnaires were taken back. They were 171 junior college students （47.2%） and 128undergraduates （42.8%） of 18-32 years old, average 21.51,and boy students held 4.6% while girl students 93.4%.METHODS： The crisis response questionnaire was used to investigate the nurse students＇ response scale to SARS crisis from three aspects such as cognition, emotion and behavior. The response grade is from 1 to 10.The total score scale is 3-30. 3 means no impairment, 3-9 means is a little impairment, 9-15 means slight impairment, 15-21 means moderate, 21-27 means significant, and more than 27 means severe. The self-rating anxiety scale （SAS） compiled by Zung in 1971 was mainly used to assess the frequency of the appearance of the symptoms defined in each item in the students being investigated, including 20 items and score in 4 grades： 1 indicates never （appear） or in a little time,2 indicates in a small part of time,3indicates in a large part of time,4 indicates almost in the whole or in the whole time. Only the matter of fact in the recent week was investigated in the above two questionnaires. The students were required to fill in the questionnaires separately on the spot, and the questionnaires were handed in as soon as they were filled out.MAIN OUTCOME MEASURES： The nurse students＇ response scale and anxiety level to SARS crisis on cognition, emotion and behavior.RESULTS： 305 questionnaires were sent out and 299 were taken back,with a back rate of 98%. ①Crisis response scale： in the three aspects of cognition, emotion and behavior of the nurse students, 21.7% of them had no impairment,56.8% had a little impairment, 13.8% had slight impairment,5.4% had moderate impairment ,1.7% had significant impairment and only 0.7% had severe impairment. The score of the undergraduates on their cognition, emotion and behavior and the total score of crisis response were obviously higher than those of the junior college students （P ＜ 0.05）.②Anxiety level： the nurse students＇ self-assessed result was that the total score was higher than that of the average normal Chinese [（39.89±11.98,29.78±0.46）,（P＜0.05）],the number of them with score higher than normal level made up 82.3% and there was no significant difference in scores on SAS between junior college students and undergraduates. ③Relation between crisis response and anxiety level： the analytic result of the relation between the stress response scale and anxiety level indicated that they had relativity （r=0.685 ,P ＜0.01）.CONCLUSION： Facing the stress response to SARS crisis, the nurse students are impaired to some extent on their cognition, emotion and behavior.Their anxiety level are higher than that of the average normal Chinese and their psychological stress response scale has positive correlation with the anxiety level.