广州市急诊护士遭受工作场所暴力后应激障碍发生状况及相关因素分析

Analysis on post- traumatic stress disorder and its relative factors of emergency department nurses after suffering from workplace violence

目的描述广州市5家三甲医院急诊科工作场所暴力发生的概况；调查急诊护士遭受工作场所暴力后应激障碍发生的情况；分析急诊护士遭受工作场所暴力后发生应激障碍的相关因素。方法采用自行设计的一般资料调查问卷、工作场所暴力问卷、创伤后应激障碍评定量表平民版（PCL-C）以及社会支持评定量表（SSRS）对广州市5家三甲医院急诊科143名护士进行问卷调查，并对调查结果进行分析。结果广州市急诊护士遭受工作场所暴力的总体发生率为86．7％；语言暴力是主要形式。急诊护士在遭受暴力后产生委屈、气愤、工作热情下降、精神无法集中以及转行等负性情绪，甚至个别有轻生念头。过去1年内曾经遭受暴力的急诊护士（遭受暴力组）的PCL-C得分明显高于过去1年内未遭受暴力的急诊护士（非暴力组），差异具有统计学意义。在过去1年内曾经遭受暴力的急诊护士中，21．8％出现了一定程度的创伤后应激障碍症状，12．1％出现了明显的创伤后应激障碍症状。伤害程度、客观支持以及对支持的利用度进入创伤后应激障碍的回归方程，解释变异度的42．4％。结论急诊护士正面临日益严峻的工作场所暴力情况；遭受工作场所暴力的急诊护士存在创伤后应激障碍；急诊护士遭受工作场所暴力后应激障碍的发生与伤害程度、客观支持以及对支持的利用度有关。

Objective To describe the general condition of workplace violence against emergency department nurses in five hospitals of Guangzhou;to investigate the status of the post-traumatic stress disor- der in the emergency department nurses after suffering from workplace violence;to analyze the relative fac- tors of post-traumatic stress disorder. Methods 143 emergency department nurses from 5 hospitals in Guangzhou were investigated by general information questionnaire,workplace violence questionnaire, PCL- C and SSRS. The investigation data were analyzed. Results 86.7% of emergency department nurses suf- fered from workplace violence during the past 1 year;the most popular style was non-physical violence. The emergency department nurses suffered from negative emotional experience, such as grievance, chagrin, low work passion, not focused spirit. The scores of PCL-C of emergency department nurses who had suffered from workplace violence were obviously higher than those who hadn＇t. 21.8% of the emergency department nurses who suffered from workplace violence in the past one year had certain degree of the signs of PTSD, 12.1% had obvious signs of PTSD. The influencing factors of PTSD： degree of hurt, objective support and availability of social support. Conclusions The situation of workplace violence which the emergency de- partment nurses were faced with was more and more grave. The emergency department nurses who had suf- fered from workplace violence were in different degree of PTSD. The more social supports the nurses get, the better mental health status they will possess.