支持性团体心理治疗缓解遭受暴力事件精神科护士心理创伤水平的作用

Effectiveness of supportive group psychotherapy on the psychological traumatic in the nurses who experienced a violence event caused by patients

目的评估支持性团体心理治疗对精神科护士遭受暴力攻击事件后心理创伤的作用。方法将58位经历暴力攻击的护士按随机数字表法分为心理治疗组与对照组，治疗组进行为期6周，每周1次90min的支持性团体心理治疗。在治疗前、治疗结束时、治疗结束后3个月时使用事件影响量表（ImpactofEventScale—Revised，IES—R）及简明心境量表（Profile of Mood States，POMS）评估疗效。结果治疗结束时1ES—R总减分值明显高于对照组[-5．00（3．89），-1．48（3．05），P〈0．01]，其中闯入性、回避性及高警觉性因子减分值也高于对照组[分别为：-1．53（1．46），-0．60（1．90），P〈0．05；-1．97（2．71），-0．18（1．76），P〈0．01；-1．50（2．60），-0．70（2．08），P〈0．01]。治疗结束时POMS总减分值高于对照组[-2．80（19．40），-0．41（14．05），P〈0．01]。紧张-焦虑，抑郁-沮丧因子减分值高于对照组[-1．85（3．64），0．37（3．40），P〈0．01；-1．10（6．52），0．13（4．30），P〈0．01]；在治疗结束3个月时上述因子减分值差异仍具有统计学意义。结论团体治疗能够缓解护士遭受暴力后的心理创伤，推荐使用此方式对遭受暴力攻击的护士进行心理干预。

Objective To evaluate the effectiveness of the supportive group therapy on the psychological traumatic in the nurses who experienced a violence event. Methods 58 nurses were enrolled in this study and randomly arranged to therapy group and control group. Ninety minutes group psychotherapy was used in the therapy group once weekly and last 6 weeks, and no any intervention method was used in the control group. For both groups, evaluations were conducted at three time points that was baseline, immediately after the completion of the intervention and 3 months after the completion of psychotherapy. Evaluations were conducted using the Impact of E- vent Scale-Revised （IES-R） and Profile of Mood States （POMS）. Results The reduction of the total scores of ISE-R and flashback factor, hyper-arousal factor, avoidance behavior factor in the therapy group were higher than those in control group （ - 5.00 （3.89） vs - 1.48 （ 3.05 ）, P 〈 0.01 ; - 1.53 （1.46） vs - 0.60 （ 1.90）, P 〈 0.05 ; - 1.97 （2.71 ） vs - 0.18 （ 1.76）, P 〈 0.01 ; - 1.50 （2.60） vs - 0.70 （ 2.08 ）, P 〈 0.01, respectively）. Both the reduction of total scores of PMOS and the tension-anxiety factor and depression-dejection factor scores on the POMS differed significantly between the two groups（ - 2.80 （ 19.40 ） vs - 0.41 （ 14.05 ）, P 〈 0.01 ; - 1.85 （ 3.64 ） vs 0.37（3.40）, P〈0.01 ; - 1.10（6.52） vs 0.13（4.30）, P〈0.01 ,respectively）. All these effects maintained 3 months after the psychotherapy completion. Conclusion The group psychotherapy can alleviate the psychological traumatic of nurses experienced violence events, and it can be used to protect the mental health of these nurses.