影响重症监护病房清醒患者心理状况的压力源分析

Stressors and nursing strategies affecting mental state of conscious patients in intensive care unit

目的研究重症监护病房(ICU)环境中影响意识清醒患者心理状态的压力源,分析其影响因素。方法临床纳入该院2015年5月‐2017年5月ICU收治的198例患者作为研究对象。收集患者一般资料,采用中文版知觉压力(CPSS)量表测试患者心理压力情况,对有压力和无压力的患者进行资料对比,差异项带入Logistic回归方程中计算,分析ICU环境中影响意识清醒患者心理的主要压力源,探讨其影响因素。结果 198例ICU意识清醒患者调查结果显示,心理有压力患者59例,占29.80%;心理无压力者139例,占70.20%。ICU意识清醒有压力和无压力患者在性别、年龄、文化程度、职业、婚姻状况、转入ICU前科室、高血压、糖尿病、血脂异常、机械通气、ICU住院时间、健康程度、焦虑以及抑郁等方面差异均有统计学意义(χ~2=10.708,23.497,26.150,13.048,16.998,12.063,34.557,15.962,5.238,14.073,4.068,17.856,23.128,7.566,P<0.05)。将上述有差异资料带入Logistic回归方程进行计算,结果发现,性别、年龄、文化程度、职业、婚姻状况、转入ICU前科室、高血压、糖尿病、血脂异常、机械通气、ICU住院时间、健康程度、焦虑以及抑郁均是ICU环境中意识清醒患者心理压力的影响因素。结论 ICU患者意识清醒后出现心理压力较为常见,影响患者心理压力的影响因素较多,根据患者自身情况针对性实施干预措施,可有效缓解ICU意识清醒患者的心理压力,减少压力源,保障患者的心理健康,促进患者预后情况。

【Objective】To study the stressors affecting the mental state of conscious patients in the intensive care unit（ICU） environment and analyze the influencing factors.【Methods】A total of 198 patients admitted to ICU in our hospital from May 2015 to May 2017 were included in the study. The general information of patients were collected, Chinese version of Perceived Stress Scale（CPSS） was used to test the patient＇s psychological stress, the data of the patients with stress or without stress were compared, the difference was plug into the Logistic regression equation, the main stressors affecting the mental health of conscious patients in the ICU environment were analyzed and the influencing factors were discussed.【Results】The results of 198 cases of ICU conscious patients showed that 59 cases of psychological stress patients accounted for 29.80%; there were 139 cases without psychological stress, which accounted for 70.20%. In conscious patients with or without pressure in ICU, the gender, age, education, occupation, marital status, previous departments before transferring to ICU, hypertension and diabetes, dyslipidemia, mechanical ventilation, ICU stay, health, anxiety and depression had obvious difference（ χ^2=10.708, 23.497, 26.150, 13.048, 16.998, 12.063, 34.557, 15.962, 5.238, 14.073, 4.068, 17.856, 23.128, 7.566, P 0.05）. The computed results of the Logistic regression equation showed that gender, age, education, occupation, marital status, previous departments before transferring to ICU, hypertension and diabetes, dyslipidemia, mechanical ventilation, ICU stay, health, anxiety and depression were all influencing factors of the psychological pressure of conscious patients in ICU environment.【Conclusion】Psychological pressure is more common in ICU patients after regaining consciousness, there are many factors affecting the psychological pressure of patients, the implementation of targeted interventions according to the patient＇s own situation can effectively alleviate the psychological pressure of ICU conscious patients, reduce the pressure source, protect the patient＇s mental health, and promote the prognosis of the patients.