私营口腔门诊医生职业紧张与抑郁、焦虑和睡眠的关系

Association between occupational stress of dentists in private dental clinics and their depression,anxiety and sleep

[目的]调查广州市私营口腔门诊医生的职业紧张状况及其与抑郁、焦虑和睡眠的相关性。[方法]选取195名口腔医生,采用医生工作压力量表(包括工作因素、患者因素、临床责任/判断因素等三个因素)评估其职业紧张状况,使用心理社交工具简介版本(BEPSI-K)评估其心理压力,通过主观问卷评估口腔科医生的心理健康状况,即抑郁评分(CES-D评分)、焦虑指数(STAI)和睡眠质量指数(PSQI);采用多元线性回归统计方法分析职业紧张、心理压力同心理健康的相关性。[结果]医生工作压力量表的平均分为(3.11±0.63)分。BEPSI-K、CES-D、STAI-S和PSQI量表评分异常率分别为52.3%、41.5%、13.3%、53.8%。CES-D与其心理压力、医生工作压力(患者因素和临床责任/判断因素)的相关性有统计学意义(P<0.01);STAI-S与其饮酒、心理压力、医生工作压力(患者因素和临床责任/判断因素)相关性有统计学意义(P<0.01);PSQI与其心理压力、医生工作压力(患者因素和临床责任/判断因素)的相关性有统计学意义(P<0.01)。[结论]广州市私营口腔医生职业紧张和心理压力问题较严重,压力主要取决于医患关系。两者可能会导致抑郁、焦虑及睡眠质量下降。建议重视对口腔医生的心理健康教育,以预防因工作压力而带来的心理疾患。

[Objective] To investigate the occupational stress of dentists in private dental clinics in Guangzhou City and its association with depression,anxiety and sleep. [Methods] A total of 195 dentists were studied and their occupational stress and psychological pressure were assessed by using a physician work stress scale（including work factors,patient factors,and clinical responsibility/judgment factors） and the PEPSI-K,respectively. The mental health status,including depression score（CES-D score）,anxiety index（STAI） and sleep quality index（PSQI）were assessed with a subjective questionnaire. Multiple regression methods were used to analyze the association of occupational stress,psychological stress and mental health. [Results] Their average score of physician work stress scale was（3.11 ± 0.63）. The abnormal rates of BEPSI-K,CES-D,STAI-S,and PSQI scales were 52.3%,41.5%,13.3%,and 53.8%,respectively. The CES-D was significantly associated with psychological pressure and physician work stress（patient factors and clinical responsibility/judgment factors）（P〈 0. 01）; STAI-S was significantly associated with alcohol consumption,psychological stress,and physician work stress（patient factors and clinical liability/judgment factors）（P〈 0. 01）; PSQI was significantly associated with psychological pressure and physician work stress（patient factors and clinical liability/judgment factors）（P〈 0. 01）. [Conclusion] The problem of occupational stress and psychological stress of dentists in private dental clinics in Guangzhou was serious,and the psychological stress resulted from worry about the doctor-patient relationship. Both occupational stress and psychological stress might cause depression,anxiety,and decreased sleep quality. The attention should be given to dentists in order to prevent mental disorders caused by work stress.