个性化干预对手术室医护人员血源性职业暴露后应激反应的影响

Effects of individualized intervention on stress response after blood-borne occupational exposure in operating room

目的探讨个性化干预对手术室医护人员血源性职业暴露后应激反应的影响。方法2017年1月-2018年10月我院手术室医护人员发生血源性职业暴露者76例,随机分为对照组和观察组,每组各38例。对照组给予常规干预,观察组在对照组基础上给予个性化干预。干预3个月,比较两组焦虑自评量表(SAS)、抑郁自评量表(SDS)、生活质量(SF-36)、创伤后应激障碍量表(PCL-5)、压力知觉量表(PSS-4)评分。结果干预后观察组SAS和SDS评分为(46.3±3.1)和(42.9±4.1)分,明显低于对照组[(53.4±4.2)和(51.6±3.9)分],差异有统计学意义(P<0.05)。观察组SF-36各项指标(包括心理职能、生命活力、生活功能、情感职能、躯体功能、社会功能、精神健康和总体健康)评分分别为(24.1±1.2)、(16.8±1.4)、(21.0±2.3)、(16.9±2.4)、(16.9±2.4)、(11.3±2.7)、(25.1±2.6)、(22.9±2.4)和(63.2±4.9)分,均高于对照组的[(17.6±2.1)、(12.3±1.2)、(17.3±1.9)、(12.3±1.9)、(7.2±1.6)、(20.8±1.9)、(17.3±2.9)和(51.3±5.7)分],差异有统计学意义(P<0.05)。干预后观察组PSS-4和PCL-5评分为(23.4±3.7)和(28.7±2.0)分,明显低于对照组[(30.4±5.6)和(39.1±3.6)分],差异有统计学意义(P<0.05)。结论手术室医护人员发生血源性职业暴露者给予个性化干预,能有效降低负性情绪及应激反应,减轻心理负担。

Objective To explore the effects of individualized intervention on stress response after bloodborne occupational exposure in operating room.Methods 76nurses,who had blood-borne occupational exposure in a hospital from January 2017to October 2018,were randomly divided into control group and observation group,and 38cases in each group.The control group received routine intervention and the observation group received personalized intervention on the basis of the control group.After 3months of the intervention,the scores of anxiety self-rating scale(SAS),depression self-rating scale(SDS),quality of life(SF-36),post-traumatic stress disorder scale(PCL-5)and stress perception scale(PSS-4)in the two groups were compared.Results After intervention,SAS score(46.3±3.1)and SDS score(42.9±4.1)in the observation group were significantly lower than those in the control group(53.4±4.2)and(51.6±3.9),with statistically significant differences(P<0.05).SF-36scores of all indicators(including psychological function,vitality,life function,emotional function,physical function,social function,mental health and overall health)in the observation group were higher than those in the control group[in order:(24.1±1.2)vs(17.6±2.1),(16.8±1.4)vs(12.3±1.2),(21.0±2.3)vs(17.3±1.9),(11.9±2.4)vs(12.3±1.9),(25.1±2.6)vs(20.8±1.9),(22.9±2.4)vs(17.3±2.9),(63.2±4.9)vs(51.3±5.7)].The difference was statistically significant(P<0.05).After intervention,PSS-4score(23.4±3.7)and PCL-5score(28.7±2.0)in the observation group were significantly lower than those in the control group(30.4±5.6)and(39.1±3.6),with statistically significant differences(P<0.05).Conclusions Personalized intervention for medical staff with blood-borne occupational exposure in operating room can effectively reduce negative emotions and stress response and reduce psychological burden.