器官捐献手术室护士心理健康及干预效果研究

Psychological health of nurses in operating room participating in organ donation and intervention effect

目的:了解器官捐献手术室护士心理健康状况并探讨干预效果。方法:选取2015年1月至2018年12月我院60名在职参与器官捐献手术的手术室护士,使用《症状自评(SCL-90)量表》和《死亡态度描绘(DAP-R)量表》调查其心理健康状况,并观察团体心理培训、积极心理干预、完善排班制度、经济支持等干预策略的效果。结果:干预前护士SCL-90量表的躯体化、人际关系敏感、抑郁、焦虑、恐怖、偏执、精神病性因子均分分别为(2.07±0.63)、(2.07±0.69)、(1.88±0.62)、(1.71±0.57)、(1.78±0.67)、(1.71±0.68)、(1.73±0.60)分,均高于中国常模(P<0.01);干预后分别为(1.64±0.60)、(1.46±0.57)、(1.53±0.62)、(1.48±0.60)、(1.28±0.50)、(1.45±0.56)、(1.43±0.52)分,均低于干预前(P<0.01)。干预前后护士DAP-R量表得分均趋向于死亡恐惧[16.7%(10/60)和6.7%(4/60)]和死亡接受[83.3%(50/60)和93.3%(56/60)]。干预后SCL-90量表得分≥160分的比例低于干预前,差异有统计学意义(χ^2=5.82,P<0.05)。结论:器官捐献手术室护士心理健康水平较低,干预后缓解和改善,能够用积极的心态看待死亡。

Objective To understand the effect of organ donation surgery on the mental health of nurses in operating room,and to explore the intervention effects.Methods From Jan.2015 to Dec.2018,60 operating room nurses in our hospital participating in organ donation surgery were selected for investigation of mental health,and were intervened by group psychological training,positive psychological intervention,improving shift arrangement system and financial support.The SCL-90 scale and DAP-R scale were used to evaluate before and after intervention.Results The mean scores of somatization,interpersonal sensitivity,depression,anxiety,terror,paranoia and psychoticism in SCL-90 scale of 60 operating room nurses were(2.07±0.63),(2.07±0.69),(1.88±0.62),(1.71±0.57),(1.78±0.67),(1.71±0.68),(1.73±0.60)before intervention respectively,which were significantly higher than the Chinese norm(P<0.01)and those[(1.64±0.60),(1.46±0.57),(1.53±0.62),(1.48±0.60),(1.28±0.50),(1.45±0.56),(1.43±0.52)]after intervention were lower than before(P<0.01).Before and after the intervention,the scores of DAP-R scale tended to be death fear dimension and acceptance dimension,the proportion of the death fear dimension was 16.7%(10/60)and 6.7%(4/60),respectively,and the approaching acceptance dimension was 83.3%(50/60)and 93.3%(56/60).The proportion of the nurses with scores of SCL-90 scale≥160 after the intervention was significantly lower than that before the intervention(χ^2=5.82,P<0.05).Conclusion The mental health of nurses in the operating room participating in organ donation surgery is lower;After intervention,the investigated nurses present improved mental health and positively emotional attitude towards death.