基于结构方程模型的抗击COVID-19护士社会支持、焦虑及抑郁关系研究

Study on the relationship among social support,anxiety and depression of nurses fighting against COVID-19 based on structural equation model

目的:调查抗击新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)护士社会支持、焦虑、抑郁现状,探讨三者之间的关系。方法:采用社会支持评定量表(the social support rating scale,SSRS)、广泛性焦虑自评量表(the generalized anxiety disorder,GAD-7)及患者健康问卷抑郁症状群量表(the patient health questionnaire,PHQ-9)对重庆市新型冠状病毒肺炎1所定点救治医院268名护士进行网络问卷调查。对护士社会支持、焦虑、抑郁现状及潜在影响因素进行分析,并以社会支持影响焦虑、焦虑影响抑郁为理论模型构建结构方程模型,并对三者的关系进行分析。结果:268名受访护士社会支持与焦虑和抑郁的测量值均呈负相关(R=-0.5872、-0.5925,P<0.001),焦虑和抑郁呈正相关(R=0.6337,P<0.0001)。护士焦虑在不同工龄、职称及是否有孩子的差异具有统计学意义(P<0.05);护士抑郁在不同婚姻状况、工龄、职称及是否有孩子的差异具有统计学意义(P<0.05)。结构方程模型拟合良好(GFI=0.90,AGFI=0.87,RMSEA=0.05)。结论:抗击COVID-19护士的社会支持与其焦虑、抑郁状况显著相关,社会支持对焦虑具有负向调节作用,焦虑对抑郁具有正向调节作用,医院管理者可从内部和外部提升护士的社会支持,从而减少其工作中的焦虑,保持良好健康状态。

Objective:To investigate the status of social support,anxiety,and depression among nurses fighting against COVID-19,and explore the relationship among the three aspects.Methods:A total of 268 nurses in a designated hospital for treatment of novel coronavirus pneumonia in Chongqing were investigated using the social support rating scale(SSRS),the generalized anxiety disorder(GAD-7)and the patient health questionnaire(PHQ-9)to conduct online surveys.The social support,anxiety,depression status and potential influencing factors of nurses were analyzed,and the social support influences anxiety and anxiety affects depression as theoretical models.A structural equation model was constructed and the relationship among the three was analyzed.Results:The social support of 268 interviewed nurses was negatively correlated with the measured values of anxiety and depression(R=-0.5872,-0.5925,P<0.001),and anxiety and depression were positively correlated(R=0.6337,P<0.0001).Nurse anxiety was significant in different working ages,job titles,and the condition whether they have children(P<0.05);nurse depression was significant in different marital statuses,working ages,job titles,and the condition whether they have children(P<0.05).The structural equation model fits well(GFI=0.90,AGFI=0.87,RMSEA=0.05).Conclusion:The social support of nurses is significantly related to their anxiety and depression.Social support has a negative regulating effect on anxiety and anxiety has a positive regulating effect on depression.Hospital managers can improve the social support of nurses from inside and outside,thereby reducing anxiety at work and maintaining good health of nurses.