公共卫生应急状态下临床护士心理应激水平及其影响因素

Psychological stress level of clinical nurses and its influencing factors in emergency state of public health

目的调查公共卫生应急状态下临床护士的心理应激水平及其影响因素。方法2020年2月,采用团体用心理社会应激调查表(PSSG)和简易应对方式量表(SCSQ),对全国各省份三级甲等医院527名医院临床护士进行调查,并探讨临床护士心理应激水平的相关影响因素。结果疫情期间,临床护士心理社会应激水平平均总得分为(33.69±20.46)分,各维度得分中,积极应对态度得分最高,其次为消极情绪体验、消极应对态度、积极情绪体验和生活事件得分。临床护士的积极应对方式得分为(1.99±0.80)分,高于全国常模,消极应对方式得分为(1.28±0.56)分,低于全国常模,差异均具有统计学意义(P<0.05)。多元线性回归分析结果显示:分别相比18~39岁、工龄>10年、来自其他医院、男性临床护士,40~59岁、工龄<10年、来自隔离医院、女性临床护士有更高的心理社会应激水平(β=0.052~0.353,P<0.05或0.01);无宗教信仰的临床护士心理社会应激水平较低(β=-0.170,P<0.01);越能采取积极应对方式的护士,其心理社会应激水平越低(β=-5.433,P<0.01),越采取消极应对方式的护士,其心理社会应激水平越高(β=5.623,P<0.01)。结论公共卫生应急状态下临床护士心理社会应激水平较高,但能采取积极对应方式缓解心理压力。心理社会应激水平受多种因素的影响。须密切关注临床护士特别是一线抗疫护士的心理应激状况,采取适当方法进行心理疏导,缓解心理压力。

Objective To investigate the psychological stress level and its influencing factors among clinical nurses while they were facing the epidemic of corona virus disease 2019(COVID-19)in emergency state of public health.Methods The Psychosocial Stress Survey for Groups(PSSG)and the Simplified Coping Style Questionnaire(SCSQ)were applied to investigate 527 clinical nurses in three top-level hospitals during epidemic of COVID-19 in February 2020.The related factors influencing the psychological stress level of these clinical nurses were explored.Results The psychological stress score(TS)of these clinical nurses was(33.69±20.46),and the score of positive coping was the highest,followed by negative emotion,negative coping,positive emotion and life events.The score of positive coping style of clinical nurses was(1.99±0.80),higher than the national norm in China,while the score of negative coping style was(1.28±0.56)and lower than the national norm(P<0.05).The results of multiple linear regression analysis showed that the nurses,aged with 40 to 59 years old(vs.18 to 39 years old),with employment time less than 10 years(vs.more than 10 years),working in the hospitals with isolation wards(vs.without isolation wards),being female(vs.male),had higher level of psychosocial stress(β=0.052-0.353,P<0.05 or 0.01).The clinical nurses without religious beliefs showed lower level of psychosocial stress(β=-0.170,P<0.01).The nurses who adopt more positive coping style showed lower level of psychosocial stress(β=-5.433,P<0.01).The nurses who adopt more negative coping style showed higher level of psychosocial stress(β=5.623,P<0.01).Conclusions Clinical nurses showed high level of psychosocial stress.However,they have adopt positive coping style to relieve psychological stress when facing the epidemic situation of novel coronavirus pneumonia in emergency state of public health.The level of psychosocial stress are affected by several factors.It is necessary to pay close attention to the psychological stress of clinical nurses,especially the first-line nurses.Appropriate measures should be applied for psychological counseling to ease the psychological stress.