新型冠状病毒肺炎疫情下急诊科医护人员应激压力状况调查及应对措施探讨

Investigation on stress of emergency department medical staff under coronavirus disease 2019 epidemic and discussion on countermeasures

目的调查新型冠状病毒肺炎(简称新冠肺炎)疫情下急诊科医护人员的心理应激压力状况.方法2020年2月26日至3月1日,采用方便抽样法,通过网络发放问卷,对四川省达州市新冠肺炎疫情发生以来坚守在急诊工作岗位的医护人员进行心理应激压力调查,比较急诊医生与护士的应激感受量表-10(PSS-10)评分;根据性别、婚姻状况、学历及职称等对不同群体医护人员进行亚组分析,并分析急诊医护人员心理应激压力的来源.结果截至2020年3月1日24:00,共回收问卷160份,排除既往有焦虑、抑郁等心理疾病的调查者的问卷1份和填写时间不足180 s的问卷2份,有效问卷共计157份,有效率98.1%.在157名有效完成问卷的医护人员中,男性70名,女性87名;平均年龄(35.89±9.27)岁;医生80名,护士77名,医生与护士的性别、年龄、学历及婚姻状况差异均有统计学意义(均P<0.05).急诊医生和护士的PSS-10总分均较高,且医生组和护士组间PSS-10总分比较差异无统计学意义(分:16.98±5.73比17.56±6.43,P>0.05).对不同性别、婚姻状况、学历及职称的医护人员进行亚组分析,结果显示,不同性别、学历及职称医护人员间PSS-10总分差异均无统计学意义(均P>0.05);在不同学历人群中,本科以下医护人员PSS-10中应对能力知觉评分明显高于本科及以上者(分:9.24±2.43比8.26±2.72),差异有统计学意义(P<0.05);已婚者PSS-10中危机知觉评分、应对能力知觉评分及PSS-10总分均明显低于单身者〔危机知觉评分(分):8.13±5.10比10.13±4.39,应对能力知觉评分(分):8.35±2.75比9.58±2.05,PSS-10总分(分):16.48±6.90比19.71±5.38〕,差异均有统计学意义(均P<0.05).应激心理压力来源调查显示,有87.90%(138/157)的急诊医护人员不同程度地担心自己被感染,其中88.41%(122/138)的人员担心是由对病毒的未知、自我防护不到位引起;91.08%(143/157)的医护人员希望得到家人、配偶的关爱,96.82%(152/157)的医护人员需要获得心理培训及团队的支持.结论在新冠肺炎疫情下,急诊医护人员普遍存在较大的心理应激压力,尤其是单身的医护人员,因此需关注其心理压力状况,必要时及时干预.

Objective To investigate the psychological stress situation of emergency department medical staff under coronavirus disease 2019(COVID-19)epidemic.Methods During February 26 to March 1,2020,questionnaires were distributed online by convenient sampling method to investigate the psychological stress of medical staff who kept on working in the emergency department of Dazhou City,Sichuan Province since the outbreak of the epidemic,and compare the perception stress scale-10(PSS-10)scores of emergency doctors and nurses.According to gender,marital status,education background and professional title,the subgroup analyses of different groups of medical staff were carried out,and the sources of psychological stress of emergency medical staff were analyzed.Results By 24:00 on March 1,2020,160 questionnaires had been collected,excluding the questionnaires answered by research objects with previous anxiety,depression and other psychological diseases(1 paper)and the filling time of less than 180 seconds(2 papers).The total number of effective questionnaires was 157,with an effective rate of 98.1%,ineluding 70 males and 87 females,with an average age of(35.89±9.27)years old.Among them,there were 80 doctors and 77 nurses;their gender,age,educational level and marital status were significantly different between the doctors and nurses(all P<0.05).The total scores of PSS-10 of emergency physicians and nurses were all relatively high,and the difference between them had no significant difference(points:16.98±5.73 vs.17.56±6.43,P>0.05).Subgroup analyses were carried out on the medical staff with different gender,marital status,education background and professional title.The results showed that there were no significant differences in total scores of PSS-10 among the medical staff with different gender,marital status,educational background and professional title(all P>0.05).Among the people with different education background,the coping capability perception score of PSS-10 in medical staff below undergraduate level was significantly higher than that of the medical staff above undergraduate level(points:9.24±2.43 vs.8.26±2.72. P< 0.05). The scores of crisis perception, coping ability perception and total score of PSS-10 in marriedpeople were significantly lower than those in single people (crisis perception score: 8.13±5.10vs. 10.13±4.39. copingability perception score: 8.35±2.75 vs. 9.58±2.05. total score of PSS-10: 16.48 ±6.90 vs.19.71±5.38, all P < 0.05).According to the investigation on psychological stress sources, 87.90% (138/157) of emergency medical staff were worriedabout their infection to some extent, of whom 88.41% (122/138) were worried about the unknown virus and inadequateself-protection;there were 91.08% (143/157) of the staff hoping to get the love of their families and spouses, and 96.82%(152/157) of the staff hoping to get psychological training and team support. Conclusion Under the COVID-19epidemic, the emergency medical staff generally has a relatively great psychological stress, espeeially the single medicalstaff. Attention should be paid to their psychological stress situation and timely intervention be given when necessary.