新型冠状病毒肺炎隔离病房护士与普通护士心理状态差异及影响因素分析

Analysis on the difference and influencing factors of mental state between nurses in isolation ward of coronavirus disease 2019 and nurses in general wards

目的比较在新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)隔离病房工作的护士与在普通门诊或病房工作的护士之间的心理健康状况差异,为开展更具针对性的护理人员心理健康促进工作,提高疫情期间各类护理人员的心理健康水平提供科学参考。方法运用方便取样及在线问卷答题方式,通过健康问卷抑郁症状群量表(PHQ9)、广泛性焦虑量表(GAD7)、失眠严重程度指数量表(ISI)和心理健康自评问卷(SRQ20)四个量表分别对某三甲医院COVID-19隔离病房护士及普通病房或门诊护士的抑郁、焦虑情绪及失眠和应激反应水平进行评估,比较不同工作环境下护士群体的上述心理健康指标之间差异。结果COVID-19隔离病房护士的焦虑[2.0(0.0~5.0)vs 4.0(2.0~7.0)]、抑郁[4.0(1.0~6.0)vs 6.0(2.5~10.0)]及应激反应水平[2.0(1.0~5.0)vs 5.0(2.0~9.3)]均显著低于普通病房或门诊护士(P均<0.05),主要表现为隔离病房护士在中重度焦虑(1.01%vs 14.15%)、抑郁(8.08%vs 25.47%)及应激反应(10.10%vs 33.96%)的发生率显著低于普通病房或门诊护士(χ^(2)分别为9.049、12.285和16.747,P均<0.001)。主动报名参加抗疫一线但未成行的护士的心理健康水平介于两组之间,中重度焦虑(5.26%vs 14.15%)的发生率显著低于普通病房或门诊护士(χ^(2)=15.779,P<0.001)。对自身健康状态的评价及对疫情的担忧会影响护士的焦虑、抑郁及应激反应水平。结论COVID-19隔离病房护士具有较好的心理健康水平,自愿参与抗疫一线工作未对护理人员的心理健康带来明显的不利影响。

Objective To provide more scientific data for mental health promotion for nurses working in coronavirus disease 2019(COVID-19)isolation wards by comparing the mental health status between the nurses working in COVID-19 isolation wards and those from general inpatient wards or outpatient wards.Methods Four self-report scales of PHQ9,GAD7,ISI and SRQ20 were used to assess the depression,anxiety,insomnia and stress response levels of nurses from one third class general hospital,who working in COVID-19 isolation wards or general inpatient,outpatient wards.All the psychological tests were finished through online questionnaire answering with a convenient sampling method.Composite scores of the four scales were compared between nurses from COVID-19 isolation wards and those from general inpatient or outpatient wards.Results The nurses working in COVID-19 isolation wards had significantly lower level of M(P25-P75)of anxiety[2.0(0.0-5.0)vs 4.0(2.0-7.0)],depression[4.0(1.0-6.0)vs 6.0(2.5-10.0)]and stress response[2.0(1.0-5.0)vs 5.0(2.0-9.3)]than the nurses working in general inpatient wards or outpatient wards(P<0.01).The nurses working in COVD-19 isolation wards had a significantly lower prevalence of moderate to severe anxiety(1.01%vs 14.15%),depression(8.08%vs 25.47%)and stress response(10.10%vs 33.96%)than that in general wards or outpatient nurses(χ^(2)=9.049,12.285,16.747,P<0.001 for all).The mental health level of the nurses who took the initiative to participate in the first-line of fight against the epidemic but did not make it was between the two groups,with a significantly lower prevalence of moderate to severe anxiety(5.26%vs 14.15%)than the general wards or outpatient nurses(χ^(2)=15.779,P<0.001).The evaluation of their own health status and the worry about the epidemic influenced the nurses’level of anxiety,depression and stress response.Conclusions The nurses in COVID-19 isolation ward have a relative well mental health status.Voluntary participation in first-line work against the epidemic did not have significant negative impact on mental health of nursing staff.