新型冠状病毒肺炎疫情背景下护士的心理应激研究

Psychological stress of nurses under the backgroud of corona virus disease-19 epidemic

目的调查新型冠状病毒肺炎(COVID-19)疫情造成的急性应激状况下护士的心理健康问题和康复过程。方法研究调查COVID-19疫情期间工作于武汉隔离病房的护士(北京医疗队2020年支援武汉协和医院西院的护士)、首都医科大学附属北京安贞医院呼吸科和非呼吸科的护士焦虑、抑郁、失眠状况。使用焦虑自评量表(SAS)、抑郁自评量表(SDS)和匹兹堡睡眠质量指数(PSQI)量表,采用面对面或者电话问卷的随访方式,动态记录2020年1、3、12月护士的心理健康状况,分析护士焦虑或抑郁情绪的相关因素和心理健康状况的动态变化。结果研究共纳入60名护士,年龄(34±6)岁,工作年限(13±6)年。武汉隔离病房工作的护士发生中度焦虑和明显抑郁的比例分别为5.0%(1/20)和10.0%(2/20)。年龄<35岁的护士在2020年3月发生失眠的风险低于年龄≥35岁的护士(P=0.005),工作年限<13年的护士在2020年1、3月发生失眠的风险低于工作时间≥13年的护士(P=0.048、0.015)。在疫情高峰期(2020年3月),相关性分析结果显示年龄(R2=0.150,P=0.002)和工作年限(R2=0.140,P=0.004)均与PSQI量表评分呈正相关。动态随访发现,武汉隔离病房的护士在2020年12月SAS评分、PSQI量表评分较1月份显著下降[(39±6)分比(45±10)分、(6.4±2.5)分比(9.8±5.7)分](均P<0.05)。疫情高峰期(2020年3月)武汉隔离病房护士PSQI评分显著高于北京安贞医院呼吸科和非呼吸科的护士,差异均有统计学意义(均P<0.05)。北京地区工作的护士心理量表评分没有显著动态变化(均P>0.05)。结论COVID-19疫情期间武汉隔离病房的护士发生焦虑和抑郁风险显著高于其他岗位工作的护士;年轻护士睡眠状况相对较好。经过心理干预后,护士的焦虑或抑郁情绪于1年时间内基本康复。

Objective To investigate the psychological health problems and rehabilitation process of nurses under acute stress condition caused by corona virus disease-19(COVID-19).Methods Nurses working during COVID-19 epidemic period in isolation wards in Wuhan(who supported Wuhan Union Hospital Xi Yuan from Beijing medical group in 2020),and department of respiratory and department of non-respiratory in Beijing Anzhen Hospital,Capital Medical University were investigated to determine the severity of anxiety,depression and insomnia.By using self-rating anxiety scale(SAS),self-rating depression scale(SDS)and Pittsburgh sleep quality index(PSQI)scale,nurses’psychological health status in January,March and December 2020 were dynamically recorded via face-to-face interview or phone questionnaire.Factors associated with anxiety and depression and the dynamic changes of psychological health status of nurses were analyzed.Results A total of 60 nurses were enrolled,mean age of(34±6)years and mean working seniority of(13±6)years.The rates of moderate anxiety and obrionsly depression of nurses working in isolation wards in Wuhan were 5.0%(1/20)and 10.0%(2/20),respectively.The risk of insomnia in nurses aged<35 years was lower than those aged≥35 years in March 2020(P=0.005).The risks of insomnia in nurses working seniority<13 years were lower than those working seniority≥13 years in January and March 2020(P=0.048,0.015).At the peak period of epidemic(March 2020),age(R2=0.150,P=0.002)and working seniority(R2=0.140,P=0.004)were postively correlated with PSQI scale score.Dynamic follow-up showed that SAS and PSQI scale scores of nurses working in isolation wards in Wuhan in December 2020 were significantly lower than that in January[(39±6)vs(45±10),(6.4±2.5)vs(9.8±5.7)](both P<0.05).In peak period of epidemic(March 2020),the PSQI scale score of nurses working in isolation wards in Wuhan was significantly higher than that of nurses in department of respiratory and department of non-respiratory in Beijing Anzhen Hospital(both P<0.05).There was no significant dynamic change in the psychological scale score of nurses working in Beijing(all P>0.05).Conclusions Nurses working in isolation wards in Wuhan under the background of COVID-19 epidemic have higher risk for anxiety and depression than those working in other positions.Young nurses present with better sleep quality.After psychological intervention,the anxiety or depression of nurses basically recovered within 1 year.