新型冠状病毒肺炎疫情期集中医学隔离观察点社区医务人员同情疲劳状况及影响因素研究

Compassion fatigue of medical staff working in centralized quarantine sites and its influencing factors during COVID-19 epidemic

目的探讨新型冠状病毒肺炎(新冠肺炎)疫情期间集中医学隔离观察点社区医务人员同情疲劳状况及影响因素,为医务人员心理健康干预工作提供依据。方法2020年9—10月,采用横断面研究方法,用自行设计的一般资料问卷、职业生命质量量表、一般自我效能感量表、领悟社会支持量表,通过问卷调查方式对上海2个区、13个社区卫生服务中心参与集中隔离观察点工作的213名医务人员开展调查,比较不同人口学特征、一般自我效能感、领悟社会支持状态的医务人员的同情疲劳程度,并分析其影响因素。结果同情疲劳的3个维度中,213名医务人员同情满意得分为33.00(28.25,37.75)分,超临界值者141人(66.20%);职业倦怠得分为26.00(21.50,30.50)分,超临界值者96人(45.07%);继发性创伤应激得分为25.00(20.50,29.50)分,超临界值者192人(90.14%)。多因素logistic回归分析显示,与0 h者相比,污染区工作日均时长>8 h者的同情疲劳程度较高(OR=7.787,95%CI:1.127~53.820,P<0.05);与工作较满意者相比,较不满意者的同情疲劳程度较高(OR=6.209,95%CI:1.474~26.157,P<0.05);与压力一般及较小者相比,压力较大者的同情疲劳程度较高(OR=2.567,95%CI:1.228~5.366,P<0.05);与自信心很高者相比,自信心偏低、自信心较高者的同情疲劳程度均较高(OR=13.519,95%CI:3.394~53.848;OR=3.462,95%CI:1.038~11.548;均P<0.05);与领悟社会支持感高者相比,领悟社会支持感低者的同情疲劳程度较高(OR=2.071,95%CI:1.027~4.175,P<0.05)。结论集中医学隔离观察点医务人员同情疲劳状况待改善,应重点关注污染区日均工作时长较长、工作满意度较低、工作压力较大、一般自我效能感较差、领悟社会支持较差者的同情疲劳状况,及时干预。

Objective To investigate the compassion fatigue of medical staff working in centralized quarantine sites and its influencing factors during the COVID-19 epidemic.Methods From September 2020 to October 2020,a cross-sectional study was conducted on 213 medical staff working in 13 quarantine centers in two districts of Shanghai.A self-made general information questionnaire,professional quality of life scale,general self-efficacy scale and perceived social support scale were used in the study.Results The score of empathy satisfaction was 33.00(28.25,37.75),and there were 141 cases(66.20%)with supercritical value.The score of job burnout was 26.00(21.50,30.50),and 96 cases(45.07%)exceeded the critical value.The score of secondary traumatic stress was 25.00(20.50,29.50),and 192 cases(90.14%)exceeded the critical value.Multivariate logistic regression analysis showed that average daily working hours,job satisfaction,self-evaluation of work pressure,general self-efficacy and perceived social support were the influencing factors of compassion fatigue among medical staff.Compared with those who worked for 0 h in the polluted area,those who worked for more than 8 h had a higher degree of compassion fatigue(OR=7.787,95%CI:1.127-53.820);compared with those who were more satisfied with their work,those who were less satisfied with their work had a higher degree of compassion fatigue(OR=6.209,95%CI:1.474-26.157);compared with those with no or low stress,those with high stress had higher degree of compassion fatigue(OR=2.567,95%CI:1.228-5.366);compared with those with high self-confidence,those with low self-confidence or moderate self-confidence had higher degree of compassion fatigue(OR=13.519,95%CI:3.394-53.848;OR=3.462,95%CI:1.038-11.548);compared with those with high perceived social support,those with low perceived social support had higher degree of compassion fatigue(OR=2.071,95%CI:1.027-4.175)(all P<0.05).Conclusion The status of compassion fatigue of medical staff working in the centralized quarantine sites need to be improved.We should pay more attention to the those medical staff having long daily working hours in the polluted area,those with low job satisfaction,poor self-evaluation of work pressure,poor general self-efficacy and low perceived social support.