抗新型冠状病毒肺炎一线医务人员焦虑产生影响因素分析

AN ANALYSIS OF THE INFLUENCING FACTORS FOR ANXIETY IN FRONTLINE MEDICAL STAFF FIGHTING COVID-19

目的探讨抗新型冠状病毒肺炎一线医务人员焦虑产生的影响因素。方法采用症状自评量表(SCL-90)从抗新型冠状病毒肺炎一线医护人员中筛选出31例焦虑者作为研究对象,以汉密尔顿焦虑量表(HAMA)分析焦虑者躯体性与精神性焦虑情况,自行编制的《压力感测评问卷》对焦虑者进行压力感评估。多参数生物反馈仪检测静息状态下焦虑者心率变异性指标,包括正常心动周期的标准差(SDNN)、每5 min平均心动周期的标准差(SDANN)、相邻正常心动间期差值的均方根(RMSSD)、R-R间期差值超过50 ms的心搏数占总心搏数的百分比(PNN50)、低频功率(LF)及高频功率(HF)等。结果焦虑者HAMA总分均>14分,平均为(23.18±4.13)分,躯体性焦虑因子分(11.45±3.14)分,精神性焦虑因子分(10.28±2.39)分。工作责任重、周围负性事件的影响、工作超负荷为影响焦虑情绪的主要因素(t=12.089~18.840,P<0.01)。焦虑者SDNN、SDANN、RMSSD、PNN50显著低于参考值(t=-15.77~-5.44,P<0.05)。焦虑者LF/HF明显高于参考值(t=4.49,P<0.05)。焦虑者躯体性焦虑因子分与LF呈正相关(r=0.54,P<0.05),精神性焦虑因子分与PNN50呈负相关(r=-0.60,P<0.05);HAMA总分与SDNN呈负相关(r=-0.53,P<0.05)。结论工作责任重、周围负性事件影响、工作超负荷为导致抗新型冠状病毒肺炎一线医务人员产生焦虑情绪的主要因素,应加强抗疫一线医务人员焦虑者的心理干预,以不断提高其心理健康水平。

Objective To explore the influencing factors for anxiety among frontline medical staff fighting COVID-19.Methods Thirty-one anxious people were selected using the SCL-90 among the front-line medical staff in the fight against COVID-19.Analyses of somatic and mental anxiety were performed using the Hamilton Anxiety Scale(HAMA).A Stress Sensitivity Eva-luation Questionnaire designed by the authors was used to evaluate the stress perception.A multi-parameter biofeedback instrument was used to measure the heart rate variability indices of anxious people in their resting state,including standard deviation of normal-to-normal intervals(SDNN),standard deviation of sequential five-minute N-N interval means(SDANN),root mean square successive difference(RMSSD),percentage of successive normal sinus RR intervals>50 ms(PNN50),low frequency power(LF),and high frequency power(HF).Results The HAMA total scores of all anxious people were>14(mean 23.18±4.13).The mean somatic anxiety factor score was 11.45±3.14,and the mean score of mental anxiety factor was 10.28±2.39.The main factors affecting anxiety were high responsibility,negative events,and work overload(t=12.089-18.840,P<0.01).The SDNN,SDANN,RMSSD,and PNN50 were significantly lower than the reference values(t=-15.77--5.44,P<0.05).The LF/HF was significantly higher than the reference value(t=4.49,P<0.05).Somatic anxiety factor score was positively correlated with LF(r=0.54,P<0.05),mental anxiety factor score was negatively correlated with PNN50(r=-0.60,P<0.05),and HAMA total score was negatively correlated with SDNN(r=-0.53,P<0.05).Conclusion High responsibility,the influence of surroun-ding negative events,and work overload are the main factors leading to anxiety in the frontline medical staff.Psychological interventions of anxious frontline medical workers should be strengthened to continuously improve their mental health.