突发公共卫生事件中医护人员风险感知演变的质性研究

Evolution of risk perception of medical staff during public health emergencies:a qualitative study

目的了解在突发公共卫生事件期间医护人员风险感知的演变规律,为评估医护人员风险感知状态及预测其行为变化提供理论依据。方法采取目的抽样法,选取16名医护人员为研究对象,运用现象学研究方法对其进行半结构式访谈,采用Colaizzi 7步分析法进行资料归纳并提炼主题。结果医护人员风险感知随着风险演化呈现3个阶段,①警惕期:主要体现在多渠道的信息获取途径、既往类似事件经历的警示作用、警惕性高并主动采取防护措施、反应冷静;②观望期:主要体现在防护行为逐渐规范化、主动辨别舆情信息并了解突发公共卫生事件演化趋势、情绪随疫情波动而变化;③维持期:主要体现在形成关注疫情发展相关信息的习惯、情绪反应呈现平稳状态、适应疫情常态化且形成恰当防护行为。结论动态评估医护人员风险感知,提供必要的组织支持,包括及时准确公布风险信息,建立标准化流程及开展医务人员培训,将有助于医护人员保持适当的风险感知水平而降低其可能带来的不利影响,对提高突发公共卫生事件的应急防控能力具有重要意义。

Objective To explore the evolution law for risk perception of medical staff during public health emergencies so as to provide decision support for assessing the risk perception status of medical staff, predicting their behavioral changes and guiding their emotional responses. Methods A total of 16 medical staff were enrolled as the research objects by purposive sampling. Semi-structured interviews were conducted with phenomenological research methods. Colaizzi 7-step analysis method was used to summarize the data and abstract the themes. Results In this study, the risk perception of medical staff showed three stages along with the evolution of risk: 1.vigilance period,during which the perception included the multi-channel access to information, warning of previous similar events, high vigilance, taking active protective measures, and calm response;2. observation period, during which the perception mainly covered gradual standardization of protective behaviors, proactive identification of public opinion information and understanding of the evolution trend of public health emergencies, and the emotion changes with the fluctuation of the epidemic;and 3. maintenance period, during which the main perception including the habitual formation of paying attention to the development of information related to the epidemic, the stability of emotional response, the normalization of adaptation to the epidemic and the formation of appropriate protective behavior. Conclusions Such measures as dynamic assessmen t of risk perception of medical staff,necessary organizational support including timely and accurate publication of risk-related information, and establishment of a standardized process for medical personnel training will help medical staff to maintain proper risk perception level and reduce the possibility of adverse effects, which is of great significance for improving the emergency control ability for handling public health emergencies.