ICU医护人员创伤后应激障碍的危险因素及正念情绪调节需求调查

Investigation on the risk factors of post-traumatic stress disorder and demands for mindfulness emotion regulation in intensive care unitmedical staff

目的调查重症监护室(ICU)医护人员创伤后应激障碍(PTSD)水平并分析PTSD的危险因素,了解ICU医护人员的正念情绪调节需求及其与PTSD的相关性,为预防PTSD的发生提供参考。方法采用创伤后应激障碍自评量表-民用版(PCL-C)、Maslach职业倦怠调查普适量表(MBI-GS)、简易应对方式问卷(SCSQ)和五因素正念量表(FFMQ-CH)对ICU医护人员进行问卷调查;根据PCL-C评分将其分为PTSD组和正常组,采用Logistic回归分析探究ICU医护人员发生PTSD的影响因素,采用Pearson相关分析PCL-C得分与FFMQ-CH得分的相关性。结果ICU医护人员PTSD发生率为23.33%,女性、SCSQ消极应对评分≥16分为ICU医护人员发生PTSD的危险因素。ICU医护人员对正念减压疗法、正念认知疗法的需求高于其他正念情绪调节方法,PTSD组的观察、描述、觉知的行动、不判断及FFMQ-CH总分均低于正常组;差异均有统计学意义(P<0.05)。Pearson相关性分析结果显示,PCL-C评分与FFMQ-CH评分呈负相关(r=-0.369,P<0.05)。结论ICU医护人员易发生PTSD,尤其是采用消极应对方式的女性。ICU医护人员具有一定的正念情绪调节需求,其正念水平与PTSD的发生有关。

Objective To investigate the post-traumatic stress disorder(PTSD)in medical staff in intensive care unit(ICU),analyze the risk factors of PTSD and understand the demands for mindfulness emotion regulation of ICU medical staff and the correlation with PTSD so as to provide a reference for preventing PTSD.Methods The medical personnel in the ICU were assessed using the PTSD Check-list-Civilian Version(PCL-C),Maslach Burnout Inventory General Survey(MBI-GS),Simplified Coping Style Questionnaire(SCSQ)and Five Facet Mindfulness Questionnaire-Chinese Version(FFMQ-CH).Based on their PCL-C scores,they were categorized into either a PTSD group or a normal group.The influencing factors of PTSD among ICU medical staff were analyzed using logistic regression analysis,while Pearson correlation analysis was employed to examine the relationship between the CL-C score and FFMQ-CH score.Results The incidence rate of PTSD in ICU medical staff was 23.33%.Female gender and a score of 16 or higher on the SCSQ negative coping scale were identified as risk factors for PTSD among ICU medical staff.Mindfulness-based stress reduction and mindfulness-based cognitive therapy were found to be the preferred methods for emotion regulation through mindfulness in this population.Furthermore,the PTSD group exhibited lower scores than the normal group in terms of observation,description,perceived action,and non-judgment,as well as the overall score of FFMQ-CH.These differences were statistically significant(P<0.05).The Pearson correlation analysis results indicated a significant negative correlation between the PCL-C score and the FFMQ-CH score(r=-0.369,P<0.05).Conclusions ICU medical staffs are prone to PTSD,especially women with negative coping styles.ICU medical staff have a certain need for mindful emotional regulation,and the level of mindfulness is related to the occurrence of PTSD.