闭环管理中医务人员身心健康状况与心理弹性的关系

The relationship between physical and mental health and psychological resilience of medical staff under closedloop management

目的 评估接受闭环管理的医务人员身心健康状况及其与心理弹性的关系。方法 便利抽取复旦大学附属华山医院禾滨康复分中心383位医务人员作为研究对象。分别采用一般社会学资料量表、焦虑自评量表(Self-rating Anxiety Scale,SAS)、抑郁自评量表(Self-rating Depression Scale,SDS)、症状自评量表(Symptom Checklist 90,SCL-90)和心理弹性量表(Connor-Davidson Resilience Scale,CD-RISC)收集医务人员一般社会学资料、焦虑抑郁程度、身心健康状况和心理弹性情况,并进一步比较不同社会学特征和心理弹性水平的医务人员的焦虑抑郁及心身症状得分,分析医务人员心理健康状况的影响因素。结果 本次共发放问卷410份,回收有效问卷383份(93.4%),其中心理异常检出率为19.1%,医务人员心理异常状况在文化程度方面差异有统计学意义(χ^(2)=12.089,P<0.01);不同部门的调查对象在SAS总分、SCL-90总分及强迫症状、抑郁、敌对和精神病性及心理弹性的力量性方面差异有统计学意义(P<0.05);不同职称的调查对象在SCL-90总分及躯体化、强迫症状、抑郁、焦虑、恐惧、精神病性,以及CD-RISC总分及坚韧性、力量性、乐观性方面差异有统计学意义(P<0.05或P<0.01);正常与异常心理的调查对象在CD-RISC总分及坚韧性、力量性和乐观性方面差异有统计学意义(P<0.05);调查对象异常身心状况的回归模型公式为:SCL-90总分=86.278-1.550*坚韧性-11.020*婚姻状况-11.988*职称+12.384*文化程度。结论 闭环管理的情况下,医务人员存在不同程度的焦虑、抑郁情绪和身心异常状况,提高其心理弹性有助于降低异常心理几率。

Objective To assess the physical and mental health of medical staff under closed-loop management and its relationship with resilience.Methods 383 medical staff from Hebin Rehabilitation Branch Center of Huashan Hospital Affiliated to Fudan University were selected as research objects.The general sociological data scale,Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS),Symptom Checklist 90(SCL-90)and Connor-Davidson Resilience Scale(CD-RISC)were used to collect their general sociological data,degree of anxiety and depression,physical and mental health,psychological resilience.Then compared the scores of anxiety,depression and psychosomatic symptoms of medical staff with different general sociological characteristics,isolation conditions and psychological resilience levels,and analyzed the psychological health status of medical staff influencing factors.Results A total of 410 questionnaires were distributed this time,and 383 valid questionnaires were recovered(93.4%),of which the detection rate of psychological abnormalities was 19.1%.There was a statistically significant difference in the educational level of psychological abnormalities among medical staff(χ^(2)=12.089,P<0.01).There were significant differences in the SAS total score,SCL-90 total score,obsessive-compulsive symptoms,depression,hostility,psychosis,and resilience among survey subjects in different departments(P<0.05).There were statistically significant differences in SCL-90 total scores and somatization,obsessive-compulsive symptoms,depression,anxiety,fear,psychosis,and CD-RISC total scores and toughness,strength,and optimism among respondents with different professional titles(P<0.05).There were significant differences in CD-RISC total score,toughness,strength and optimism between normal and abnormal psychological survey subjects(P<0.05).The regression model formula of abnormal physical and mental status of the surveyed subjects was:SCL-90 total score = 86.278-1.550 * tenacity-11.020 * marital status-11.988 * title + 12.384 * educational level.Conclusion Closed-loop working medical staff have different degrees of anxiety,depression,and abnormal physical and mental conditions.Improving their psychological resilience can help reduce the probability of abnormal psychology.