新冠肺炎疫情下定点发热门诊护士压力来源及恐慌焦虑的横断面调查-东南大学学报医学版

新冠肺炎疫情下定点发热门诊护士压力来源及恐慌焦虑的横断面调查

单位：1. 中山大学附属肿瘤医院, 广东广州 510060;
2. 汕头大学医学院伤害预防研究中心, 广东汕头 515041;
3. 江苏大学附属昆山医院, 江苏苏州 215300

分类号：R749.72;R563.14

出版年·卷·期（页码）：2020·39·第五期（569-575）

摘要：

目的:了解新型冠状病毒肺炎(COVID-19)疫情背景下定点发热门诊所在医院护理人员的工作压力来源及感到恐慌焦虑的情况,并分析影响因素。方法:通过电子问卷在发热门诊定点医院收集研究对象828人(男35人,女793人)在一、二线值班护士的压力和不良情绪资料。结果:护士的压力来源排位前5的是:口罩防护服等防护物资紧缺;患者不能配合医护人员的医嘱和操作;目前对COVID-19没有系统有效的诊疗方法和特效药;社会对医务人员的支持不够;COVID-19的传播机制、发病原因尚不完全清楚。发热定点医院的护士感到恐慌不受年龄、婚姻、职称、疫情期间工作风险等级等人群特征的影响(P>0.05),而性别女(P<0.001)、积极转发/评论疫情(P=0.008)、防护口罩短缺(P=0.051)是影响护士恐慌的独立危险因素。此外,护士感到焦虑不受性别、婚姻、职称、防护口罩短缺等人群特征、防护特征的影响(P>0.05),而积极参与疫情转发评论(P<0.001)、工作的高风险等级(P=0.024)是影响焦虑的独立危险因素;高年龄护士的焦虑程度较低(P=0.014)。结论:在发热门诊定点医院,超七成的护士感到有精神压力,恐慌焦虑情绪较突出。建议加强对一线护士的关怀疏导和心理干预,缓解其压力。建议政策制定者与医疗管理者重视对医护人员的社交自媒体的正向引导,减少疫情讯息传播尤其是阻断谣言的传播。

Objective: To understand the source of working stress among nurses in designated hospitals for patients with fever, the situation of panic and anxiety and the influencing factors under the background of COVID-19 epidemic were analyzed. Methods: Smartphone-based questionnaire was used to collect the stress and negative mood data of 828 nurses(35 males and 793 females), who worked in the first and second line on duty in designated hospitals for patients with fever. Results: The top five factors leading to nurses' working stress:(1) shortage of protective materials such as masks and medical protective clothing; (2) patients refused to cooperate with the medical worker's order and medical operations; (3) there were no systematic diagnosis, treatment methods and targeted drugs for COVID-19; (4) social support for nurses was not enough; (5) pathological causes and transmission mechanism were not completely clear. Nurses in designated hospitals for patients with fever who felt panic were not subject to age, marriage, professional level, job risk grade during the epidemic period(P>0.05). Gender as female(P<0.001), active reposting or commenting on the pandemic(P=0.008) and a shortage of medical masks(P=0.051) were independent risk factors for nurses' panic. In addition, nurses' anxiety was not subject to gender, marriage, professional level, shortage of masks and other characteristics(P>0.05). Active participation in reposting or commenting on the pandemic(P<0.001) and high job risk level(P=0.024) were independent risk factors for anxiety, while elder nurses had a lower level of anxiety(P=0.014). Conclusion: In the designated hospitals for fever patients, more than 70% of nurses felt stressed, and their panic and anxiety were prominent. Strengthening the care, counseling and psychological intervention for front-line nurses is needed. It is, therefore, suggested that policy makers and medical managers should pay more attention to the positive guidance of social medium to doctors and nurses, so as to reduce the spread of negative news, especially block the spread of rumors.

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