陈晓燕, 李良俊, 杜艇, 李龙倜, 宋述琴, 程利. 一线抗疫医务人员应激障碍现状及影响因素[J]. 环境与职业医学, 2021, 38(11): 1244-1250. DOI: 10.13213/j.cnki.jeom.2021.21112
引用本文: 陈晓燕, 李良俊, 杜艇, 李龙倜, 宋述琴, 程利. 一线抗疫医务人员应激障碍现状及影响因素[J]. 环境与职业医学, 2021, 38(11): 1244-1250. DOI: 10.13213/j.cnki.jeom.2021.21112
CHEN Xiaoyan, LI Liangjun, DU Ting, LI Longti, SONG Shuqin, CHENG Li. Status quo and influencing factors of post-traumatic stress disorder among front-line anti-epidemic medical staff[J]. Journal of Environmental and Occupational Medicine, 2021, 38(11): 1244-1250. DOI: 10.13213/j.cnki.jeom.2021.21112
Citation: CHEN Xiaoyan, LI Liangjun, DU Ting, LI Longti, SONG Shuqin, CHENG Li. Status quo and influencing factors of post-traumatic stress disorder among front-line anti-epidemic medical staff[J]. Journal of Environmental and Occupational Medicine, 2021, 38(11): 1244-1250. DOI: 10.13213/j.cnki.jeom.2021.21112

一线抗疫医务人员应激障碍现状及影响因素

Status quo and influencing factors of post-traumatic stress disorder among front-line anti-epidemic medical staff

  • 摘要: 背景

    一线医务人员是抗击新型冠状病毒肺炎(COVID-19)疫情的重要群体,其心理健康不容忽视。

    目的

    了解COVID-19疫情流行期间一线抗疫医务人员的创伤后应激障碍(PTSD)现状及影响因素。

    方法

    2020年5月采用方便抽样法从湖北省某市内3所三级甲等医院和4所二级甲等医院中抽取曾参与抗疫的一线医务人员作为研究对象,以创伤后应激障碍检查量表-平民版(PCL-C)为主要调查工具,采用网络电子问卷调查抗疫医务人员发生PTSD的现状及特征。共计回收问卷1120份,其中有效问卷1071份,有效率95.6%。

    结果

    纳入调查对象1071名,平均年龄为(32.59±5.21)岁 ;男女比例为1 : 5.02 ;医护比例为1 : 5.8;三甲医院员工近7成;已婚者占75.4%;本科及以上居多(86.5%);党员占比22.9%;初级职称者占50.9%;工龄多在5~10年(42.8%);自愿参与抗疫者超过80.0%;95.1%的医务人员获得了家人的支持;参与抢救者占43.0%;78.1%的医务人员在本院参与抗疫;超过6成者认为工作量比原科室大;抗疫总时长多在2~4周(34.4%),其次是6周以上(23.5%)。PTSD症状阳性(PCL-C总分≥38分)者111例,阳性率为10.4%;其中再体验1.40(1.00,1.80)分和高警觉症状得分1.40(1.00,2.00)分高于回避症状得分 1.14(1.00,2.57)分。单因素结果显示不同年龄、政治面貌、工作年限、抗疫地点、抗疫时长、是否有子女、是否自愿参与、家人是否支持、家人是否参与抗疫、是否参与抢救的医务人员PTSD发生情况不同(P<0.05)。logistic回归分析发现,年龄介于31~40岁(OR=0.346,95%CI: 0.164~0.730)和≥41岁(OR=0.513,95%CI: 0.319~0.823)医务人员的PTSD发生率比20~30岁低;党员身份(OR=0.499,95%CI: 0.274~0.909)、自愿参与抗疫(OR=0.584,95%CI: 0.360~0.945)和家人支持(OR=0.453,95%CI: 0.222~0.921)的医务人员PTSD发生率低于非党员身份、非自愿参与和缺乏家人支持者(P<0.05);有子女(OR=2.372,95%CI: 1.392~4.042)、有家人参与抗疫(OR=1.709,95%CI: 1.135~2.575)和参与抢救(OR=1.705,95%CI: 1.133~2.565)的医务人员PTSD发生率比无子女、无家庭成员参与抗疫和未参与抢救者高(P<0.05)。

    结论

    一线抗疫医务人员PTSD的阳性率为10.4%;年龄、政治面貌、是否自愿参与、家人是否支持、有无子女、有无家人参与抗疫以及是否参与抢救可能是其发生PTSD的影响因素。

     

    Abstract: Background

    Front-line medical staff are an important group in fighting against Coronavirus Disease 2019 (COVID-19), and their mental health should not be ignored.

    Objective

    This study investigates the current situation and influencing factors of post-traumatic stress disorder (PTSD) among front-line anti-epidemic medical staff during COVID-19 epidemic.

    Methods

    Medical staff who had participated in fighting against the COVID-19 epidemic wereselected from three grade III Class A hospitals and four grade II Class A hospitals in a city of Hubei Province by convenient sampling method in May 2020. The survey was conducted online using the Post-traumatic Stress Checklist-Civilian Version (PCL-C) as the main survey tool to investigate current situation and characteristics of PTSD among these participants. A total of 1120 questionnaires were collected, of which 1071 were valid, and the effective rate was 95.6%.

    Results

    Of the 1071 participants, the average age was (32.59±5.21) years; the ratio of male to female was 1: 5.02; the ratio of doctor to nurse was 1:5.8; nearly 70% participants came from grade III Class A hospitals; married participants accounted for 75.4%; most of them held a bachelor degree or above (86.5%); members of the Communist Party of China (CPC) accounted for 22.9%; 50.9% had junior titles; the working years were mainly 5−10 years (42.8%); more than 80.0% participants volunteered to join the front-line fight; 95.1% participants received family support; 43.0% participated in rescue missions; 78.1% participants fought the epidemic in their own hospitals; more than 60% participants considered the workload was greater than before; 34.4% participants fought in the front-line for 2−4 weeks, and 23.5% participants did for more than 6 weeks. There were 111 cases of positive PTSD syndromes (PCL-C total score ≥38) with an overall positive rate of 10.4%, and the scores of reexperience 1.40 (1.00, 1.80) and hypervigilance 1.40 (1.00, 2.00) were higher than the score of avoidance 1.14 (1.00, 2.57). The results of univariate analysis revealed that PTSD occurred differently among participants grouped by age, political affiliation, working years, anti-epidemic activities location, accumulated working hours in fighting against COVID-19, having child parenting duty, voluntariness, family support, whether family members participated in front-line activities, and rescue mission assignment (P<0.05). The results of logistic regression analysis showed that the incidence rates of reporting PTSD syndromes in medical personnel aged 31−40 years (OR=0.346, 95%CI: 0.164−0.730) and aged 41 years and above (OR=0.513, 95%CI: 0.319-0.823) were lower than that in those aged 20−30 years; the incidence rates of reporting PTSD syndromes in medical staff who were CPC members (OR=0.499, 95%CI: 0.274−0.909), volunteered to participate (OR=0.584, 95%CI: 0.360−0.945), and received family support (OR=0.453, 95%CI: 0.222-0.921) were lower than those did not (P<0.05); the incidence rates of reporting PTSD syndromes among medical workers who had child parenting duty (OR=2.372, 95%CI: 1.392−4.042), whose family members participated in front-line activities (OR=1.709, 95%CI: 1.135−2.575), and who participated in rescue missions (OR=1.705, 95%CI: 1.133-2.565) were higher than those who did not (P<0.05).

    Conclusion

    The positive PTSD syndrome rate is 10.4% in the front-line anti-epidemic medical staff. Age, political affiliation, voluntariness, family support, having child parenting duty, with a family members participating in the fight, and rescue mission assignment are the influencing factors of PTSD.

     

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