摘要
目的调查广东省内各医院血液透析(hemodialysis,HD)室护理人员心理状况及其影响因素。方法借助“问卷星App”对2020年2、3月广东省内71家医院或单位HD室1630名护理人员,采用心理健康评定量表(the 10⁃item Kessler psychological distress scale,Kessler 10)、一般自我效能感量表(general self⁃efficacy scale,GSES)和心理弹性量表(Connor⁃Davidson resilience scale,CD⁃RISC)对他们的心理状况进行问卷调查,采用失眠严重程度指数(insomnia severity index,ISI)和疲劳量表⁃14(fatigue scale⁃14,FS⁃14)对他们的失眠程度和疲劳程度进行调查,并收集他们的性别、年龄分布、文化程度、婚姻状态、经济收入情况、职称、HD工作时间、加班次数及时长、HD室每天HD患者总数、是否兼任他职等一般资料。结果最终共回收问卷1630份,其中有效问卷1629份,有效回收率为99.9%。护理人员三个量表的得分分别为(20.16±7.47)分、(27.03±4.45)分和(58.37±15.75)分。根据Kessler 10量表得分,出现心理障碍者835人(51.2%)。单因素分析显示,年龄分布、文化程度、经济收入情况、工作单位类型、HD室每天HD患者总数及近1周居住状态与Kessler 10得分相关(均P<0.05);经济收入情况、工作单位类型、是否兼任他职、HD室每天HD患者总数及近1周居住状态与GSES得分相关(均P<0.05);年龄分布、婚姻状态、经济收入情况、职称、工作单位类型、是否兼任他职及近1周居住状态与CD⁃RISC得分相关(均P<0.05)。Spearman秩相关分析显示,血液透析机器台数(r=0.100,P<0.001)、科室护士人数(r=0.082,P=0.001)、平均每周加班次数(r=0.142,P<0.001)、平均每周加班小时数(r=0.136,P<0.001)、ISI评分(r=0.572,P<0.001)和FS⁃14评分(r=0.635,P<0.001)与Kessler 10得分相关;ISI评分(r=-0.311,P<0.001)和FS⁃14评分(r=-0.335,P<0.001)与GSES得分相关;HD工作年限(r=0.112,P<0.001)、ISI评分(r=-0.289,P<0.001)和FS⁃14评分(r=-0.314,P<0.001)与CD⁃RISC得分相关。多重线性回归分析显示,经济收入在5001~10000元(以3000元以下作为参照,B=-1.603,95%CI-3.036~-0.169,P=0.028)、HD室每天HD患者总数在200以上(以≤50以作为参照,B=-1.153,95%CI-2.242~-0.065,P=0.038)与Kessler 10得分呈负相关,平均每周加班次数(B=0.221,95%CI 0.069~0.374,P=0.004)、ISI评分(B=0.518,95%CI 0.454~0.582,P<0.001)及FS⁃14评分(B=1.166,95%CI 1.066~1.265,P<0.001)与Kessler 10得分呈正相关;经济收入(以3000元以下作为参照)在3001~5000元(B=1.930,95%CI 0.847~3.013,P<0.001)、5001~10000元(B=1.949,95%CI 0.887~3.012,P<0.001)、10001~15000元(B=1.482,95%CI 0.318~2.647,P=0.013)、>20000元(B=4.300,95%CI 2.463~6.136,P<0.001)、工作单位为二级医院(以一级医院作为参照,B=1.078,95%CI 0.005~2.152,P=0.049)、兼任他职(B=0.729,95%CI 0.277~1.181,P=0.002)与GSES得分呈正相关,ISI评分(B=-0.169,95%CI-0.217~-0.120,P<0.001)和FS⁃14评分(B=-0.403,95%CI-0.478~-0.328,P<0.001)与GSES得分呈负相关;经济收入(以3000元以下作为参照)在3001~5000元(B=7.631,95%CI 3.753~11.509,P<0.001)、5001~10000元(B=9.236,95%CI 5.362~13.110,P<0.001)、10001~15000元(B=9.039,95%CI 4.735~13.342,P<0.001)、15001~20000元(B=8.639,95%CI 2.989~14.289,P=0.003)、>20000元(B=16.101,95%CI 9.162~23.039,P<0.001)、兼任他职(B=3.228,95%CI 1.510~4.945,P<0.001)与CD⁃RISC得分呈正相关,ISI评分(B=-0.593,95%CI-0.765~-0.420,P<0.001)和FS⁃14评分(B=-1.258,95%CI-1.525~-0.992,P<0.001)与CD⁃RISC得分呈负相关。结论广东省内各医院HD室护理人员心理状况有待提高,采取有效的预防措施,发现存在心理异常的护理人员,及时给予心理支持、疏导和干预,必要时鼓励其主动进行心理咨询,进而促进其身心健康。
Objective To investigate the psychological status of HD nursing staff in hospitals in Guangdong province and its influential factors.Methods 1630 nursing staff in HD rooms of 71 hospitals or units in Guangdong Province in February and March 2020 were evaluated by using the 10⁃item Kessler psychological distress scale(Kessler 10),General self⁃efficacy scale(GSES)and Connor⁃Davidson resilience scale(CD⁃RISC)to conduct a questionnaire survey on their psychological status.Insomnia severity index(ISI)and Fatigue scale⁃14(FS⁃14)were used to investigate their degree of insomnia and fatigue.General information on gender,age,educational level,marital status,economic income,professional title,HD working hours,average weekly overtime times and hours,total number of HD patients per day,and whether holding other positions were collected.Results A total of 1630 questionnaires were collected,among which 1629 were valid,with an effective recovery rate of 99.9%.The scores of the three scales were(20.16±7.47),(27.03±4.45)and(58.37±15.75),respectively.According to the Kessler 10,835 people(51.2%)had mental disorders.Univariate analysis showed that age,educational level,economic income,type of work unit,total number of HD patients per day and living status in recent one week were related with Kessler 10 score(all P<0.05).Economic income,type of work unit,whether holding other positions,total number of HD patients per day and living status in recent one week were related with GSES scores(all P<0.05).Age,marital status,economic income,professional title,type of work unit,whether holding other positions and living status in recent one week were related to CD-RISC score(all P<0.05).Spearman rank correlation analysis showed that the number of HD machines(r=0.100,P<0.001),the number of nurses(r=0.082,P=0.001),average weekly overtime times(r=0.142,P<0.001)and overtime hours(r=0.136,P<0.001),ISI score(r=0.572,P<0.001)and FS-14 score(r=0.635,P<0.001)were correlated with Kessler 10 score.ISI score(r=-0.311,P<0.001)and FS-14 score(r=-0.335,P<0.001)were correlated with GSES score.Working years of HD service(r=0.112,P<0.001),ISI score(r=-0.289,P<0.001)and FS-14 score(r=-0.314,P<0.001)were correlated with CD-RISC score.Multiple linear regression analysis showed that the economic income in 5001-10000 yuan(with<3000 yuan as reference,B=-1.603,95%CI-3.036--0.169,P=0.028)and the total number of HD patients per day>200(with≤50 as reference,B=-1.153,95%CI-2.242--0.065,P=0.038)were negatively correlated with Kessler 10 score,and average weekly overtime times(B=0.221,95%CI 0.069-0.374,P=0.004),ISI score(B=0.518,95%CI 0.454-0.582,P<0.001)and FS-14 score(B=1.166,95%CI 1.066-1.265,P<0.001)were positively correlated with Kessler 10 score.The economic income(with<3000 yuan as reference)in 3001-5000 yuan(B=1.930,95%CI 0.847-3.013,P<0.001),5001-10000 yuan(B=1.949,95%CI 0.887-3.012,P<0.001),10001-15000 yuan(B=1.482,95%CI 0.318-2.647,P=0.013),>20000 yuan(B=4.300,95%CI 2.463-6.136,P<0.001),secondary hospital(with primary hospitals as reference,B=1.078,95%CI 0.005-2.152,P=0.049)and holding other positions(B=0.729,95%CI 0.277-1.181,P=0.002)were positively correlated with GSES score,and ISI score(B=-0.169,95%CI-0.217--0.120,P<0.001)and FS-14 score(B=-0.403,95%CI-0.478--0.328,P<0.001)were negatively correlated with GSES score.The economic income(with<3000 yuan as reference)in 3001-5000 yuan(B=7.631,95%CI 3.753-11.509,P<0.001),5001-10000 yuan(B=9.236,95%CI 5.362-13.110,P<0.001),10001-15000 yuan(B=9.039,95%CI 4.735-13.342,P<0.001),15001-20000 yuan(B=8.639,95%CI 2.989-14.289,P=0.003),>20000 yuan(B=16.101,95%CI 9.162-23.039,P<0.001)and holding other positions(B=3.228,95%CI 1.510-4.945,P<0.001)were positively correlated with CD-RISC score,and ISI score(B=-0.593,95%CI-0.765--0.420,P<0.001)and FS-14 score(B=-1.258,95%CI-1.525--0.992,P<0.001)were negatively correlated with CD-RISC score.Conclusion The psychological status of nursing staff in HD rooms of hospitals in Guangdong Province needs to be improved.Effective preventive measures should be taken to provide timely psychological support,counseling and intervention to nursing staff with psychological abnormalities,and encourage them to take the initiative to seek psychological counseling when necessary,so as to promote their physical and mental health.
作者
李影花
张文轩
温穗溱
叶晓青
王饶萍
Li Yinghua;Zhang Wenxuan;Wen Suiqin;Ye Xiaoqing;Wang Raoping(Blood Purification Center of Nephrology Department,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China;Department of Epidemiology,School of Public Health,Sun Yat-sen University,Guangzhou 510080,China)
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
2024年第11期858-867,共10页
Chinese Journal of Nephrology
关键词
肾透析
护理人员
心理状况
影响因素
量表
Renal dialysis
Nursing staff
Psychological status
Influencing factors
Scale
