河北省三级医院ICU护士死亡焦虑现状调查及干预研究
[Abstract]:Objective: With the continuous development of society, the pace of modern life is getting faster and faster, and psychological pressure is rising in the general population. As we all know, life-death alternation is the inevitable stage of human evolution, which everyone must experience and accept. ICU is the concentration of critically ill patients in hospitals. Life-death parting takes place every day. At present, most of the researches on psychological status focus on the critically ill patients and their family members, and few of them pay attention to the medical staff directly involved in hospice care. These medical staff play an important role in the treatment of critically ill patients. Psychological comfort and social and spiritual support from family members have brought about negative effects. Nurses working hard all the year round in ICU as health care escorts of the people should arouse wider social concern about their level of death anxiety. Methods: From March 2016 to December 2016, ICU nurses in Hebei tertiary hospitals were selected by convenience sampling method, and the Chinese version of the fifth level of death anxiety was used. A total of 450 questionnaires were sent out and 409 of them were recovered with an effective recovery rate of 90.89%. The study was divided into two parts. First, the general conditions of nurses included gender, age, nationality, marital status, educational background, nursing age, professional title, religious belief, and work room, etc. The results were analyzed by SPSS22.0 data package. The comparison of the counting data was analyzed by Chi-square test, and the measurement data was analyzed by ANOVA and T-test. The data were compared by SNK-q test; the influencing factors of death anxiety were analyzed by multivariate conditional logistic regression method; and the scores of death anxiety before and after training were compared by paired t test. Results: 1 The death anxiety score of ICU nurses was generally higher, 386 (94.38%) showed higher level of death anxiety. The proportion of nurses with death anxiety was 95.3%, which was higher than 86.4% of male nurses. The difference was statistically significant (P 0.05.2). The score of death anxiety of nurses was 43.43+7.97, which was significantly lower than that of female nurses (45.37+5.78, t=-2.006, p=0.046); the score of death anxiety of nurses with initial education was 46.63+6.02, 45.78+5.24 and 42.53+7.44, respectively, and the difference was statistically significant (f=12.230, p0.001). The scores of death anxiety of nurses with professional titles were 43.81 (+5.36), 44.73 (+6.03), 46.16 (+5.46) and 40.57 (+4.86), respectively. There was statistical difference between the four groups, f = 3.259, P = 0.033. The level of death anxiety of nurses in charge was higher than that of nurses and nurses in charge, but the level of death anxiety of nurses in charge and above was higher than that of nurses in charge. The scores of high death anxiety were the lowest; different marital status, the highest educational background, the type of employment and whether or not to be a teaching teacher, the head of the Department and the length of work had no influence on the scores of death anxiety, the difference was not statistically significant, p0.05.3 whether or not to receive death education and events had participated in the impact of death anxiety scores. The score of death anxiety of nurses trained or trained in death education or hospice care was 42.37 + 6.92, which was significantly lower than that of nurses trained or trained in death education or hospice care (46.01 + 5.52). The difference was statistically significant (t = - 5.293, P 0.001); the score of death anxiety of nurses involved in hospice care of patients or relatives was 44.52 + 6.63. It was significantly lower than that of the patients or relatives who had not participated in the hospice treatment, the difference was statistically significant, t = - 2.017, P = 0.045; whether or not witnessed serious accidents or life-threatening events had no effect on the score of death anxiety, the difference was not statistically significant, p0.05.4 23 nurses without death anxiety as the study object, according to the 1:2 ratio. Case matched with department, gender, family environment, retrospective questionnaire and conditional logistic regression were used to study the influencing factors of death anxiety score. Methods Forty-five ICU nurses (who had not participated in similar training or educational experience before) were trained in Hebei Thoracic Hospital to observe the changes of the scores of death anxiety before and after training. The death anxiety score of U nurses was reduced to 44.68+5.62, and the death anxiety score of ICU nurses was reduced to 42.35+6.15 after training. Conclusion: The death anxiety score of ICU nurses in Grade 1 tertiary hospitals was generally higher, 94.38% of them showed higher level of death anxiety, and there were gender differences, among them, the death anxiety level of female nurses was higher than that of male nurses. The scores of U nurses'death anxiety were significantly lower than those of 25-year-old nurses. The higher the initial educational background, the lower the score of death anxiety; the higher the professional title, the higher the score of death anxiety. 3. Nurses who participated in the training or learning of care and hospice treatment of patients or relatives had lower scores of death anxiety than those who did not. 4 conditional logistic regression was used to study the influencing factors of death anxiety score. The results showed that the age of nurses who participated in hospice treatment of relatives was less than 25 years old. It is helpful to reduce the level of death anxiety of ICU nurses. 5 It is effective to organize the training of death anxiety system for ICU nurses. After participating in the training, the level of death anxiety decreased significantly.
【学位授予单位】:河北医科大学
【学位级别】:硕士
【学位授予年份】:2017
【分类号】:R47
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