17170名医务人员心理健康状况及其影响因素研究

发布时间：2018-11-15 23:30

【摘要】：目的：了解医务人员心理健康现况及其影响因素,为提高医务人员心理健康水平提供科学依据。方法：采用多阶段分层整群抽样方法,从湖南省14个市州48个县共计445家各级医疗保健机构中随机抽取17170名医务人员(包括医生、护士、医技检验人员、药剂人员、后勤行政人员等),进行问卷调查。医务人员心理健康影响因素的单因素分析采用卡方检验或方差分析,多因素分析采用非条件logistic回归分析(Backward:LR法)。结果：医务人员焦虑、抑郁的总检出率分别为35.3%、64.6%,其中,护士焦虑和抑郁检出率最高分别为38.6%、67.9%；其次为医生分别为37.1%、67.1%；他们是医务人员中焦虑和抑郁的高发人群。不同性别中,女性医务人员抑郁检出率(65.8%)高于男性(61.9%)；不同职称中,初级职称医务人员焦虑和抑郁检出率(37.2%和65.8%)明显高于副高(33.6%和54%)及以上职称者；检出焦虑、抑郁医务人员的社会支持总分、客观支持分、主观支持分、支持利用度方面均显著低于无焦虑和抑郁者,差异有统计学意义。焦虑影响因素的多因素分析结果显示：护士职业、经常加班、每周晚夜班次数增加、医患关系紧张、感受到医患纠纷中安全得不到保障、感到晋升困难、工作缺乏他人的尊重、同事之间缺乏理解、管理者的批评过多、及未感受到领导器重等因素将增加医务人员焦虑发生的风险；而对工作环境满意度高,有继续深造学习机会、遇到压力时找人倾诉或参加文体活动、社会支持得分高等因素将减少医务人员焦虑发生的风险。抑郁影响因素的多因素分析结果显示：医护职业、经常加班、每周晚夜班次数增加、感受到医患纠纷中安全得不到保障、感到晋升困难、工作缺乏他人的尊重、同事之间缺乏理解、及未感受到领导器重等将增加医务人员抑郁发生的风险；而对工作环境满意度高,有继续深造学习机会、遇到压力时找人倾诉或参加文体活动、社会支持得分高等将减少医务人员抑郁发生的风险。结论：医务人员心理健康状况不容乐观,应采取必要措施进行心理干预,以促进与保护医务人员身心健康。
[Abstract]:Objective: to understand the mental health status of medical staff and its influencing factors, and to provide scientific basis for improving the mental health level of medical staff. Methods: 17170 medical personnel (including doctors, nurses, medical examiners, pharmacists) were randomly selected from 445 medical care institutions in 14 cities and 48 counties of Hunan province by multi-stage stratified cluster sampling. Logistic administrative staff, etc.), conduct questionnaire survey. Univariate analysis of influencing factors of mental health of medical staff was performed by chi-square test or variance analysis, and non-conditional logistic regression analysis (Backward:LR method) was used for multivariate analysis. Results: the total detectable rates of anxiety and depression in medical staff were 35.3and 64.6, respectively. Among them, the highest detectable rate of anxiety and depression in nurses was 38.6 and 67.9, and the second was 37.1 and 67.1, respectively, and that of doctors was 37.1 and 67.1, respectively. They are a high incidence of anxiety and depression among medical workers. The prevalence of depression in female medical staff (65.8%) was higher than that in male (61.9%). The detectable rate of anxiety and depression of medical staff with junior titles (37.2% and 65.8%) was significantly higher than that with subtropical high (33.6% and 54%). The total scores of social support objective support subjective support and support utilization of anxiety and depression medical staff were significantly lower than those without anxiety and depression. The results of multivariate analysis of anxiety factors showed that nursing profession, frequent overtime, increasing number of night shifts per week, tension between doctors and patients, feeling that safety is not guaranteed in doctor-patient disputes, difficulties in promotion, lack of respect from others, Lack of understanding among colleagues, too much criticism from managers, and failure to feel the importance of leadership will increase the risk of anxiety among medical staff. The factors such as high satisfaction with the work environment, the opportunity to continue further study, the chance to talk to others or participate in sports activities when under pressure, and the high score of social support will reduce the risk of medical staff anxiety. The results of multivariate analysis of the influencing factors of depression showed that: medical profession, frequent overtime, increased number of night shifts per week, felt that safety was not guaranteed in doctor-patient disputes, it was difficult to promote, and work lacked respect from others. Lack of understanding among colleagues and lack of sense of leadership will increase the risk of depression among medical staff; The higher score of social support will reduce the risk of depression of medical staff because of the high degree of satisfaction with the work environment, the opportunity to continue further study, the chance to talk to others or to participate in sports activities when they are under pressure, and the higher score of social support will reduce the risk of depression. Conclusion: the state of mental health of medical staff is not optimistic and necessary measures should be taken to promote and protect their physical and mental health.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R395

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