青岛市三级甲等医院医务人员功能性胃肠病流行病学和精神心理因素调查

发布时间：2018-05-04 15:18

本文选题：医护人员 + 功能性胃肠病　；参考：《青岛大学》2017年硕士论文

【摘要】：目的:1.本研究调查医务人员FGIDs的患病率及相关影响因素。2.通过回顾文献以及对医务人员进行问卷调查研究,大致判断医务人员精神心理健康状况,了解精神心理因素对功能性胃肠病患病的影响,为医务人员FGIDs的治疗、预防及维护医务人员良好的心理健康状况提供参考依据。方法:对青岛市四所三级甲等医院医务人员群体采取整群、分层、随机抽样的方法。采用罗马III成人功能性胃肠病诊断问卷进行诊断;根据医务人员的自身特点设计基本情况、生活方式等内容,应用焦虑自评量表(SAS)、抑郁自评量表(SDS)等两个量表对抽样人群进行调查分析,比较FGIDs患病组与非患病组焦虑、抑郁得分情况。运用SPSS17.0统计软件进行数据分析。计数资料组间的比较采用卡方检验,用平均值±标准差来描述计量资料,2组计量资料之间的比较采用t检验,多组间的比较应用单因素方差分析。如无明显特殊说明P0.05为差异有显著。结果:1.本次研究共调查医护人员1380人,女性657人(47.6%),男性723人(52.4%),医生656人(47.5%),护士724人(52.5%)。2.青岛市三级甲等医院医护人员FGIDs总体患病率为31.5%,不同性别间FGID患病率存在差异,女性患病256人(38.9%)高于男性179人(24.7%);25-35岁组FGIDs患病率高(40.0%);不同工作类别间,护士253人(34.94%)高于医生182人(27.74%);不同职称间,副高级(38.8%)高于初级(23.19%)、中级(38.17%)和高级(32.08%);急诊科室患病率最高108人(58.69%);工年限为5-10年患病率最高(41.91%),科室主任患病率最高(67.4%)。以上各组间比较差异均有统计学意义(P0.5)。3.功能性消化不良,肠易激综合征和功能性便秘的患病率分别为17.1%,8.4%和6.0%,其中在237例功能性消化不良中,上腹痛综合征为115例(48.5%),餐后不适综合征为122例(51.5%)。在115例肠易激综合征中,肠易激综合征便秘型15例(13.0%),腹泻型85例(73.9%),混合型15例(13.1%)。上腹痛综合征与餐后不适综合征在不同性别、工作性质和职称间,患病情况有显著性差异(P0.05)。肠易激综合征在不同职称间,患病情况有显著性差异(P0.05)。3.焦虑自评量表(SAS)和抑郁自评量表(SDS):SAS和SDS结果显示,医务人员FGIDs组SAS和SDS得分均值都高于非FGIDs组,具有显著性差异(P0.05),提示焦虑和或抑郁与功能性胃肠病的患病有关。结论:青岛市三级甲等医院医护人员FGIDs患病率高,其中,女性患病率高于男性,护士患病率高于医生,年龄以25-35岁患病率最高,工作年限以5-10年患病率最高,功能性消化不良,肠易激综合征和功能性便秘患病率分别为17.1%,8.4%和6.0%,其中餐后不适综合征为功能性消化不良的主要病种,肠易激综合征腹泻型为肠易激综合征的最主要病种。医务人员FGIDs患者与焦虑和或抑郁明显相关,应当给予更多的精神心理咨询,以缓解医务人员心理压力。意义:功能性胃肠病(Functional gastrointestinal disorders,FGIDs)是一种常见的消化系统疾病,临床上诊断功能性疾病的必要条件是充分排除器质性病变(如肿瘤、炎症等),这一点对于功能性胃肠病尤为重要[1]。FGIDs主要有功能性消化不良(Functional dyspepsia,FD)、肠易激综合征(Irritable bowel syndromeIBS、和功能性便秘(Functional constipation,FC)。功能性胃肠病治疗周期长,发病诱因多,临床疗效差,其症状常常反复出现,难以根治,对患者的生活及工作质量、经济支出造成了显著的影响,从而占用了大量的医疗资源。FGIDs患者不仅长期承受躯体上的不适,精神、心理方面也同样受到极大的影响。近几年来随着医疗市场竞争日益激烈,病人对健康的要求日益增高以及目前不和谐的医患关系,这些因素促使相应的医务人员的精神心理压力越来越大。我国有关FGIDs的流行病学调查研究虽然已经涉及到不同人群、不同职业如大学生,解放军官兵、出租车司机、远洋轮船海员等,但是关于医护人员的系统调查较少。
[Abstract]:Objective: 1. to investigate the prevalence and influencing factors of FGIDs in medical staff,.2. through a review of the literature and the investigation of medical staff, the mental and mental health status of medical staff was roughly judged, the effects of psycho psychological factors on the disease of functional gastrointestinal diseases, the treatment of medical personnel FGIDs, and the prevention and maintenance of medical treatment, were also discussed. Methods: a group, stratified and random sampling method was adopted in the group of four grade three first class hospitals in Qingdao, using a questionnaire on the diagnosis of adult functional gastrointestinal diseases in Rome III, and the basic situation and life style should be designed according to the self characteristics of the medical staff. Two scales, such as the self rating Anxiety Scale (SAS) and the self rating Depression Scale (SDS), were used to investigate and analyze the sampling population. The scores of anxiety and depression in the FGIDs and non diseased groups were compared. The data were analyzed by the SPSS17.0 software. The comparison between the count data groups was compared with the chi square test, and the mean standard deviation was used to describe the measurement data, 2 The comparison of the data between the groups was compared with the single factor analysis of variance using t test. For example, there was a significant difference between the 1380 people, 657 women (47.6%), 723 men (52.4%), 656 doctors (47.5%), 724 nurses (52.5%) in Qingdao City, Qingdao City three a class hospital. The overall prevalence rate of FGIDs was 31.5%, the prevalence of FGID in different sexes was different, 256 (38.9%) of women were higher than that of men (24.7%); the prevalence rate of FGIDs in 25-35 year old group was higher (40%); 253 (34.94%) in different work categories (34.94%) was higher than that of doctors 182 (27.74%); the secondary (38.8%) was higher than junior (23.19%) and intermediate (3). 8.17%) and advanced (32.08%); the prevalence rate of the emergency department was the highest (58.69%); the age of 5-10 years was the highest (41.91%), and the prevalence rate of the department director was the highest (67.4%). The differences were statistically significant (P0.5).3. functional dyspepsia, and the prevalence rates of irritable bowel syndrome and functional constipation were 17.1%, 8.4% and 6%, respectively. Among 237 cases of functional dyspepsia, upper abdominal pain syndrome was 115 cases (48.5%), postprandial discomfort syndrome was 122 (51.5%). 115 cases of irritable bowel syndrome, 15 cases of irritable bowel syndrome (13%), 85 cases of diarrhea (73.9%), and mixed 15 (13.1%). The characteristics of upper abdominal pain syndrome and postprandial discomfort syndrome were different sex and working nature. There was a significant difference in the prevalence of the disease (P0.05). There was a significant difference in the prevalence of irritable bowel syndrome in different titles (P0.05).3. Anxiety Scale (SAS) and self rating Depression Scale (SDS): the results of SAS and SDS showed that the average score of SAS and SDS in FGIDs group of medical staff was higher than that of non FGIDs group, and there was significant difference (P0.05). Anxiety and depression were associated with the disease of functional gastrointestinal diseases. Conclusion: the prevalence rate of FGIDs in the three grade a hospital was higher, among them, the prevalence rate of women was higher than that of men, the prevalence rate of nurses was higher than that of the doctors, the highest prevalence rate at the age of 25-35 years, the highest rate of 5-10 years of work, functional dyspepsia, irritable bowel syndrome and work. The prevalence rates of energy constipation were 17.1%, 8.4% and 6% respectively. The postprandial discomfort syndrome was the main disease of functional dyspepsia, and irritable bowel syndrome was the most important disease of irritable bowel syndrome. The FGIDs patients in medical staff were closely related to anxiety and depression. More psychological counseling should be given to relieve the medical workers. Psychological stress. Significance: Functional gastrointestinal disorders (FGIDs) is a common digestive system disease. The essential condition for clinical diagnosis of functional diseases is to fully exclude organic diseases (such as tumors, inflammation, etc.), which is particularly important for functional gastrointestinal diseases, especially in [1].FGIDs. Functional dyspepsia (FD), irritable bowel syndrome (Irritable bowel syndromeIBS, and functional constipation (Functional constipation, FC). The treatment cycle of functional gastrointestinal disease is long, the causes of the disease are many, the clinical curative effect is poor, the symptoms are often recurring, it is difficult to root out, and it has caused significant economic expenditure to the life and work quality of the patients. The effects, thus taking up a large amount of medical resources,.FGIDs patients not only have long suffered from physical discomfort, mental, psychological aspects are also greatly affected. In recent years, with the increasingly fierce competition in the medical market, the increasing demand for health and the current unharmonious relationship between doctors and patients, these factors contribute to the medical treatment. The mental and psychological pressure of the personnel is becoming more and more serious. Although the epidemiological investigation of FGIDs has been involved in different populations, different professions such as college students, PLA officers and soldiers, taxi drivers, marine steamers, and so on, there are few systematic investigations on medical and nursing personnel.

【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R57

【参考文献】