新型冠状病毒肺炎疫情期间安徽省医护人员心理健康现状及影响因素

陈贵梅; 荣健; 何欣然; 原洪旭; 陈任; 王丽; 徐王权; 郑涛; 丁宏

doi:10.16462/j.cnki.zhjbkz.2020.08.020

新型冠状病毒肺炎疫情期间安徽省医护人员心理健康现状及影响因素

doi: 10.16462/j.cnki.zhjbkz.2020.08.020

陈贵梅¹,
荣健¹,
何欣然¹,
原洪旭³,
陈任¹,
王丽¹,
徐王权²,
郑涛³,
丁宏^1, ,

1.
230032 合肥, 安徽医科大学卫生管理学院卫生管理系
2.
230032 合肥, 安徽医科大学卫生管理学院卫生信息系
3.
230022 合肥, 安徽省胸科医院医务部

基金项目:

安徽省卫生健康委员会科研计划项目 2020XK001

详细信息

通讯作者:
丁宏, E-mail:dinghong_cn2003@163.com

中图分类号: R395.6;R181
计量
- 文章访问数: 447
- HTML全文浏览量: 250
- PDF下载量: 43
- 被引次数: 0
出版历程
- 收稿日期: 2020-05-20
- 修回日期: 2020-06-23
- 刊出日期: 2020-08-10

Mental health status of medical staff based on SCL-90 in Anhui Province during the epidemic situation of COVID-19

1.
Department of Health Service Management, School of Health Service Management, Anhui Medical University, Hefei 230032, China
2.
Department of Health Information, School of Health Service Management, Anhui Medical University, Hefei 230032, China
3.
Medical Department, Anhui Chest Hospital, Hefei 230022, China

Funds:

Scientifie Research Project from Health Commission of Anhui Province 2020XK001

More Information

Corresponding author: DING Hong, E-mail:dinghong_cn2003@163.com

摘要

摘要: 目的了解新型冠状病毒肺炎（coronavirus disease 2019，COVID-19，简称“新冠肺炎”）疫情期间安徽省医护人员心理健康现况及其影响因素，为进一步开展针对医务人员的心理健康干预和疏导提供科学依据。方法 2020年2月12日到3月4日，使用症状自评量表（symptom check list 90，SCL-90）对安徽省医护人员心理健康状况进行评估，共获得有效问卷12 759份。运用描述性分析、t检验、χ²检验和二元Logistic回归分析模型进行统计学分析。结果调查样本SCL-90总因子得分为（1.41±0.45）分，心理异常检出率为36.1%。医护人员强迫症状、人际关系敏感、抑郁、敌对、偏执、精神病性和寝食状态7个因子得分均低于中国常模人群，恐怖因子得分则高于中国常模人群，差异有统计学意义（均有P < 0.05）。多因素分析结果显示女性、高级职称以及所在医院类型为省级、县级医院是医生发生心理异常的危险因素（均有P < 0.05），女性、年龄为30~39岁以及所在医院类型为省级、市级和县级医院是护士发生心理异常的危险因素（均有P < 0.05）。结论安徽省新冠肺炎疫情期间医护人员总体心理健康水平相对稳定，但心理异常检出率较高。医生和护士发生心理异常的危险因素存在差异，应有针对性地对医护人员采取心理健康干预措施，提高其心理健康水平。
- 新型冠状病毒肺炎 /
- SCL-90 /
- 医护人员 /
- 影响因素 /
- 横断面研究
Abstract: Objective To understand the current situation and the influencing factors of psychological symptoms of medical staff in Anhui Province during the epidemic situation of coronavirus disease 2019 (COVID-19), and to provide scientific basis for targeted psychological intervention and guidance for medical staff. Methods The data were collected from February 12 to March 4, 2020. Symptom checklist 90 (SCL-90) was used to evaluate the mental health status of medical staff in Anhui Province. A total of 12 759 valid questionnaires were obtained. Descriptive analysis, t-test, χ² test and binary Logistic regression model were employed for statistical analysis. Results The total factor score of SCL-90 was (1.41±0.45), and the positive rate of psychological abnormality detection was 36.1%. Compared with the Chinese normal population, the scores of obsessive-compulsive symptoms, interpersonal sensitivity, depression, hostility, paranoia, psychosis and sleeping and eating state of the medical staff were lower than those of the Chinese norm, while the score of phobia factor was higher than that of the Chinese norm, and the differences were statistically significant (all P < 0.05). The results of Binary Logistic regression showed that female, senior professional, in provincial or county type hospital were risk factors for mental health of doctors (all P < 0.05), and female, 30-39 age group, in provincial, municipal or county type hospital were risk factors for mental health of nurses (all P < 0.05). Conclusions The overall mental health level of medical staff during the epidemic of COVID-19 in Anhui Province is relatively stable, which is better than the Chinese norm, but the positive rate of psychological abnormal is high. The risk factors of psychological abnormalities are different in doctors and nurses. It is suggested that targeted measures should be taken to improve mental health level of medical staff.
- COVID-19 /
- SCL-90 /
- Medical staff /
- Influencing factors /
- Cross-sectional study

HTML全文

表 1 新冠肺炎疫情期间医护人员SCL-90得分与2015年中国常模得分比较(x±s)

Table 1. The SCL-90 scores of medical staff during the epidemic situation of COVID-19 compared with 2015 Chinese norm's(x±s)

因子	医护人员	2015年中国常模	t值	P值
躯体化	1.37±0.45	1.37±0.46	-1.242	0.214
强迫症状	1.61±0.56	1.66±0.58	-10.707	< 0.001
人际关系敏感	1.46±0.52	1.51±0.55	-11.469	< 0.001
抑郁	1.42±0.51	1.45±0.53	-7.128	< 0.001
焦虑	1.40±0.48	1.40±0.48	-1.170	0.242
敌对	1.41±0.51	1.48±0.57	-16.061	< 0.001
恐怖	1.29±0.44	1.23±0.39	16.302	< 0.001
偏执	1.34±0.45	1.41±0.50	-18.392	< 0.001
精神病性	1.32±0.43	1.34±0.44	-4.141	< 0.001
寝食状态	1.50±0.52	1.51±0.58	-3.199	0.001

下载: 导出CSV

表 2 新冠肺炎疫情期间医生和护士SCL-90得分比较(x±s)

Table 2. Comparison of SCL-90 scores between doctors andnurses during the epidemic situation of COVID-19(x±s)

因子	医生(n=5 812)	护士(n=6 947)	t值	P值
躯体化	1.33±0.43	1.40±0.46	9.180	< 0.001
强迫症状	1.54±0.54	1.66±0.57	11.758	< 0.001
人际关系敏感	1.42±0.50	1.49±0.53	7.176	< 0.001
抑郁	1.38±0.50	1.45±0.52	6.787	< 0.001
焦虑	1.35±0.46	1.43±0.50	9.687	< 0.001
敌对	1.37±0.49	1.44±0.52	7.965	< 0.001
恐怖	1.24±0.41	1.34±0.46	11.967	< 0.001
偏执	1.32±0.44	1.35±0.45	4.201	< 0.001
精神病性	1.29±0.42	1.35±0.44	7.327	< 0.001
寝食状态	1.46±0.51	1.53±0.53	7.078	< 0.001
总因子分	1.37±0.43	1.45±0.46	9.198	< 0.001

下载: 导出CSV

表 3 新冠肺炎疫情期间不同人口学特征的医护人员心理异常分布情况[n(%)]

Table 3. Psychological abnormalities distribution of medical staff in different demographic characteristics during the epidemic situation of COVID-19 [n(%)]

变量	医生(n=5 812)				护士(n=6 947)				合计(n=12 759)
变量	异常	正常	χ²值	P值	异常	正常	χ²值	P值	异常	正常	χ²值	P值
性别			36.391	< 0.001			11.477	0.001			105.362	< 0.001
男	973(29.1)	2 369(70.9)			90(29.9)	211(70.1)			1 062(29.2)	2 580(70.8)
女	904(36.6)	1 566(63.4)			2 635(39.6)	4 011(60.4)			3 539(38.8)	5 577(61.2)
年龄(岁)			7.659	0.022			16.271	< 0.001			25.704	< 0.001
＜30	388(31.5)	845(65.8)			1 156(37.0)	1 966(63.0)			1 544(35.5)	2 811(64.5)
30~	801(34.3)	1 532(65.7)			1 136(42.1)	1 560(57.9)			1 937(38.5)	3 092(61.5)
≥40	688(30.6)	1 558(69.4)			433(38.4)	696(61.6)			1 121(33.2)	2 254(66.8)
职称			13.209	0.001			11.700	0.003
初级	981(30.5)	2 236(69.5)			1 935(38.0)	3 152(62.0)			2 916(35.1)	5 388(64.9)	9.376	0.009
中级	652(33.7)	1 284(66.3)			754(42.3)	1 028(57.7)			1 406(37.8)	2 312(62.2)
高级	244(37.0)	415(63.0)			36(46.2)	42(53.8)			280(38.0)	457(62.0)
学历			20.895	< 0.001			18.466	< 0.001			12.347	0.002
专科及以下	516(28.8)	1 273(71.2)			1 315(37.1)	2 226(62.9)			1 831(34.4)	3 499(65.6)
本科	1 063(32.9)	2 170(67.1)			1 392(41.2)	1 985(58.8)			2 455(37.1)	4 155(62.9)
硕士及以上	298(37.7)	492(62.3)			18(62.1)	11(37.9)			316(38.6)	503(61.4)
医院等级			33.669	< 0.001			59.544	< 0.001			99.512	< 0.001
省级	275(37.7)	455(62.3)			465(46.9)	526(53.1)			740(43.0)	981(57.0)
市级	436（32.7）	899(67.3)			588(40.0)	882(62.0)			1024(36.5)	1781(63.5)
县级	598（35.0）	1113(65.0)			963(40.8)	1395(59.2)			1561(38.4)	2508(61.6)
县级以下	433（28.3）	1098(71.7)			348(32.4)	727(67.6)			781(30.0)	1825(70.0)
民营	135(26.7)	370(73.3)			361(34.3)	692(65.7)			496(31.8)	1062(68.2)
合计	1877(32.3)	3955(67.7)			2725(39.5)	4222(60.8)			4602(36.1)	8157(63.9)

下载: 导出CSV

表 4 新冠肺炎疫情期间医护人员心理异常的二元Logistic回归分析模型分析

Table 4. Analysis of bnary Logistic regression model of psychological abnormality in medical staff during the epidemic situation of COVID-19

变量	β值	S_x值	Wald值	OR(95% CI)值	P值
性别
女				1.000
男	-0.352	0.052	44.949	0.703(0.635~0.780)	< 0.001
年龄(岁)
< 30				1.000
30~	0.133	0.049	7.490	1.142(1.039~1.257)	0.006
≥40	0.048	0.064	0.558	1.049(0.926~1.188)	0.455
学历
专科及以下				1.000
本科	0.014	0.046	0.090	1.014(0.927~1.109)	0.764
硕士及以上	0.093	0.095	0.954	1.098(0.911~1.323)	0.329
职业
护士				1.000
医生	-0.167	0.050	11.302	0.846(0.767~0.933)	0.001
职称
初级				1.000
中级	0.090	0.049	3.368	1.095(0.994~1.206)	0.066
高级	0.269	0.094	8.220	1.308(1.089~1.573)	0.004
医院类型
民营				1.000
省级	0.435	0.078	31.472	1.546(1.327~1.799)	< 0.001
市级	0.190	0.070	7.381	1.209(1.054~1.387)	0.007
县级	0.300	0.064	21.762	1.350(1.190~1.531)	< 0.001
县级以下	0.007	0.072	0.011	1.007(0.874~1.161)	0.918
常数项	-0.725	0.060	145.457

下载: 导出CSV

表 5 新冠肺炎疫情期间医生和护士心理异常的二元Logistic回归分析模型分析

Table 5. Binary Logistic regression analysis of psychological abnormalities in doctors and nurses during the epidemic situation of COVID-19

变量	医生(n=5 812)					护士(n=6 947)
变量	β值	S_x值	Wald值	OR(95% CI)值	P值	β值	S_x值	Wald值	OR(95% CI)值	P值
性别
女				1.000					1.000
男	-0.358	0.058	38.547	0.699(0.624~0.782)	< 0.001	-0.365	0.131	7.787	0.694(0.537~0.897)	0.005
年龄(岁)
< 30				1.000					1.000
30~	0.070	0.084	0.698	1.072(0.910~1.263)	0.403	0.168	0.061	7.699	1.183(1.051~1.332)	0.006
≥40	-0.032	0.100	0.104	0.968(0.796~1.178)	0.747	0.084	0.088	0.911	1.088(0.915~1.294)	0.340
学历
专科及以下				1.000					1.000
本科	0.028	0.081	0.123	1.029(0.878~1.205)	0.725	-0.008	0.057	0.021	0.992(0.887~1.108)	0.884
硕士及以上	0.167	0.122	1.887	1.182(0.931~1.500)	0.170	0.743	0.389	3.652	2.103(0.981~4.509)	0.056
职称
初级				1.000					1.000
中级	0.120	0.073	2.692	1.127(0.977~1.300)	0.101	0.079	0.068	1.314	1.082(0.946~1.237)	0.252
高级	0.327	0.112	8.534	1.387(1.114~1.726)	0.003	0.263	0.240	1.202	1.301(0.813~2.082)	0.273
医院类型
省级	0.321	0.14	5.275	1.378(1.048~1.813)	0.022	0.491	0.094	27.326	1.635(1.36~1.965)	< 0.001
市级	0.173	0.121	2.034	1.189(0.937~1.509)	0.154	0.199	0.087	5.232	1.220(1.029~1.446)	0.022
县级	0.370	0.115	10.329	1.447(1.155~1.813)	0.001	0.255	0.078	10.636	1.290(1.107~1.504)	0.001
县级以下	0.133	0.119	1.254	1.142(0.905~1.441)	0.263	-0.100	0.094	1.130	0.905(0.752~1.088)	0.288
民营				1.000					1.000
常数项	-0.901	0.126	50.959				-0.712	0.070	104.649

下载: 导出CSV

参考文献(19)

[1]	Wordometer. COVID-19 coronavirus pandemic[EB/OL]. (2020-05-20)[2020-05-20]. https://www.worldometers.info/coronavirus/.
[2]	王发强, 许建阳, 刘庆安, 等. SARS患者与抗SARS医务人员心理健康对比分析[J].中国心理卫生杂志, 2003, 17(8):532-533. DOI: 10.3321/j.issn:1000-6729.2003.08.006. Wang FQ, Xu JY, Liu AQ, et al. Comparison of psychological status between patients with SARS and physicians, nurses treating SARS[J]. Chin Ment Health J, 2003, 17(8):532-533. DOI: 10.3321/j.issn:1000-6729.2003.08.006.
[3]	Waterman S, Hunter ECM, Cole CL, et al. Training peers to treat Ebola centre workers with anxiety and depression in Sierra Leone[J]. Int J Soc Psychiatry, 2018, 64(2):156-165. DOI: 10.1177/0020764017752021.
[4]	Zhang WR, Wang K, Yin L, et al. Mental health and psychosocial problems of medical health workers during the COVID-19 epidemic in China[J]. Psychother Psychosom, 2020, 89(4):242-250. DOI: 10.1159/000507639.
[5]	Wu K, Wei X. Analysis of psychological and sleep status and exercise rehabilitation of front-line clinical staff in the fight against COVID-19 in China[J]. Med Sci Monit Basic Res, 2020, 26:e924085. DOI: 10.12659/MSMBR.924085.
[6]	唐秋萍, 程灶火, 袁爱华, 等. SCL-90在中国的应用与分析[J].中国临床心理学杂志, 1999, 7(1):19-20. DOI: 10.16128/j.cnki.10053611.1999.01.005. Tang QP, Cheng ZH, Yuan AH, et al. The use and reanalysis of SCL-90 in China[J]. Chin J Clin Psychol, 1999, 7(1):19-20. DOI: 10.16128/j.cnki.10053611.1999.01.005.
[7]	Derogatis LR, Lipman RS, Covi L. SCL-90:an outpatient psychiatric rating scale——preliminary report[J]. Psychopharmacol Bull, 1973, 9(1):13-28. http://onlinelibrary.wiley.com/resolve/reference/PMED?id=4682398
[8]	汪向东, 王希林, 马弘.心理卫生评定量表手册:增订版[M].北京:中国心理卫生杂志社, 1999. Wang XD, Wang XL, Ma H. Rating scales for mental health (Updated version)[M]. Beijing:Chinese Mental Health Journal, 1999.
[9]	刘媛媛, 武圣君, 李永奇, 等.基于SCL-90的中国人群心理症状现况调查[J].中国心理卫生杂志, 2018, 32(5):437-441. DOI: 10.3969/j.issn.1000-6729.2018.05.016. Liu YY, Wu SJ, Li YQ, et al. A survey of mental symptoms of Chinese population based on SCL-90[J]. Chin Ment Health J, 2018, 32(5):437-441. DOI: 10.3969/j.issn.1000-6729.2018.05.016.
[10]	国家卫生健康委办公厅, 国家中医药管理局办公室.关于印发新型冠状病毒肺炎诊疗方案(试行第七版)的通知[EB/OL]. (2020-03-03)[2020-05-20].http://www.nhc.gov.cn/yzygj/s7653p/202003/46c9294a7dfe4cef80dc7f5912eb1989.shtml. National Health Commission, State Administration of Traditional Chinese Medicine. Diagnosis and treatment protocol for Novel Coronavirus Pneumonia (Trial Version 7)[EB/OL]. (2020-03-03)[2020-05-20]. http://www.nhc.gov.cn/yzygj/s7653p/202003/46c9294a7dfe4cef80dc7f5912eb1989.shtml.
[11]	李士雪, 单莹.新型冠状病毒肺炎研究进展述评[J].山东大学学报(医学版), 2020, 58(3):19-25. DOI: 10.6040/j.issn.1671-7554.0.2020.205. Li SX, Shan Y. Latest research advances on novel coronavirus pneumonia[J]. J Shandong Univ (Health Sci), 2020, 58(3):19-25. DOI: 10.6040/j.issn.1671-7554.0.2020.205.
[12]	Tian F, Li H, Tian S, et al. Psychological symptoms of ordinary Chinese citizens based on SCL-90 during the level I emergency response to COVID-19[J]. Psychiatry Res, 2020, 288:112992. DOI: 10.1016/j.psychres.2020.112992.
[13]	宋斐翡, 王鑫, 剧志英, 等.新型冠状病毒肺炎流行期间公众心理健康状况及其影响因素研究[J].公共卫生与预防医学, 2020, 31(2):23-27. DOI: 10.3969/j.issn.1006-2483.2020.02.006. Song FF, Wang X, Ju ZY, et al. Mental health status and related influencing factors during the epidemic of coronavirus disease (COVID-2019)[J]. J Pub Health Prev Med, 2020, 31(2):23-27. DOI: 10.3969/j.issn.1006-2483.2020.02.006.
[14]	周洁, 吴国霞.新型冠状病毒肺炎流行期间医院医务人员心理健康状况调查分析[J].首都食品与医药, 2020, 27(8):6-8. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=sdyy202008002 Zhou J, Wu GX. Investigation and analysis of mental health status of hospital medical staff during epidemic of Corona Virus Disease 2019[J]. Capital Food Med, 2020, 27(8):6-8. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=sdyy202008002
[15]	王月莹,贾欣睿,宋继权,等.新型冠状病毒肺炎流行期间医护人员的心理健康状况调查及分析[J/OL].武汉大学学报(医学版)，2020:[ 2020-05-20]. https://doi.org/10.14188/j.1671-8852.2020.0154.DOI:10.14188/j.1671-8852.2020.0154." target="_blank">10.14188/j.1671-8852.2020.0154.">https://doi.org/10.14188/j.1671-8852.2020.0154.DOI:10.14188/j.1671-8852.2020.0154. Wang YY, Jia XR, Song JQ, et al. Mental health status of medical staff during the outbreak of Coronavirus Disease 2019[J/OL].Med J Wuhan Univ，2020: [2020-05-20]. https://doi.org/10.14188/j.1671-8852.2020.0154.DOI:10.14188/j.1671-8852.2020.0154." target="_blank">10.14188/j.1671-8852.2020.0154.">https://doi.org/10.14188/j.1671-8852.2020.0154.DOI:10.14188/j.1671-8852.2020.0154.
[16]	王竞, 程雅倩, 周照, 等.新型冠状病毒肺炎疫情对武汉市一线医护人员心理状况的影响[J].武汉大学学报(医学版), 2020, 41(4):547-550. DOI: 10.14188/j.1671-8852.2020.0098. Wang J, Cheng YQ, Zhou Z, et al. Psychological status of Wuhan medical staff in fighting against COVID-19[J]. Med J Wuhan Univ, 2020, 41(4):547-550. DOI: 10.14188/j.1671-8852.2020.0098.
[17]	童延, 蒋兆强, 张艺潇, 等.医生和护士心理健康及影响因素分析[J].中华劳动卫生职业病杂志, 2018, 36(2):115-118. DOI: 10.3760/cma.j.issn.1001-9391.2018.02.009. Tong Y, Jiang ZQ, Zhang YX, et al. Analyzing the mental health status and its impact factors among female anises in China[J]. Chin J Indust Hyg Occ Dis, 2018, 36(2):115-118. DOI: 10.3760/cma.j.issn.1001-9391.2018.02.009.
[18]	陈敏.已婚护士工作家庭冲突调查分析[J].河南中医, 2014, 34(11):415-416. http://www.cqvip.com/QK/92183X/2014B11/663269327.html Chen M. Analysis of conflicts between their working and families of married nurses[J]. Henan Tradit Chin Med, 2014, 34(11):415-416. http://www.cqvip.com/QK/92183X/2014B11/663269327.html
[19]	Cai WP, Lian B, Song XR, et al. A cross-sectional study on mental health among health care workers during the outbreak of Corona Virus Disease 2019[J]. Asian J Psychiatr, 2020, 51:102-111. DOI: 10.1016/j.ajp.2020.102111.