Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center, Hospital East, Kashiwa, Chiba, Japan.
Palliat Support Care. 2010 Sep;8(3):291-5. doi: 10.1017/S1478951510000088.
The purpose of this study is to identify psychiatric disorders and stress factors experienced by staff members in cancer hospitals who were referred to psychiatric consultation service, and to investigate the association between psychiatric disorders and stress factors.
A retrospective descriptive study using clinical practice data on staff members referred to psychiatric consultation service, obtained for 8 years, was conducted at two National Cancer Center Hospitals in Japan. Psychiatric disorders were identified according to DSM-IV. Stress factors were extracted from a chief complaint at the initial visit in medical charts, using a coding approach, and grouped as job stress or personal stress. The frequencies of the stress factors were determined by two coders who were unaware of the categorized procedure. Fisher's exact test was used to determine the association between psychiatric disorders and stress factors.
Of 8077 psychiatric consultations, 65 (1%) staff members were referred. The most common psychiatric disorder was adjustment disorder (n = 26, 40%), followed by major depression (n = 17, 26%). Eight stress factors were identified from 76 meaning units and were grouped into five job stresses and three personal stresses. Of the five job stresses, four were most frequently experienced in adjustment disorders, and "failure to adapt to job environmental change" was significantly associated (p = 0.014). Two of the three personal stresses were most frequently experienced in psychiatric disorders other than major depressive disorder and adjustment disorders, and "suffering from mental disease" was significantly associated (p = 0.001).
We found that very few staff members were provided with psychiatric consultation service. A comprehensive support system for job stress might be needed to prevent adjustment disorders, as those are suggested to be the most common psychiatric disorders among staff members in cancer hospitals.
本研究旨在识别癌症医院向精神科咨询服务转诊的员工所经历的精神障碍和压力因素，并探讨精神障碍与压力因素之间的关联。
对日本两家国家癌症中心医院的精神科咨询服务转诊员工的临床实践数据进行了为期 8 年的回顾性描述性研究。根据 DSM-IV 识别精神障碍。从病历的首次就诊的主要诉求中提取编码方法的压力因素，并分为工作压力或个人压力。两名对分类程序不知情的编码员确定压力因素的频率。使用 Fisher 确切检验确定精神障碍与压力因素之间的关联。
在 8077 次精神科咨询中，有 65 名（1%）员工被转诊。最常见的精神障碍是适应障碍（n=26，40%），其次是重度抑郁症（n=17，26%）。从 76 个意义单位中确定了 8 个压力因素，并分为五个工作压力和三个个人压力。在五个工作压力中，有四个在适应障碍中最常经历，“未能适应工作环境变化”显著相关（p=0.014）。三个个人压力中有两个在除重度抑郁症和适应障碍以外的精神障碍中最常经历，“患有精神疾病”显著相关（p=0.001）。
我们发现很少有员工接受精神科咨询服务。可能需要建立一个全面的工作压力支持系统，以预防适应障碍，因为适应障碍是癌症医院员工中最常见的精神障碍。
