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遭受身体暴力的中国医护人员创伤后应激障碍症状的患病率及其相关因素:一项横断面研究

Prevalence and correlates of symptoms of post-traumatic stress disorder among Chinese healthcare workers exposed to physical violence: a cross-sectional study.

作者信息

Shi Lei, Wang Lingling, Jia Xiaoli, Li Zhe, Mu Huitong, Liu Xin, Peng Boshi, Li Anqi, Fan Lihua

机构信息

Department of Health Management, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China.

Department of Autonomous Protection, Chinese Hospital Association, Beijing, China.

出版信息

BMJ Open. 2017 Aug 1;7(7):e016810. doi: 10.1136/bmjopen-2017-016810.

Abstract

OBJECTIVES

Post-traumatic stress disorder (PTSD) is a common psychological maladjustment to undergoing a traumatic event. Our aim was to measure the prevalence of PTSD among Chinese healthcare workers exposed to physical violence' and explore the associations of their demographic characteristics, social support, personality traits' and coping styles with their PTSD symptoms.

METHODS

A cross-sectional study was conducted using the Workplace Violence Scale, Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C), Social Support Rating Scale (SSRS), Eysenck Personality Questionnaire-Revised Short Scale and Trait Coping Style Questionnaire. We used convenience sampling method to collect data from March 2015 to September 2016. Healthcare workers (n=2706) from 39 public hospitals located in Heilongjiang, Hebei and Beijing provinces of China completed the questionnaires (effective response rate=84.25%).

RESULTS

Overall, the prevalence of physical violence in the previous 12 months was 13.60% (n=2706). The prevalence of PTSD among the healthcare workers who experienced physical violence was 28.0% (n=368). Most of the victims of physical violence (50.80%) did not exhibit PTSD symptoms based on their PCL-C scores, and 47.0% did not manifest the diagnostic criteria for PTSD after experiencing physical violence. The level of PTSD symptoms was negatively correlated with their scores on the SSRS (r=-0.188, p<0.001). The hierarchical regression analysis (block 3) revealed that, in women, positive coping was significantly associated with PTSD symptoms (β=-0.376, p=0.001). However, the effect of positive coping was not significant in men.

CONCLUSIONS

The results suggest that the aftermath of physical violence contributes to the current prevalence of PTSD. The positive effects of social support on PTSD symptoms suggest that it has practical implications for interventions to promote psychological health. The healthcare workers' coping styles influenced the development of PTSD symptoms. Therefore, adopting effective coping styles and receiving social support have potential roles in the recovery from trauma after experiencing physical violence.

摘要

目的

创伤后应激障碍(PTSD)是经历创伤性事件后常见的心理适应不良。我们的目的是测量遭受身体暴力的中国医护人员中PTSD的患病率,并探讨其人口统计学特征、社会支持、人格特质和应对方式与PTSD症状之间的关联。

方法

采用横断面研究,使用工作场所暴力量表、创伤后应激障碍检查表-平民版(PCL-C)、社会支持评定量表(SSRS)、艾森克人格问卷修订简式量表和特质应对方式问卷。我们采用便利抽样方法,于2015年3月至2016年9月收集数据。来自中国黑龙江、河北和北京三省39家公立医院的医护人员(n = 2706)完成了问卷调查(有效回复率 = 84.25%)。

结果

总体而言,过去12个月身体暴力的患病率为13.60%(n = 2706)。遭受身体暴力的医护人员中PTSD的患病率为28.0%(n = 368)。根据PCL-C评分,大多数身体暴力受害者(50.80%)未表现出PTSD症状,47.0%在经历身体暴力后未表现出PTSD的诊断标准。PTSD症状水平与他们在SSRS上的得分呈负相关(r = -0.188,p < 0.001)。分层回归分析(第3组)显示,在女性中,积极应对与PTSD症状显著相关(β = -0.376,p = 0.001)。然而,积极应对在男性中的作用不显著。

结论

结果表明,身体暴力的后果导致了当前PTSD的患病率。社会支持对PTSD症状的积极影响表明,它对促进心理健康的干预具有实际意义。医护人员的应对方式影响了PTSD症状的发展。因此,采用有效的应对方式和获得社会支持在经历身体暴力后的创伤恢复中具有潜在作用。

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