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护士照顾 COVID-19 患者的心理困扰及影响因素。

Mental distress and influencing factors in nurses caring for patients with COVID-19.

机构信息

Department of Cardiovascular Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China.

Department of Nursing, The Affiliated Hospital of Qingdao University, Qingdao, China.

出版信息

Nurs Crit Care. 2021 Mar;26(2):94-101. doi: 10.1111/nicc.12528. Epub 2020 Jul 27.

Abstract

BACKGROUND

Nurses are experiencing tremendous stress during the new coronavirus disease 2019 (COVID-19) pandemic, especially intensive care nurses. The pandemic of the disease is a tragedy, which may leave a catastrophic psychological imprint on nurses. Understanding nurses' mental distress can help when implementing interventions to mitigate psychological injuries to nurses.

AIMS AND OBJECTIVES

To quantify the severity of nurses' post-traumatic stress disorder (PTSD) symptoms and stress and explore the influencing factors of their psychological health when caring for patients with COVID-19.

DESIGN

A cross-sectional survey.

METHODS

The PTSD Checklist-Civilian and the Perceived Stress Scale were administered from 11 to 18 March 2020, to 90 nurses selected from another city to go and help an intensive care unit (ICU) in Wuhan, China. These nurses were selected because of their high levels of clinical performance and resilience status.

RESULTS

Nurses' average PTSD score was 24.62 ± 6.68, and five (5.6%) of the nurses reported a clinically significant level of PTSD symptoms (>38 points). Nurses' perceived stress averaged 19.33 ± 7, and 20 nurses (22.22%) scored positively >25 points. Nurses' stress and PTSD symptoms were positively correlated (P < .01). Major stress sources included working in an isolated environment, concerns about personal protective equipment shortage and usage, physical and emotional exhaustion, intensive workload, fear of being infected, and insufficient work experiences with COVID-19.

CONCLUSIONS

This study showed that even relatively highly resilient nurses experienced some degree of mental distress, including PTSD symptoms and perceived stress. Our findings highlight the importance of helping nurses cultivate resilience and reduce stress.

RELEVANCE TO CLINICAL PRACTICE

Recommendations for practice include providing adequate training and orientation before assigning nurses to ICU to help, offering disaster-emergency-preparedness training to keep nurses prepared, providing caring and authentic nursing leadership, offering ongoing psychological support to frontline nurses.

摘要

背景

护士在新型冠状病毒病 2019(COVID-19)大流行期间承受着巨大的压力,尤其是重症监护病房的护士。这场疾病的大流行是一场悲剧,可能会给护士留下灾难性的心理印记。了解护士的心理困扰有助于在实施干预措施减轻护士的心理伤害时提供帮助。

目的

量化护士创伤后应激障碍(PTSD)症状和压力的严重程度,并探讨在照顾 COVID-19 患者时影响其心理健康的因素。

设计

横断面调查。

方法

2020 年 3 月 11 日至 18 日,对从另一城市挑选前往中国武汉一家重症监护病房(ICU)协助的 90 名护士进行了平民版 PTSD 检查表和感知压力量表的评估。选择这些护士是因为他们具有较高的临床绩效和弹性状态。

结果

护士的 PTSD 平均得分为 24.62±6.68,5 名(5.6%)护士报告 PTSD 症状存在临床显著水平(>38 分)。护士的感知压力平均为 19.33±7,20 名(22.22%)护士得分>25 分呈阳性。护士的压力和 PTSD 症状呈正相关(P<.01)。主要的压力源包括在隔离环境中工作、担心个人防护设备短缺和使用、身体和情绪疲惫、工作量大、害怕感染以及 COVID-19 工作经验不足。

结论

本研究表明,即使是相对具有弹性的护士也经历了一定程度的心理困扰,包括 PTSD 症状和感知压力。我们的研究结果强调了帮助护士培养韧性和减轻压力的重要性。

临床意义

实践建议包括在安排护士到 ICU 协助前提供充足的培训和入职指导、提供灾害应急准备培训以保持护士的准备状态、提供关怀和真实的护理领导力、为一线护士提供持续的心理支持。

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