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湖南省 4237 名护士焦虑、抑郁和失眠现状及影响因素分析。

Status quo and influencing factors for anxiety, depression, and insomnia among 4 237 nurses in Hunan Province.

机构信息

Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha 410011.

Mental Health Institute, Second Xiangya Hospital, Central South University, Changsha 410011.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2021 Aug 28;46(8):822-830. doi: 10.11817/j.issn.1672-7347.2021.210212.

Abstract

OBJECTIVES

Public health emergencies have caused significant psychological burden on nurse and affect their mental health. After the coronavirus disease 2019 pandemic, the nurse's mental health has been paid much attention. This study aims to investigate status and influencing factors for anxiety, depression, and insomnia in nurses during the normalized epidemic period, and to further compare the risk of anxiety, depression, and insomnia among nurses at different levels of hospitals between front-line epidemic nurses and other nurses so as to provide a basis for mental health work, nursing management, and relevant study in hospital.

METHODS

A total of 4 237 nurses from all levels of hospitals in Hunan Province participated in the survey in December 2020. A self-designed anonymous questionnaire was used in this study. Anxiety, depression, and insomnia were assessed using Generalized Anxiety Disorder-7 items (GAD-7), Patient Health Questionnaire-9 items (PHQ-9), and Insomnia Severity Index (ISI), respectively. Descriptive statistical analysis was used to evaluate nurses' anxiety, depression, and insomnia; -test, analysis of variance, and multiple linear stepwise regression analysis were used to analyze the influencing factors of nurses' anxiety, depression, and insomnia.

RESULTS

The scores of GAD-7 among 4 237 nurses were 4.44±4.20, with 10.3% of them experienced moderate to severe level anxiety. The scores of PHQ-9 were 6.03±4.76, with 17.5% of them experienced moderate to severe level depressive symptom. The scores of ISI were 8.37±5.42, with 12.3% of them experienced moderate to severe insomnia. There were significant differences in GAD-7, PHQ-9, and ISI scores among different groups of hospital levels, gender, professional title, position, education level, night shifts, and family monthly income (all <0.05). Marital status, whether to participate in the front-line, and whether to participate in psychology training groups were not associated with anxiety, depression, and insomnia (all >0.05). Gender, hospital level, professional title, educational background, more night shifts, and family monthly income were the influencing factors for the GAD-7 and PHQ-9 scores. Gender, length of service, position, hospital level, educational background, night shifts in the last year, and family monthly income were the influencing factors for ISI score.

CONCLUSIONS

There is no difference in the scores of the GAD-7, PHQ-9, and ISI between nurses whether to participate in the front-line, indicating that series of measures for front-line medical staff are effective in China.Meanwhile, some nurses experienced anxiety, depression, and insomnia, and attention should be paid to nurses with low position, more night shifts, lower-level hospitals, and families with low income. It is recommended that management policies, psychological support, and human resource protection should be given to relieve the pressure and maintain the mental health of nurses. At the same time, it is necessary to make mental health knowledge training as a routine training when responding to public health emergencies.

摘要

目的

公共卫生事件给护士带来了巨大的心理负担,影响了他们的心理健康。新冠肺炎疫情后,护士的心理健康备受关注。本研究旨在调查常态化疫情防控期间护士焦虑、抑郁和失眠的现状及其影响因素,并进一步比较不同级别医院一线抗疫护士与其他护士的焦虑、抑郁和失眠风险,为医院心理健康工作、护理管理和相关研究提供依据。

方法

2020 年 12 月,采用便利抽样法选取湖南省各级医院的 4237 名护士进行问卷调查。采用一般焦虑障碍量表-7 项(GAD-7)、患者健康问卷-9 项(PHQ-9)和睡眠障碍严重程度指数量表(ISI)分别评估护士的焦虑、抑郁和失眠状况。采用描述性统计分析评估护士的焦虑、抑郁和失眠状况;采用 t 检验、方差分析和多元线性逐步回归分析护士焦虑、抑郁和失眠的影响因素。

结果

4237 名护士的 GAD-7 得分为 4.44±4.20,其中 10.3%存在中重度焦虑。PHQ-9 得分为 6.03±4.76,其中 17.5%存在中重度抑郁症状。ISI 得分为 8.37±5.42,其中 12.3%存在中重度失眠。不同医院级别、性别、职称、岗位、学历、夜班数和家庭月收入护士的 GAD-7、PHQ-9 和 ISI 得分差异有统计学意义(均<0.05)。婚姻状况、是否参与一线抗疫和是否参加心理培训小组与焦虑、抑郁和失眠无关(均>0.05)。性别、医院级别、职称、学历、夜班数和家庭月收入是 GAD-7 和 PHQ-9 得分的影响因素。性别、工作年限、岗位、医院级别、学历、去年夜班数和家庭月收入是 ISI 得分的影响因素。

结论

中国针对一线医护人员实施的一系列措施有效,参与一线抗疫的护士与未参与一线抗疫的护士 GAD-7、PHQ-9 和 ISI 得分无差异。同时,部分护士存在焦虑、抑郁和失眠,应关注低岗位、夜班多、低级别医院和低收入家庭的护士。建议为护士提供管理政策、心理支持和人力资源保护,以减轻压力,维护护士的心理健康。同时,有必要将心理健康知识培训作为应对突发公共卫生事件的常规培训。

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