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疫情常态化下叙事护理对照顾者心理问题的干预研究

Intervention Research of Narrative Nursing on the Psychological Problems of the Caregivers Under the Normalization of the Epidemic.

作者信息

Yue Manxia, Li Heyu, Lv Shukun, Wang Yufeng, Li Xinyuan, Zhao Wei, Shang Min

出版信息

Altern Ther Health Med. 2024 Sep;30(9):134-140.

Abstract

OBJECTIVE

The research aims to investigate the impact of narrative nursing on the psychological well-being of nursing personnel in the context of the normalization of epidemic.

METHODS

A cohort of 170 frontline nursing staff at our institution was selected for this clinical study from January 1st to October 31st of 2023. The Symptom Checklist-90 (SCL-90) was employed to evaluate the psychological health of these frontline nursing personnel, compared to the standard norms for nurses in mainland China. Employing a randomized selection method, the cohort was divided into two groups: a control group (85 cases) receiving conventional nursing care and a research group (85 cases) receiving narrative nursing care. The duration of nursing intervention in both groups was set at 12 weeks. Various aspects of psychological well-being, work-related stress, psychological resilience, post-traumatic stress disorder, occupational burnout, job satisfaction, and coping strategies were assessed both before and after the nursing intervention.

RESULTS

Among the positive projects of 170 frontline nursing personnel, 32 exhibited positive symptoms, resulting in a positive rate of 18.82%. With the exception of the paranoia dimension score, the scores for other dimensions in the SCL-90 scale within the clinical group were notably higher than those observed in the norm group (P < .05). Among the ten items with the highest frequency of positive symptoms, anxiety, obsessive-compulsive symptoms, and hostility were identified as the most prevalent psychological health issues among frontline nursing personnel. Post-nursing intervention, the research group exhibited lower scores in dimensions other than paranoia in the SCL-90 scale compared to the control group (P < .05). The research group also displayed lower scores in SAS, SDS, SRQ, PCL-C, MBI-HSS and higher scores in CD-RISC and JWS post-intervention (P < .05). In the post-nursing intervention phase, the research group demonstrated lower scores in negative coping and higher scores in positive coping as per the SCSQ scale in comparison to the control group (P < .05).

CONCLUSIONS

Amidst the ongoing normalization of the epidemic, the psychological well-being of frontline nursing staff was lower than the established norms for nurses in mainland China. Notably, somatization, anxiety, and depression emerged as predominant manifestations. Narrative nursing was identified as an effective intervention to enhance nursing personnel's psychological well-being and coping strategies, ultimately regulating negative emotions, reducing post-traumatic stress disorder and occupational burnout, reducing stress levels, and enhancing job satisfaction and psychological resilience.

摘要

目的

本研究旨在探讨在疫情常态化背景下叙事护理对护理人员心理健康的影响。

方法

选取2023年1月1日至10月31日在我院的170名一线护理人员作为研究对象。采用症状自评量表(SCL-90)评估这些一线护理人员的心理健康状况,并与中国大陆护士常模进行比较。采用随机分组法将研究对象分为两组:对照组(85例)接受常规护理,研究组(85例)接受叙事护理。两组护理干预时间均为12周。在护理干预前后,对两组人员的心理健康、工作压力、心理韧性、创伤后应激障碍、职业倦怠、工作满意度及应对方式等方面进行评估。

结果

170名一线护理人员中,阳性项目数为32项,阳性率为18.82%。临床组SCL-90量表中除偏执维度得分外,其他各维度得分均显著高于常模组(P<0.05)。在阳性症状出现频率最高的10个项目中,焦虑、强迫症状和敌对是一线护理人员中最常见的心理健康问题。护理干预后,研究组SCL-90量表中除偏执维度外的其他各维度得分均低于对照组(P<0.05)。干预后研究组的SAS、SDS、SRQ、PCL-C、MBI-HSS得分低于对照组,CD-RISC和JWS得分高于对照组(P<0.05)。在护理干预后阶段,研究组SCSQ量表中消极应对得分低于对照组,积极应对得分高于对照组(P<0.05)。

结论

在疫情常态化期间,一线护理人员的心理健康状况低于中国大陆护士常模,主要表现为躯体化、焦虑和抑郁。叙事护理是提高护理人员心理健康水平和应对能力的有效干预措施,可调节负面情绪,减少创伤后应激障碍和职业倦怠,降低压力水平,提高工作满意度和心理韧性。

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