急诊护士创伤后应激障碍影响因素及心理危机干预的研究进展

摘要/Abstract

摘要： 急诊作为抢救危重症患者的一线场所,急诊护士频繁暴露于各种创伤应激事件中,处于快节奏和高压力的工作环境中,几乎没有过渡的时间,应对机制可能失效,又忙于照顾患者,无法识别自身的创伤后应激障碍（posttraumatic stress disorder,PTSD）和情绪困扰迹象,长时间压抑自己的情绪,可能导致恢复力下降,极易可能出现PTSD。因此,本文对国内外急诊护士PTSD现状、影响因素及心理危机干预进行综述,以促进急诊护士创伤后恢复和创伤后成长,为今后提升我国急诊护理服务及急诊护士的心理健康提供借鉴。

关键词: 急诊护士, 创伤后应激障碍, 现状, 影响因素, 心理干预

Abstract: As a first-line place for rescuing critically ill patients,emergency nurses are frequently exposed to various traumatic stress events,and are in a fast-paced and high pressure working environment. There is almost no transition time. The coping mechanism may be ineffective,and they are busy taking care of patients. They cannot recognize their own signs of post-traumatic stress disorder（PTSD） and emotional distress,and suppress their own emotions for a long time,which may lead to a decline in resilience,which is very likely to lead to PTSD. Therefore,this study summarizes the current situation,influencing factors and psychological crisis intervention of PTSD among emergency nurses at home and abroad,in order to promote the post traumatic recovery and growth of emergency nurses,and provide reference for improving emergency nursing services and the psychological health of emergency nurses in China in the future.

Key words: Emergency nurse, Post-traumatic stress disorder, Current situation, Influencing factors, Psychological intervention

中图分类号:

R395.6

王小星, 张宝珍, 程志强, 李夏欣, 严宪峰. 急诊护士创伤后应激障碍影响因素及心理危机干预的研究进展. [J]职业与健康, 2023, 39(22): 3164-3168.

WANG Xiaoxing, ZHANG Baozhen, CHENG Zhiqiang, LI Xiaxin, YAN Xianfeng. Research progress on influencing factors of post-traumatic stress disorder and psychological crisis intervention of emergency nurses. [J]OCCUPATION AND HEALTH, 2023, 39(22): 3164-3168.

参考文献

[1] 邓明昱. 创伤后应激障碍的临床研究新进展(DSM-5新标准)[J].中国健康心理学杂志,2016,24(5):641-650.
[2] 朱小莉,王红萍,邹敏.急诊护士创伤后应激障碍干预措施的研究进展[J].护理研究,2016,30(9):1040-1043.
[3] SCHUSTER M,DWYER P A.Post-traumatic stress disorder in nurses:An integrative review[J].J Clin Nurs,2020,29(15-16):2769-2787.
[4] 陈征. 天津市社区人群创伤性事件及创伤后应激障碍流行病学调查分析[D].天津:天津医科大学,2018.
[5] 周守志,尹弘青,金学勤,等.急诊科护士创伤后应激障碍与生存质量及睡眠质量的相关性研究[J].护士进修杂志,2020,35(15):1357-1361.
[6] SONG X,FU W,LIU X,et al.Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China[J].Brain Behav Immun,2020,88:60-65.
[7] 严敏怡. 院前急救科护理人员创伤后应激障碍反应的影响因素分析[J].护理实践与研究,2021,18(14):2076-2081.
[8] CANTU L,THOMAS L.Baseline well-being,perceptions of critical incidents,and openness to debriefing in community hospital emergency department clinical staff before COVID-19,a cross-sectional study[J].BMC Emerg Med,2020,20(1):82.
[9] SHAHROUR G,DARDAS L A.Acute stress disorder,coping self-efficacy and subsequent psychological distress among nurses amid COVID-19[J].J Nurs Manag,2020,28(7):1686-1695.
[10] 朱波,任宝玲,高惠玲,等.三甲医院急诊护士述情障碍、社会阻抑对创伤后应激障碍的影响[J].职业与健康,2018,34(19):2684-2688.
[11] COLVILLEG A,SMITH J G,BRIERLEY J,et al.Coping with staff burnout and work-related posttraumatic stress in intensive care[J].Pediatr Crit Care Med,2017,18(7):e267-e273.
[12] RODRIGUEZ-REY R,PALACIOS A,ALONSO-TAPIA J,et al.Burnout and posttraumatic stress in paediatric critical care personnel:Prediction from resilience and coping styles[J].Aust Crit Care,2019, 32(1):46-53.
[13] KOOHSARI E,DARBAN F,SAFARZAI E,et al.Understanding the effect of post-traumatic stress on the professional quality of life of pre-hospital emergency staff[J].Emerg Nurse,2021,29(4):33-40.
[14] CARMASSI C,GESI C,CORSI M,et al.Exploring PTSD in emergency operators of a major University Hospital in Italy:a preliminary report on the role of gender,age,and education[J].Ann Gen Psychiatry,2018,17:17.
[15] MAIA A C,RIBEIRO E.The psychological impact of motor vehicle accidents on emergency service workers[J].Eur J Emerg Med,2010,17(5):296-301.
[16] 印怡臻,王安妮,张杰,等.遭受工作场所暴力的护士创伤后应激障碍影响因素研究[J].护士进修杂志,2018,33(7):587-592.
[17] 范慧,李筱,范湘鸿.新型冠状病毒肺炎疫情期间护理人员创伤后应激障碍调查[J].护理学杂志,2020,35(24):84-86.
[18] 周守志,林征,金学勤,等.急诊科护士创伤后应激障碍与职业韧性及社会支持的相关性[J].护理学杂志,2016,31(22):48-51.
[19] 张伊,伏干,姜慧丽,等.专业救援人员的正念对创伤后应激障碍的影响:侵入反刍和社会支持的作用[J].中国临床心理学杂志,2019
27(2):311-315.
[20] SARENMANLM K E,MARTENSSONL B,ANDERSSON B A,et al.Mindfulness and its efficacy for psychological and biological responses in women with breast cancer[J].Cancer Med,2017,6(5):1108-1122.
[21] 王倩,王俊芝,成杰,等.脑损伤患者创伤后应激障碍与正念觉知水平、人格韧性的关系[J].中国老年学杂志,2021,41(13):2872-2875.
[22] 鲁芳,徐媛媛,于永菊,等.重症监护室护士情感衰竭特点及其与抑郁和创伤后应激障碍的关系:正念的调节作用[J].第三军医大学学报,2019,41(14):1397-1402.
[23] 袁媛,邵艳霞,王钰姝,等.急诊科护士创伤后应激反应与正念及应对方式的关系研究[J].护理学杂志,2021,36(10):17-20,44.
[24] GHAWADRA S F,LIM A K,CHOO W Y,et al.The effect of mindfulness-based training on stress,anxiety,depression and job satisfaction among ward nurses:A randomized control trial[J].J Nurs Manag,2020,28(5):1088-1097.
[25] SCHNEIDER A,WEIGL M.Associations between psychosocial work factors and provider mental well-being in emergency d-epartments:a systematic review[J].PLoS One,2018,13(6):e0197375.
[26] DE WIJI A N,VAN DER DOEF M P.Patient-related stressful situations and stress-related outcomes in emergency nurses:A cross-sectional study on the role of work factors and recovery during leisure time[J].Int J Nurs Stud,2020,107:103579.
[27] 王慧凤,孟德敏,赵阳阳.遭受医疗暴力事件急诊ICU护士的护理伦理决策能力与创伤后应激障碍的相关性[J].临床研究,2019,27(12):162-165.
[28] 陈洁,郑一宁.临床护士工作场所欺凌现状及影响因素研究[J].护理学杂志,2020,35(7):62-65.
[29] 李惠艳,张丽敏,张欢,等.肿瘤医院工作场所暴力与护士共情疲劳的相关性研究[J].中国实用护理杂志,2018,34(29):2241-2245.
[30] ADRIAENSSENS J,GUCHT D V,MAES S.The impact of traumatic events on emergency room nurses:findings from a questionnaire survey[J].Int J Nurs Stud,2012,49(11):1411-1422.
[31] 邹敏,王红萍,王会莲.急诊护士创伤后应激障碍影响因素的研究进展[J].中华护理杂志,2014,49(9):1107-1111.
[32] SORAVIA L M,SCHWAB S,WALTHER S,et al.Rescuers at risk:Posttraumatic stress symptoms among police officers,fi-re fighters,ambulance personnel,and emergency and psychiatric nurses[J].Front Psychiatry,2020,11:602064.
[33] SALMON G,MOREHEAD A.Posttraumatic Stress Syndrome and Implications for Practice in Critical Care Nurses[J].Crit Care Nurs Clin North Am,2019,31(4):517-526.
[34] 胡曼曼,周英,杨从艳,等.新冠肺炎疫情期间护理人员创伤后应激障碍影响因素研究[J].赣南医学院学报,2020,40(11):1107-1111.
[35] CENAT J M,BLAIS-ROCHETTE C,KOKOU-KPOLOU C K,et al.Prevalence of symptoms of depression,anxiety,insomnia,pos-ttraumatic stress disorder,and psychological distress among populations affected by the COVID-19 pandemic:A systematicreview and meta-analysis[J].Psychiatry Res,2021,295:113599.
[36] 张烨,任蓉,杨玲慧,等.创伤后应激障碍与睡眠障碍[J].四川大学学报(医学版),2021,52(1):28-32.
[37] GILLESPIE G L.Posttraumatic stress symptomatology among emergency department workers following workplace aggression[J].Workplace Health Saf,2013.61(6):247-254.
[38] 姜秋萍,江榕,孙小文,等.ICU护士共情疲劳与创伤后应激障碍的现状及其关系[J].职业与健康,2021,37(14):1934-1937.
[39] VAHEDIAN-AZIMI A,HAJIESMAEILI M,KANGASNIEMI M,et al.Effects of Stress on Critical Care Nurses:A National Cross-Sectional Study[J].J Intensive Care Med,2019,34(4):311-322.
[40] MOTTAGHI S,POURSHEIKHALI H,SHAMELI L.Empathy,compassion fatigue,guilt and secondary traumatic stress in nurses[J].Nurs Ethics,2020,27(2):494-504.
[41] PALAZOGLUC A,KOC Z.Ethical sensitivity,burnout,and job satisfaction in emergency nurses[J].Nurs Ethics,2019,26(3):809-822.
[42] 李洋,李佳泽,王志红,等.肺炎疫情期间医护人员心理危机干预效果分析[J].灾害学,2021,36(2):166-170.
[43] BIEGEL G M,BROWN K W,SHAPIRO S L,et al.Mindfulness-based stress reduction for the treatment of adolescent psychiatric outpatients:A randomized clinical trial[J].J Consult Clin Psychol,2009,77(5):855-866.
[44] ZHANG Q,ZHAO H,ZHENG Y.Effectiveness of mindfulness-based stress reduction(MBSR) on symptom variables and health-related quality of life in breast cancer patients-a systematic review and meta-analysis[J].Support Care Cancer,2019,27(3):771-781.
[45] 袁媛. 急诊科护士创伤后应激反应现状及正念减压训练的效果研究[D].重庆:中国人民解放军陆军军医大学,2022.
[46] 楚鑫,蒋运兰,程冬梅,等.品管圈干预国内对肿瘤患者经外周置入中心静脉导管并发症的Meta分析[J].实用医院临床杂志,2018,15(5):29-32.
[47] 鲍小栋,郑桂茹,夏建洪,等.品管圈在医院药事管理中应用研究进展[J].中医药管理杂志,2022,30(19):173-177.
[48] 马海芬,张幸国.基于品管圈理念的医院质量文化建设[J].中国现代医生,2022,60(1):173-176.
[49] 周玲玲,童静,张明,等.品管圈在急诊护士经历工作场所暴力致创伤应激障碍中的应用[J].中华现代护理杂志,2014,20(32):4041-4044.
[50] 马丽铭. CISD在自杀未遂学生心理危机干预中的运用[J].中小学心理健康教育,2022(6):45-49.
[51] 罗丽. 紧急事件应激晤谈联合认知行为干预对重度烧伤病人心理康复的效果研究[J].蚌埠医学院学报,2019,44(7):954-959.
[52] SCHWAB D,NAPOLITANO N,CHEVALIERK,et al.Hidden grief and lasting emotions in emergency department nurses[J].Creat Nurs,2016,22(4),249-253.
[53] CLARK P R,POLIVKA B,ZWART M,et al.Pediatric emergency department staff preferences for a critical incident stress debriefing[J].J Emerg Nurs,2019,45(4):403-410.