Prevalence of psychiatric morbidity and psychological adaptation of the nurses in a structured SARS caring unit during outbreak: a prospective and periodic assessment study in Taiwan.
Prevalence of psychiatric morbidity and psychological adaptation of the nurses in a structured SARS caring unit during outbreak: a prospective and periodic assessment study in Taiwan.
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爆发期间，护士的精神病发病率和心理适应性的患病率：台湾的一项前瞻性和周期性评估研究。
DOI：
10.1016/j.jpsychires.2005.12.006
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发表时间：
2007-01
影响因子：
4.8
通讯作者：
Yin JC
中科院分区：
文献类型：
--
作者：
Su TP;Lien TC;Yang CY;Su YL;Wang JH;Tsai SL;Yin JC
为了评估2003年SARS暴发急性期护士心理状态的快速变化，我们对SARS病房和非SARS病房护士的精神疾病发病率和心理适应进行了前瞻性和定期评估。参与研究的护士分别来自2个SARS病房（普通SARS病房[N = 44]和SARS ICU病房[N = 26]）和2个非SARS病房（神经内科病房[N = 15]和CCU病房[N = 17]）。参与者定期自我评估他们的抑郁、焦虑、创伤后应激症状、睡眠障碍、对SARS的态度和家庭支持。结果显示，SARS科室护士抑郁（38.5%比3.1%）和失眠（37%比9.7%）的比例分别高于非SARS科室护士。创伤后应激症状发生率两组比较差异无统计学意义（33% vs. 18.7%），但ICU组、普通组和神经内科3个单元组创伤后应激症状发生率显著高于CCU组（29.7% vs. 11.8%） （p < 0.05）。对于SARS病房护士来说，在研究结束时，情绪评分、失眠率和感知到的负面情绪显著降低，对SARS的知识和理解也有所增加（均p < 0.001），表明心理适应已经逐渐发生。在结构更加结构化的SARS重症监护室环境中，护士对重症患者的护理可能与普通SARS病房中的护士一样好，甚至更好。精神症状的发生与直接接触SARS患者护理、既往情绪障碍史、年龄较小和感知到的负面情绪有关。积极的应对态度和强大的社会和家庭支持可以防止急性压力。综上所述，通过降低风险因素和更安全、更结构化的工作环境，将对护理人员面临未来生物灾害的心理影响降至最低。
To assess the rapidly changing psychological status of nurses during the acute phase of the 2003 SARS outbreak, we conducted a prospective and periodic evaluation of psychiatric morbidity and psychological adaptation among nurses in SARS units and non-SARS units. Nurse participants were from two SARS units (regular SARS [N = 44] and SARS ICU [N = 26]) and two non-SARS units (Neurology [N = 15] and CCU [N = 17]). Participants periodically self-evaluated their depression, anxiety, post-traumatic stress symptoms, sleep disturbance, attitude towards SARS and family support. Results showed that depression (38.5% vs. 3.1%) and insomnia (37% vs. 9.7%) were, respectively, greater in the SARS unit nurses than the non-SARS unit nurses. No difference between these two groups was found in the prevalence of post-traumatic stress symptoms (33% vs. 18.7%), yet, three unit subjects (SARS ICU, SARS regular and Neurology) had significantly higher rate than those in CCU (29.7% vs. 11.8%, respectively) (p < 0.05). For the SARS unit nurses, significant reduction in mood ratings, insomnia rate and perceived negative feelings as well as increasing knowledge and understanding of SARS at the end of the study (all p < 0.001) indicated that a gradual psychological adaptation had occurred. The adjustment of nurses in the more structured SARS ICU environment, where nurses care for even more severely ill patients, may have been as good or better than that of nurses in the regular SARS unit. Occurrence of psychiatric symptoms was linked to direct exposure to SARS patient care, previous mood disorder history, younger age and perceived negative feelings. Positive coping attitude and strong social and family support may have protected against acute stress. In conclusion, the psychological impact on the caring staffs facing future bio-disaster will be minimized with lowered risk factors and a safer and more structured work environment.
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