肿瘤专科医护人员替代创伤的影响因素研究

周娜; 李玲; 唐宇; 崔轶; 马海鹰; 盛月红

doi:10.16766/j.cnki.issn.1674-4152.002747

肿瘤专科医护人员替代创伤的影响因素研究

doi: 10.16766/j.cnki.issn.1674-4152.002747

周娜¹,
李玲¹,
唐宇¹,
崔轶¹,
马海鹰¹,
盛月红^2, ,

1.
海军军医大学心理系心理健康教育与咨询中心，上海 200433
2.
上海市东方肝胆外科医院超声介入科，上海 200438

基金项目:

上海市卫健委临床科研课题 201940093

详细信息

通讯作者:
盛月红, E-mail: yuehongsheng73@163.com

中图分类号: R192 R73-31
计量
- 文章访问数: 265
- HTML全文浏览量: 83
- PDF下载量: 3
- 被引次数: 0
出版历程
- 收稿日期: 2022-05-23
- 网络出版日期: 2022-12-30

Study on the influencing factors of vicarious trauma in oncological medical staff

1.
Center of Mental Health Education and Counseling, Department of Psychology, Naval Military Medical University, Shanghai 200433, China

摘要

摘要: 目的探讨肿瘤专科医护人员替代创伤的特点以及睡眠、应对方式、依恋模式对替代创伤的影响。方法于2021年11—12月选取上海市东方肝胆外科医院357名肿瘤病房医护人员作为研究对象，使用自编一般资料问卷、睡眠质量指数量表(PSQI)、成人依恋量表(AAS)、简易应对方式量表(SCSQ)、替代创伤问卷(VTQ)作为研究工具。数据使用SPSS 20.0统计学软件进行统计分析，采用单因素方差分析、Spearman相关分析、多元线性回归分析进行影响因素的统计学分析。结果 357名肿瘤病房医护人员VTQ总得分为(81.70±24.37)分；不同性别、岗位、婚姻状况、教育程度和是否有创伤记忆的医护人员VTQ总分差异有统计学意义(均P < 0.05)；VTQ总分与PSQI得分、AAS焦虑分量表、SCSQ消极应对分量表呈正相关关系(r=0.458、0.498、0.354，均P < 0.01)，与AAS亲近、依赖分量表，SCSQ积极应对分量表呈负相关关系(r=-0.457、-0.277、-0.370，均P < 0.01)；多元线性回归分析结果显示，性别、PSQI得分、SCSQ积极应对、消极应对分量表得分和AAS亲近、焦虑分量表得分为替代创伤的影响因素(决定系数R²=0.431；调整后R²=0.411, F=21.639，P＜0.001)。结论肿瘤科医护人员替代创伤程度较高，且女性、睡眠质量差、消极应对方式和依恋焦虑是其危险因素。
- 替代创伤 /
- 应对方式 /
- 依恋模式 /
- 睡眠质量指数
Abstract: Objective To explore the characteristics of vicarious trauma in oncological medical staff and the effects of sleep, coping style and attachment pattern on surrogate trauma. Methods A total of 357 medical staff in the Oncology Ward of Shanghai East Hepatobiliary Surgery Hospital from November to December 2021 were selected as the subjects. Self-designed general information questionnaire, Pittsburgh sleep quality index (PSQI), adult attachment scale (AAS), simplified coping style questionnaire (SCSQ) and vicarious traumatization questionnaire (VTQ) were used as research tools. SPSS 20.0 was used for statistical analysis, and ANOVA, Spearman correlation analysis and multiple linear regression analysis were used for statistical test of influencing factors. Results The total VTQ score of 357 medical staff in the Oncology Ward was (81.70±24.37) points. There were significant differences in the total score of VTQ among medical staff of different gender, position, marital status, education level and whether they had traumatic memory (all P < 0.05). The total score of VTQ was significantly positively correlated with AAS anxiety subscales and SCSQ negative coping subscales (r=0.458, 0.498, 0.354, all P < 0.01), and significant negative correlation with AAS proximity subscale, dependence subscale and SCSQ positive coping subscale (r=-0.457, -0.277, -0.370, all P < 0.01). Multiple linear regression analysis showed that gender, PSQI score, positive coping and negative coping subscales in SCSQ, AAS closeness and anxiety subscale score were the influencing factors of vicarious trauma (decision coefficient R²=0.431; adjusted R²=0.411, F=21.639, P < 0.001). Conclusion The degree of vicarious trauma is higher in oncology medical staff, and female, poor sleep quality, negative coping style and attachment anxiety are the risk factors.
- Vicarious trauma /
- Coping style /
- Attachment pattern /
- Sleep quality index

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表 1 不同一般资料肿瘤科医护人员VTQ得分比较(x±s, 分)

Table 1. Comparison of VTQ scores of medical staff in oncology Department with different general data (x±s, points)

项目	人数(%)	VTQ得分	统计量	P值
性别			-3.329^a	0.001
男性	103(28.85)	75.05±24.10
女性	254(71.15)	84.40±24.00
工龄			0.575^b	0.632
≤5年	213(59.67)	82.56±25.64
6~10年	91(25.49)	80.56±24.50
11~20年	38(10.64)	83.08±18.64
21~30年	15(4.20)	74.93±17.35
婚姻状况			3.069^b	0.048
已婚	190(53.22)	84.13±24.59
未婚	165(46.22)	78.65±23.88
离异或丧偶	2(0.56)	103.50±6.36
岗位			6.343^b	0.002
护士	250(70.02)	84.65±24.13
医生	103(28.85)	74.67±24.00
辅诊	4(1.13)	81.00±11.86
职称			1.703^b	0.166
初级(士)	138(38.66)	84.74±25.76
初级(师)	132(36.97)	81.36±23.93
中级	70(19.60)	78.00±23.25
高级	17(4.77)	75.00±18.01
是否独生子女			-1.301^a	0.194
是	100(28.01)	79.02±24.13
否	257(71.99)	82.75±24.43
是否有创伤经历			7.650^b	< 0.001
无	181(50.70)	74.93±24.28
小时候有过	126(35.29)	88.18±20.85
成年后有过	41(11.48)	88.65±23.26
好像经常发生	9(2.53)	93.88±40.29
教育程度			3.188^b	0.014
大专	145(40.61)	84.96±25.15
本科	113(31.65)	83.92±22.20
硕士及以上	99(27.74)	74.12±25.39
注：^a为t值，^b为F值。

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表 2 肿瘤科医护人员替代创伤与睡眠质量、应对方式、依恋模式的相关性分析(r值)

Table 2. Correlation analysis of vicarious trauma with sleep, coping style and attachment among medical oncology staff (r value)

项目	PSQI	SCSQ		AAS
项目	PSQI	积极应对	消极应对	亲近	依赖	焦虑
生理反应	0.557	-0.374	0.265	-0.446	-0.261	0.412
情绪反应	0.403	-0.331	0.339	-0.404	-0.246	0.465
行为反应	0.277	-0.283	0.340	-0.366	-0.149	0.425
认知反应	0.227	-0.218	0.341	-0.405	-0.293	0.443
生活信念	0.336	-0.356	0.282	-0.362	-0.300	0.399
VTQ总分	0.458	-0.370	0.354	-0.457	-0.277	0.498
注：均P＜0.01。

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表 3 肿瘤科医护人员替代创伤影响因素的多元线性回归分析

Table 3. Multiple linear regression analysis of the factors influencing vicarious trauma among medical staff in oncology department

变量	B	SE	β	t值	P值
性别	8.804	2.422	0.164	3.635	< 0.001
PSQI得分	1.512	0.342	0.200	4.417	< 0.001
SCSQ积极应对维度得分	-13.841	1.994	-0.327	-6.940	< 0.001
SCSQ消极应对维度得分	13.000	2.456	0.242	5.292	< 0.001
AAS亲近分量表得分	-8.926	2.355	-0.194	-3.790	< 0.001
AAS焦虑分量表得分	2.908	1.439	0.102	2.021	0.044
注：自变量赋值如下，性别，男性=0、女性=1；教育程度，大专=0、本科=1、硕士及以上=2；婚姻状况，未婚(1, 0)、已婚(0, 1)、离异或其他(0, 0)；岗位，护士(1, 0)、医生(0, 1)、医技(0, 0)；创伤经历，无(0, 0, 0)、小时候有过(1, 0, 0)、成年后有过(0, 1, 0)、好像经常发生(0, 0, 1)；其余计量资料以实际值赋值。

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