医务人员血源性传染病职业暴露后心理应激反应的纵向研究

摘要

目的:了解医务人员血源性传染病职业暴露后不同时间点的心理应激反应的发生状况与动态变化趋势.方法:本研究为纵向研究设计,选取血源性传染病职业暴露于乙肝病毒、丙肝病毒、艾滋病病毒、梅毒螺旋体的医务人员分别为67例、5例、4例和2例.选用压力知觉量表(PSS-4)、创伤后应激障碍量表(PCL-5)、医院焦虑抑郁量表(HADS)对血源性职业暴露的医务人员于暴露时、暴露后1个月、暴露后2个月、暴露后4个月4个时间点的感知压力、创伤后应激症状、焦虑、抑郁水平进行纵向调查分析.采用重复测量方差分析探讨暴露人群心理应激反应的时间效应.结果:职业暴露的医务人员PSS-4总分、PCL-5总分、HADS-A得分、HADS-D得分自暴露时均开始增高,暴露后1个月时达到最高,暴露后2个月、4个月的水平逐渐下降(Ps ＜0.05).结论:提示医务人员接受暴露后预防后1个月的感知压力、创伤后应激症状、焦虑、抑郁等水平最高.%Objective:To probe into the status characteristics and the dynamic change trend of the psychological stress among medical staff at four time points after exposed to blood-borne pathogen.Methods:A longitudinal study was carried out among 78 medical personnel in this study,with 67 of hepatitis B virus,5 of hepatitis C virus,4 of HIV and 2 of treponema pallidum respectively.Perceived stress scale (PSS-4),Post-traumatic stress disorder Checklist-5 (PCL-5),Hospital anxiety and depression scale (HADS) were used to assess the psychological status,including perceived stress,post-traumatic stress symptom,anxiety and depression at the four times.Data analysis was performed using repeated measures analysis of variance (RMANOVA) and paired sample t test to explore time effect of the psychological stress reaction in the exposed population.Results:The scores of PSS-4,PCL-5,HADS-A,and HADS-D increased from exposure,and gained highest at one month after exposed,then gradually declined with time (Ps ＜ 0.05).Conclusion:It suggests that the levels of perceived stress,post-traumatic stress symptom,anxiety,depression may be the highest at one month after exposed.