肿瘤专科医护人员替代创伤的影响因素研究

  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。 

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

  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.