医护人员艾滋病职业暴露原因及心理状况调查分析

目的调查分析医护人员艾滋病职业暴露原因及心理状况。方法以本院2011年1月—2017年6月发生的30例艾滋病职业暴露医护人员为研究对象,通过调查,统计分析职业暴露方式、暴露环节、暴露原因、暴露后处理及医护人员心理状况。结果艾滋病职业暴露方式中针刺伤占70.00%;暴露环节中有创术中操作占30.00%,注射穿刺占26.67%,拔针占16.67%;暴露原因中自护意识不足占30.00%,安全管理缺陷占46.67%,防控能力弱占26.67%;相比中国成人常模,艾滋病职业暴露人员躯体化症状、焦虑、抑郁、恐惧、人际关系敏感、敌对、强迫及偏执评分均显著增高,差异有统计学意义(P均0.05);随访均无感染发生。结论艾滋病职业暴露原因包括医护人员自护意识不足、防控能力较弱、安全管理有缺陷等,易出现焦虑、抑郁、敌对等心理症状,须加强防护培训,提高医护人员安全意识及心理干预,以减少职业暴露发生。

Causes of occupational exposure to AIDS and psychological status of medical staff

Objective To investigate and analyze the causes of occupational exposure to AIDS and psychological status of medical staff. Methods Thirty medical staff with occupational exposure to AIDS observed in Chengdu Second People's Hospital from January 2011 to June 2017 were enrolled in the study. The mode, link, causes of occupational exposure, post-exposure treatment and psychological status of medical staff were investigated and statistically analyzed. Results Among the occupational exposure modes, needle injuries accounted for 70.00%. Among the exposure links, invasive intraoperative operation accounted for 30.00%, needle injection accounted for 26.67% and needle pulling accounted for 16.67%. Among the causes of exposure, insufficient self-protection awareness accounted for 30.00%, defective safety management system accounted for 46.67% and weak prevention-control ability accounted for 26.67%. Compared with Chinese norms, scores of somatization, anxiety, depression, fear, interpersonal sensitivity, hostility, paranoid and compulsion of medical staffs with occupational exposure to AIDS were significantly increased (P<0.05). There was no infected case during follow-up. Conclusions Causes of occupational exposure to AIDS include insufficient self-protection awareness, weak prevention-control ability and defective safety management. Medical staff with occupational exposure to AIDS are prone to anxiety, depression, hostility and other psychological symptoms. The protection training should be strengthened to improve the safety awareness and psychological intervention of medical staffs, thus reducing the incidence of occupational exposure.