汶川地震灾区一线医务救援人员的心理健康状况及其相关因素分析

目的 探讨汶川地震灾区一线医务救援人员的心理健康变化特点及其相关因素.方法 使用精神疾病预测量表(MDPS)对参加抗震救灾的一线医务救援人员(136名,研究组)和未参加本次抗震救灾的医务人员(274名,对照组)进行心理测试.结果 研究组MDPS总分及成长经历、精神病性、抑郁、跺狂因子等评分上均明显高于对照组(t=2.299～5.301,P<0.01～0.05).研究组中低年龄(<35岁)者的成长经历、心理防御不良、精神病性及人格偏移因子分明显高于高年龄(≥35岁)者(t=2.028～3.602,P<0.01～0.05),而个性内向因子分则明显低于高年龄者(t=——4.429,P<0.01);女性的总分及心理防御不良、精神病性、神经症因子分明显高于男性(t=2.422～5.079,P<0.01～0.05),社会支持缺乏因子分明显低于男性(t=-2.526,P<0.05);未婚者心理防御不良、精神病性、抑郁、神经症因子分明显高于已婚者(t=1.982～2.801,P<0.01～0.05),既往及家族史、个性内向因子分明显低于已婚者(t=-2.077～-4.257,P<0.01～0.05);护士的总分及心理防御不良、抑郁、神经症因子分明显高于医生(t=2.563～4.241,P<0.01～0.05).研究组精神障碍危险因子与精神障碍症状因子密切相关(r=-0.294～0.522).影响研究组心理健康的主要因素为心理防御不良、文化程度、社会支持缺乏、婚姻等,解释了总体方差的64.6%～84.6%.结论 汶川地震灾区一线医务救援人员的心理健康受到一定程度损害,尤以低龄者、女性、未婚者及护士的心理健康问题突出.

The mental health status and correlation factors of the anti-earthquake medical staffs

Objective To explore the mental health characters and correlation factors of medical staffs who participated in the rescue work in Sichuan. Methods Altogether 136 medical staffs took part in the rescue work( experimental group) and 274 not in the rescue (control group) were investigated with the Mental Disorders Predictive Scale(MDPS). Results For the total score and factor scores such as growth experience, psychosis, depress, mania, the experimental group were significandy higher than the control group (P <0. 01 -0. 05). The factor scores of growth experience, unhealthy mental defense, psychosis and personality disturbance of the younger medical staffs were obviously higher than those of the elder ( P <0. 01 -0. 05 ), while the score of introversion was lower ( P < 0. 01 ). The total score and factor scores of unhealthy mental defense, psychosis and neurosis of the female medical staffs were notably higher than those of the male ( P <0. 01 -0. 05 ), whereas the score of lack of social support was lower (P < 0. 05 ). The factor scores of unhealthy mental defense, psychosis, depress and neurosis of the unmarried medical staffs were higher than those of the married ( P < 0. 01 - 0. 05 ), however the scores of past and family history and introversion were lower (P < 0. 01 - 0. 05 ). The total score and factor scores of unhealthy mental defense,depression and neurosis of the nurses were higher than those of the doctors (P<0. 01 -0. 05). Risk factors were significantly correlated with symptom factors, the correlation coefficients ranged from -0. 294 to 0. 522. Unhealthy mental defense, educational level, lack of social support and marriage were the main factors which had effect on the mental health of the medical staffs, and explained 64. 6% - 84. 6% of the population variance. Conclusion The mental health of medical staffs, especially the younger, female,unmarried and nurses, are injured certainly during their experience of rescue work.