疫情期间医务人员有效预防行为影响因素分析

目的揭示新型冠状病毒肺炎疫情期间医务人员有效预防行为的影响因素,提升医务人员在疫情期间的防护能力。方法2020年2—3月,在多个省市向医务人员发放有效调查问卷863份。使用抑郁-焦虑-压力量表、领悟社会支持量表、简易应对方式问卷和自行编制的人口学特征量表收集研究对象的信息。采用Pearson相关分析检验变量之间的相关性;利用Mplus软件构建结构方程模型,分析影响医务人员有效预防行为的直接及间接因素。结果863名医务人员有效预防行为得分为(50.18±4.99)分。焦虑与有效预防行为成弱的负相关(r=-0.139,P<0.05),积极应对方式、态度、感知严重性、行为技巧和领悟社会支持均与有效预防行为成弱的正相关(r=0.258、0.104、0.131、0.302、0.276,P<0.05)。建立的结构方程模型拟合度较好(χ2/df=2.829,CFI=0.931,TLI=0.920,RMSEA=0.046,SRMR=0.045)。领悟社会支持对有效预防行为有影响,其总效应(β=0.270)和直接效应(β=0.134)均具有统计学意义(P<0.05)。积极应对方式可在领悟社会支持和有效预防行为间发挥部分中介作用(β=0.049,P=0.019),行为技巧可在领悟社会支持和有效预防行为间发挥部分中介作用(β=0.061,P=0.002),焦虑、态度、行为技巧可在领悟社会支持和有效预防行为间发挥链式中介作用(β=0.002,P=0.012),焦虑、感知严重性、行为技巧可在领悟社会支持和有效预防行为间发挥链式中介作用(β=-0.001,P=0.028),中介效应与总效应之比分别为0.181、0.226、0.007、-0.004(P<0.05)。结论通过提升医务人员的领悟社会支持、积极的态度和应对策略、提高医务人员的行为技巧,可以促进其采取有效的预防行为。

Factors influencing effective prevention behavior among medical care workers during epidemic

  Objective  To identify the influencing factors of effective prevention behaviors among medical staff during the COVID-19 pandemic in China.  Methods  A total of 863 medical care workers were recruited from hospitals of some regions in China from February to March, 2020. Depression, anxiety and stress scale (DASS), the perceived social support scale (PSSS), simplified coping style questionnaire (SCSQ) and some self-developed scales were used to collect information of the study participants. Pearson correlation analysis was used to test the correlation between variables; Mplus was used to build a structural equation model to analyze the direct and indirect factors affecting the effective prevention behavior of these medical personnel.  Results  The score of effective preventive behavior of 863 medical staff was (50.18 ± 4.99). Anxiety was weakly negatively correlated with effective prevention behavior (r = - 0.139, P < 0.05), and positive coping style, attitude, perceived severity, behavior skills and perceived social support were weakly positively correlated with effective prevention behavior (r = 0.258, 0.104, 0.131, 0.302, 0.276, P < 0.05, respectively). The fitting degree of the established structural equation model was good (χ2/df = 2.829, CFI = 0.931, TLI = 0.920, RMSEA = 0.046, SRMR = 0.045). The perceived social support had an impact on effective prevention behavior, and its total effect(β = 0.270) and direct effect(β = 0.134) were statistically significant (P < 0.05). Positive coping style could play a part of intermediary role between understanding social support and effective prevention behavior(β = 0.049, P = 0.019), behavioral skills could play a partial intermediary role between understanding social support and effective prevention of behavior(β = 0.061, P = 0.002), anxiety, attitude and behavior skills could play a chain intermediary role between understanding social support and effectively preventing behavior(β = 0.002, P = 0.012), and anxiety, perceived severity, and behavioral skills can play a chain intermediary role between understanding social support and effectively preventing behavior(β = - 0.001, P = 0.028), with the ratio of intermediary effect to total effect 0.181, 0.226, 0.007, - 0.004 (P < 0.05), respectively.  Conclusions  By improving the understanding of social support, positive attitude and coping strategies, and improving the behavior skills can promote medical staff to take effective preventive behavior.