医务人员血源性传染病职业暴露及认知、心理状态调查
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摘要
目的:调查医务人员血液性传染病职业暴露、认知状态和心理状态,并进行相关的心理干预。方法:选择2013年5月-2016年4月本院发生过血源性传染病职业暴露的医务人员90例,分析医务人员发生职业暴露的部位、医疗器械、科室、环节、认知和心理状态,并使用症状自评量表(SCL-90)对90例医务人员进行心理干预效果评价。结果:90例发生血源性传染病职业暴露的医务人员中,暴露的部位是手指48例、手心15例、手背12例、眼部5例等;暴露的医疗器械是45.56%输液器针头、23.33%注射器针头等;暴露的科室主要是内科30例(33.34%)、外科25例(27.78%),以及传染科16例(17.78%);发生暴露的环节主要是进针和拔针、拔针帽,分别为40例、23例;暴露后的认知、心理状态为15例不在意,38例担忧,19例焦虑,12例恐惧,7例回避。心理干预前90例医务人员职业暴露的SCL-90评分(15.35±3.03);心理干预后SCL-90评分为(5.04±1.26),明显小于干预前,差异有统计学意义(t=10.427,P<0.05)。结论:医务人员在发生血源性传染病职业暴露后,认知状态和心理状态都会出现不同程度的下降,但以稳定心态、纠正认知为主的心理干预措施后,能够有效改善医务人员的负面情绪,促进其及时治疗。
Objective:To investigate the cognitive state and psychological state of medical personnel about occupational exposure to blood transmissible disease,and to conduct related psychological intervention.Methods:A total of90 cases of medical personnel who experienced occupational exposure to blood transmission disease in our hospital since May 2013 to April 2016 were selected.Analysis was conducted on these medical personnel for body part,medical devices,department,link,cognitive and psychological state of occupational exposure.SCL-90 was adopted to evaluate the effects of psychological intervention over 90 cases of medical personnel.Results:Among 90 cases of medical personnel who experienced occupational exposure to blood transmission disease,there were 48 cases of exposed fingers,15 cases of exposed palm,12 cases of exposed opisthenar and 5 cases of exposed eyes.Among exposed medical devices,there were 45.56% of infusion needle and 23.33% of syringe needle,etc.The exposed departments were30 cases of internal medicine(33.34%),25 cases of department of surgery(27.78%)and 16 cases of department of infectious diseases(17.78%).The exposed links were 40 cases of inserting and withdrawing needle and 23 cases of taking down cap.As for cognitive state and psychological state after exposure,there were 90 cases of carelessness,15 cases of worry,19 cases of anxiety,12 cases of fear and 7 cases of avoidance.Before psychological intervention,the SCL-90 score for occupation exposure of 90 cases of medical personnel was(15.35±3.03),while that after psychological intervention was(5.04±1.26),which was obviously less than that before intervention,having statistical significance(t=10.427,P<0.05).Conclusion:Medical staff in the event of blood-borne infectious diseases after occupational exposure,cognitive and psychological state will appear different degrees of decline,but predominantly stable mentality,correcting cognitive psychological intervention measures,can effectively improve the medical staff of the negative emotions,promote the timely treatment.
Objective:To investigate the cognitive state and psychological state of medical personnel about occupational exposure to blood transmissible disease,and to conduct related psychological intervention.Methods:A total of90 cases of medical personnel who experienced occupational exposure to blood transmission disease in our hospital since May 2013 to April 2016 were selected.Analysis was conducted on these medical personnel for body part,medical devices,department,link,cognitive and psychological state of occupational exposure.SCL-90 was adopted to evaluate the effects of psychological intervention over 90 cases of medical personnel.Results:Among 90 cases of medical personnel who experienced occupational exposure to blood transmission disease,there were 48 cases of exposed fingers,15 cases of exposed palm,12 cases of exposed opisthenar and 5 cases of exposed eyes.Among exposed medical devices,there were 45.56% of infusion needle and 23.33% of syringe needle,etc.The exposed departments were30 cases of internal medicine(33.34%),25 cases of department of surgery(27.78%)and 16 cases of department of infectious diseases(17.78%).The exposed links were 40 cases of inserting and withdrawing needle and 23 cases of taking down cap.As for cognitive state and psychological state after exposure,there were 90 cases of carelessness,15 cases of worry,19 cases of anxiety,12 cases of fear and 7 cases of avoidance.Before psychological intervention,the SCL-90 score for occupation exposure of 90 cases of medical personnel was(15.35±3.03),while that after psychological intervention was(5.04±1.26),which was obviously less than that before intervention,having statistical significance(t=10.427,P<0.05).Conclusion:Medical staff in the event of blood-borne infectious diseases after occupational exposure,cognitive and psychological state will appear different degrees of decline,but predominantly stable mentality,correcting cognitive psychological intervention measures,can effectively improve the medical staff of the negative emotions,promote the timely treatment.
引文
[1]薛小萍,韩崇旭,韩东升.2009-2012年医务人员职业暴露现状分析[J].现代预防医学,2015,42(2):216-218
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[5]余红,杨惠英,刘银梅.三级综合医院医务人员职业暴露监测[J].中国感染控制杂志,2015,14(6):421-423
[6]蒋景华,张晓莉.血源性致病因子在某医院医务人员职业暴露中的分布及其发生因素[J].中国消毒学杂志,2015,32(11):1107-1108
[7]姚源,穆丽焕,肇颖新.职业暴露防护体系对乙型肝炎病毒职业暴露的影响[J].中华医院感染学杂志,2009,19(23):3185-3187
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[9]孙建,徐华,顾安曼,等.中国医务人员职业暴露与防护工作的调查分析[J].中国感染控制杂志,2016,15(9):681-685
[10]屈丹,梁进娟,刘育新,等.医务人员职业暴露因素调查与预防措施[J].中国消毒学杂志,2015,32(5):473-474
[11]王宇,张曼华,史从戎,等.团体心理干预对HIV感染者/AIDS患者的影响效果研究[J].中国健康心理学杂志,2009,17(11):1316-1318
[12]方惠娟,周艳芝,邓晓辉,等.实习护士职业暴露现况调查[J].中国感染控制杂志,2016,15(8):624-626
[13]陈皓,郑小英,张晓雯,等.心理干预对艾滋病人应对方式和支持利用度的影响[J].中国健康心理学杂志,2012,20(11):1699-1701
[14]尤红,朱亚利,辛博,等.综合心理护理干预对抑郁症康复的影响[J].中国健康心理学杂志,2012,20(1):11-12
[15]王靖,樊宏英,程芸,等.医务人员血源性传染病职业暴露危险因素调查分析与防范对策[J].中国消毒学杂志,2015,32(4):374-376
[16]陈莉,孟长秀,薛均,等.护理人员职业暴露现状分析及防范对策[J].中国医学创新,2015,12(10):86-88
[2]李皎皎,刘旭峰,陈奕霏,等.信息损伤的佐证--来自职业暴露领域的证据[J].中国健康心理学杂志,2009,17(3):278-280
[3]陈倞倞,郭晶.护理人员血源性职业暴露防护研究进展[J].护士进修杂志,2015,30(10):887-888
[4]童书蓉,党桂宁,TONGShu-rong,等.临床护士职业暴露现状分析与防护对策[J].护理管理杂志,2016,16(1):45-46
[5]余红,杨惠英,刘银梅.三级综合医院医务人员职业暴露监测[J].中国感染控制杂志,2015,14(6):421-423
[6]蒋景华,张晓莉.血源性致病因子在某医院医务人员职业暴露中的分布及其发生因素[J].中国消毒学杂志,2015,32(11):1107-1108
[7]姚源,穆丽焕,肇颖新.职业暴露防护体系对乙型肝炎病毒职业暴露的影响[J].中华医院感染学杂志,2009,19(23):3185-3187
[8]黄继峥,周晓平,罗腾达,等.一所三级传染病医院连续5年医务人员血源性职业暴露特点[J].中国感染控制杂志,2016,15(2):114-116
[9]孙建,徐华,顾安曼,等.中国医务人员职业暴露与防护工作的调查分析[J].中国感染控制杂志,2016,15(9):681-685
[10]屈丹,梁进娟,刘育新,等.医务人员职业暴露因素调查与预防措施[J].中国消毒学杂志,2015,32(5):473-474
[11]王宇,张曼华,史从戎,等.团体心理干预对HIV感染者/AIDS患者的影响效果研究[J].中国健康心理学杂志,2009,17(11):1316-1318
[12]方惠娟,周艳芝,邓晓辉,等.实习护士职业暴露现况调查[J].中国感染控制杂志,2016,15(8):624-626
[13]陈皓,郑小英,张晓雯,等.心理干预对艾滋病人应对方式和支持利用度的影响[J].中国健康心理学杂志,2012,20(11):1699-1701
[14]尤红,朱亚利,辛博,等.综合心理护理干预对抑郁症康复的影响[J].中国健康心理学杂志,2012,20(1):11-12
[15]王靖,樊宏英,程芸,等.医务人员血源性传染病职业暴露危险因素调查分析与防范对策[J].中国消毒学杂志,2015,32(4):374-376
[16]陈莉,孟长秀,薛均,等.护理人员职业暴露现状分析及防范对策[J].中国医学创新,2015,12(10):86-88