职业暴露对个体心理健康的影响
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摘要
-2-随着时代的发展和现代化建设的推进,加强军队现代化建设,立足打赢未来信息化战争,必须抓好高素质军事人才的培养。部队官兵的心理健康问题已经逐渐得到军队各级的高度重视。但是,目前关于部队的职业暴露问题研究很少,尤其是特定情况下的职业暴露对官兵心理健康的影响更是鲜为人知。因此,探讨军队职业暴露对个体心理健康的影响,对于军事人才的全面培养,提高官兵整体素质和部队战斗力具有非常重要的现实意义和军事意义。
本研究从实证的角度出发,运用症状自评量表、焦虑自评量表、抑郁自评量表和状态-特质焦虑问卷等研究工具,探讨了长期职业暴露对军人心理健康的影响,以及短期职业暴露前后军人心理健康的变化特点,为军队院校培养特殊技能教育工作中出现的职业暴露所引起心理问题的干预提供参考依据。
主要的研究结果:
1.长期处于职业暴露环境人员的SCL-90阳性项目数和各因子与中国军人常模比较均无统计学差异。抑郁自评量表(SDS)抑郁指数平均为0.59±0.06(最小值0.48,最大值0.73),与正常值0.5分进行独立样本t检验结果为t=8.92(p<0.001)。焦虑自评量表(SAS)得分平均为50.30±5.58(最小值43分,最大值62分),与正常值50分进行独立样本t检验结果为t=0.29(p>0.05)。焦虑状态-特质问卷(STAI)状态焦虑因子(S-AI)平均为1.93±0.37(最小值1.05分,最大值2.30分),与正常值2分进行独立样本t检测结果为t=0.98(p>0.05);特质焦虑因子(T-AI)平均为2.45±0.31(最小值1.60分,最大值2.85分),与正常值2分进行独立样本t检验结果为t=8.02(p<0.001)。
2.短期职业暴露前SCL-90各项得分均高于职业暴露后,其中躯体化、强迫、人际关系、抑郁、偏执、精神病性、阳性项目数、总分均达到统计学显著水平(p<0.05),但焦虑、敌对和恐怖等因子未达到统计学显著水平(p>0.05)。抑郁自评量表(SDS)抑郁指数平均为0.49±0.05(最小值0.40,最大值0.56);职业暴露后,抑郁指数平均为0.47±0.06(最小值0.35,最大值0.56)。前后配对t检验结果为t=3.42(p<0.01)。焦虑自评量表(SAS)得分平均为55.16±5.25(最小值43,最大值63);职业暴露后,得分平均为39.64±5.45(最小值30,最大值51)。前后配对t检验结果为t=9.22(p<0.001)。焦虑状态-特质问卷(STAI)状态焦虑因子(S-AI)平均为2.02±0.28(最小值1.50分,最大值2.50分),特质焦虑因子(T-AI)平均为2.04±0.31(最小值1.45分,最大值2.50分);职业暴露后,状态焦虑因子(S-AI)平均为1.52±0.26(最小值1.05分,最大值2.00分),特质焦虑因子(T-AI)平均为1.98±0.34(最小值1.10分,最大值2.50分)。前后配对t检验S-AI结果为,t=38.73(p<0.001);T-AI结果为t=2.56(p<0.05)。
主要结论:
1.长期处于职业暴露环境人员心理健康总体情况正常,但存在一定程度的抑郁状态。
2.短期职业暴露前的心理健康状况比职业暴露后差。
3.验证了信息损伤理论,提供了依据。
4.部队应加强职业暴露个体的职业教育和心理健康教育。
It’s very important to focus on the cultivation of mental health of military personnel. But the study on occupational exposure of army is rare, especially on some special occupational exposure. So, it has very significant meaning to study the effect of occupational exposure in army on mental health of military personnel.
In this study, SCL-90, SAS, SDS and STAI were used to assess the effect of long-term occupational exposure on the mental health of 30 applicants and the characteristics of mental health of 25 applicants were also compared before and after short-term occupational exposure.
Main results:
1. During the long-term occupational exposure: (1) There was no significant difference between the data of SCL-90 of applicants in this study and Chinese Army Norm. (2) There was a significant difference between average level of SDS depression index of applicants in this study and the normal value 0.5 (av. 0.59±0.06, Min 0.48, Max 0.73, t=8.92, p<0.001). (3) There was no significant difference between the value of SAS and the normal value 50 (av. 50.30±5.58, Min 43, Max 62, t=0.29, p>0.05). (4) There was no significant difference between the value of S-AI and the normal value 2 (av. 1.93±0.37, Min 1.05, Max 2.30, t=0.98, p>0.05), but there was a significant difference between the value of T-AI and the normal value 2 (av. 2.45±0.31, Min 1.60, Max 2.85, t=8.02, p<0.001).
2. The state of mental health before the short-term occupational exposure was worse compared with after. The scores of SCL-90 factors, such as somatization, obsessive-compulsive, interpersonal sensitivity, depression, paranoid ideation and psychoticism were significant higher before the exposure than after. The same results were found in other scales. To SDS, the depression index was significant higher before exposure than after (before av. 0.49±0.05, Min 0.40, Max 0.56, after av. 0.47±0.06, Min 0.35, Max 0.56, t=3.42, p<0.01). To SAS, the score was significant higher before exposure than after (before av. 55.16±5.25, Min 43, Max 63, after av. 39.64±5.45, Min 30, Max 51, t=9.22, p<0.001). To STAI, the score of S-AI was significant higher before exposure than after (before av. 2.02±0.28, Min 1.50, Max 2.50, after av. 1.52±0.26, Min 1.05, Max 2.00, t=38.73, p<0.001), the score of T-AI was significant higher before exposure than after (before av. 2.04±0.31, Min 1.45, Max 2.50, after av. 1.98±0.34, Min 1.10, Max 2.50, t=2.56, p<0.05).
Conclusions:
1. The mental health of military personnel is normal during the long-term occupational exposure, but still exist a certain depression.
2. The state of mental health is poor before short-term occupational exposure than after.
3. The results give a strong proof of verifying the theory of information injure.
4. The authority of army should enhance the education of occupational career and mental health to those who are under the situation of some actual exposure.
本研究从实证的角度出发,运用症状自评量表、焦虑自评量表、抑郁自评量表和状态-特质焦虑问卷等研究工具,探讨了长期职业暴露对军人心理健康的影响,以及短期职业暴露前后军人心理健康的变化特点,为军队院校培养特殊技能教育工作中出现的职业暴露所引起心理问题的干预提供参考依据。
主要的研究结果:
1.长期处于职业暴露环境人员的SCL-90阳性项目数和各因子与中国军人常模比较均无统计学差异。抑郁自评量表(SDS)抑郁指数平均为0.59±0.06(最小值0.48,最大值0.73),与正常值0.5分进行独立样本t检验结果为t=8.92(p<0.001)。焦虑自评量表(SAS)得分平均为50.30±5.58(最小值43分,最大值62分),与正常值50分进行独立样本t检验结果为t=0.29(p>0.05)。焦虑状态-特质问卷(STAI)状态焦虑因子(S-AI)平均为1.93±0.37(最小值1.05分,最大值2.30分),与正常值2分进行独立样本t检测结果为t=0.98(p>0.05);特质焦虑因子(T-AI)平均为2.45±0.31(最小值1.60分,最大值2.85分),与正常值2分进行独立样本t检验结果为t=8.02(p<0.001)。
2.短期职业暴露前SCL-90各项得分均高于职业暴露后,其中躯体化、强迫、人际关系、抑郁、偏执、精神病性、阳性项目数、总分均达到统计学显著水平(p<0.05),但焦虑、敌对和恐怖等因子未达到统计学显著水平(p>0.05)。抑郁自评量表(SDS)抑郁指数平均为0.49±0.05(最小值0.40,最大值0.56);职业暴露后,抑郁指数平均为0.47±0.06(最小值0.35,最大值0.56)。前后配对t检验结果为t=3.42(p<0.01)。焦虑自评量表(SAS)得分平均为55.16±5.25(最小值43,最大值63);职业暴露后,得分平均为39.64±5.45(最小值30,最大值51)。前后配对t检验结果为t=9.22(p<0.001)。焦虑状态-特质问卷(STAI)状态焦虑因子(S-AI)平均为2.02±0.28(最小值1.50分,最大值2.50分),特质焦虑因子(T-AI)平均为2.04±0.31(最小值1.45分,最大值2.50分);职业暴露后,状态焦虑因子(S-AI)平均为1.52±0.26(最小值1.05分,最大值2.00分),特质焦虑因子(T-AI)平均为1.98±0.34(最小值1.10分,最大值2.50分)。前后配对t检验S-AI结果为,t=38.73(p<0.001);T-AI结果为t=2.56(p<0.05)。
主要结论:
1.长期处于职业暴露环境人员心理健康总体情况正常,但存在一定程度的抑郁状态。
2.短期职业暴露前的心理健康状况比职业暴露后差。
3.验证了信息损伤理论,提供了依据。
4.部队应加强职业暴露个体的职业教育和心理健康教育。
It’s very important to focus on the cultivation of mental health of military personnel. But the study on occupational exposure of army is rare, especially on some special occupational exposure. So, it has very significant meaning to study the effect of occupational exposure in army on mental health of military personnel.
In this study, SCL-90, SAS, SDS and STAI were used to assess the effect of long-term occupational exposure on the mental health of 30 applicants and the characteristics of mental health of 25 applicants were also compared before and after short-term occupational exposure.
Main results:
1. During the long-term occupational exposure: (1) There was no significant difference between the data of SCL-90 of applicants in this study and Chinese Army Norm. (2) There was a significant difference between average level of SDS depression index of applicants in this study and the normal value 0.5 (av. 0.59±0.06, Min 0.48, Max 0.73, t=8.92, p<0.001). (3) There was no significant difference between the value of SAS and the normal value 50 (av. 50.30±5.58, Min 43, Max 62, t=0.29, p>0.05). (4) There was no significant difference between the value of S-AI and the normal value 2 (av. 1.93±0.37, Min 1.05, Max 2.30, t=0.98, p>0.05), but there was a significant difference between the value of T-AI and the normal value 2 (av. 2.45±0.31, Min 1.60, Max 2.85, t=8.02, p<0.001).
2. The state of mental health before the short-term occupational exposure was worse compared with after. The scores of SCL-90 factors, such as somatization, obsessive-compulsive, interpersonal sensitivity, depression, paranoid ideation and psychoticism were significant higher before the exposure than after. The same results were found in other scales. To SDS, the depression index was significant higher before exposure than after (before av. 0.49±0.05, Min 0.40, Max 0.56, after av. 0.47±0.06, Min 0.35, Max 0.56, t=3.42, p<0.01). To SAS, the score was significant higher before exposure than after (before av. 55.16±5.25, Min 43, Max 63, after av. 39.64±5.45, Min 30, Max 51, t=9.22, p<0.001). To STAI, the score of S-AI was significant higher before exposure than after (before av. 2.02±0.28, Min 1.50, Max 2.50, after av. 1.52±0.26, Min 1.05, Max 2.00, t=38.73, p<0.001), the score of T-AI was significant higher before exposure than after (before av. 2.04±0.31, Min 1.45, Max 2.50, after av. 1.98±0.34, Min 1.10, Max 2.50, t=2.56, p<0.05).
Conclusions:
1. The mental health of military personnel is normal during the long-term occupational exposure, but still exist a certain depression.
2. The state of mental health is poor before short-term occupational exposure than after.
3. The results give a strong proof of verifying the theory of information injure.
4. The authority of army should enhance the education of occupational career and mental health to those who are under the situation of some actual exposure.
引文
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2.李丽娟。化学因素护理职业暴露危险与防范。中国误诊学杂志,2007;7(23): 5471-5473
3.戴青梅,王立英,刘素美,等。医务人员职业损伤的危险因素及防护对策。中华护理杂志, 2002;37(7):532
4.张翠花。急诊科医护人员对职业暴露的认知及暴露后心理状态的调查分析。河南外科学杂志,2006;12(3):82-83
5.张可,福燕。临床医护人员HIV职业暴露及其防护。中国性病艾滋病防治,2002;8(1):15
6.杨慧,李静。医护人员对锐器伤的认知及伤后心理状态的调查分析。现代医药卫生,2005;21(17):2345-2346
7.顾瑜琦,张颖。健康心理学。中国医药科技出版社,2006,pp.90-91
8.苗丹民,王家同。临床心理学。第四军医大学出版社,2005
9. John G, Bartlett M D, Joel E, et al. Medical management of HIV. Infection,2004,1:5
10.郭翔鹤,刘宇,刘瑶。新闻晨报。2005年3月20日,第2271期
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