医护人员艾滋病职业暴露原因及心理状况调查分析
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摘要
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。
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.
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.
引文
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[2]赵英.医务人员艾滋病职业暴露及防护现状调查[J].昆明医科大学学报,2015,36(1):151-153,156.
[3]钱静娟,黄利华,钟亚君,等.传染病医院艾滋病职业暴露监测分析与防控策略[J].护理管理杂志,2015,15(4):269-270.
[4]程五琴,张玲,马兴爱,等.医务人员艾滋病职业暴露知识掌握现况与心理状态研究[J].中国护理管理,2015,15(s1):85-87.
[5]罗斌华,吴志勇,李福太,等.医务人员职业暴露相关危险因素调查与分析[J].中华医院感染学杂志,2014,24(24):6223-6225.
[6]Schmitz N,Hartkamp N,Kiuse J,et al.The Symptom Check-List-90-R(SCL-90-R):a German validation study[J].Qual Life Res,2000,9(2):185-193.
[7]金华,吴文源,张明园.中国正常人SCL-90评定结果的初步分析[J].中国神经精神疾病杂志,1986,12(5):260-263.
[8]Wicker S,Stirn AV,Rabenau HF,et al.Needlestick injuries:causes,preventability and psychological impact[J].Infection,2014,42(3):549-552.
[9]Europische Agentur für Sicherheit und Gesundheitsschutz am Arbeitsplatz(OSHA-EU):Vermeidung von Verletzungendurchscharfe/spitze Instrumente am Arbeitsplatz[EB/OL].[2017-10-28].http://osha.europa.eu/de/sector/healthcare/prevention-sharpinjuries-workplace.
[10]赵鲜丽,李小龙,任伟,等.医务人员HIV职业暴露分析[J].中国感染控制杂志,2017,16(2):179-181.
[11]Aynalem TF,Dejenie HT.Assessment of prevalence and determinants of occupational exposure to HIV infection among healthcare workers in selected health institutions in Debre Berhan Town,North Shoa Zone,Amhara Region,Ethiopia,2014[J].Aids Res Treat,2014,2014:731848.
[12]陈嘉,王红红,李现红,等.青年医务人员对艾滋病传播途径的认识及职业暴露的防护及意外事故处理[J].实用临床医药杂志,2017,21(10):161-162.
[13]彭玉娇,张开友,易隽,等.四川省乡镇医院医务人员艾滋病应对能力与培训调查[J].预防医学情报杂志,2017,33(4):307-311.
[14]赵昌松,张强,李鑫,等.HIV感染者骨科手术过程中职业暴露防护流程分析[J].传染病信息,2016,29(6):336-339.
[15]倪裕玲,胡跃强.金华市19名护理人员艾滋病职业暴露情况分析及防护对策[J].护理与康复,2015,14(11):1077-1079.
[16]杨梅钦.助产士HIV职业暴露后心理状况调查及护理干预[J].齐鲁护理杂志,2015,21(10):63-65.