河北省三級醫(yī)院ICU護士死亡焦慮現(xiàn)狀調(diào)查及干預(yù)研究
發(fā)布時間：2018-08-18 11:39
【摘要】：目的:隨著社會的不斷發(fā)展、現(xiàn)代生活節(jié)奏越來越快,心理壓力在普通人群中都有所提升。眾所周知,生死交替是人類進化的必然階段,是每個人都必須要經(jīng)歷和承受的。ICU是醫(yī)院危急重癥患者的集中地,每天都上演著生離死別。我國學(xué)者目前大部分心理狀況的研究集中在重癥患者及家屬,較少對直接參與臨終關(guān)懷的醫(yī)護人員給予關(guān)注,這類醫(yī)護人員在重癥患者救治的過程中發(fā)揮著舉足輕重的作用。當ICU護士出現(xiàn)相關(guān)不良心理應(yīng)激或者死亡焦慮的反應(yīng)時,給患者及其家屬的心理慰藉和社會精神支持等方面帶來負面作用。常年奮戰(zhàn)在ICU一線的護士作為人民健康的保健護航者,其死亡焦慮水平理應(yīng)引起更廣泛的社會關(guān)注。本次調(diào)查研究主要為了了解河北省三級醫(yī)院ICU護理人員死亡焦慮現(xiàn)狀,探討護理人員死亡焦慮的相關(guān)影響因素,針對可控性因素實施相應(yīng)對策,為今后有效降低ICU護士的死亡焦慮感提供數(shù)據(jù)支持。方法:從2016年3月至2016年12月,采用便利抽樣法,抽取河北省三級醫(yī)院ICU護士作為研究對象,使用中文版五級死亡焦慮量表,調(diào)查三級醫(yī)院ICU護士死亡焦慮現(xiàn)狀。共發(fā)放調(diào)查問卷450份,回收409份,有效回收率為90.89%。本調(diào)查研究分為兩部分內(nèi)容:第一,納入護理人員的一般狀況包括性別、年齡、民族、婚姻狀況、學(xué)歷、護齡、職稱、宗教信仰、工作科室等;第二,把護士是否接受過死亡教育或親歷死亡事件納入到調(diào)查范疇。以35分認為調(diào)查人群處于高死亡焦慮狀態(tài)。采用SPSS22.0數(shù)據(jù)包對所得結(jié)果進行分析,計數(shù)資料間的對比采用卡方檢驗、計量資料采用方差分析和t檢驗進行分析;涉及到兩兩比較的數(shù)據(jù)采用SNK-q檢驗進行對比;死亡焦慮的影響因素分析采用多元條件Logistic回歸方法;培訓(xùn)前后死亡焦慮得分情況對比采用配對t檢驗。結(jié)果:1ICU護士死亡焦慮評分(45.16±6.07)普遍得分較高,386人(94.38%)表現(xiàn)出較高死亡焦慮水平。其中女性護士存在死亡焦慮比例達95.3%,高于男性護士的86.4%,差異有統(tǒng)計學(xué)意義,P0.05。2ICU護士一般情況與死亡焦慮評分的對比情況如下:年齡≤25歲的護士死亡焦慮評分為38.74±5.66,明顯低于25歲的護士得分水平47.32±4.45,t=-15.761,p0.001;icu男性護士的死亡焦慮評分為43.43±7.97明顯低于女性護士的45.37±5.78,t=-2.006,p=0.046;護士初始學(xué)歷是中專、大專和本科水平的護士死亡焦慮評分分別為46.63±6.02、45.78±5.24和42.53±7.44,三者對比有統(tǒng)計學(xué)差異,f=12.230,p0.001,學(xué)歷越高死亡焦慮評分越低;職稱水平分別為護士、護師、主管護師和副主任護師及以上的護士死亡焦慮評分分別為43.81±5.36、44.73±6.03、46.16±5.46和40.57±4.86,四者對比有統(tǒng)計學(xué)差異,f=3.259,p=0.033,主管護師的死亡焦慮水平高于護師和護士,但是副主任護師及以上的高死亡焦慮評分最低;不同婚姻狀況、最高學(xué)歷、用工形式以及是否為科室?guī)Ы汤蠋�、科室�(guī)ЫM組長和工作年限等對護士死亡焦慮評分情況無影響,差異沒有統(tǒng)計學(xué)意義,p0.05。3是否接受過死亡教育及事件對死亡焦慮評分影響情況參加過死亡教育或臨終關(guān)懷的培訓(xùn)或?qū)W習的護士死亡焦慮評分為42.37±6.92,明顯低于未參加過死亡教育或臨終關(guān)懷的培訓(xùn)或?qū)W習的護士46.01±5.52,差異有統(tǒng)計學(xué)意義,t=-5.293,p0.001;參與患者或親人的臨終處置的護士死亡焦慮評分為44.52±6.63,明顯低于未參與患者或親人的臨終處置的45.62±5.59,差異有統(tǒng)計學(xué)意義,t=-2.017,p=0.045;是否目睹過嚴重事故或威脅生命事件對死亡焦慮評分的情況無影響,差異沒有統(tǒng)計學(xué)意義,p0.05。4將23例不存在死亡焦慮的護士作為研究對象,按照1:2比例進行科室、性別、家庭環(huán)境進行匹配,追溯其填寫的調(diào)查問卷,采用條件logistic回歸研究死亡焦慮評分的影響因素。研究表明有參與親人臨終處置的經(jīng)歷和曾經(jīng)系統(tǒng)參加臨終關(guān)懷相關(guān)培訓(xùn)工作是死亡焦慮的“保護因素”。5采用就近原則的方法,在河北省胸科醫(yī)院組織對45名icu護士(之前均未參加過類似培訓(xùn)或者教育經(jīng)歷)進行死亡焦慮培訓(xùn)工作,觀察培訓(xùn)前、培訓(xùn)中、培訓(xùn)后死亡焦慮評分的變化情況。培訓(xùn)前我院icu護士死亡焦慮評分為45.36±5.93,培訓(xùn)過程中調(diào)查發(fā)現(xiàn)icu護士死亡焦慮評分降低至44.68±5.62,培訓(xùn)結(jié)束后icu護士死亡焦慮評分降低至42.35±6.15。結(jié)論:1三級醫(yī)院ICU護士死亡焦慮評分普遍得分較高,94.38%表現(xiàn)出較高死亡焦慮水平,并且存在性別差異,其中女性護士死亡焦慮水平高于男性護士。2 ICU護士死亡焦慮評分在年齡、初始學(xué)歷、職稱水平上存在差異,年齡≤25歲的護士死亡焦慮評分明顯低于25歲的護士得分水平;初始學(xué)歷越高死亡焦慮評分情況相應(yīng)越低;職稱水平升高,死亡焦慮評分情況相應(yīng)升高。3參加過死亡教育或臨終關(guān)懷的培訓(xùn)或?qū)W習以及參與患者或親人的臨終處置的護士死亡焦慮評分低于沒有上述經(jīng)歷的護士。4條件Logistic回歸研究死亡焦慮評分的影響因素,結(jié)果表明年齡≤25歲、有參與親人臨終處置的經(jīng)歷和曾經(jīng)系統(tǒng)參加臨終關(guān)懷相關(guān)培訓(xùn)工作有助于降低ICU護士死亡焦慮水平。5組織ICU護士開展的死亡焦慮系統(tǒng)培訓(xùn)工作行之有效,在參加過培訓(xùn)后,死亡焦慮水平降低效果顯著。
[Abstract]:Objective: With the continuous development of society, the pace of modern life is getting faster and faster, and psychological pressure is rising in the general population. As we all know, life-death alternation is the inevitable stage of human evolution, which everyone must experience and accept. ICU is the concentration of critically ill patients in hospitals. Life-death parting takes place every day. At present, most of the researches on psychological status focus on the critically ill patients and their family members, and few of them pay attention to the medical staff directly involved in hospice care. These medical staff play an important role in the treatment of critically ill patients. Psychological comfort and social and spiritual support from family members have brought about negative effects. Nurses working hard all the year round in ICU as health care escorts of the people should arouse wider social concern about their level of death anxiety. Methods: From March 2016 to December 2016, ICU nurses in Hebei tertiary hospitals were selected by convenience sampling method, and the Chinese version of the fifth level of death anxiety was used. A total of 450 questionnaires were sent out and 409 of them were recovered with an effective recovery rate of 90.89%. The study was divided into two parts. First, the general conditions of nurses included gender, age, nationality, marital status, educational background, nursing age, professional title, religious belief, and work room, etc. The results were analyzed by SPSS22.0 data package. The comparison of the counting data was analyzed by Chi-square test, and the measurement data was analyzed by ANOVA and T-test. The data were compared by SNK-q test; the influencing factors of death anxiety were analyzed by multivariate conditional logistic regression method; and the scores of death anxiety before and after training were compared by paired t test. Results: 1 The death anxiety score of ICU nurses was generally higher, 386 (94.38%) showed higher level of death anxiety. The proportion of nurses with death anxiety was 95.3%, which was higher than 86.4% of male nurses. The difference was statistically significant (P 0.05.2). The score of death anxiety of nurses was 43.43+7.97, which was significantly lower than that of female nurses (45.37+5.78, t=-2.006, p=0.046); the score of death anxiety of nurses with initial education was 46.63+6.02, 45.78+5.24 and 42.53+7.44, respectively, and the difference was statistically significant (f=12.230, p0.001). The scores of death anxiety of nurses with professional titles were 43.81 (+5.36), 44.73 (+6.03), 46.16 (+5.46) and 40.57 (+4.86), respectively. There was statistical difference between the four groups, f = 3.259, P = 0.033. The level of death anxiety of nurses in charge was higher than that of nurses and nurses in charge, but the level of death anxiety of nurses in charge and above was higher than that of nurses in charge. The scores of high death anxiety were the lowest; different marital status, the highest educational background, the type of employment and whether or not to be a teaching teacher, the head of the Department and the length of work had no influence on the scores of death anxiety, the difference was not statistically significant, p0.05.3 whether or not to receive death education and events had participated in the impact of death anxiety scores. The score of death anxiety of nurses trained or trained in death education or hospice care was 42.37 + 6.92, which was significantly lower than that of nurses trained or trained in death education or hospice care (46.01 + 5.52). The difference was statistically significant (t = - 5.293, P 0.001); the score of death anxiety of nurses involved in hospice care of patients or relatives was 44.52 + 6.63. It was significantly lower than that of the patients or relatives who had not participated in the hospice treatment, the difference was statistically significant, t = - 2.017, P = 0.045; whether or not witnessed serious accidents or life-threatening events had no effect on the score of death anxiety, the difference was not statistically significant, p0.05.4 23 nurses without death anxiety as the study object, according to the 1:2 ratio. Case matched with department, gender, family environment, retrospective questionnaire and conditional logistic regression were used to study the influencing factors of death anxiety score. Methods Forty-five ICU nurses (who had not participated in similar training or educational experience before) were trained in Hebei Thoracic Hospital to observe the changes of the scores of death anxiety before and after training. The death anxiety score of U nurses was reduced to 44.68+5.62, and the death anxiety score of ICU nurses was reduced to 42.35+6.15 after training. Conclusion: The death anxiety score of ICU nurses in Grade 1 tertiary hospitals was generally higher, 94.38% of them showed higher level of death anxiety, and there were gender differences, among them, the death anxiety level of female nurses was higher than that of male nurses. The scores of U nurses'death anxiety were significantly lower than those of 25-year-old nurses. The higher the initial educational background, the lower the score of death anxiety; the higher the professional title, the higher the score of death anxiety. 3. Nurses who participated in the training or learning of care and hospice treatment of patients or relatives had lower scores of death anxiety than those who did not. 4 conditional logistic regression was used to study the influencing factors of death anxiety score. The results showed that the age of nurses who participated in hospice treatment of relatives was less than 25 years old. It is helpful to reduce the level of death anxiety of ICU nurses. 5 It is effective to organize the training of death anxiety system for ICU nurses. After participating in the training, the level of death anxiety decreased significantly.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R47
本文編號：2189353
[Abstract]:Objective: With the continuous development of society, the pace of modern life is getting faster and faster, and psychological pressure is rising in the general population. As we all know, life-death alternation is the inevitable stage of human evolution, which everyone must experience and accept. ICU is the concentration of critically ill patients in hospitals. Life-death parting takes place every day. At present, most of the researches on psychological status focus on the critically ill patients and their family members, and few of them pay attention to the medical staff directly involved in hospice care. These medical staff play an important role in the treatment of critically ill patients. Psychological comfort and social and spiritual support from family members have brought about negative effects. Nurses working hard all the year round in ICU as health care escorts of the people should arouse wider social concern about their level of death anxiety. Methods: From March 2016 to December 2016, ICU nurses in Hebei tertiary hospitals were selected by convenience sampling method, and the Chinese version of the fifth level of death anxiety was used. A total of 450 questionnaires were sent out and 409 of them were recovered with an effective recovery rate of 90.89%. The study was divided into two parts. First, the general conditions of nurses included gender, age, nationality, marital status, educational background, nursing age, professional title, religious belief, and work room, etc. The results were analyzed by SPSS22.0 data package. The comparison of the counting data was analyzed by Chi-square test, and the measurement data was analyzed by ANOVA and T-test. The data were compared by SNK-q test; the influencing factors of death anxiety were analyzed by multivariate conditional logistic regression method; and the scores of death anxiety before and after training were compared by paired t test. Results: 1 The death anxiety score of ICU nurses was generally higher, 386 (94.38%) showed higher level of death anxiety. The proportion of nurses with death anxiety was 95.3%, which was higher than 86.4% of male nurses. The difference was statistically significant (P 0.05.2). The score of death anxiety of nurses was 43.43+7.97, which was significantly lower than that of female nurses (45.37+5.78, t=-2.006, p=0.046); the score of death anxiety of nurses with initial education was 46.63+6.02, 45.78+5.24 and 42.53+7.44, respectively, and the difference was statistically significant (f=12.230, p0.001). The scores of death anxiety of nurses with professional titles were 43.81 (+5.36), 44.73 (+6.03), 46.16 (+5.46) and 40.57 (+4.86), respectively. There was statistical difference between the four groups, f = 3.259, P = 0.033. The level of death anxiety of nurses in charge was higher than that of nurses and nurses in charge, but the level of death anxiety of nurses in charge and above was higher than that of nurses in charge. The scores of high death anxiety were the lowest; different marital status, the highest educational background, the type of employment and whether or not to be a teaching teacher, the head of the Department and the length of work had no influence on the scores of death anxiety, the difference was not statistically significant, p0.05.3 whether or not to receive death education and events had participated in the impact of death anxiety scores. The score of death anxiety of nurses trained or trained in death education or hospice care was 42.37 + 6.92, which was significantly lower than that of nurses trained or trained in death education or hospice care (46.01 + 5.52). The difference was statistically significant (t = - 5.293, P 0.001); the score of death anxiety of nurses involved in hospice care of patients or relatives was 44.52 + 6.63. It was significantly lower than that of the patients or relatives who had not participated in the hospice treatment, the difference was statistically significant, t = - 2.017, P = 0.045; whether or not witnessed serious accidents or life-threatening events had no effect on the score of death anxiety, the difference was not statistically significant, p0.05.4 23 nurses without death anxiety as the study object, according to the 1:2 ratio. Case matched with department, gender, family environment, retrospective questionnaire and conditional logistic regression were used to study the influencing factors of death anxiety score. Methods Forty-five ICU nurses (who had not participated in similar training or educational experience before) were trained in Hebei Thoracic Hospital to observe the changes of the scores of death anxiety before and after training. The death anxiety score of U nurses was reduced to 44.68+5.62, and the death anxiety score of ICU nurses was reduced to 42.35+6.15 after training. Conclusion: The death anxiety score of ICU nurses in Grade 1 tertiary hospitals was generally higher, 94.38% of them showed higher level of death anxiety, and there were gender differences, among them, the death anxiety level of female nurses was higher than that of male nurses. The scores of U nurses'death anxiety were significantly lower than those of 25-year-old nurses. The higher the initial educational background, the lower the score of death anxiety; the higher the professional title, the higher the score of death anxiety. 3. Nurses who participated in the training or learning of care and hospice treatment of patients or relatives had lower scores of death anxiety than those who did not. 4 conditional logistic regression was used to study the influencing factors of death anxiety score. The results showed that the age of nurses who participated in hospice treatment of relatives was less than 25 years old. It is helpful to reduce the level of death anxiety of ICU nurses. 5 It is effective to organize the training of death anxiety system for ICU nurses. After participating in the training, the level of death anxiety decreased significantly.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R47
【參考文獻】
相關(guān)期刊論文 前10條
1 陳蓄;梁燕儀;;臨床護理人員死亡態(tài)度現(xiàn)狀及影響因素的研究進展[J];中國醫(yī)學(xué)倫理學(xué);2016年06期
2 陳淑娟;陶艷;胡成文;丁娜;;人生回顧對惡性腫瘤患者死亡焦慮的影響[J];醫(yī)學(xué)與哲學(xué)(B);2016年08期
3 王俊暉;陳禹;姚之涵;邱禮英;穆輝提;楊娟;;高死亡喚醒職業(yè)人群的死亡態(tài)度調(diào)查研究[J];華南師范大學(xué)學(xué)報(社會科學(xué)版);2016年03期
4 胡佳佳;;國內(nèi)臨床護士死亡態(tài)度相關(guān)研究進展[J];全科護理;2016年10期
5 仇琦;房圓;林翔;班春霞;朱敏捷;王濤;肖世富;李霞;;大學(xué)生死亡焦慮及其影響因素分析[J];上海交通大學(xué)學(xué)報(醫(yī)學(xué)版);2015年10期
6 胡成文;陶艷;丁娜;陳淑娟;;腫瘤醫(yī)院護士死亡焦慮現(xiàn)狀及其影響因素研究[J];中國護理管理;2015年08期
7 唐魯;李玉香;周玲君;孟憲麗;趙繼軍;;死亡教育課程對護士照護臨終患者態(tài)度的影響[J];上海護理;2015年04期
8 楊勛;陶雪燕;程科;;藏漢大學(xué)生死亡焦慮的調(diào)查研究及對生命教育的啟示[J];西南民族大學(xué)學(xué)報(人文社科版);2015年07期
9 黃敏清;楊翠芹;胡春儀;方奕;;腫瘤科護士面對患者死亡情緒體驗的質(zhì)性研究[J];齊魯護理雜志;2015年13期
10 張慧蘭;王丹;羅羽;;國內(nèi)外死亡教育發(fā)展的分析與思考[J];護理學(xué)報;2015年11期
相關(guān)碩士學(xué)位論文 前3條
1 楊紅;死亡焦慮量表的跨文化調(diào)適及其應(yīng)用的研究[D];北京中醫(yī)藥大學(xué);2011年
2 沈峰平;護士死亡教育培訓(xùn)知識體系的構(gòu)建[D];第二軍醫(yī)大學(xué);2011年
3 孫榮光;大學(xué)生生活事件、自尊與社交焦慮的關(guān)系[D];山東師范大學(xué);2008年
，本文編號：2189353
本文鏈接：http://sikaile.net/linchuangyixuelunwen/2189353.html
最近更新
教材專著
