【摘要】：目的：了解醫(yī)務人員心理健康現況及其影響因素,為提高醫(yī)務人員心理健康水平提供科學依據。 方法：采用多階段分層整群抽樣方法,從湖南省14個市州48個縣共計445家各級醫(yī)療保健機構中隨機抽取17170名醫(yī)務人員(包括醫(yī)生、護士、醫(yī)技檢驗人員、藥劑人員、后勤行政人員等),進行問卷調查。醫(yī)務人員心理健康影響因素的單因素分析采用卡方檢驗或方差分析,多因素分析采用非條件logistic回歸分析(Backward:LR法)。 結果：醫(yī)務人員焦慮、抑郁的總檢出率分別為35.3%、64.6%,其中,護士焦慮和抑郁檢出率最高分別為38.6%、67.9%；其次為醫(yī)生分別為37.1%、67.1%；他們是醫(yī)務人員中焦慮和抑郁的高發(fā)人群。不同性別中,女性醫(yī)務人員抑郁檢出率(65.8%)高于男性(61.9%)；不同職稱中,初級職稱醫(yī)務人員焦慮和抑郁檢出率(37.2%和65.8%)明顯高于副高(33.6%和54%)及以上職稱者；檢出焦慮、抑郁醫(yī)務人員的社會支持總分、客觀支持分、主觀支持分、支持利用度方面均顯著低于無焦慮和抑郁者,差異有統(tǒng)計學意義。焦慮影響因素的多因素分析結果顯示：護士職業(yè)、經常加班、每周晚夜班次數增加、醫(yī)患關系緊張、感受到醫(yī)患糾紛中安全得不到保障、感到晉升困難、工作缺乏他人的尊重、同事之間缺乏理解、管理者的批評過多、及未感受到領導器重等因素將增加醫(yī)務人員焦慮發(fā)生的風險；而對工作環(huán)境滿意度高,有繼續(xù)深造學習機會、遇到壓力時找人傾訴或參加文體活動、社會支持得分高等因素將減少醫(yī)務人員焦慮發(fā)生的風險。抑郁影響因素的多因素分析結果顯示：醫(yī)護職業(yè)、經常加班、每周晚夜班次數增加、感受到醫(yī)患糾紛中安全得不到保障、感到晉升困難、工作缺乏他人的尊重、同事之間缺乏理解、及未感受到領導器重等將增加醫(yī)務人員抑郁發(fā)生的風險；而對工作環(huán)境滿意度高,有繼續(xù)深造學習機會、遇到壓力時找人傾訴或參加文體活動、社會支持得分高等將減少醫(yī)務人員抑郁發(fā)生的風險。 結論：醫(yī)務人員心理健康狀況不容樂觀,應采取必要措施進行心理干預,以促進與保護醫(yī)務人員身心健康。
[Abstract]:Objective: to understand the mental health status of medical staff and its influencing factors, and to provide scientific basis for improving the mental health level of medical staff. Methods: 17170 medical personnel (including doctors, nurses, medical examiners, pharmacists) were randomly selected from 445 medical care institutions in 14 cities and 48 counties of Hunan province by multi-stage stratified cluster sampling. Logistic administrative staff, etc.), conduct questionnaire survey. Univariate analysis of influencing factors of mental health of medical staff was performed by chi-square test or variance analysis, and non-conditional logistic regression analysis (Backward:LR method) was used for multivariate analysis. Results: the total detectable rates of anxiety and depression in medical staff were 35.3and 64.6, respectively. Among them, the highest detectable rate of anxiety and depression in nurses was 38.6 and 67.9, and the second was 37.1 and 67.1, respectively, and that of doctors was 37.1 and 67.1, respectively. They are a high incidence of anxiety and depression among medical workers. The prevalence of depression in female medical staff (65.8%) was higher than that in male (61.9%). The detectable rate of anxiety and depression of medical staff with junior titles (37.2% and 65.8%) was significantly higher than that with subtropical high (33.6% and 54%). The total scores of social support objective support subjective support and support utilization of anxiety and depression medical staff were significantly lower than those without anxiety and depression. The results of multivariate analysis of anxiety factors showed that nursing profession, frequent overtime, increasing number of night shifts per week, tension between doctors and patients, feeling that safety is not guaranteed in doctor-patient disputes, difficulties in promotion, lack of respect from others, Lack of understanding among colleagues, too much criticism from managers, and failure to feel the importance of leadership will increase the risk of anxiety among medical staff. The factors such as high satisfaction with the work environment, the opportunity to continue further study, the chance to talk to others or participate in sports activities when under pressure, and the high score of social support will reduce the risk of medical staff anxiety. The results of multivariate analysis of the influencing factors of depression showed that: medical profession, frequent overtime, increased number of night shifts per week, felt that safety was not guaranteed in doctor-patient disputes, it was difficult to promote, and work lacked respect from others. Lack of understanding among colleagues and lack of sense of leadership will increase the risk of depression among medical staff; The higher score of social support will reduce the risk of depression of medical staff because of the high degree of satisfaction with the work environment, the opportunity to continue further study, the chance to talk to others or to participate in sports activities when they are under pressure, and the higher score of social support will reduce the risk of depression. Conclusion: the state of mental health of medical staff is not optimistic and necessary measures should be taken to promote and protect their physical and mental health.
【學位授予單位】：中南大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R395

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