發(fā)布時間：2018-05-04 15:18

  本文選題：醫(yī)護(hù)人員 + 功能性胃腸病��； 參考：《青島大學(xué)》2017年碩士論文

【摘要】：目的:1.本研究調(diào)查醫(yī)務(wù)人員FGIDs的患病率及相關(guān)影響因素。2.通過回顧文獻(xiàn)以及對醫(yī)務(wù)人員進(jìn)行問卷調(diào)查研究,大致判斷醫(yī)務(wù)人員精神心理健康狀況,了解精神心理因素對功能性胃腸病患病的影響,為醫(yī)務(wù)人員FGIDs的治療、預(yù)防及維護(hù)醫(yī)務(wù)人員良好的心理健康狀況提供參考依據(jù)。方法:對青島市四所三級甲等醫(yī)院醫(yī)務(wù)人員群體采取整群、分層、隨機(jī)抽樣的方法。采用羅馬III成人功能性胃腸病診斷問卷進(jìn)行診斷;根據(jù)醫(yī)務(wù)人員的自身特點設(shè)計基本情況、生活方式等內(nèi)容,應(yīng)用焦慮自評量表(SAS)、抑郁自評量表(SDS)等兩個量表對抽樣人群進(jìn)行調(diào)查分析,比較FGIDs患病組與非患病組焦慮、抑郁得分情況。運用SPSS17.0統(tǒng)計軟件進(jìn)行數(shù)據(jù)分析。計數(shù)資料組間的比較采用卡方檢驗,用平均值±標(biāo)準(zhǔn)差來描述計量資料,2組計量資料之間的比較采用t檢驗,多組間的比較應(yīng)用單因素方差分析。如無明顯特殊說明P0.05為差異有顯著。結(jié)果:1.本次研究共調(diào)查醫(yī)護(hù)人員1380人,女性657人(47.6%),男性723人(52.4%),醫(yī)生656人(47.5%),護(hù)士724人(52.5%)。2.青島市三級甲等醫(yī)院醫(yī)護(hù)人員FGIDs總體患病率為31.5%,不同性別間FGID患病率存在差異,女性患病256人(38.9%)高于男性179人(24.7%);25-35歲組FGIDs患病率高(40.0%);不同工作類別間,護(hù)士253人(34.94%)高于醫(yī)生182人(27.74%);不同職稱間,副高級(38.8%)高于初級(23.19%)、中級(38.17%)和高級(32.08%);急診科室患病率最高108人(58.69%);工年限為5-10年患病率最高(41.91%),科室主任患病率最高(67.4%)。以上各組間比較差異均有統(tǒng)計學(xué)意義(P0.5)。3.功能性消化不良,腸易激綜合征和功能性便秘的患病率分別為17.1%,8.4%和6.0%,其中在237例功能性消化不良中,上腹痛綜合征為115例(48.5%),餐后不適綜合征為122例(51.5%)。在115例腸易激綜合征中,腸易激綜合征便秘型15例(13.0%),腹瀉型85例(73.9%),混合型15例(13.1%)。上腹痛綜合征與餐后不適綜合征在不同性別、工作性質(zhì)和職稱間,患病情況有顯著性差異(P0.05)。腸易激綜合征在不同職稱間,患病情況有顯著性差異(P0.05)。3.焦慮自評量表(SAS)和抑郁自評量表(SDS):SAS和SDS結(jié)果顯示,醫(yī)務(wù)人員FGIDs組SAS和SDS得分均值都高于非FGIDs組,具有顯著性差異(P0.05),提示焦慮和或抑郁與功能性胃腸病的患病有關(guān)。結(jié)論:青島市三級甲等醫(yī)院醫(yī)護(hù)人員FGIDs患病率高,其中,女性患病率高于男性,護(hù)士患病率高于醫(yī)生,年齡以25-35歲患病率最高,工作年限以5-10年患病率最高,功能性消化不良,腸易激綜合征和功能性便秘患病率分別為17.1%,8.4%和6.0%,其中餐后不適綜合征為功能性消化不良的主要病種,腸易激綜合征腹瀉型為腸易激綜合征的最主要病種。醫(yī)務(wù)人員FGIDs患者與焦慮和或抑郁明顯相關(guān),應(yīng)當(dāng)給予更多的精神心理咨詢,以緩解醫(yī)務(wù)人員心理壓力。意義:功能性胃腸病(Functional gastrointestinal disorders,FGIDs)是一種常見的消化系統(tǒng)疾病,臨床上診斷功能性疾病的必要條件是充分排除器質(zhì)性病變(如腫瘤、炎癥等),這一點對于功能性胃腸病尤為重要[1]。FGIDs主要有功能性消化不良(Functional dyspepsia,FD)、腸易激綜合征(Irritable bowel syndromeIBS、和功能性便秘(Functional constipation,FC)。功能性胃腸病治療周期長,發(fā)病誘因多,臨床療效差,其癥狀常常反復(fù)出現(xiàn),難以根治,對患者的生活及工作質(zhì)量、經(jīng)濟(jì)支出造成了顯著的影響,從而占用了大量的醫(yī)療資源。FGIDs患者不僅長期承受軀體上的不適,精神、心理方面也同樣受到極大的影響。近幾年來隨著醫(yī)療市場競爭日益激烈,病人對健康的要求日益增高以及目前不和諧的醫(yī)患關(guān)系,這些因素促使相應(yīng)的醫(yī)務(wù)人員的精神心理壓力越來越大。我國有關(guān)FGIDs的流行病學(xué)調(diào)查研究雖然已經(jīng)涉及到不同人群、不同職業(yè)如大學(xué)生,解放軍官兵、出租車司機(jī)、遠(yuǎn)洋輪船海員等,但是關(guān)于醫(yī)護(hù)人員的系統(tǒng)調(diào)查較少。
[Abstract]:Objective: 1. to investigate the prevalence and influencing factors of FGIDs in medical staff,.2. through a review of the literature and the investigation of medical staff, the mental and mental health status of medical staff was roughly judged, the effects of psycho psychological factors on the disease of functional gastrointestinal diseases, the treatment of medical personnel FGIDs, and the prevention and maintenance of medical treatment, were also discussed. Methods: a group, stratified and random sampling method was adopted in the group of four grade three first class hospitals in Qingdao, using a questionnaire on the diagnosis of adult functional gastrointestinal diseases in Rome III, and the basic situation and life style should be designed according to the self characteristics of the medical staff. Two scales, such as the self rating Anxiety Scale (SAS) and the self rating Depression Scale (SDS), were used to investigate and analyze the sampling population. The scores of anxiety and depression in the FGIDs and non diseased groups were compared. The data were analyzed by the SPSS17.0 software. The comparison between the count data groups was compared with the chi square test, and the mean standard deviation was used to describe the measurement data, 2 The comparison of the data between the groups was compared with the single factor analysis of variance using t test. For example, there was a significant difference between the 1380 people, 657 women (47.6%), 723 men (52.4%), 656 doctors (47.5%), 724 nurses (52.5%) in Qingdao City, Qingdao City three a class hospital. The overall prevalence rate of FGIDs was 31.5%, the prevalence of FGID in different sexes was different, 256 (38.9%) of women were higher than that of men (24.7%); the prevalence rate of FGIDs in 25-35 year old group was higher (40%); 253 (34.94%) in different work categories (34.94%) was higher than that of doctors 182 (27.74%); the secondary (38.8%) was higher than junior (23.19%) and intermediate (3). 8.17%) and advanced (32.08%); the prevalence rate of the emergency department was the highest (58.69%); the age of 5-10 years was the highest (41.91%), and the prevalence rate of the department director was the highest (67.4%). The differences were statistically significant (P0.5).3. functional dyspepsia, and the prevalence rates of irritable bowel syndrome and functional constipation were 17.1%, 8.4% and 6%, respectively. Among 237 cases of functional dyspepsia, upper abdominal pain syndrome was 115 cases (48.5%), postprandial discomfort syndrome was 122 (51.5%). 115 cases of irritable bowel syndrome, 15 cases of irritable bowel syndrome (13%), 85 cases of diarrhea (73.9%), and mixed 15 (13.1%). The characteristics of upper abdominal pain syndrome and postprandial discomfort syndrome were different sex and working nature. There was a significant difference in the prevalence of the disease (P0.05). There was a significant difference in the prevalence of irritable bowel syndrome in different titles (P0.05).3. Anxiety Scale (SAS) and self rating Depression Scale (SDS): the results of SAS and SDS showed that the average score of SAS and SDS in FGIDs group of medical staff was higher than that of non FGIDs group, and there was significant difference (P0.05). Anxiety and depression were associated with the disease of functional gastrointestinal diseases. Conclusion: the prevalence rate of FGIDs in the three grade a hospital was higher, among them, the prevalence rate of women was higher than that of men, the prevalence rate of nurses was higher than that of the doctors, the highest prevalence rate at the age of 25-35 years, the highest rate of 5-10 years of work, functional dyspepsia, irritable bowel syndrome and work. The prevalence rates of energy constipation were 17.1%, 8.4% and 6% respectively. The postprandial discomfort syndrome was the main disease of functional dyspepsia, and irritable bowel syndrome was the most important disease of irritable bowel syndrome. The FGIDs patients in medical staff were closely related to anxiety and depression. More psychological counseling should be given to relieve the medical workers. Psychological stress. Significance: Functional gastrointestinal disorders (FGIDs) is a common digestive system disease. The essential condition for clinical diagnosis of functional diseases is to fully exclude organic diseases (such as tumors, inflammation, etc.), which is particularly important for functional gastrointestinal diseases, especially in [1].FGIDs. Functional dyspepsia (FD), irritable bowel syndrome (Irritable bowel syndromeIBS, and functional constipation (Functional constipation, FC). The treatment cycle of functional gastrointestinal disease is long, the causes of the disease are many, the clinical curative effect is poor, the symptoms are often recurring, it is difficult to root out, and it has caused significant economic expenditure to the life and work quality of the patients. The effects, thus taking up a large amount of medical resources,.FGIDs patients not only have long suffered from physical discomfort, mental, psychological aspects are also greatly affected. In recent years, with the increasingly fierce competition in the medical market, the increasing demand for health and the current unharmonious relationship between doctors and patients, these factors contribute to the medical treatment. The mental and psychological pressure of the personnel is becoming more and more serious. Although the epidemiological investigation of FGIDs has been involved in different populations, different professions such as college students, PLA officers and soldiers, taxi drivers, marine steamers, and so on, there are few systematic investigations on medical and nursing personnel.

【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R57

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