CAJ | 학술논문

目的：探讨心理危机管理模式在急重症高风险科室医护人员中的应用效果，为维护急重症高风险科室医护人员的身心健康，提高其心理素质和应对能力提供指导。方法以提高社会支持、自助与他助相结合的心理危机管理模式，对急诊科、ICU、神经外科高风险科室96名医护人员应用心理危机干预技术进行为期6个月的心理干预。干预前后采用医务人员压力调查量表、症状自评量表（ SCL-90）、社会支持评定量表进行问卷调查，比较干预前后效果。结果压力调查结果显示，影响急诊科、ICU、神经外科医护人员身心健康的压力因素主要来源于工作、人际关系和学习，其中来自工作时间长、担心差错事故、医疗纠纷、医患纠纷中感到自身安全无保障的压力人数占100％。96名医护人员干预前社会支持总分（37．57±7．74）分，干预后（41．52±8．19）分，差异有统计学意义（ t＝3．434，P＜0．05）。干预后SCL-90因子分值降低，其中躯体化（1．97±0．51）、强迫（1．88±0．54）、人际敏感（1．83±0．55）、抑郁（1．72±0．61）、焦虑（1．69±0．49）、敌意（1．28±0．48）、恐怖（1．55±0．46）、偏执（1．50±0．56）、精神病性（1．30±0．41）分，与干预前比较差异均有统计学意义（ t 值分别为15．861，9．173，7．989，7．966，9．198，6．311，5．573，1．271，5．828；P＜0．05）；急重症高风险科室医护人员SCL-90各因子得分与院内其他科室及国内常模比较差异均有统计学意义（P＜0．05）。结论急重症高风险科室医护人员存在较严重心理健康问题。采用自助与他助相结合的心理危机管理模式，提高社会支持的利用度，对维护医务人员身心健康，提高心理素质及应对能力有显著作用。
목적：탐토심리위궤관리모식재급중증고풍험과실의호인원중적응용효과，위유호급중증고풍험과실의호인원적신심건강，제고기심리소질화응대능력제공지도。방법이제고사회지지、자조여타조상결합적심리위궤관리모식，대급진과、ICU、신경외과고풍험과실96명의호인원응용심리위궤간예기술진행위기6개월적심리간예。간예전후채용의무인원압력조사량표、증상자평량표（ SCL-90）、사회지지평정량표진행문권조사，비교간예전후효과。결과압력조사결과현시，영향급진과、ICU、신경외과의호인원신심건강적압력인소주요래원우공작、인제관계화학습，기중래자공작시간장、담심차착사고、의료규분、의환규분중감도자신안전무보장적압력인수점100％。96명의호인원간예전사회지지총분（37．57±7．74）분，간예후（41．52±8．19）분，차이유통계학의의（ t＝3．434，P＜0．05）。간예후SCL-90인자분치강저，기중구체화（1．97±0．51）、강박（1．88±0．54）、인제민감（1．83±0．55）、억욱（1．72±0．61）、초필（1．69±0．49）、활의（1．28±0．48）、공포（1．55±0．46）、편집（1．50±0．56）、정신병성（1．30±0．41）분，여간예전비교차이균유통계학의의（ t 치분별위15．861，9．173，7．989，7．966，9．198，6．311，5．573，1．271，5．828；P＜0．05）；급중증고풍험과실의호인원SCL-90각인자득분여원내기타과실급국내상모비교차이균유통계학의의（P＜0．05）。결론급중증고풍험과실의호인원존재교엄중심리건강문제。채용자조여타조상결합적심리위궤관리모식，제고사회지지적이용도，대유호의무인원신심건강，제고심리소질급응대능력유현저작용。
Objective To investigate the effect of application of the psychological crisis intervention on the medical staff in acute and critical care departments and to improve the physical and psychological health of medical staff .Methods The psychological crisis intervention of improving the social support and self -and-others assistance was applied on 96 medical staff who worked in the intensive care units ( ICU ) , emergency room ( ER) and the department of neurosurgery for 6 month.The Pressure Scale , the Social Support Rating Scale and the Symptom checklist 90 (SCL-90) were used for data collection.The effects before and after intervention were compared.Results The pressure scale results showed that the source of pressure were from work , interpersonal relationship and study , among which 100% investigators felt the pressure from long working hours , worries of mistakes , medical dispute and lack of security .The score of social support before intervention was ( 37 .57 ± 7.74), which was significantly lower than (41.52 ±8.19) after the intervention (t=3.434, P<0.05).The score of SCL-90 was lower after the intervention .The score of somatization , obsessive-compulsive , interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism were (1.97 ± 0.51), (1.88 ±0.54), (1.83 ±0.55), (1.72 ±0.61), (1.69 ±0.49), (1.28 ±0.48), (1.55 ±0.46), (1.50 ±0.56) and (1.30 ±0.41), respectively, the differences had statistical significances (t =15.861, 9.173, 7.989, 7.966, 9.198, 6.311, 5.573, 1.271, 5.828, respectively; P<0.05).Compared with the medical staff in other departments , the medical staff in acute and critical care departments had a significantly lower score of SCL-90 (P<0.05).Conclusions The study indicates that the medical staff in acute and critical care departments has mental problems .Using self-and-others assistance with the psychological crisis intervention can improve their availability of social support .It also plays a significant role in helping the medical staff keep a healthy physical and psychological state .At the same time, it can promote the mental quality and the ability of problem-solving.