摘要目的 探讨重症监护病房(ICU)护士社会支持、心理韧性及自尊评价与创伤后应激障碍(PTSD)的相关性并分析PTSD的相关危险因素.方法 采用事件冲击量表(修订版)(IES-R)、社会支持量表(SSRS)、心理弹性量表(CD-RISC)和Rosenberg自尊量表(SES)对来自24省值辖市的717名ICU护士进行问卷调查.其中男101名,女616名,年龄(30±5)岁.以IES-R≥35定义为PTSD阳性,IES-R＜35为阴性将被调查人员分为2组,比较组间差异以进一步探讨PTSD相关影响因素.结果 717名调查对象中,414名(57.7％)PTSD阳性,303名PTSD阴性.Spearman相关分析发现,IES-R评分与SSRS、CD-RISC及SES评分呈显著负相关(r=-0.275、-0.202、-0.709,均P＜0.05).多因素回归分析提示ICU工作年限是PTSD阳性独立危险因素,SES评分、SSRS评分和健康状况是保护因素.SES自尊评分在SSRS支持评分与IES-R间起部分中介作用,中介效应为51.5％.受试者工作特征曲线(ROC)分析显示,SSRS、CD-RISC、SES评分及PTSD危险得分Logit(P)评估PTSD阳性的ROC下面积分别为0.629、0.604、0.831、0.848.结论 社会支持、身体健康和自尊水平是PTSD保护性因素,而ICU工作年限是危险因素.SES评分在SSRS支持评分与IES-R间起部分中介作用.

abstractsObjective To investigate the correlation between social support,resilience,self-esteem and post-traumatic stress disorder (PTSD) in intensive care unit (ICU) nurses.Methods A total of 717 ICU nurses from 24 provinces conducted these questionnaires (Chinese version of Impact of Event Scale-Revised(IES-R),Social Support Rate Score(SSRS),Cannor-Davidson Resilience(CD-RISC) and Self-Esteem Scale(SES)).There were 101 males and 616 females,with an average age of (30±5) years.With the aim to investigate PTSD impact factors,the ICU nurses were divided into the PTSD positive group (IES-R＞35) and PTSD negative group (IES-R＜35).The correlation between IES-R and other scales were analyzed with linear regression analysis.Results In this investigation,414 nurses were screened with PTSD and 303 nurses without.IES-R score was negatively correlated with SSRS,CD-RISC and SES (r=-0.275,-0.202,-0.709,all P＜0.05).Multivariate regression analysis showed that ICU clinical experience was an independent risk factor for PTSD,and SES Score,SSRS Score and physical health status were protective factors.SES partially mediated the association of SSRS with IES-R,and the mediating effect were 51.5％.The area under characteristic curve (ROC) showed that SSRS score,CD-RISC score,SES score and PTSD risk score Logit (P) for prediction of PTSD was 0.629,0.604,0.831 and 0.848,respectively.Conclusions Social support,physical health and self-esteem are protective factors of PTSD,while ICU clinical experience is a risk factor.SES partially mediated the association of SSRS with IES-R.