重症监护室护士创伤后应激障碍检出率及影响因素的系统评价

doi:10.3761/j.issn.1672-9234.2023.07.005

摘要/Abstract

摘要：

目的系统评价ICU护士创伤后应激障碍的检出率及影响因素。方法计算机检索PubMed、Cochrane Library、Embase、JAMA、CINAHL、PsycINFO、中国知网、万方和维普9个中英文数据库，纳入评价ICU护士创伤后应激障碍的检出率及影响因素的文献，检索时间为建库至2022年5月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后，采用Stata 14.0软件合并检出率，并对影响因素进行描述性分析。结果共纳入23篇文献，包括8 960名ICU护士，文献发表时间为2007年—2022年。Meta分析结果显示，ICU护士创伤后应激障碍检出率为31%（95%CI：0.24~0.38）。亚组分析显示，北美（0.38，95%CI：0.23~0.53）、采用事件影响量表-修订版为诊断工具（0.50，95%CI：0.31~0.69）、2021年—2022年统计（0.33，95%CI：0.23~0.44）的ICU护士创伤后应激障碍检出率更高。描述性分析显示，D型人格、身体健康状况、心理弹性和社会支持是ICU护士创伤后应激障碍发生的影响因素。结论 ICU护士创伤后应激障碍检出率较高，D型人格、身体健康状况较差、心理弹性及社会支持水平较低等可增加ICU护士创伤后应激障碍患病的风险。

关键词: 重症监护病房, 护士, 应激障碍, 创伤后, 患病率, Meta分析

Abstract:

Objective To systematically evaluate the prevalence and influencing factors of post-traumatic stress disorder（PTSD） in ICU nurses. Methods A total of nine Chinese and English databases were searched by computer，including PubMed，Cochrane Library，Embase，JAMA，CINAHL，PsycINFO，CNKI，Wanfang，and VIP. The literatures on the prevalence and influencing factors of PTSD in ICU nurses were included. The retrieval time was set from the date of database’s establishment to May 2022. After that，two researchers screened the literature，extracted the data and evaluated the risk of bias in the included studies independently. The prevalence of PTSD was analyzed by Stata 14.0 software and descriptive analysis was performed on the influencing factors. Results A total of 23 articles were included，involving 8 960 ICU nurses，published between 2007 and 2022. The prevalence of PTSD among ICU nurses was 31%（95%CI：0.24~0.38）. Subgroup analysis showed a higher prevalence of PTSD among ICU nurses in North America（0.38，95%CI：0.23~0.53），using the IES-R scale as a diagnostic tool（0.50，95%CI：0.31~0.69），and during the year from 2021 to 2022（0.33，95%CI：0.23~0.44）. Descriptive analysis showed that the type of D personality，physical health status，resilience，social support were the factors affecting the development of PTSD in ICU nurses. Conclusion The prevalence of PTSD in ICU nurses is high，and the risk of PTSD in ICU nurses is increased by type D personality，poor physical health，low levels of resilience and social support.

Key words: Intensive Care Units, Nurses, Stress Disorders, Post-Traumatic, Prevalence, Meta-Analysis

段秋改, 张红梅, 张雨, 成巧梅. 重症监护室护士创伤后应激障碍检出率及影响因素的系统评价[J]. 中华护理教育, 2023, 20(7): 795-802.

DUAN Qiugai, ZHANG Hongmei, ZHANG Yu, CHENG Qiaomei. Prevalence and influence factors of post-traumatic stress disorder among nurses in intensive care unit：a systematic review[J]. Chinese Journal of Nursing Education, 2023, 20(7): 795-802.

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