累积儿童期逆境对护士抑郁症状的影响

doi:10.6040/j.issn.1671-7554.0.2019.566

摘要/Abstract

摘要： 目的探究护士的累积儿童期逆境和新发抑郁症状的关系。方法采用巢式病例对照研究方法以随访时病人健康问卷(PHQ-9)≥10分为有抑郁症状,共74名纳入病例组,按照1 ∶7的原则在剩余样本中筛选518名纳入对照组。使用儿童期不良经历问卷修订版(ACEQ-R)、PHQ-9和护士工作压力源量表等进行数据收集。采用多元Logistic回归分析探究累积儿童期逆境和新发抑郁症状间的关系;采用Spearman秩相关分析和依次检验法探究工作压力的中介作用。结果累积儿童期逆境的归因危险度百分比(PAR%)为8.0%。控制护士的工作压力、家庭负担之后,经历多种儿童期逆境的个体新发抑郁症状的风险是未经历儿童期逆境个体的2.60倍(95%CI:1.12~ 6.01)。工作压力起部分中介作用。结论累积儿童期逆境可以增加护士新发抑郁症状的风险,应该采取相关措施减少儿童期逆境的暴露。

关键词: 累积儿童期逆境, 新发抑郁症状, 工作压力, 临床护士, 巢式病例对照研究

Abstract: Objective To explore the relationship between cumulative childhood adversity and emerging depressive symptoms among nurses. Methods A nested case-control study was conducted among subjected with PHQ-9≥10. A total of 74 subjects who had depressive symptoms were selected as the case group, and 518 subjects were included in the control group. Data were collected using PHQ-9, ACEQ-R and Nurse Job Stressors Inventory. The relationship between cumulative childhood adversity and emerging depressive symptoms was assessed with multivariate Logistic regression analysis. The mediation of work stress was analyzed with Spearman rank correlation and causal steps. Results The PAR% of cumulative childhood adversity was 8.0%. After nurses work stress and family burden were adjusted, the risk of imaging depressive symptoms for those with cumulative childhood adversity was 2.60 times of those without childhood adversity(OR=2.60, 95%CI:1.12-6.01). Work stress could partially mediate cumulative childhood adversity and emerging depression symptoms. Conclusion It is noteworthy that cumulative childhood adversity increases the risk of emerging depressive symptoms in nurses. Measures should be taken to reduce exposure to childhood adversity.

Key words: Cumulative childhood adversity, Emerging depressive symptoms, Work stress, Clinical nurses, Nested case-control study

中图分类号:

R749.92

王颖,杨蓓,王娟,李艳艳,曹枫林. 累积儿童期逆境对护士抑郁症状的影响[J]. 山东大学学报 (医学版), 2019, 57(11): 83-89.

WANG Ying, YANG Bei, WANG Juan, LI Yanyan, CAO Fenglin. Effects of cumulative childhood adversity on depressive symptoms among nurses[J]. Journal of Shandong University (Health Sciences), 2019, 57(11): 83-89.

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