[Mental health sataus and influencing factors of medical staff after blood-borne occupational exposure].

Objective: To explore the mental health status and influencing factors of medical staff after blood-borne occupational exposure, and to provide scientific basis for effective psychological intervention. Methods: From January 2017 to December 2018, 178 medical staff with blood-borne occupational exposure in three hospitals of Shandong Province were collected as the contact group, and 100 routine medical staff as the control group during the same period. Questionnaires were conducted among medical staff in the two groups, including general information questionnaire, symptom checklist 90 (SCL-90) , post-traumatic stress disorder self-rating scale (PCL-C) , coping style scale (CPS) , social support scale (SSRS) . The basic situation and mental health level of medical staff in the two groups, as well as the coping and social support status of medical staff exposed to hematogenous occupational exposure were analyzed. Relevant influencing factors. Results: The total score of SCL-90 was 1.66+0.33, 45 (38.14%) were positive, and 21 (21.00%) were positive in the control group. The difference was statistically significant (χ(2)=7.529, P<0.05) . Compared with the control group, the scores of SCL-90 somatization, obsessive-compulsive symptoms, depression, anxiety, hostility, paranoia and total scores of medical staff in the exposure group increased significantly (P<0.05) . The total PCL-C score of exposure group was 36.84+9.50, PTSD positive 47 (39.83%) and control group 13 (13.00%) . The difference was statistically significant (χ(2)=19.534, P<0.05) . Compared with the control group, PCL-C re-experience, avoidance, vigilance factor scores and total scores of medical staff in the contact group increased significantly (P<0.05) . The problem solving, help seeking and subjective support of the medical staff in the positive mental health group with blood-borne occupational exposure were significantly lower than those in the negative group, while self-blame, fantasy and withdrawal were significantly higher than those in the negative group (P<0.05) . The mental health level of medical staff with occupational exposure was negatively correlated with problem solving, help seeking and subjective support, and positively correlated with self-blame, fantasy and withdrawal (P<0.05) . Problem solving, help seeking and subjective support were protective factors of mental health (OR=2.121, 1.616, 1.371) , and self-blame and withdrawal were risk factors of mental health (OR=0.160, 0.484) . Conclusion: Medical personnel exposed to blood-borne occupational exposure are prone to psychological problems and PTSD. Solving problems, seeking help and subjective support are protective factors for mental health, while self-blame and withdrawal are risk factors for mental health.目的： 探究医护人员发生血源性职业暴露后的心理健康状况及影响因素，为其进行有效心理干预提供科学依据。 方法： 收集山东省3家医院2017年1月至2018年12月发生血源性职业暴露的医务人员118人作为接触组，以同期常规医务人员100人作为对照组。对两组医务人员进行问卷调查，包括一般资料问卷、症状自评量表（SCL-90）、创伤后应激障碍（PTSD）自评量表（PCL-C）、应对方式量表（CPS）、社会支持量表（SSRS），分析两组医务人员的基本情况和心理健康水平、发生血源性职业暴露医务人员的应对和社会支持状况以及相关影响因素。 结果： 发生血源性职业暴露医务人员的SCL-90总均分为1.66±0.33，心理健康测评阳性45人（38.14%），对照组21人（21.00%），差异有统计学意义（χ(2)=7.529，P<0.05）。与对照组比较，接触组医务人员发生血源性职业暴露后SCL-90躯体化、强迫症状、抑郁、焦虑、敌对、偏执因子分及总分均明显增加（P<0.05）。接触组PCL-C总分36.84±9.50，PTSD阳性47人（39.83%），对照组13人（13.00%），差异有统计学意义（χ(2)=19.534，P<0.05）。与对照组比较，接触组医务人员PCL-C再体验、回避、警觉因子分及总分均明显增加（P<0.05）。发生血源性职业暴露的心理健康阳性组医务人员解决问题、求助、主观支持明显低于阴性组，自责、幻想、退缩明显高于阴性组（P<0.05）。发生血源性职业暴露医务人员心理健康水平的SCL-90总均分与解决问题、求助、主观支持均呈负相关，与自责、幻想、退缩均呈正相关（P<0.05）。解决问题、求助、主观支持是心理健康的保护因素（OR=2.121、1.616、1.371），自责、退缩是心理健康的危险因素（OR=0.160、0.484）。 结论： 发生血源性职业暴露的医务人员易出现心理问题和PTSD，且解决问题、求助、主观支持、自责和退缩是心理健康的影响因素。.