面對全球新冠肺炎爆發台灣護理人員之壓力、心理困擾與緩解方式探討

Exploring the Stress, Psychological Distress, and Stress-relief Strategies of Taiwan Nursing Staffs Facing the Global Outbreak of COVID-19

背景：2019年底新型冠狀病毒疾病（COVID-19）在全球爆發，疫情期間執業護理師需面臨諸多壓力與擔憂，這將對護理人員的心理健康產生立即性與持久性的重大影響。目的：探討護理人員於COVID-19疫情下的壓力、心理困擾與緩解方式。方法：此橫斷式研究採線上問卷填答，問卷含括四部分：基本資料、護理人員於COVID-19期間的壓力、心理困擾、與緩解壓力方式調查。以方便取樣方法，獲全台各級醫院共469位執業護理師參與填答。結果：COVID-19疫情期間，多數護理人員擔心疫情期間的居住問題（72.7％）。護理人員的壓力以照顧病人的負擔構面得分最高，其次是擔心與社會隔離，各細項中，以擔心親友被自己傳染（2.35±0.79）最高、次為擔心感染後與家人分離（2.17±0.92）。護理人員的心理困擾平均5.49±3.83分，其中感覺緊張不安得分最高（1.32±0.84），其次為易苦惱或動怒（1.17±0.92）與感覺憂鬱心情低落（1.12±0.94）。61.8％的填答者心理情緒困擾得分在正常範圍，但3.4％的填答者已達重度困擾，「接受教育訓練」是最常用以緩解壓力的方法（2.27±0.51）。結論／實務應用：提出六點意見：（一）關懷－提供心理的評估與關懷照護；（二）支持－營造友善團隊氛圍，提供支持；（三）徵詢－優先招募自願及有相關經驗者；（四）告知－提供及時、公開透明的防疫資訊；（五）裝備－提供完整適切的防疫教育訓練；（六）協助－建立安家策略，減少後顧之憂。

Background: The global outbreak of coronavirus disease (COVID-19) began in December 2019. The high levels of stress experienced by nurses during this pandemic may have immediate and long-term effects on their mental health. Purpose: To explore the stress and psychological problems of nurses during this pandemic and to identify strategies used by these nurses to relieve stress. Methods: A cross-sectional online survey was conducted that included a basic information datasheet, stress of nursing staff during COVID-19 outbreak scale, psychological distress scale, and stress relief methods survey form. Convenience sampling was used and a total of 469 practicing nurses participated in this study. Results: Most of the participants expressed concerns about living problems (72.7%). On the stress questionnaire, the facets of ''burden of taking care of patients'' and ''worries about social isolation'' earned the first and second highest scores, respectively. In terms of items, ''worrying about infecting family members and friends'' and ''worrying about being separated from family after being infected'' earned the two highest scores (2.35 ± 0.79 and 2.17 ± 0.92, respectively). Scores for psychological distress averaged 5.49 ± 3.83, with stress anxiety (1.32 ± 0.84) earning the highest mean subscale score followed by distress and irritability (1.17 ± 0.92) and depression (1.12 ± 0.94). Nearly twothirds (61.8%) of the participants earned psychological and emotional distress scores within the ‘normal' range, and 3.4% earned scores indicating severe distress. ''Receiving education and training'' was the most common method used by the participants to relieve stress (2.27 ± 0.51). Conclusions: The following six strategies are proposed based on the above findings: (1) Caring: provide psychological assessment and care; (2) Supporting: create a friendly team atmosphere and provide support; (3) Inquiring: recruit volunteers with relevant experience; (4) Informing: provide timely, open, and transparent epidemicprevention information; (5) Equipping: provide complete and appropriate epidemic-prevention education and training; (6) Assisting: establish a strategy for family support and caring to reduce the stress and worries of nurses.