肖丽华　宗艳红　钟志兵

[摘要] 目的 探討团体心理治疗对临床一线医师心理应激反应的影响。 方法 选择我院临床一线医师60例，按随机数字表法分为实验组和对照组，每组30例，实验组行团体咨询活动，对照组给予一般的心理健康教育。两组分别于干预前后进行焦虑自评量表、抑郁自评量表和症状自评量表测查。 结果 经过团体心理咨询活动的干预，干预前两组SCL-90各因子评分比较，差异无统计学意义（P>0.05），干预后两组SCL-90评分中抑郁、焦虑、躯体化、强迫、人际、偏执、精神病比较，差异有统计学意义（P<0.05），实验组干预前后SCL-90评分中抑郁、焦虑、躯体化、强迫、人际、偏执较治疗前降低，差异有统计学意义（P<0.05），对照组实验前后SCL-90评分中除抑郁评分差异有统计学意义（P<0.05），余评分差异均无统计学意义（P>0.05）。干预前两组SDS、SAS评分比较，差异均无统计学意义（P>0.05）；干预后两组SDS、SAS评分比较，差异有统计学意义（P<0.05）；实验组干预前后SDS、SAS评分较治疗前均有明显下降，差异有统计学意义（P<0.05）；对照组实验前后SDS、SAS评分比较，差异均无统计学意义（P>0.05）。 结论 团体心理治疗对于改善临床一线医师工作压力所致的心理应激反应具有积极的效果。

[关键词] 团体心理治疗；临床一线医师；应激反应；干预效果

[中图分类号] R395.5 [文献标识码] B [文章编号] 1673-9701（2018）12-0091-04

The effect of group psychotherapy on the work pressure of clinical frontline physician

XIAO Lihua1 ZONG Yanhong1 ZHONG Zhibing2

1.Department of Neurology， Nanchang University Fourth Affiliated Hospital， Nanchang 330003， China； 2.Department of Psychology， Nanchang University Fourth Affiliated Hospital， Nanchang 330003， China

[Abstract] Objective To investigate the effect of group psychotherapy on the psychological stress response of clinical frontline physician. Methods A total of 60 clinical frontline doctors were selected from the Fourth Affiliated Hospital of Nanchang University. According to the random number table method， they were divided into experimental group and control group， with 30 people in each group. The experimental group was received group counseling activities. The control group was received general mental health education. The two groups were tested by anxiety self-rating scale， self-rating depression scale and symptom self-rating scale before and after the intervention. Results After intervention of group psychological counseling， there was no significant difference in the scores of SCL-90 between two groups before intervention（P>0.05）. There was statistically significant difference in the scores of depression， anxiety， somatization， obsession， interpersonal， paranoid， psychosis in the SCL-90 scores between two groups before and after the intervention（P<0.05）. The scores of depression， anxiety， somatization， obsession， interpersonal and paranoia in the experimental group after the intervention were lower than those before treatment in the SCL-90 scores， and the difference was statistically significant（P<0.05）. There was no significant difference in the remaining scores of SCL-90 except for depression score in the control group before and after the intervention（P>0.05）. There was no significant difference in the SDS and SAS scores between the two groups before the intervention（P>0.05）. And there was significant difference in the SDS and SAS scores between the two groups after the intervention（P<0.05）. The SDS and SAS scores in the experimental group after the intervention were significantly lower than those before treatment， and the difference was significant（P<0.05）. There was no significant difference in the SDS and SAS scores before and after the intervention in the control group（P>0.05）. Conclusion Group psychotherapy has a positive effect in improving psychological stress response of frontline physician caused by work stress.

[Key words] Group psychotherapy； Clinical frontline physician； Stress response； Intervention effect

随着我国经济的不断发展，当前社会主要矛盾发生变化，已经转变为人们日益增长的美好生活需要和不平衡不充分的发展之间的矛盾，其中包括人们对医疗行业的要求越来越高。在目前医疗大环境以及医患关系异常紧张的形势下，临床一线医师的压力越来越大，如果压力得不到及时有效的缓解和释放，不仅医患关系越来越恶劣，而且社会矛盾也会日益加深。據统计，目前国内医师抑郁症的患病率高达25%～30%，为普通人群的4倍[1]，其中恐惧症、焦虑症、职业倦怠等心理问题成为困扰他们的常见心理问题。因此……