调查新型冠状病毒肺炎疫情期间援鄂医务人员不适现状并分析其影响因素。

采用便利抽样法选取2020年2月至4月在湖北省某3家新型冠状病毒肺炎定点收治医院工作的医务人员为研究对象。由研究者自行设计人口学特征问卷及援鄂医务人员不适症状问卷，其中人口学特征问卷包括性别、年龄、原单位级别、职业、工作年限等因素；援鄂医务人员不适症状问卷包括生理维度11个条目，心理维度2个条目，社会支持维度1个条目。另外增加1个开放式问题。各个条目采用Likert 5级评分法，各条目得分1~2分代表轻度不适；3~4分代表中度不适；5分代表重度不适。采用"问卷星"微信小程序，由研究者于调查开始前对调查对象进行统一指导，之后以二维码形式在线发放问卷。调查对象于开展工作2周后根据自身实际感受填写问卷，研究者于后台进行资料收集。按照因子分析的具体要求计算样本量。分析援鄂医务人员不适问卷的内部一致性信度和结构效度；统计援鄂医务人员人口学特征，并进行援鄂医务人员不适因素的单因素分析和多元线性回归分析。数据比较采用t检验、单因素方差分析、非参数检验、多元线性逐步回归。

通过对前期收集的72份预实验问卷数据进行统计分析，本研究问卷的Cronbach′s系数为0.89，生理维度和心理维度的Cronbach′s系数分别为0.86和0.88，表明该问卷具有较好的内部一致性信度；对各条目进行探索性因子分析，Bartlett球形检验χ²值为364.54，差异有统计学意义(P<0.05)，KMO值为0.85，3个公因子的累计方差贡献率为61.98%，说明本问卷具有较好的结构效度。本研究共发放问卷240份，回收240份，有效问卷216份，有效回收率90%。经统计，援鄂医务人员各条目不适总均分为(3.03±0.76)分，不适得分处于中度水平。身体部位受挤压、皮肤改变、失眠/多梦、呼吸困难/缺氧及肢体酸痛是援鄂医务人员主要的不适症状；对援鄂医务人员不适得分进行单因素分析，结果显示性别、职业、工作年限、职称、工作时长、是否有相关疾病史差异有统计学意义(P<0.05)，进一步对以上因素进行多因素分析结果显示，职业、职称及是否有相关疾病史是援鄂医务人员不适得分的主要影响因素(t＝6.24、5.15、-5.84，P<0.05)。开放式问题调查结果显示防护用品穿戴问题和合理排班问题也是援鄂医务人员存在不适的问题。

新型冠状病毒肺炎疫情期间援鄂医务人员存在不同程度的身心不适，管理者需重视抗疫期间医务人员的不适症状，关注医务人员是否有相关疾病史，从职业、职称方面进行干预，并采取综合性护理管理对策，减少引起援鄂医务人员不适的影响因素，使援鄂医务人员的不适程度降至最低，保持最佳的状态参与抗疫。

To investigate the discomfort status of medical staff aiding Hubei Province during the epidemic situation of COVID-19 and analyze its influencing factors.

Medical staff who worked in three designated admission hospital for COVID-19 in Hubei Province from February to April 2020 were selected by convenient sampling method. The demographic characteristics questionnaire and the questionnaire of discomfort symptoms of medical staff aiding Hubei Province were designed by researchers, and the questionnaire on demographic characteristics included factors such as gender, age, original unit level, occupation and working years and so on; the discomfort symptoms for medical staff aiding Hubei Province includes 11 items in physiological dimension, 2 items in psychological dimension and 1 item in social support dimension. In addition, add an open-ended question. Grade Likert 5 scoring was used for each item, with 1-2 points for each item for mild discomfort; 3-4 points for moderate discomfort; and 5 points for severe discomfort. The "Questionnaire Star" WeChat small program were used and the unified guide to the respondents before the investigation began were gave by researchers, and then distributed the questionnaire online in the form of two-dimensional code. The respondents filled in the questionnaire according to their actual feelings within 2 weeks after work, and the researcher collected the data in the background. The sample size was calculated according to the specific requirements of the factor analysis. The internal consistency reliability and structural validity of the questionnaire on the discomfort of the medical staff aiding Hubei Province were analyzed; the demographic characteristics of the medical staff aiding Hubei Province were calculated, and the univariate analysis and multiple linear regression analysis of the discomfort factors of the staff aiding Hubei Province were conducted. Data were compared with t test, one-way analysis of variance, non-parametric test, and multiple linear stepwise regression.

Through statistical analysis of 72 pre-experimental questionnaires data collected in the previous period, the Cronbach′s coefficient of this research questionnaire was 0.89, and the Cronbach′s coefficients of physiological and psychological dimensions were 0.86 and 0.88, respectively, showed that the questionnaire had good internal consistency reliability. The χ² value of Bartlett was 364.54, the difference was statistically significant (P<0.05), the KMO value accumulated variance was 0.85 and the cumulative variance contribution rate of the three common factors was 61.98%, indicated that the questionnaire showed good structural validity. In total, 240 questionnaires were distributed, 240 questionnaires were recovered, 216 valid questionnaires were collected, and the effective recovery rate was 90%. According to statistics, the average score of discomfort for each item of the medical staff aiding Hubei Province was (3.03±0.76) points, which was at the moderate level. Extrusion of the body parts, skin changes, insomnia / multiple dreams, dyspnea / anoxia and body pain were the main discomfort symptoms of medical staff aiding Hubei Province; the univariate analysis of the discomfort scores of medical staff aiding Hubei Province showed that the differences in gender, occupation, working years, job title, working hours, and whether there was a history of related diseases were statistically significant (P<0.05). The results of further multi-factor analysis of these factors showed that occupation, job title and history of related diseases were the main influencing factors of discomfort scores of medical staff aiding Hubei Province(t=6.24, 5.15, -5.84; P<0.05). Open problem survey results showed that protective equipment clothing problems and reasonable scheduling problems were also uncomfortable problems for medical staff aiding Hubei Province.

Medical staff aiding Hubei Province have different degrees of medical discomfort during the epidemic situation of COVID-19. Managers should pay attention to the discomfort symptoms of medical staff, focus on whether they have related disease history, intervene from occupational and professional titles, and adopt comprehensive nursing management countermeasures to reduce the influencing factors, minimize the discomfort of medical staff and maintain the best state to participate in the anti-epidemic of COVID-19.