Study On The Cognition And Influencing Factors Of Mental Health Of Changhang Personnel

The notion of burnout was advocated by Freudenberger in1974, after which it has been concerned by researchers. Burnout has highly incidence, thus influences the individuals and society. Long-term and non-changed way of work make people feel exhaustion diminished interest in work, the main three aspects are as follows, emotional exhaustion (enthusiasm loss in work, extremely feel of fatigue), depersonalization (be indifferent to work object and work condition, perfunctory to work, behavioral quirks, in a blue mood or irritability), and reduced sense of personal accomplishment negative evaluation of oneself and the work, feel boring), situational specificity exists in burnout. Burnout is a common disease with high incidence in escort troops, but seldom medical researchers focus on it. Long voyage includes military and civilian, which is normalized operation for the people who participate in escort troops, offshore fishing and oversea shipping. The long voyage has significant meaning to safeguard the country’s overall interests and good image, and to improve the international influence. There are practical significance and strategic importance to investigate burnout in escort troops under the theoretical guide of traditional Chinese medicine—adaptation of human body to natural, treatment in accordance with seasonal conditions, treatment in accordance with local conditions and treatment in accordance with the patient’s individuality. This study focuses on the research status of burnout and the understanding from Chinese medicine in escort troops. Besides, epidemiological investigation is used to make clear the general health, burnout and its characteristics in different time and the influence factors in escort troops, which provide theoretical evidence and data support for drug intervention with Chinese medicine.Theoretical ResearchBurnout is caused by long-term and non-changed work, which is part of "tired" in traditional Chinese medicine, its manifestations focus on mental performance, thus could be part of "seven emotions", which enriches the connotation and denotation of seven emotions pathogenic. In this study, we found that the location of burnout is five-zang organs, especially in the liver and spleen, the evidences come from emotional changes, no appetite and physical fatigue. The core pathogenesis is liver stagnation and spleen deficiency. Liver stagnation and spleen deficiency can influence each other which aggravate burnout. During long voyage, the environmental changes affect human body, shift work changes the biological rhythmwhich induce sleep disorders, missing families and friends causes emotional changes, dietary patterns causes dysfunction of spleen and stomach, and the mutual influence between various factors induces the dysfunction of the heart, liver, spleen, kidney and lungs. Treatment based on syndrome differentiation is peculiar to Chinese medicine. The syndrome study of burnout is necessary for normalization, standardization and scientization of syndrome study. The study of burnout syndrome characteristics will provide a feasible way for the prevention and treatment in clinic. The publications about Chinese medicine and burnout in domestic medical journals from Jan1st,1979to Dec31st,2013were searched and statistical analyzed. The results showed that there were79kinds of syndrome, and the total frequency is582. The top10syndromes were:syndrome of liver stagnation and spleen deficiency, syndrome of stagnation of liver qi, syndrome of qi deficiency, syndrome of blood stasis, syndrome of blood deficiency, syndrome of yang deficiency of spleen and kidney, syndrome of stagnation of phlegm-dampness, syndrome of deficiency of heart and spleen, syndrome of spleen deficiency and syndrome of yin deficiency of liver and kidney. The patterns include excessive syndrome, deficiency syndrome and syndrome of intermingled deficiency and excess, in which31patterns are excessive syndrome, the total frequency is185(31.79%),36patterns are deficiency syndrome, the total frequency is319(54.81%), and the last12are syndrome of intermingled deficiency and excess, with a total frequency of78(13.40%).Clinical Research1. The investigation of physical health in escort troopsObjective To explore the constitution, sleep condition and the correlation between them in escort troops, which may provide the feasible evidence and way for prevention and treatment of the diseases. Methods Standardized TCM Constitution Questionnaire and Pittsburgh Sleep Quality Index (PSQI) were used to investigate162escort troops. Results TCM constitution questionnaire showed there were72people who got normal constitution(47.4%) while the number of escort troops who had biased constitution was80(52.6%), which included31pure biased constitution (20.4%) and31mixed biased constitution (20.4%), the other18were tended to biased constitution (11.8%). The top3biased constitutions were:qi deficiency, phlegm-damp ness, and damp ness-heat. PSQI showed that the sleep index of escort troops were7.41±3.55, the number of escort troops who had bad sleeping(PSQI>7) was66, which acounted for46.2%. Compared to national norm, the sleep quality, time to fall asleep, sleep time, sleep efficacy, sleep disorder and sleep index were all significantly higher(P<0.01) There were significant differences among different official ranks and military service length. The constitution distribution differs in marriage, official ranks, education and ages. PSQI factors had significant correlation with education, ages and marriage with low correlation coefficient. Correlation research showed there were46people (70.3%) were judged as biased constitution in escort who had bad sleep, the last19were normal constitution (29.7%). The top four biased constitution in bad sleep ones were:qi deficiency, phlegm-dampness, dampness-heat and yang deficiency. It was positive correlation among PSQI factor sleep disorder, daytime dysfunction, sleep index and qi deficiency, yang deficiency, yin deficiency and dampness-heat in escort troops who had bad sleep, and negative correlation with normal constitution. Conclusion The constitution distribution of escort troops differs in different marriages, ages and educations. Escort troops had bad sleep, which can attribute to the official ranks and ages. The pathologic changes were the imbalance between yin and yang, which mainly affect the heart, spleen and liver, the other influence factors needed further study. There were correlation between sleep and constitution in escort troops, which indicated that the improvement of sleep could start with improve constitution. The theory of treatment in accordance with seasonal conditions, local conditions and the patient’s individuality had significance in improving the health of escort troops, ensuring safety of navigation and improving the battle effectiveness.2. The study of symptoms and syndrome characteristics in escort troopsObjective To explore the characteristics of symptoms and syndromesin escort troops.Methods Syndrome Questionnaire of Traditional Chinese Medicine was used to investigate the escort troops. Results The symptoms with the occurrence rate over40%in escort troops were:difficult in falling asleep, annoyance, waist aches, joint sore, irritable, amnesia, muscle strength decrease, drowsiness, dreaminess, asthenic breathing and no desire to speak, inappetence, early awaking, sweating of hands and feet, pain in the limbs. The study of pulse manifestation showed the most pulse was floating pulse, slippery pulse and stringy pulse were the top2excess pulse, which accounted for77.85%of all. The syndromes with the occurrence rate over3%were syndrome of liver stagnation and spleen deficiency, syndrome of deficiency of spleen qi, syndrome of yang deficiency of spleen and kidney, syndrome of flaring heart fire, syndrome of stagnation of liver qi, syndrome of disharmony between heart and kidney and syndrome of deficiency of spleen yang. The disease locations were the heart, liver and spleen. Marriage, official ranks, education, BMI and ages were all influence factors to symptoms and syndrome in escort troops. The most common syndrome was syndrome of liver stagnation and spleen deficiency. In escort troops, the symptom of liver stagnation and spleen deficiency syndrome appeared first were emotional symptoms, then the symptoms of spleen cannot govern movement and transformation, and ascending clear. The top10symptoms were:annoyance, irritable, amnesia, muscle strength decrease, asthenic breathing and no desire to speak, joint sore, dreaminess, inappetence, preference for sighing and lacking in strength. Conclusion There were healthy problems in escort troops, in Chinese medicine, most symptoms were about the heart, liver and spleen. The syndrome of liver stagnation and spleen deficiency was the top pattern. Syndrome differentiation should be considered in clinic.3. The study of burnout characteristics at different points in escort troops.Objective To investigate burnout status at5th day post voyage,80th day post voyage,120th day post voyage and3rd day post reaching home port. Methods FSAS was used to do cross-sectional study at different time in voyage. Results The highest scores of fatigue factors happened at3rd day post reaching home port. Characteristics of fatigue differ in different time points. Physical fatigue happened at the first part of the voyage, and mental fatigue happened at the last part, all the fatigue was mild. The number of mental fatigue escort was increasing with the extension of the voyage. Fatigue situation was keeping high during the voyage. Conclusion Long time voyage can induce mental fatigue, the symptoms included burnout, weakness, being in bad health, attention-deficit disorder, slow in reacting, amnesia, be in black mood, tired of working, decreased learning efficacy, and aggravate due to black mood, psychentonia, noisy and stuffiness ship. Mental fatigue was aggravated with the extension of voyage, and was affected by ages, official ranks, military service length and marriages, which indicated that the significance and necessity of treatment in accordance with seasonal conditions; local conditions and the patient’s individuality in medical support during escort.4。 The influence factors study of burnout in escort troopsObjective To explore the effect of demographic characteristic, sleep condition, constitution, and psychological health on burnout in escort troops. Methods FSAS, TCM Constitution Questionnare, PSQI and CMI were used to do the cross-sectionalstudy of escort troops. Results The morbidity of burnout in escort troops was69.8%. Results of PSQI showed the escort who had burnout got a higher sore than the non-burnout ones, The former ones tended to have bad sleep. CMI showed there was significant difference between burnout and non-burnout escort troops. The total score of M-R, CMI, eye and ear disease, cardiovascular system, digestive system, dermal system, genitourinary system, fatigue, anamnesis, habit, maladjustment, anxiety, sensitivity and tension of burnout escort troops were higher than non-burnout ones. TCM Constitution Questionnare showed significant difference between normal constitution and biased constitution in burnout ones. Biased constitution were happened in burnout ones, and normal constitution ones usually didn’t have burnout. And, significant difference existed in different constitutions, qi deficiency, phlegm-dampness, yang deficiency were more inclined to burnout. Correlation study showed positive correlation between factors of FSAS and sleep indexes. Factors of FSAS had negative correlation with normal constitution and negative correlation with biased constitution. Mental fatigue had a high correlation coefficient with dampness-heat constitution. Logistic regression analysis showed military service length had correlation with mental fatigue.Conclusion High occurrence rate of burnout in escort troops which can affect physical and psychological health. Burnout usually associated with sleep disorder and constitutional symptoms, and correlates with military service length, constitution and psychological status. Fully consideration of the influence factors mediation completely can improve burnout in escort troops and strength the naval combat effectiveness.