汶川地震后儿童和青少年生命质量随访研究
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摘要
目的探讨汶川地震后儿童和青少年生命质量变化趋势和影响因素。方法采用随机抽样和系统抽样相结合的方法,利用地震创伤经历问卷(EEQ)、儿童创伤后应激障碍反应指数量表(CPTSD-RI)、儿童抑郁指数量表(CDI)以及儿童生命质量量表(PedsQL)进行调查,采用描述性统计分析、χ2检验和多元线性回归进行统计分析。结果 596名调查对象中,其生命质量总分随时间显著下降2.0(82.2∶80.2,P=0.01)。创伤后应激障碍(PTSD)和抑郁是影响灾区儿童和青少年生命质量的最重要因素,PTSD或抑郁每变化1分都会引起生命质量0.3~0.5的反向变动。结论遭遇严重受伤、丧失亲人的儿童和青少年生命质量持续低迷,但没有特定创伤经历的个体生命质量也随时间显著下降,灾后心理危机干预的对象不应只包括直接卷入灾难的儿童和青少年,还应涵盖间接暴露的个体。
Objectives To investigate the trends and risk factors of life quality of child and adolescent survivors of Wenchuan earthquake.Methods Random sampling and systematic sampling method were combined to select the objects.Earthquake traumatic Experiences Questionnaire(EEQ),Child Posttraumatic Stress Disorder Reaction Index(CPTSD-RI),the Children's Depression Inventory(CDI)and the Pediatric Quality of Life InventoryTM(PedsQL)were used to carried out the investigation.Descriptive statistical analysis,chi-square tests and multiple linear regression were applied for statistical analysis.Results 596 respondents were involved in the research.Scores of quality of life decreased significantly over time by 2.0(82.2∶80.2,P=0.01).The most important risk factors of quality of life among affected children and adolescents were posttraumatic stress disorder(PTSD)and depression,the alteration of which would result in a reverse change of scores of quality of life from 0.3to 0.5per point,respectively.Conclusions The life quality of Child and adolescent survivors who had been seriously injured and had lost family members were in sustained downturn.However,the quality of life among child and adolescent survivors with no specific traumatic experiences decreased significantly with time,either.Therefore,the object of post-disaster psychological crisis intervention should include not only children and adolescents who were directly involved in the disaster,but individuals with indirect exposure.
Objectives To investigate the trends and risk factors of life quality of child and adolescent survivors of Wenchuan earthquake.Methods Random sampling and systematic sampling method were combined to select the objects.Earthquake traumatic Experiences Questionnaire(EEQ),Child Posttraumatic Stress Disorder Reaction Index(CPTSD-RI),the Children's Depression Inventory(CDI)and the Pediatric Quality of Life InventoryTM(PedsQL)were used to carried out the investigation.Descriptive statistical analysis,chi-square tests and multiple linear regression were applied for statistical analysis.Results 596 respondents were involved in the research.Scores of quality of life decreased significantly over time by 2.0(82.2∶80.2,P=0.01).The most important risk factors of quality of life among affected children and adolescents were posttraumatic stress disorder(PTSD)and depression,the alteration of which would result in a reverse change of scores of quality of life from 0.3to 0.5per point,respectively.Conclusions The life quality of Child and adolescent survivors who had been seriously injured and had lost family members were in sustained downturn.However,the quality of life among child and adolescent survivors with no specific traumatic experiences decreased significantly with time,either.Therefore,the object of post-disaster psychological crisis intervention should include not only children and adolescents who were directly involved in the disaster,but individuals with indirect exposure.
引文
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[8]张伯华,刘羽曦,张德秀,等.汶川地震一年半后重灾区受灾群众社会支持及其与心理卫生状况的相关研究[J].中国社会医学杂志,2011,28(5):318-320.
[9]宗焱,祝卓宏,王晓刚,等.书法心理治疗对震后儿童创伤应激反应的心理干预研究[J].中国社会医学杂志,2011,28(1):31-33.
[2]Somasundaram DJ,van de Put WA.Management of trauma in special populations after a disaster[J].J Clin Psychiatry,2006,67(Suppl 2):64-73.
[3]Roussos A,Goenjian A K,Steinberg AM,et al.Posttraumatic stress and depressive reactions among children and adolescents after the 1999earthquake in Ano Liosia,Greece[J].Am J Psychiatry,2005,162(3):530-537.
[4]Jia Z,Tian W,He X,et al.Mental health and quality of life survey among child survivors of the 2008Sichuan earthquake[J].Qual Life Res,2010,19(9):1381-1391.
[5]Kovacs M.Rating scales to assess depression in schoolaged children[J].Acta Paedopsychiatr,1981,46(5-6):305-315.
[6]Tian W,Jia Z,Duan G,et al.Longitudinal study on health-related quality of life among child and adolescent survivors of the 2008 Sichuan earthquake[J].Qual Life Res,2013,22(4):745-752.
[7]陈茹,田文华.自然灾害后儿童和青少年创伤后应激障碍评估量表的应用[J].中国社会医学杂志,2013,30(1):53-56.
[8]张伯华,刘羽曦,张德秀,等.汶川地震一年半后重灾区受灾群众社会支持及其与心理卫生状况的相关研究[J].中国社会医学杂志,2011,28(5):318-320.
[9]宗焱,祝卓宏,王晓刚,等.书法心理治疗对震后儿童创伤应激反应的心理干预研究[J].中国社会医学杂志,2011,28(1):31-33.
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