汶川地震异地治疗伤员创伤后应激症状及影响因素分析
|
摘要
【目的】了解异地治疗地震伤员的创伤后应激障碍(PTSD)症状和影响因素。【方法】对从震区转入广州市中山大学附属第三医院的37例伤员在汶川大地震1月时进行一般状况、PTSD检查量表平民版(PCL-C)、焦虑自评量表(SAS)、抑郁自评量表(SDS)、社会支持评定量表(SSRS)、艾森克人格问卷(EPQ)、应对方式问卷(CSQ)调查。【结果】6例(16.22%)伤员发生PTSD,PTSD症状最常见的是再体验症状,发生率78.4%;其次是高警觉症状,发生率为62.2%。相关分析发现年龄与再体验得分成正相关,地震前健康状况与回避/麻木得分成负相关,客观支持与PCL-C总分、再体验、高警觉成正相关,SAS和SDS的得分与PCL-C总分、再体验、回避麻木、高警觉都成正相关。【结论】汶川大地震的异地治疗伤员PTSD发生率不高,对异地治疗的地震伤员心理干预时要关注年龄较大者、震前患有躯体疾病者、客观支持过高和焦虑抑郁情绪明显者,还要注意避免过度关注引起二次心理伤害。
【Objective】 To seek post-traumatic stress disorder(PTSD) symptoms and impact factors of the earthquake injured patients with remote treatment.【Method】 Thirty-seven wounded patients on the Wenchuan Earthquake of the Third Affiliated Hospital of SUN Yat-sen University in Guangzhou City from Wenchuan,were investigated by the general situation,Post Traumatic Stress Disorder Check List for Civic(PCL-C),Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS),Social Support Rating Scale(SSRS),Eysenck Personality Questionnaire(EPQ),Coping Style Questionnaire(CSQ) in one month after earthquake.【Result】 There were six cases(16.22%) with PTSD.The most common of PTSD symptoms was re-experience symptoms,the incidence was 78.4%,followed by the symptoms of high alert,the rate was 62.2%.Correlation analysis showed that age and re-experience points to a positive correlation,health state of the former earthquakes and avoid/numbness scored a negative correlation,the objective to support and PCL-C total score,re-experience,high alert to a positive correlation,SAS,SDS scores,and PCL-C Total score,and re-experience,avoid/numbness,high alert to a positive correlation.【Conclusion】The PTSD rate of wounded patients on Wenchuan Earthquake with remote treatment is not high.The psychological intervention of the injured patients with remote treatment on earthquake should be concerned about older,suffering from physical disease before the earthquake,excessive objective support and serious anxiety and depression.Attention should be paid to avoid excessive attention from secondary psychological harm.
【Objective】 To seek post-traumatic stress disorder(PTSD) symptoms and impact factors of the earthquake injured patients with remote treatment.【Method】 Thirty-seven wounded patients on the Wenchuan Earthquake of the Third Affiliated Hospital of SUN Yat-sen University in Guangzhou City from Wenchuan,were investigated by the general situation,Post Traumatic Stress Disorder Check List for Civic(PCL-C),Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS),Social Support Rating Scale(SSRS),Eysenck Personality Questionnaire(EPQ),Coping Style Questionnaire(CSQ) in one month after earthquake.【Result】 There were six cases(16.22%) with PTSD.The most common of PTSD symptoms was re-experience symptoms,the incidence was 78.4%,followed by the symptoms of high alert,the rate was 62.2%.Correlation analysis showed that age and re-experience points to a positive correlation,health state of the former earthquakes and avoid/numbness scored a negative correlation,the objective to support and PCL-C total score,re-experience,high alert to a positive correlation,SAS,SDS scores,and PCL-C Total score,and re-experience,avoid/numbness,high alert to a positive correlation.【Conclusion】The PTSD rate of wounded patients on Wenchuan Earthquake with remote treatment is not high.The psychological intervention of the injured patients with remote treatment on earthquake should be concerned about older,suffering from physical disease before the earthquake,excessive objective support and serious anxiety and depression.Attention should be paid to avoid excessive attention from secondary psychological harm.
引文
American Psychiatric Association.Diagnosis and statisticmanual of mental disorders[M].4th ed.Washington DC:American Psychiatric Association,1994:424-429.
汪向东,王希林,马弘,等.心理卫生评定量表手册[M].北京:中国心理卫生杂志社,1999:15-85.
龚耀先编著.修订艾森克个性问卷[M].长沙:湖南医学院,1986:10-20.
伍志刚,刘爱忠,谭红专,等.洪灾区成人PTSD及其危险因素的研究[J].中国临床心理学杂志,2003,11(3):173-175.
汪向东,张华彪,新福尚隆,等.地震后创伤后应激障碍的发生率及影响因素[J].中国心理卫生杂志,1999,13(1):28-30.
张本,王学义,孙贺祥.唐山大地震所致孤儿心理创伤后应激障碍的调查[J].中华精神科杂志,2000,3(2):111-114.
徐勇,张克让,薛云珍,等.SARS一线医务人员创伤后应激反应研究[J].护理研究:下半月,2004,18(1):179-181.
赵承智,李俊福,王明山,等.地震后17个月受灾青少年PTSD及其相关因素[J].中国心理卫生杂志,2001,15(3):145-147.
Wang X,Gao L,Shinfuku N,et al.Longitudinal studyof earthquake-related PTSD in a randomly selectedcommunity sample in north China[J].Am J Psychiatry,2000,157(8):1260-1266.
Galea S,Nandi A,Vlahov D.The epidemiology of Post-traumatic stress disorder after disasters[J].EpidemiolRev,2005,27(11):78-91.
王相兰,陶炯,温盛霖,等.汶川地震灾民的心理健康状况及影响因素[J].中山大学学报:医学科学版,2008,29(4):367-371.
隋双戈,李凌江,陈树林,等.公交系统恐怖袭击应激障碍流行病学调查[J].中国行为医学科学,2007,16(5):444-446.
汪向东,王希林,马弘,等.心理卫生评定量表手册[M].北京:中国心理卫生杂志社,1999:15-85.
龚耀先编著.修订艾森克个性问卷[M].长沙:湖南医学院,1986:10-20.
伍志刚,刘爱忠,谭红专,等.洪灾区成人PTSD及其危险因素的研究[J].中国临床心理学杂志,2003,11(3):173-175.
汪向东,张华彪,新福尚隆,等.地震后创伤后应激障碍的发生率及影响因素[J].中国心理卫生杂志,1999,13(1):28-30.
张本,王学义,孙贺祥.唐山大地震所致孤儿心理创伤后应激障碍的调查[J].中华精神科杂志,2000,3(2):111-114.
徐勇,张克让,薛云珍,等.SARS一线医务人员创伤后应激反应研究[J].护理研究:下半月,2004,18(1):179-181.
赵承智,李俊福,王明山,等.地震后17个月受灾青少年PTSD及其相关因素[J].中国心理卫生杂志,2001,15(3):145-147.
Wang X,Gao L,Shinfuku N,et al.Longitudinal studyof earthquake-related PTSD in a randomly selectedcommunity sample in north China[J].Am J Psychiatry,2000,157(8):1260-1266.
Galea S,Nandi A,Vlahov D.The epidemiology of Post-traumatic stress disorder after disasters[J].EpidemiolRev,2005,27(11):78-91.
王相兰,陶炯,温盛霖,等.汶川地震灾民的心理健康状况及影响因素[J].中山大学学报:医学科学版,2008,29(4):367-371.
隋双戈,李凌江,陈树林,等.公交系统恐怖袭击应激障碍流行病学调查[J].中国行为医学科学,2007,16(5):444-446.
版权所有：© 2023 中国地质图书馆 中国地质调查局地学文献中心