汶川地震后一年参与灾区医疗救援医务人员的心理健康状况调查
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摘要
目的调查5·12汶川地震后一年,灾区参与医疗救援医务人员的创伤后应激障碍(PTSD)以及焦虑和抑郁的发生率及严重程度。方法按照目的抽样方法抽取2009年5月12日到5月18日期间在绵竹、德阳、什邡、成都、绵阳、彭州、梓潼、安县八个市县参与地震医疗救援的医务人员共500名。采用PTSD-17项筛查问卷(PCL-C),焦虑自评量表(SAS),抑郁自评量表(SDS)进行调查。对回收有效问卷按地区分为灾区组(绵竹、什邡、绵阳、彭州、安县)和非灾区组(德阳、成都、梓潼)。结果发放问卷500份,回收有效问卷481份,有效率为96.2%。汶川地震后一年,从上述参与医疗救援的医务人员中共初筛出PTSD112例(23.3%),焦虑240例(21.6%),抑郁104例(49.9%),焦虑合并抑郁94例(19.54%)。两组在PCL-C总分(48.29±29.90vs34.76±18.03)、PCL-C频率分(16.27±15.14vs9.99±10.25)和PCL-C严重程度分(32.03±15.26vs24.85±8.60),SAS粗分(37.39±10.35vs32.22±7.61)和SAS标准分(46.73±12.94vs40.27±9.51)以及SDS粗分(42.00±8.32vs37.99±9.63)和SDS标准分(52.50±10.39vs47.48±11.92)方面,灾区组均较高,且差异有统计学意义。两组的PTSD(28.52%vs16.59)、焦虑(28.89%vs12.32%)、抑郁(58.15%vs39.34%)、焦虑共病抑郁(26.67%vs10.43%)的初筛阳性率比较发现,灾区组均高,差异有统计学意义。比较两组不同程度焦虑和抑郁的分布发现,灾区组分布比率更高,其差异有统计学意义。结论经历汶川地震灾难后一年,灾区参与救援医务人员中的PTSD、焦虑、抑郁发生率仍较高,且严重程度比非灾区参与救援医务人员更重,应制定出相应的心理干预与康复方案,提高医务人员,尤其是灾区救援医务人员应对危机的能力。
Objective To examine the prevalence of post-traumatic stress disorder (PTSD),anxiety,and depression for medical staffs who took part in rescue in the disaster area after Wenchuan Earthquake. Methods According to purpose sampling method,from June 12th to June 18th,we investigated the medical staffs in eight areas,and the total number was 500. The eight areas included Mianzhu,Deyang,Shifang,Chengdu,Mianyang,Pengzhou,Zitong,and Anxian. The survey tools were PTSD Checklist-Civilian Version (PCL-C),Self-Rating Anxiety Scale (SAS),and Self-Rating Depression Scale (SDS). After collecting all questionnaires,we divided 500 medical staffs into 2 groups,according to the fact whether the rescue was carried out in the disaster area or not. Results A total of 500 questionnaires were given to the subjects,of which 481 effective ones were collected,and the effective rate was about 96.2%. In addition,the prevalence of PTSD for overall was 23.3%,anxiety was 21.6%,depression was 49.9%,and the anxiety plus depression was 19.54%. At the same time,we found out the averages of PCL-C (48.29±29.90 vs. 34.76±18.03),PCL-C frequency (16.27±15.14 vs. 9.99±10.25),PCL-C severity (32.03±15.26 vs. 24.85±8.60),SAS primitive (37.39±10.35 vs. 32.22±7.61),SAS standard (46.73±12.94 vs. 40.27±9.51),SDS primitive (42.00±8.32 vs. 37.99±9.63),and SDS standard (52.50±10.39 vs. 47.48±11.92) were different. The medical staffs in the disaster area were under more severe conditions,and there were significant differences between the 2 groups. The prevalence of PTSD (28.52% vs. 16.59),anxiety (28.89% vs. 12.32%),depression (58.15% vs. 39.34%),and anxiety plus depression (26.67% vs. 10.43%) between the 2 groups was significantly different,and the disaster area was under severe conditions. Additionally,the prevalences at three levels within SAS and SDS were much higher in the disaster area. There were also significant differences. Conclusion The prevalences of PTSD,SAS,and SDS within medical staffs who took part in rescue in the disaster area after Wenchuan Earthquake are higher than in the non-disaster area. Therefore,we should work out mental intervention and rehabilitation project for medical staffs,especially those who took part in rescue in the disaster area. Finally,the medical staffs’ ability to copy with stress can be improved.
Objective To examine the prevalence of post-traumatic stress disorder (PTSD),anxiety,and depression for medical staffs who took part in rescue in the disaster area after Wenchuan Earthquake. Methods According to purpose sampling method,from June 12th to June 18th,we investigated the medical staffs in eight areas,and the total number was 500. The eight areas included Mianzhu,Deyang,Shifang,Chengdu,Mianyang,Pengzhou,Zitong,and Anxian. The survey tools were PTSD Checklist-Civilian Version (PCL-C),Self-Rating Anxiety Scale (SAS),and Self-Rating Depression Scale (SDS). After collecting all questionnaires,we divided 500 medical staffs into 2 groups,according to the fact whether the rescue was carried out in the disaster area or not. Results A total of 500 questionnaires were given to the subjects,of which 481 effective ones were collected,and the effective rate was about 96.2%. In addition,the prevalence of PTSD for overall was 23.3%,anxiety was 21.6%,depression was 49.9%,and the anxiety plus depression was 19.54%. At the same time,we found out the averages of PCL-C (48.29±29.90 vs. 34.76±18.03),PCL-C frequency (16.27±15.14 vs. 9.99±10.25),PCL-C severity (32.03±15.26 vs. 24.85±8.60),SAS primitive (37.39±10.35 vs. 32.22±7.61),SAS standard (46.73±12.94 vs. 40.27±9.51),SDS primitive (42.00±8.32 vs. 37.99±9.63),and SDS standard (52.50±10.39 vs. 47.48±11.92) were different. The medical staffs in the disaster area were under more severe conditions,and there were significant differences between the 2 groups. The prevalence of PTSD (28.52% vs. 16.59),anxiety (28.89% vs. 12.32%),depression (58.15% vs. 39.34%),and anxiety plus depression (26.67% vs. 10.43%) between the 2 groups was significantly different,and the disaster area was under severe conditions. Additionally,the prevalences at three levels within SAS and SDS were much higher in the disaster area. There were also significant differences. Conclusion The prevalences of PTSD,SAS,and SDS within medical staffs who took part in rescue in the disaster area after Wenchuan Earthquake are higher than in the non-disaster area. Therefore,we should work out mental intervention and rehabilitation project for medical staffs,especially those who took part in rescue in the disaster area. Finally,the medical staffs’ ability to copy with stress can be improved.
引文
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2Wan g XD,Gao L,Shinfuku N,et al.Long itudinal study of earthquake.related PTSD in a randomly selected community sample in north China.Am J Psychiatry,2000,157:1260-1266.
3严首春,朱霞,苗丹民.急诊科医护人员心理健康状况调查分析.第四军医大学学报,2006,27(11):1052-1054.
4钟霞,姜乾金,钱丽菊,等.医务人员压力反应与社会支持、生活事件、应对方式的相关研究.中国临床心理学杂志,2005,20(1):263-266.
5Souza R,Bernatsky S,Reyes R,et al.Mental health status of vulnerable tsunami-affected communities:a survey in Aceh Province,Indonesia.J Trauma Stress,2007,20(3):263-269.
6王斌,吴红金,王凡,等.106例SARS一线医务人员心理健康调查.北京中医,2004,20(3):11-13.
7甘景梨,李晓琼,张伟红,等.SARS医务人员心理健康相关因素分析.实用医药杂志,2004,21(1):42-43.
8蒋春清,陶建青.医务人员群体心理健康现状及其相关因素.中国组织工程研究与临床康复,2007,20(30):15-17.
2Wan g XD,Gao L,Shinfuku N,et al.Long itudinal study of earthquake.related PTSD in a randomly selected community sample in north China.Am J Psychiatry,2000,157:1260-1266.
3严首春,朱霞,苗丹民.急诊科医护人员心理健康状况调查分析.第四军医大学学报,2006,27(11):1052-1054.
4钟霞,姜乾金,钱丽菊,等.医务人员压力反应与社会支持、生活事件、应对方式的相关研究.中国临床心理学杂志,2005,20(1):263-266.
5Souza R,Bernatsky S,Reyes R,et al.Mental health status of vulnerable tsunami-affected communities:a survey in Aceh Province,Indonesia.J Trauma Stress,2007,20(3):263-269.
6王斌,吴红金,王凡,等.106例SARS一线医务人员心理健康调查.北京中医,2004,20(3):11-13.
7甘景梨,李晓琼,张伟红,等.SARS医务人员心理健康相关因素分析.实用医药杂志,2004,21(1):42-43.
8蒋春清,陶建青.医务人员群体心理健康现状及其相关因素.中国组织工程研究与临床康复,2007,20(30):15-17.
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