5·12汶川地震后一年半医务人员创伤后应激障碍影响因素研究和症状分析
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摘要
目的:随访5·12汶川地震后一年半震区一线医务工作者创伤后应激障碍(PTSD)的发病率,症状特点和影响因素。方法:应用德国埃森创伤问卷(ETI)对四川什邡地区4家医院一线医务工作者进行调查,并以临床医师专用PTSD量表(CAPS)进行诊断。结果:①震后一年半医护群体PTSD发病率为1.8%。②PTSD的特征性症状群中,最突出的为高激惹症状。女性在PTSD总分上与男性无显著差别,但在睡眠问题、未来希望是否破灭或者理想能否实现、情绪改变上得分显著高于男性。③初始暴露程度在PTSD总分和所有特征症状群得分上没有显著差异,初始暴露程度高者在高激惹症状上更为突出。④PTSD总分及症状得分影响因素是籍贯和初始暴露程度。结论:震区一线医务工作者震后一年半PTSD状况与半年时有同有异,心理工作者应该给出针对性的预防和干预措施。
Objective:To investigate the incidence rate,symptoms,and influencing factors of Post-traumatic Stress Disorder (PTSD) among medical staff one year and a half after the Wenchuan Earthquake. Methods: The German Essen Trauma questionnaire (ETI) and the Clinician-Administered PTSD Scale (CAPS) were used to diagnose PTSD among the first-line medical workers in four hospitals of Shifang. Results: The incidence rate of PTSD among the medical workers was 1.8%. Comparing the four symptom clusters,hyper-arousal was the most prominent one. Although there was no significant difference between the males and females in the PTSD total score,the scores of sleep disorders,hope for the future or ideal and emotional changes in females were significantly higher than that in males. The initial exposure level showed no significant influence on the PTSD total score and symptom clusters scores. However,people with a high degree of initial exposure were more prominent in irritation symptoms between the two groups. The factors affecting PTSD total score and symptom scores were birthplace and initial exposure level. Conclusion: The first-line health care workers showed some changes in PTSD at one and a half years following the earthquake compared with that at half a year following the earthquake. Psychological staff should apply individual prevention and intervention measures.
Objective:To investigate the incidence rate,symptoms,and influencing factors of Post-traumatic Stress Disorder (PTSD) among medical staff one year and a half after the Wenchuan Earthquake. Methods: The German Essen Trauma questionnaire (ETI) and the Clinician-Administered PTSD Scale (CAPS) were used to diagnose PTSD among the first-line medical workers in four hospitals of Shifang. Results: The incidence rate of PTSD among the medical workers was 1.8%. Comparing the four symptom clusters,hyper-arousal was the most prominent one. Although there was no significant difference between the males and females in the PTSD total score,the scores of sleep disorders,hope for the future or ideal and emotional changes in females were significantly higher than that in males. The initial exposure level showed no significant influence on the PTSD total score and symptom clusters scores. However,people with a high degree of initial exposure were more prominent in irritation symptoms between the two groups. The factors affecting PTSD total score and symptom scores were birthplace and initial exposure level. Conclusion: The first-line health care workers showed some changes in PTSD at one and a half years following the earthquake compared with that at half a year following the earthquake. Psychological staff should apply individual prevention and intervention measures.
引文
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[10]赵丞智,汪向东,高岚,等.张北尚义地震后创伤后应激障碍随访研究[J].中国心理卫生杂志,2000,14(6):361-363.
[11]徐唯,宋瑛,梁爱民,等.特大爆炸事故幸存者创伤后应激障碍的初步研究[J].中国心理卫生杂志,2003,17(9):603-606.
[12]Breslau N,Kessler RC,Chilcoat HD,et al.Trauma and Posttraumatic Stress Disorderin the Community:the1996Detroitarea Survey of Trauma[J].Arch Gen Psychiatry(S0003-990X),1998,55(7):626-632.
[13]王婷,韩布新.佛教信仰与地震灾区老年人的心理健康状况[J].中国老年学杂志,2009,29(10):1272-1274.
[2]杨来启,吴兴曲,张彦,等.非典时期一线医务人员远期心理健康状况调查研究[J].中国健康心理学杂志,2007,15(6):567-568.
[3]Kolkow TT,Spira JL,Morse JS,et al.Post-traumatic Stress Disorder and Depression in Health Care Providers Returning from Deploy-ment to Iraq and Afghanistan[J].Mil Med(S0026-4075),2007,172(5):451-455.
[4]周肖榕,周娟,施琪嘉.震区医务工作者半年后创伤后应激障碍发病情况研究[J].神经损伤与功能重建,2010,5(4):271-276.
[5]Tagay S,Eri m Y.Das Essener Trauma-In-ventar(ETI)-Ein Screeninginstrument zur Identifikation Traumatischer Ereignisse und posttraumatischer St rungen[J].Z Psycho-som Med Psychother(S1438-3608),2007,1(2):75-89.
[6]周娟,周肖榕,李航,等.埃森创伤问卷中文版的信、效度研究[J].中华物理医学与康复杂志,2010,32(2):121-124.
[7]Keane TM,Fairbank JA,Caddell J M,et al.Clinical Evaluation of a Measure to Assess Combat Exposure[J].Psychol Assess(S1040-3590),1989,1(1):53-55.
[8]赵丞智,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.
[9]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.
[10]赵丞智,汪向东,高岚,等.张北尚义地震后创伤后应激障碍随访研究[J].中国心理卫生杂志,2000,14(6):361-363.
[11]徐唯,宋瑛,梁爱民,等.特大爆炸事故幸存者创伤后应激障碍的初步研究[J].中国心理卫生杂志,2003,17(9):603-606.
[12]Breslau N,Kessler RC,Chilcoat HD,et al.Trauma and Posttraumatic Stress Disorderin the Community:the1996Detroitarea Survey of Trauma[J].Arch Gen Psychiatry(S0003-990X),1998,55(7):626-632.
[13]王婷,韩布新.佛教信仰与地震灾区老年人的心理健康状况[J].中国老年学杂志,2009,29(10):1272-1274.
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