45例地震伤员的心理健康状况评估及护理
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摘要
目的探讨地震灾后伤员心理健康状况及相关心理护理措施。方法用心理健康自评问卷(SRQ)结合精神检查对我院收治的45例地震伤员进行入院时与入院1个月后的心理评估。从环境设置、日常生活护理、心理社会支持等多方面进行心理护理干预。结果入院时SRQ筛查出7分以上20例,阳性率44.4%,需重点干预人数14例,占31.1%。1个月后SRQ复测,阳性6例,阳性率13.3%,与干预前比较有统计学意义(χ2=5.3,P<0.05)。SRQ评分与干预前比较亦有统计学意义(t=5.51,P<0.01)。结论地震灾后伤员出现较为明显的心理生理反应,应该加强心理社会支持,帮助受灾伤员度过心理危机,逐步适应新的生活状态。
Objective To explore psychological health status of earthquake wounded persons and nursing intervention. Methods Forty-five earthquake wounded persons were assessed by Self Reporting Questionnaire(SRQ) ,their mental status were by psy-chologists. Nursing intervention consisted of supplying safe and comfortable circumstances,daily life management and psycho-so-cial supporting. Results The average score of SRQ was 7±4.61. Twenty(44.4%) patients were screened with SRQ score over 7 points and 14(31.1%) patients need intensive intervention. The common psychological symptoms included anxiety,perceptu-al insecurity,sad and depression,angry and insomnia. After one month nursing intervention,the average score of SRQ was 4.5± 2.8 and 6(13.3%) patients' SRQ score remained over 7 points. There was significant difference in SRQ after intervention(t= 5.512,P<0.01;χ2=5.3,P<0.05) . Conclusions Persons had obvious psychological symptoms after earthquake. Application of psycho-social supporting is necessary to help them getting through psychological crisis and adapting life status.
Objective To explore psychological health status of earthquake wounded persons and nursing intervention. Methods Forty-five earthquake wounded persons were assessed by Self Reporting Questionnaire(SRQ) ,their mental status were by psy-chologists. Nursing intervention consisted of supplying safe and comfortable circumstances,daily life management and psycho-so-cial supporting. Results The average score of SRQ was 7±4.61. Twenty(44.4%) patients were screened with SRQ score over 7 points and 14(31.1%) patients need intensive intervention. The common psychological symptoms included anxiety,perceptu-al insecurity,sad and depression,angry and insomnia. After one month nursing intervention,the average score of SRQ was 4.5± 2.8 and 6(13.3%) patients' SRQ score remained over 7 points. There was significant difference in SRQ after intervention(t= 5.512,P<0.01;χ2=5.3,P<0.05) . Conclusions Persons had obvious psychological symptoms after earthquake. Application of psycho-social supporting is necessary to help them getting through psychological crisis and adapting life status.
引文
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[14]贾晓明.从民间祭祀到精神分析关于丧失后哀伤的过程[J].中国心理卫生杂志,2005,8(19):569-571.
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[17]童辉杰.严重突发性事件应激反应的理论模型[J].中国临床康复,2006,10(2):164-165.
[18]丁宇,肖凌,郭文斌,等.社会支持在生活事件—心理健康关系中的作用模型研究[J].中国健康心理学杂志,2005,13(3):161-164.
[19]王海琴,刘雪琴,石红梅.SARS病人社会支持与心理健康状况的相关分析[J].中华护理杂志,2004,39(1):865-866.
[2]张本,王学义,孙贺祥,等.唐山大地震对人类心身健康远期影响[J].中国心理卫生杂志,1998,12(4):200-202.
[3]张本,王学义,孙贺祥,等.唐山大地震心理创伤后应激障碍的抽样调查研究[J].中华精神科杂志,1999,32(2):106-108.
[4]Freedy JR,Simpson WM.Disaster-related physical and mental health:aroleforthefamilyphysician[J].Am Fam Physician,2007,75(6):841-846.
[5]任凯,彭龙颜,邢济春.什邡地震灾区984名灾民心理健康调查[J].中国公共卫生管理,2008,24(3):243-245.
[6]Kuo CJ,Tang HS,Tsay CJ,et al.Prevalence of psychiatric disorders a-mong bereaved survivors of a disastrous earthquake in Taiwan[J].Psy-chiatry Serv,2003,54:249-251.
[7]Neria Y,Nandi A,Galea S.Post-traumatic stress disorder following disasters:a systematic review[J].Psychological Medicine,2008,38(4):467-480.
[8]Goenjian AK,Walling D,Steinberg AM,et al.A prospective study of posttraumatic stress and depressive reactions among treated and un-treated adolescents5years after a catastrophic disaster[J].Am J Psy-chiatry,2005,162:2302-2308.
[9]赵国秋.心理危机干预技术[J].中国全科医学,2008,11(1):45-47.
[10]www.china.com.cn/policy/txt/2008-05/21/content.紧急心理危机干预指导原则.
[11]陈美英,张仁川.“桑美”台风心理应激反应调查与居丧干预[J].福建医药杂志,2007,29(3):142-144.
[12]李小妹.护理学导论[M].长沙:湖南科学技术出版社,2003:182.
[13]王志英,翁永震,张大光.对住院精神分裂症患者实施医护小组工作制的研究[J].中华护理杂志,2002,37(10):725-728.
[14]贾晓明.从民间祭祀到精神分析关于丧失后哀伤的过程[J].中国心理卫生杂志,2005,8(19):569-571.
[15]Worden JW.Grief Counseling&Grief therapy:a handbook for the mental health practitioner[M].New York:Spring Publishing Company,2002:1-4.
[16]汪向东,王希林,马弘.心理卫生评定量表手册[M].增订版.北京:中国心理卫生杂志社,1999:127-128.
[17]童辉杰.严重突发性事件应激反应的理论模型[J].中国临床康复,2006,10(2):164-165.
[18]丁宇,肖凌,郭文斌,等.社会支持在生活事件—心理健康关系中的作用模型研究[J].中国健康心理学杂志,2005,13(3):161-164.
[19]王海琴,刘雪琴,石红梅.SARS病人社会支持与心理健康状况的相关分析[J].中华护理杂志,2004,39(1):865-866.
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