外科住院患者创伤后应激障碍相关因素及护理需求研究

Investigation of Post-traumatic Stress Disorder and Demand for Nursing Care

目的调查外科住院患者创伤后应激障碍(posttraumaticstressdisorder,PTSD)的相关因素及护理需求,为护理干预提供依据。方法对93例创伤事件后外科住院患者于伤后1个月进行PTSD诊断,并采用精神卫生症状自评量表(SCL90)、艾森克个性问卷(EPQ)和自制创伤事件后护理需求调查量表进行评估。结果确诊PTSD31例(33.33%),PTSD组性别、受教育年限、外伤情况与非PTSD组(62例)比较,差异有显著性意义(P<0.05,P<0.01)。PTSD患者各项SCL90因子分及总分均显著高于非PTSD组(P<0.05,P<0.01)。PTSD患者的精神病性(P)、神经质或情绪(N)和人格稳定性(L)评分显著高于非PTSD组,而内外向性(E)评分显著低于非PTSD组(P<0.05,P<0.01)。PTSD患者的心理需求、精神需求和护理需求总分均显著高于非PTSD组(P<0.05,P<0.01)。结论遭遇创伤事件的外科住院患者并发PTSD概率较高,且PTSD患者护理需求高,需及早采取能满足其需求的针对性护理干预措施,以提高患者的应对能力,降低PTSD发生率。

Objective To investigate related factors involved in pos-traumatic stress disorder（PTSD） and nursing demand to provide information for the nursing intervention. Methods Ninety-three patients with PTSD was diagnosed in terms of PTSD on the basis of DSM-4. The SCL-90, Eysenck personality questionnaire （EPQ） and the self-designed questionnaire on demand for nursing care after traumatic events were used. Results PTSD was definitely diagnosed in 31 cases （33. 33 % ）. There were significant differences in sex, years of education and condition of trauma between PTSD patients and non-PTSD patients （n = 62） （P〈0. 05, P〈0.01 ）. The individual scores and total score of SCL-90 in PTSD patients were significantly higher than those of non-PTSD group （P〈0.05, P〈0.01）. And the scores on the psyehoticism （P）, neuroticism （N）, lie （L） scales were higher than those of non-PTSD patients but the score of introversion （E） was significantly lower than that of non-PTSD patients. The total scores of demands for psychological, mental and nursing care in PTSD patients were much higher than non- PTSD patients （P〈0. 05, P〈0.01）. Conclusion After traumatic events, the hospitalized patients are predisposed to PTSD and the PTSD patients tend to have higher demand for nursing care and nursing interventions should be taken as early as possible to meet the demand of the patients and to avoid PTSD.