住院地震伤员的应激反应与干预效果探讨

Stress reaction of inpatients injured in the earthquake and its therapeutic interventions

目的了解我院收治的238例地震中受伤患者的心理应激反应，探讨其干预方法。方法在积极治疗躯体创伤的同时，采用群体和个人干预的方法，通过沟通交流、心理健康教育、针对性心理支持等心理急救措施，对所有地震伤员进行普及性的灾后心理干预。根据症状自评量表、贝克焦虑评估量表设计调查问卷，在干预前、后对患者进行评估，了解患者的应激反应发生情况和恢复效果。结果238例患者伤后均存在不同程度的心理应激反应，排在前6位的反应包括：睡眠障碍、记忆力下降、紧张害怕、摇晃、恐慌和情绪不稳定，部分患者在入院后1周内心理状态恢复正常，大多数的患者在2周后恢复正常，3例患者发生严重的心理障碍，转精神病专科医院接受专业心理治疗和干预。结论本次地震伤员入院后普遍存在不同程度的心理应激反应，及时了解患者的应激反应并给予恰当的心理干预可有效帮助患者应对这些反应，尽快恢复正常的心理状态，促进身体康复，减少严重心理障碍（如创伤后应激障碍综合征）的发生。

Objective To observe the psychological stress reactions of 238 patients injured in earthquake in our hospital and explore their interventions to such reaction. Methods A total of 238 patients wounded in earthquake were recruited. Along with the active treatment of primary physical trauma, wide range of preventative psychological interventions for crisis was carried out individually or in group. The psychological emergency measures included communication and exchange of ideas, mental health education, and psychological support and a relaxing environment to the patients. All the patients were evaluated by using depression and anxiety assessment scales before and after the intervention. Results Various psychological stress responses were found in 238 patients after injury, in which sleep disorders, memory decline, tension and fear, wabble and emotional instability ranked the top 5. Some patients＇ psychological status recovered after one-week＇s hospitalization, while most recovered after two-week＇s hospitalization. Three patients were transferred to other professional psychiatric hospitals for professional psychological treatment and intervention because of serious psychological obstacle. Conclusion The wounded caused by earthquake manifested various psychological stress reactions. Immediate psychological intervention can effectively help the patients to recover psychologically, promote their physical rehabilitation, and prevent posttraumatic stress disorder.