意外创伤骨折病人社会支持、创伤后情绪痛苦和创伤后成长相关性研究1)

Study on correlation among social support,post-traumatic emotional distress and post-traumatic growth of accidental trauma patients

[目的]探讨意外创伤病人社会支持、创伤后情绪痛苦与创伤后成长的相关性。[方法]采用方便抽样,选取2012年6月-2013年3月入住我院创伤骨科病房行骨折切开复位内固定术的急性创伤病人197例,应用人口学一般资料、中文版创伤后成长量表、肖水源社会支持量表和中文版事件冲击问卷进行调查。[结果]意外创伤病人创伤后成长总分为(52.38±20.58)分,处于中等水平;社会支持水平和创伤后情绪痛苦水平分别为(41.98±8.74)分和(27.76±14.89)分。单因素方差分析和相关性分析结果显示:年龄、性别是影响意外创伤病人创伤后成长的人口学因素;社会支持总分、主观支持和对支持利用度与创伤后成长相关(P<0.05)。回避型维度与创伤后成长总分、自我转变和新的可能性相关(P<0.05);事件冲击量表总分及高警觉得分与自我转变、新的可能性相关(P<0.05);多元逐步回归分析显示:年龄、回避型、主观支持、对支持利用度和社会支持总分进入回归方程,解释总变量的49.9%。[结论]关注影响意外创伤病人创伤后心理的正性成长因素,针对不同人群的特征制定个性化的创伤后干预方案,重构社会支持系统的完整性,控制创伤后应激的发生,激发创伤病人正性力量的产生。

Objective：To probe into the relationships among accidental trauma patients＇ social support,emotional distress and posttraumatic growth.Methods：By convenient sampling,a total of 197 bone fracture patients admitted to orthopaedic trauma wards in our hospital undergoing elective surgery were investigated from June 2012 to March 2013.Investigation tools included demographic data questionnaire,Chinese-version posttraumatic growth scale,Xiao＇ social support scale and the Chinese-version of impact of event scale-revised.Results：Trauma patients＇ post-traumatic growth total score was 52.38±20.58,which was in the medium level;Social support score and post-traumatic emotional distress level score were 41.98±8.74,27.76±14.89.Factor analysis of variance and correlation analysis results showed that：age and gender were demographic factors of posttraumatic growth; total social support,subjective support and the availability of social support were related to posttraumatic growth （P＜0.05）.Avoidance sub-dimension was related to total score of posttraumatic growth,self transformation and new possibilities （P＜0.05） ;IES and total score of high arouse sub-dimensions was related to the possibility of self-transformation （P＜ 0.05）.Multiple stepwise regression analysis results showed that the variables of age,avoidance dimension,social support total,subjective support,the availability of social support entered the regression equation,explaining 49.9％ of total variables.Conclusion：The study suggests that the positive influencing factors of accidental trauma patients should be focused on.It is necessary to formulate personalized intervention plan after trauma,reconstruct the integrity of the social support system,control the occurrence of post-traumatic stress disorder level,stimulate to produce trauma patients positive energy according to the characteristics of the different populations.