道路交通事故致轻度精神伤残者功能障碍评定

Function Disorder Assessment on Patients with Mild Psychiatric Impairment due to Road Traffic Accidents

目的探讨道路交通事故致轻度精神伤残者功能障碍评定方法。方法以躯体伤残者为对照,运用修订的Barthel指数(the Barthel index of ADL,BI)、社会功能活动调查(Functional Activities Questionnaire,FAQ)、社会功能缺陷筛查量表(Social Disability Screening Schedule,SDSS)、日常生活能力量表(Activity of Daily Living Scale,ADL)、躯体生活自理量表(Physical Self-maintenance Scale,PSMS)、工具性日常生活量表(Instrumental Activities of Daily Living Scale,IADL)等标准化评定工具,评估轻度精神伤残者功能障碍程度。结果除BI外,FAQ、SDSS、ADL、PSMS和IADL总分均与精神伤残等级相关。各量表总分在不同躯体伤残等级间差异均无统计学意义。在十级伤残水平,FAQ、ADL总分在两组间差异无统计学意义,BI、SDSS、IADL总分精神伤残组高于躯体伤残组,PSMS总分则低于躯体伤残组;在九级,PSMS总分在两组间差异无统计学意义,BI、FAQ、SDSS、IADL、ADL总分在精神伤残组均高于躯体伤残组;在八级,BI、PSMS总分在两组间差异无统计学意义,FAQ、SDSS、IADL、ADL总分在精神伤残组均高于躯体伤残组。结论在轻度伤残范围内,精神伤残和躯体伤残的评定指标应当存在差别,在鉴定过程中应该探寻合适的评定指标。

Objective To explore the methods to assess the function disorder of patients with mild psychiatric impairment due to road traffic accidents.Methods In contrast to that of the patient with physical impairment,the function disorder of the patient with mild psychiatric impairment was assessed by the standard assessment instruments,such as the Barthel index of ADL(BI),Functional Activities Questionnaire(FAQ),Social Disability Screening Schedule(SDSS),Activity of Daily Living Scale(ADL),Physical Self-maintenance Scale(PSMS),and Instrumental Activities of Daily Living Scale(IADL).Results Except BI,the each total score of FAQ,SDSS,ADL,PSMS,and IADL correlated well with the rank of psychiatric impairment.The difference of each total score of rating scales among different physical impairment rank was not statistically significant.At the impairment rank of level 10,the difference of each total score of FAQ and ADL was not significant between the two groups;each total score of BI,SDSS,and IADL in psychiatric impairment was higher than that of physical impairment,while the total score of PSMS in psychiatric impairment was lower than that of physical impairment.At the level 9,except PSMS,the each total score of BI,FAQ,SDSS,IADL and ADL in psychiatric impairment was higher than that of physical impairment.At the level 8,except BI and PSMS,the each total score of FAQ,SDSS,IADL and ADL in psychiatric impairment was higher than that of physical impairment.Conclusion The different criteria for assessment of mild psychiatric and physical impairment may exist,and appropriate indexes for assessment between physical and psychiatric impairment need to be further elucidated.