医疗事故鉴定病人创伤后应激障碍发生影响因素分析

INFLUENCE FACTORS OF POST-TRAUMATIC STRESS DISORDER IN MALPRACTICE APPRAISING

目的分析医疗事故鉴定病人创伤后应激障碍（PTSD）的发生及其与防御机制及社会支持的关系。方法对151例医疗事故鉴定病人采用PTSD清单（PCL-C）、社会支持评定量表（SSRS）、防御方式问卷（DSQ）进行测查。结果医疗事故鉴定病人的PTSD发生率为21.19%。不同性别间差异无显著性（P〉0.05）。PTSD组SSRS社会支持总分、客观支持分及利用度分显著低于非PTSD组（t=2.02~2.84,P〈0.05、0.01）;主观支持分高于非PTSD组（t=3.16,P〈0.05）。PTSD组DSQ不成熟防御机制因子分、掩饰因子分均显著高于非PTSD组（t=2.09、2.17,P〈0.05）。结论医疗事故鉴定病人PTSD的发生率高,但无性别差异;社会支持、防御方式与PTSD的发生有关。

Objective To analyze the relationship between social support and defense styles of patients with post-traumatic stress disorder（PTSD）in malpractice appraising. Methods PTSD Check list-Civilian Version,Social support rating scale（SSRS）,defense styles questionnaire（DSQ）were applied to survey 151 patients with PTSD involved in malpractice appraising.Results The prevalence of PTSD was 21.19%in the patients involved.There was no significant difference between women and men（P〉0.05）.In PTSD group,the total score of social support,score of the objective support and availability were significantly lower than the non-PTSD group（t=2.02-2.84;P〈0.05,0.01）,but the subjective support was higher than the non-PTSD group（t=3.16,P〈0.05）.PTSD patients used more immature defense mechanisms and conceal factor than non-PTSD（t=2.09,2.17;P〈0.05）. Conclusion The prevalence of PTSD in malpractice appraising was high with no sex differences.Social support and defense styles were associated with PTSD.