交通事故精神伤残照料者的心理问题及服务需求调查

Survey to psychological problems and service needs for caregivers of mental disability in traffic accidents

目的探讨交通事故精神伤残照料者的心理问题及服务需求,为促进照料者家属心身健康和良好的应对方式提供科学依据。方法于2013年5月-2014年5月,从388例鉴定案例中按纳入排除标准选取187例照料者家属,再按不同伤残程度将照料者分为三组:重度为A组,中度为B组,轻度为C组,采用自制调查表、症状自评量表(SCL-90),由两名鉴定人员对3组伤残照料者心理健康状况进行调查分析。结果三组SCL-90总评分及各因子评分均高于国内常模(P<0.05),A组SCL-90除敌对和偏执外其他各因子评分及总评分均高于B组(P<0.05),除焦虑、敌对、偏执外其他各因子评分及总评分均高于C组(P<0.01),B组躯体化、强迫、抑郁、恐怖因子评分高于C组(P<0.05)。服务需求关注的是鉴定后如何上诉赔钱(26.20%)、伤残后续康复治疗(22.99%)、鉴定质量诚信度如何(13.90%)、鉴定后可赔到多少钱(13.90%)、需做哪些鉴定项目(11.23%)、如何办理法律援助(10.69%)。结论精神伤残照料者家属普遍存在心理健康问题,且不同伤残等级程度的照料者存在心理问题不尽相同,提示应给予照料者家属更多的心理支持,以增进照料者积极的应对方式。

Objective To investigate psychological problems and service needs for caregivers of mental disabilities in traffic acci-dents and to provide scientific basis for promoting psychosomatic health and improving ways of coping of family caregivers. Methods According to inclusion criteria and exclusion criteria,187 family caregivers were chosen from 388 appraisal cases and divided into three groups:severe group A,moderate group B and mild group C,which were based on different degrees of disablement. Two forensic ex-aminers also used a self - designed questionnaire,and Self - reporting Inventory(SCL - 90)to investigate and analyze psychological health problems of the three groups from May 2013 to May 2014. Results Total scores and all factor scores of SCL - 90 in three groups were significantly higher than those in national norm(P < 0. 05). Total score and most factors scores of SCL - 90 in group A were significantly higher than those in group B(P < 0. 05)except for hostility and paranoid,and were significantly higher than those in group C(P < 0. 01)except for anxiety,hostility and paranoid. Factor scores of somatization,compelling,depression and horror in group B were significantly higher than those in group C(P < 0. 05). The service needs were aimed at focusing on how to appeal for claim after identification(26. 20% ),the follow - up rehabilitation therapy(22. 99% ),the credibility of identification quality (13. 90% ),how much to receive after identification(13. 90% ),the necessary item identification(11. 23% )and ways to apply for lawful aid(10. 69% ). Conclusion Psychological health problems are common among family caregivers of mental - disability,and different psychological problems exist in caregivers of different disability class. Therefore we suggest that giving the caregivers more psy-chological supports is deserved,which can enhance their positive ways of coping.