社会支持及应对方式对洪灾创伤后应激障碍慢性化的影响

Influence of social support and coping style on chronic post-traumatic stress disorder after floods

目的 了解洪灾创伤后应激障碍（PTSD）慢性化,进一步研究社会支持及应对方式对洪灾后PTSD慢性化的影响。方法 2014年3-4月采用整群随机抽样方法对经历1998年洞庭湖洪灾,1999年初次调查确诊的PTSD患者分析其慢性化情况。调查中采用创伤后应激障碍量表平民版（PCL-C）将研究对象分为康复组和未康复组（慢性化组）,采用社会支持评定量表（SSRS）、简易应对方式问卷（SCSQ）测评和比较两组研究对象。结果 120名研究对象中,14名（11.67%）诊断为PTSD患者。两组患者主观支持得分、客观支持得分、社会支持总分以及积极应对得分、应对方式总分的差异有统计学意义（P〈0.05）;多因素logistic回归显示：社会支持（OR=0.281,95% CI：0.117～0.678）、应对方式（OR=0.293,95% CI：0.128～0.672）是PTSD慢性化的保护因素;受灾经历（OR=1.626,95% CI：1.118～2.365）是PTSD慢性化的危险因素。结论 洪灾后PTSD患者慢性化值得重视,而良好的社会支持、积极的应对方式能显著改善其慢性化情况。

Objective To explore the long-term prognosis and influence of social support and coping style of patients with post-traumatic stress disorder（PTSD） after suffering from floods.Methods Patients suffered PTSD due to Dongting lake flood in 1998 were selected through cluster random sampling.PTSD scale civilian version（PCL-C） was used to examine and diagnose the participants in this study.PTSD was then evaluated by the social support rating scale（SSRS） and the simple coping style questionnaire（SCSQ）.Results Among all the 120 subjects, 14（11.67%） of them were diagnosed as having PTSD.Compared with the rehabilitation group, scores on subjective support, Objective support, total social support and positive coping, total of coping style from the non-rehabilitation group all appeared significant low（P〈0.05）.Data from the multivariate logistic regression showed that social support（OR=0.281, 95% CI：0.117-0.678） and coping style（OR=0.293, 95% CI：0.128-0.672） were protective factors of the chronic PTSD after the floods while disaster experience（OR=1.626, 95% CI：1.118-2.365） appeared as a risk factor.Conclusion Chronic PTSD developed after the floods called for attention.Better social support, positive coping style could significantly improve the long-term prognosis of patients with PTSD after the floods.