多发性创伤住院患者心理状况调查及影响因素

Psychological Status and It's Correlation Factors of Inpatients with Multiple Trauma

目的：探索多发性创伤（multiple traumas）患者的心理状况及其影响因素。方法：在患者受伤后1周内使用自制的一般情况问卷和汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）及急性应激障碍诊断筛查表（ASD Diagnostic Checklist）对632例住院的多发性创伤患者进行调查。结果：在多发性创伤住院患者中有20.7%的人符合急性应激障碍（ASD）的诊断,51.27%的人存在焦虑症状,47.15%的人存在抑郁症状。影响因素分析显示,在多发性创伤患者中女性焦虑、抑郁及ASD（χ2=4.88,28.06,5.43;P〈0.05）的发生率高于男性;18~44岁年龄段焦虑、抑郁（χ2=12.92,8.04;P〈0.05）的发生率高于其他年龄段的多发性创伤患者,年龄对ASD的发生率无显著的差异;婚姻状况对多发性创伤患者出现抑郁、焦虑情绪以及发生ASD（P〈0.05）的概率影响无显著性的差异;受教育程度为初中及以下的多发性创伤患者抑郁、焦虑的发生概率以及ASD发生的概率高于高中与大专及以上的患者（χ2=7.27,6.25,7.99;P〈0.05）;月收入水平〈1000元的患者抑郁、焦虑以及ASD的发生率高于1000~3000元和〉3000元者（χ2=7.23,9.35,6.63;P〈0.05）;受伤方式对多创伤患者出现抑郁、焦虑情绪以及发生ASD的概率影响无显著差异（P〉0.05）。结论：多发性创伤患者大部分存在不良的心理状况,其主要的影响因素包括女性、青年、受教育程度及收入低者。在对多发性创伤患者进行身体治疗的同时,对特殊患者加强心理干预治疗是必要的。

Objective：To examine the mental health and correlation of factors of inpatients with multiple trauma. Metbods：A total of 632 inpatients with multiple trauma were evaluated by using Hamilton depression rating scale for depression（HAMD）,Hamilton anxiety scale（HAMA）, ASD Diagnostic Checklistand self made questionnaire in 2 weeks.Results：632 participants completed the survey.131 （20.7%）cases were diagnosed as ASD.The incidence rate of anxiety of inpatients with multiple traumas was 51.27%, and incidence rate of depression was 47.15%.There was a significant difference between female and male on the incidence rate of ASD,anxiety and depression（X2= 5.43,4.88, 28.06;P〈0.05）.The generation probability of ASD, depression and anxiety was higher in females than in males.The generation probability of depression and anxiety was higher in the ages 18-44 than ages 45-64 and 65-87（X2= 8.04,12.92;P〈0,05）;There was no significant difference on the incidence rate of ASD between ages.There were no significant difference on the incidence rate of ASD, anxiety and depression in marital status（P〉0.05）.The generation probability of ASD,depression and anxiety was higher in the low degree of education（junior high school and below） than that in high degree of education（high school and above）（X^2= 7.99,7.27,6.25 ;P〈0.05）.The generation proba- bility of ASD,depression and anxiety was higher in low level of income（〈1000）than that in high level of income （1000--3000 and〉3000）（X^2= 6.63,7.23,9.35 ;P〈0.05）;there were no significant differences between types of injury in ASD, depression and anxiety （P 〉 0.05）. Conclusion： ASD depression and anxiety are common mental prob-lems among inpatients with multiple traumas, and related factors include gender martial status,low degree of education,low level of income.Medical staff should not only think highly of their physical state,but also their psychological status.