脊髓损伤患者创伤后应激障碍、社会支持与生存质量的现状调查及相关性分析

Post-traumatic Stress Disorder,Social Support,and Quality of Life in Patients with Spinal Cord Injury

目的探讨中国康复中后期脊髓损伤患者创伤后应激障碍、社会支持与生存质量的关系及生存质量相关的影响因子。方法采用横断面研究设计,多阶段分层抽样与滚雪球抽样相结合的方法,抽取曾在9所不同等级的医院中住院治疗的206例脊髓损伤患者为研究对象。使用一般资料、创伤后应激障碍清单、社会支持量表及世界卫生组织生存质量测定量表简表进行资料收集,对资料进行统计描述,以t检验、多元线性回归及调节效应分析等对相关因素进行统计分析。结果创伤后应激障碍与生存质量呈显著负相关(r=-0.337,P<0.001),社会支持与生存质量呈显著正相关(r=0.318,P<0.001)。社会支持在创伤后应激障碍警觉症状维度与总体生存质量(β=0.324,P=0.032)及其环境领域(β=0.227,P=0.004)间表现出正向调节作用,在创伤后应激障碍闯入症状维度与生存质量环境领域间(β=-0.125,P=0.017)表现出负向调节作用。创伤后应激障碍、社会支持及性别、婚姻状况、经济状况等一般资料是生存质量各领域的显著预测因素。结论减轻创伤后应激障碍、提高社会支持水平可促进脊髓损伤患者长期维持较好的生存质量。

Objective To explore the relationship among post-traumatic stress disorder(PTSD),social support and quality of life in patients with spinal cord injury(SCI)after a long recovery in China and investigate the factors influencing the quality of life.Methods In this cross-sectional study,206 SCI patients who were hospitalized in 9 hospitals were enrolled.Data collection was performed using general information,the Post-Traumatic Stress Disorder Checklist-Civilian version,the social support scales,and the World Health Organization Quality of Life-Abbreviated version.The data were statistically analyzed using t test,multivariate linear regression,and adjustment effect analysis.Results PTSD was negatively correlated with quality of life(r=-0.337,P<0.001).Social support was positively correlated with quality of life(r=0.318,P<0.001).Social support showed a positive regulatory role between the heightened sense of threat dimension of PTSD and the overall quality of life(β=0.324,P=0.032)or its environmental domain(β=0.227,P=0.004)but showed a negative regulatory effect on the re-experiencing dimension of PTSD and the environmental domain of quality of life(β=-0.125,P=0.017).PTSD,social support,gender,marital status,and economic status were significant predictors of quality of life.Conclusion Reducing PTSD and improving social support can improve long-term quality of life in SCI patients.