病毒性脑炎患者创伤后成长状况及影响因素分析

Post-traumatic growth and influencing factors in patients with viral encephalitis

目的总结病毒性脑炎患者创伤后成长现状,并筛查其影响因素。方法以2017年7月至2019年7月在四川大学华西医院诊断与治疗的病毒性脑炎患者为调查对象,采用横断面调查方法,包括一般资料调查表、创伤后成长评定量表(PTGI)、家庭关怀度指数问卷(APGAR)以及心理弹性量表(CD-RISC),分析PTGI评分与年龄、APGAR和CD-RISC评分的相关性,筛查创伤后成长相关影响因素。结果共发放调查问卷110份,回收有效问卷105份,回收有效率95.45%。PTGI总评分平均为57.76±15.23,各维度评分依次为人际关系维度(16.92±3.49)、人生感悟维度(12.44±3.20)、个人力量维度(11.91±3.50)、精神改变维度(8.82±3.48)和新的可能性维度(7.67±3.49)。偏相关分析显示,PTGI总评分与APGAR评分(r=0.331,P=0.001)和CD-RISC评分(r=0.286,P=0.003)呈正相关关系。Logistic回归分析显示,存在并发症(OR=0.029,95%CI:0.003~0.320;P=0.004)负向影响PTGI评分,APGAR评分较高(OR=1.260,95%CI:1.051~1.511;P=0.013)和CD-RISC评分较高(OR=1.093,95%CI:1.035~1.153;P=0.001)正向影响PTGI评分。结论病毒性脑炎患者创伤后成长水平欠佳。针对出现并发症的患者应强化心理干预,同时充分认识到家庭关怀度和人格坚韧程度对创伤后成长的协同促进作用,采取针对性措施,促使此类患者建立更好的创伤后心理调控机制,加快创伤后成长。

Objective To investigate the status of post-traumatic growth of viral encephalitis patients and screen the influencing factors.Methods diagnosed and treated in West China Hospital, Sichuan University from July 2017 to July 2019 were Growth Inventory(PTGI), Family Concern Index Questionnaire(APGAR) and Connor-Davidson Resilience Scale(CD-RISC). Correlation analysis were used to analyze the relationship between PTGI score and age,factors of post-traumatic growth in patients with viral encephalitis.Results were sent out and 105 were effectively received, with an effective recovery rate of 95.45%. The mean total PTGI score was 57.76 ± 15.23, and the score of dimensions of interpersonal relationship, life perception,personal strength, spiritual change and new possibilities was 16.92 ± 3.49, 12.44 ± 3.20, 11.91 ± 3.50, 8.82 ±3.48 and 7.67 ± 3.49, respectively. The partial correlation analysis showed that the total PTGI score was Logistic regression analysis showed that higher APGAR score(OR = 1.260, 95%CI:1.051-1.511;P = 0.013)traumatic growth, while complications(OR = 0.029, 95%CI:0.003-0.320;P = 0.004) was the opposite.Conclusions patients with complications the psychological intervention should be strengthened. At the same time, family care and personality strength have additional effects on post-traumatic growth. We should take targeted measures to encourage such patients to establish better post-traumatic psychological regulation mechanism,and to accelerate the post-traumatic growth.