急危重症患者发生急性应激障碍危险因素的结构方程模型构建

Construction of structural equation model for risk factors of acute stress disorder occurrence in critically ill patients

目的了解经抢救急危重症患者急性应激障碍(ASD)现状,分析ASD的影响因素并基于结构方程探索危险因素模型。方法选取2018年10月至2019年9月于华北理工大学附属医院急诊科经历抢救结束后进入病情稳定的康复期的患者作为研究对象。应用斯坦福急性应激反应问卷(SASRQ)、医院焦虑抑郁量表(HADS)和自行设计的影响因素问卷进行测评。使用线性相关、探索性因子分析和结构方程确定ASD的危险因素模型。结果共发放问卷440例,回收有效问卷432例,有效回收率为98.2%。经抢救急危重症患者急性应激反应得分为(45.64±31.40)分,ASD患病率为33.1%。对医生、护士满意度低、急救不及时、救治效果差、急诊分级高、抢救所用时间长、疼痛、焦虑是ASD的危险因素。结论经抢救急危重症患者ASD患病率较高,结构方程模型可应用于ASD危险因素的探讨。

Objective To understand the current situation of acute stress disorder(ASD)in critically ill patients,to analyze the influencing factors of ASD,and to explore its risk factor model based on structural equation.Methods The patients entering into the stable recovery period after emergency treatment in the emergency department of Affiliated Hospital of North China University of Science and Technology from October 2018 to September 2019 were selected as the research subjects.The Stanford acute stress response questionnaire(SASRQ),the hospital anxiety and depression scale(HADS),and the self-designed influencing factors questionnaire were used to conduct the evaluation.The risk factor model for ASD was determined by using the linear correlation,exploratory factor analysis and structural equations.Results A total of 440 questionnaires were issued,and 432 effective questionnaies were recovered with the recovery rate of 98.2%.The score of acute stress response in critically ill patients after rescue was(45.64±31.40)points,and the prevalence rate of ASD was 33.1%.The low satisfaction to doctors and nurses,untimely first aid,poor treatment effect,high emergency grade,long time in emergency treatment,pain and anxiety were the risk factors of ASD.Conclusion The prevalence of ASD is higher in critically ill patients after first aid.The structural equation model can be used to study the risk factors of ASD.