对创伤后应激障碍医务人员实施心理干预措施的研究

Study on psychological intervention measures for medical staff with post-traumatic stress disorder

目的探讨对创伤后应激障碍医务人员实施心理干预措施的效果方法2020年1月至2021年6月,对我市创伤后应激障碍医务人员进行了临床对照实验研究,根据干预方式的不同将医务人员分为对照组(常规干预45例)和试验组(心理干预45例),比较2组医护人员干预前后创伤后应激障碍自评量表(PCL-C)3个维度评分、匹兹堡睡眠质量指数(PSQI)量表6个维度评分、症状自评量表3个维度评分、社会支持量表3个维度评分以及应对方式量表6个维度评分的的统计学差异。结果2组医护人员干预前后创伤再体验、麻木和回避、警觉性增高、睡眠质量、入睡时间、睡眠时间、睡眠效率、催眠药物、日间功能障碍、躯体化症状、忧郁、焦虑、客观支持、主观支持、对支持的利用率、解决问题、合理化、求助、自责、幻想和退避评分差异具有统计学意义(P<0.05),观察组医护人员的创伤再体验(2.26±0.24与2.56±0.31)、麻木和回避(1.92±0.26与2.43±0.37)、警觉性增高(2.01±0.26与2.67±0.33)、睡眠质量(1.20±1.14与1.74±0.28)、入睡时间(1.05±0.17与1.83±0.29)、睡眠时间(0.86±0.08与1.54±0.19)、睡眠效率(1.14±0.20与1.53±0.29)、催眠药物(0.15±0.03与0.18±0.04)、日间功能障碍(1.50±0.42与1.78±0.40)、躯体化症状(1.34±0.18与1.97±0.26)、忧郁(1.21±0.25与1.58±0.37)、焦虑(1.26±0.14与1.83±0.21)、客观支持(12.4±1.0与13.4±1.4)、主观支持(5.2±0.5与6.9±0.8)、对支持的利用率(4.6±1.0与5.8±1.2)、解决问题(5.0±1.1与6.2±1.4)、合理化(5.0±1.2与5.2±1.3)、求助(3.8±0.7与4.9±0.9)、自责(3.8±0.5与4.3±0.6)、幻想(3.4±0.6与4.0±1.0)和退避(3.0±0.4与3.6±0.8)评分均显著低于对照组(P<0.01)。结论相比于常规干预而言,心理干预措施对创伤后应激障碍医务人员创伤后应激障碍可明显改善。

Objective To explore the effect of psychological intervention for medical staff with post traumatic stress disorder(PTSD).Methods The clinical control experiment of the medical staff of PTSD from January 2020 to June 2021 in our hospital was carried out.According to the different intervention methods,the medical staff were divided into control group(routine intervention,n=45)and experimental group(psychological intervention,n=45).The statistical differences of 3 dimensions of PCL-C scale,6 dimensions of PSQI scale,3 dimensions of symptom self-rating scale,3 dimensions of social support scale and 6 dimensions of coping style scale were compared between the two group′s medical staff before and after intervention.Results The differences of the medical staff before and after the intervention trauma experience again,numbness and avoidance,increased alertness,sleep quality,total sleep time,sleep time,sleep efficiency and hypnotic drugs,daytime dysfunction,somatization symptoms,depression,anxiety,objective support,subjective support and utilization of support,problem solving,rationalization,for help,self-accusation,illusion and retreat scores between the two groups were significant(P<0.05).Compared with the control group,the staff trauma re-experience(2.26±0.24 vs 2.56±0.31),numbness and avoidance(1.92±0.26 vs 2.43±0.37),increased alertness(2.01±0.26 vs 2.67±0.33),sleep quality(1.20±1.14 vs 1.74±0.28),sleep latency(1.05±0.17 vs 1.83±0.29),sleep duration(0.86±0.08 vs 1.54±0.19),sleep efficiency(1.14±0.20 vs 1.53±0.29)and hypnotic drugs(0.15±0.03 vs 0.18±0.04),day-time dysfunction(1.50±0.42 vs 1.78±0.40),somatization symptoms(1.34±0.18 vs 1.97±0.26),depression(1.21±0.25 vs 1.58±0.37),anxiety(1.26±0.14 vs 1.83±0.21),objective support(12.4±1.0 vs 13.4±1.4),subjective support(5.2±0.5 vs 6.8±0.8)and utilization of support(4.6±1.0 vs 5.8±1.2),problem solving(5.0±1.1 vs 6.2±1.4),ratio-nalization(5.0±1.2 vs 5.2±1.3),for help(3.8±0.7 vs 4.9±0.9),self-accusation(3.8±0.5 vs 4.3±0.6),illusion(3.4±0.6 vs 4.0±1.0)and retreat scores(3.0±0.4 vs 3.6±0.8)in experimental group were significantly lower than those of the control group(P<0.01).Conclusion Compared with conventional intervention,psychological intervention can significantly improve post-traumatic stress disorder in medical staff with PTSD.