武汉市失独家庭帮扶人员替代性创伤现状及其影响因素

Status Quo and Influencing Factors of Vicarious Trauma Among Assistance Staff of Child-bereft Families in Wuhan

目的:探讨武汉市失独家庭帮扶人员替代性创伤现状及其影响因素,为失独家庭帮扶人员替代性创伤的恢复提供参考。方法:采用灾难救助者替代性创伤问卷、临床用DSM-Ⅳ创伤后应激障碍诊断量表、社会支持量表、汉密尔顿抑郁量表、汉密尔顿焦虑量表和简易应对方式问卷对武汉市失独家庭帮扶人员进行调查。结果:700例帮扶人员中有82人出现替代性创伤,发生率为11.71%;替代创伤组受试者创伤后应激障碍发生率为12.20%,明显高于无替代创伤组(P<0.05)。替代创伤组主观支持、对社会支持利用度、社会支持总分及积极应对评分均低于无替代创伤组,消极应对、抑郁及焦虑症状评分高于无替代创伤组(P<0.05)。女性、经历过创伤性事件是帮扶人员发生替代性创伤的独立危险因素(P<0.05),而接受过心理创伤培训和社会支持度正常是独立保护因素(P<0.05)。结论:失独家庭帮扶人员存在一定程度的替代性创伤,且影响因素较多。应关注易发生替代性创伤的人群,加强其心理筛查与护理,以减少替代性创伤的发生。

Objective:To explore the current status and influencing factors of vicarious trauma among assistance staff of child-bereft families in Wuhan,so as to provide references for the recovery of vicarious trauma among assistance staff of child-bereft families.Methods:The vicarious trauma questionnaire for disaster rescuers,DSM-IV clinician administered PTSD(post-traumatic stress disorder)scale,social support scale,Hamilton depression scale,Hamilton anxiety scale and simplified coping style questionnaire were used to conduct a survey among assistance staff of child-bereft families in Wuhan.Results:Among 700 assistance staff,there were 82 cases with vicarious trauma and the incidence rate was 11.71%.The incidence rate of PTSD of vicarious trauma group was 12.20%and significantly higher than that of group without vicarious trauma(P<0.05).Compared with the group without vicarious trauma,the scores of subjective support and social support utilization,total score of social support and score of positive coping were lower in vicarious trauma group and the scores of negative coping,depression and anxiety symptoms were higher in vicarious trauma group(P<0.05).The female and experience of traumatic events were independent risk factors of vicarious trauma in assistance staff(P<0.05),while psychological trauma training and normal social support were independent protective factors(P<0.05).Conclusion:There is certain vicarious trauma in assistance staff of child-bereft families,and there are many influencing factors.It is recommended to pay attention to the people prone to vicarious trauma and strengthen their psychological screening and nursing to reduce the occurrence of vicarious trauma.