创伤后应激相关障碍的发生及影响因素的研究-护理专业论文.docxVIP

中文摘要 目的： 调查创伤后应激相关障碍的发生以及影响其发生的心理社会因素，为早期 心理干预提供参考依据。 方法：采用方便抽样法，所有符合入组标准的就诊者均纳入研究。使用一般情况调 查表、汉密尔顿焦虑量表、汉密尔顿抑郁量表、简易应对方式问卷、社会支持评定量表、 防御方式问卷、创伤后应激障碍筛查量表对 400 例创伤事件暴露者进行调查。对取得的 数据用 EpiData3.0 建立数据库，SPSS17.0 统计软件进行处理，全部检验均为双侧检验， 检验水准 P＜0.05。 结果：1.创伤后应激相关障碍患者中ASD症状的阳性率为4.8%，PTSD症状的阳性率 为10.5%，AD的症状的阳性率为3.3%;2. ①居住地为农村被试者PTSD症状显著高于城市 （P0.05）；②丧亲和癌症患者ASD症状显著低于外伤的患者（P0.05）；癌症患者和 外伤者PTSD症状显著低于丧亲者（P0.05）；丧亲和外伤患者ASD、PTSD、AD症状显 著低于癌症的患者（P0.05）；③随着时间推移PTSD有上升的趋势（P0.05），而ASD、 AD呈下降的趋势。④女性群体PTSD症状显著高于男性群体（P0.05）；⑤外伤、丧亲、 癌症的群体PTSD症状明显高于其他受伤群体（P0.05）;3. ①防御方式中的不成熟型、 掩饰与PTSD症状总分、再体验、回避/麻木、警觉性增高呈显著正相关（P0.01）；②消 极应对与PTSD症状总分、再体验、回避/麻木、警觉性增高呈显著正相关（P0.01）； ③客观支持与PTSD症状总分、再体验、回避/麻木、警觉性增高呈显著负相关（P0.01）； ④汉密尔顿总分及各因子均与PTSD症状总分、在体验、回避/麻木、警觉性增高呈显著 正相关（P0.01）；⑤汉密尔顿抑郁总分及因子中的焦虑、睡眠、绝望感与PTSD症状总 分、在体验、回避/麻木、警觉性增高呈显著正相关（P0.01）。 结论：1. 经历外伤、癌症、丧亲的患者发生ASD和PTSD比率较高;2. 有力的社会支 持、积极的应对、成熟的防御方式对创伤群体创伤后发生应激相关症状起到缓冲作用， 能减少其应激相关障碍的发生。 关键词：应激相关障碍；发生情况；影响因素。 I Abstract Object: To investigate the incidence and the psychological and social factors of PTSD and provide guidance for early psychological intervention. Methods: Convenient sampling method was adopted and all the participants that met the standards were included in the study. We survey 400 traumatic exposure persons by using General Situation Questionnaire, Hamilton Anxiety and Depression Scales, Simplified Coping Style Questionnaire, Social Support Rating Scale, Defense Style Questionnaire Social Support Review Survey, and PTSD Checklist-Civilian Version. Database were established by EpiData 3.0 and analyzed by SPSS 17.0. All statistical tests were two-sided and P for inspection level 0.05 Result: 1.The positive rate of ASD in patients with stress related disorder was 4.8%, PTSD positive rate was 10.5%, and the positive rate of AD symptoms was 3.3%. 2. ①The PTSD symptoms in patients lived in countryside was significantly higher than that in city (P0.05) ② ASD symptoms were significantly different between different trauma types that the bereaved and cancer p