三维筛选评估模型在汶川地震外转伤员及家属心理健康状况评估中的应用  

Application of the triage assessment system for a rapid assessment of mental health of the referral wounded and their family members in Wenchuan earthquake

作　　者：周韦华[1] 胡健波[1] 胡少华[1] 魏宁[1] 黄满丽[1] 许毅[1] 

机构地区：[1]浙江大学医学院附属第一医院精神卫生科,杭州310003

出　　处：《中华预防医学杂志》2008年第11期798-801,共4页Chinese Journal of Preventive Medicine

摘　　要：目的通过快速评估四川汶川大地震中外转伤员心理状况，从而推广综合评价心理危机干预的评估系统的应用。方法对转运到我院的44名伤员和37名家属采用三维筛选评估模型进行评定，此外结合汉密尔顿抑郁他评量表（HAMD）、汉密尔顿焦虑他评量表（HAMA）来进行心理健康方面的相关分析，从而验证三维筛选评估模型的有效性。结果79名外转伤员及家属采用三维筛选评估模型进行评估，伤员组在情感方面得分平均为（3．074-1．38）分，认知方面平均为（2．34±1．39）分，行为方面平均为（2．71±1．47）分，总分平均为（8．12±3．69）分；家属组在情感方面得分平均为（2．51±1．27）分，认知方面平均为（1．57±0．85）分，行为方面平均为（1．71±1．02）分，总分平均为（5．80±2．61）分。伤员组与家属组之间在认知、行为和总分方面差异均有统计学意义（t认知=2．853，P=0．006；t行为=3．366，P=0．001；t总分=3．116，P=0．003）。伤员组与家属组在HAMD和HAMA中均存在抑郁和焦虑症状，HAMD总分分别为：（11．48±7．62）分和（9．23±5．64）分，HAMA总分分别为：（8．49±4．87）分和（9．38±7．05）分。三维筛选评估模型中情感、认知、行为和总分均与HAMD和HAMA存在较高相关（r情感-HAMD=0．393，P=0．001；r情感-HAMA=0．443，P=0．000；r认知-HAMD=0．434，P=0．000；r认知-HAMA=0．240，P=0．037；r行为-HAMD=0．529，P=0．000；r行为-HAMA=0．256，P=0．026；r总分-HAMD=0．517，P=0．000；r总分-HAMA=0．369，P=0．001）。结论地震伤员和家属在情感、认知和行为方面存在异常，地震伤员在情感、认知和行为方面较家属严重，更加需要进行及时的心理干预。三维筛选评估模型是一种能够快速、准确、简便的筛查和监测方法，适合用于指导心理干预。Objective To quickly assess the psychological status of the wounded who were transferred in the earthquake and their family members, as to promoting the system of psychological crisis intervention. Methods The triage assessment system was used to the 44 wounded and 37 family members, additionally, the Hamilton Depression Rating Scale（ HAMD）, and Hamilton Anxiety Rating Scale（HAMA） for related analysis were also administrated to verify the effectiveness of screening of the triage assessment system. Results Of the 79 wounded and their families in the triage assessment system, the score of emotion in the wounded group was （3.07 ± 1.38） ,the score of cognation was （2. 34 ± 1.39） ,the score of behavior was （2.71 ± 1.47 ）, and the total seore was （8.12 ± 3.69 ） ;the score of emotion in the family group was （2.51 ± 1.27） ,the score of eognition was（ 1.57 ±0. 85） ,the score of behavior was （ 1.71 ± 1.02） ,and the total score was （ 5.80 ± 2. 61 ）. There were significant differences in the family and the wounded group in cognition, behavior and the total （ tcognition= 2. 853, P = 0. 006 ; tbehavior = 3. 366, P = 0. 001 ; ttntol = 3.116, P = 0. 003 ）. Both the depression and anxiety symptoms in the Hamilton Depression Scale（HAMD） and Hamilton Anxiety Scale （HAMA） were 11.48 ± 7.62, 9.23 ±- 5.64, and 8.49 ± 4. 87, 9.38 ± 7.05, respectively. In the emotion, cognition, behavior and total scores of the triage assessment system related to higher with HAMD and HAMA were remotion-HaMD = 0. 393, P = 0. 001 ; remotion- HAMA =0. 443, P = 0. 000; reognition- HAMD = 0. 434, P = 0. 000 ; rcognition- HAMA =0. 240, P = 0. 037 ; rbehavior- HAMD = 0. 529, P = 0. 000 ; rbhavior-HAMA= 0. 256, P = 0. 026 ; rtotal-AMD = 0. 517, P = 0. 000 ; rtotal-HAMA = 0. 369, P = 0. 001. Conclusion , The triage assessment system should be the reliable method for an assessment featured by a rapid, accurate and simple one in screening and monitoring.

关 键 词：自然灾害 病人转运 三维筛选评估模型 心理状况评估 评价研究 

分 类 号：R686[医药卫生—骨科学]