汶川地震后送至重庆伤员的心理应激状况及干预效果  

Mental health and mental intervention effect among Wenchuan earthquake survivors transferred to Chongqing

作　　者：李玲[1] 王延江[1] 王琳[1] 于瑞英[1] 张猛[1] 邓娟[1] 李静[1] 周华东[1] 

机构地区：[1]第三军医大学附属大坪医院野战外科研究所神经内科,重庆400042

出　　处：《中华创伤杂志》2011年第11期1028-1032,共5页Chinese Journal of Trauma

基　　金：军队“十二五”预研基金

摘　　要：目的探讨汶川地震后送至重庆伤员的心理特点及心理干预的效果，为制订重大灾害后送伤员的心理干预措施提供科学依据。方法首先使用自编一般情况问卷、心理健康自评问卷（PHSQ）、症状自评量表（SCL-90）、领悟社会支持量表（PSSS）及应对方式问卷对389例伤员进行测评，按照PHSQ评分结果将伤员分为对照组及应激组，此后对应激组给予心理干预，1个月后对此组伤员进行第二次心理测评。结果（1）此批伤员入院时PHSQ评分≥8分共117人（30．08％），划分为应激组，其余为对照组。（2）应激组的SCL-90焦虑、忧郁、恐怖及附加因子分明显高于对照组（P〈0．01）。（3）应激组以不成熟型应对方式为主，其中以退避、幻想应对为主（P〈0．01），而对照组则以合理化、求助应对为主。（4）应激组的领悟社会支持评分结果明显低于对照组（P〈0．01）。（5）应激组经过1个月心理干预，PHSQ分≥8共53例，与干预前比较差异有统计学意义（t=4．32，P〈0．05）。同时SCL-90焦虑、附加因子及领悟社会支持评分均较干预前有明显差异（P〈0．01），应对方式从不成熟型向成熟型转变，以求助为主要应对方式。结论汶川地震后送伤员具有较严重心理问题，主要与焦虑、忧郁、恐怖的情绪、不成熟的应对方式及缺乏领悟社会支持相关。针对性地及时给予积极有效的心理干预，有利于伤员心理健康。Objective To provide scientific basis for developing mental interventions for the wounded in major disasters by assessing the mental health status and the mental intervention effect among the Wenchuan earthquake survivors transferred to Chongqing. Methods A total of 389 transferred wounded survivors were examined by using questionnaires including general information questionnaire, Psychological Health Self-rating Questionnaire （PHSQ）, Symptom Checklist 90 （SCL-90）, Perceived Social Support Scale （PSSS） and Coping Styles Questionnaire （CSQ）. According to PHSQ, the wounded were divided into control group and stress group. Then, the stress group was given mental intervention and taken the second mental evaluation one month later. Results Acute stress disorder （ASD） rate （30.08%） was remarkably observed in these transferred wounded, who were subsequently administered a set of mental intervention. The wounded whose PHSQ mark ≥8 were defined as the stress group （ Group A） and the others as the control group （ Group B）. Compared with Group B, Group A had higher scores in depression （P 〈 0. 01 ）, anxiety （P 〈 0.01 ） and consternation （ P 〈 0.01 ）, and lower scores in PSSS （P 〈0.01 ）. Group A inclined to negative coping styles mainly including shrink back （P 〈 0.01 ） and fantasy （P 〈0.01 ） , while Group B inclined to coping styles mainly including rationalization and help. The PSSS score in Group A was significant lower than that in Group B （P 〈0.01 ）. The scores in PHSQ,SCL-90 （anxiety and consternation）, CSQ and PSSS were significantly improved after the mental intervention in Group A. Conclusions The incidence of ASD is high in the transferred wounded survivors and is mainly related with mental stress, such as emotional symptoms, negative coping styles and low perception of social support. Early mental interventions will help improve the psychological status of the transferred wounded.

关 键 词：自然灾害 心理疗法 应激 心理学 汶川地震 

分 类 号：B84[哲学宗教—心理学]