截肢患者创伤后应激障碍与社会支持的纵向研究  

Longitudinal study of post-traumatic stress disorder and social support in amputated patients

作　　者：刘东苗[1] 李鑫 李殊 成巧梅[1] Dongmiao LIU;Xin LI;Shu LI;Qiaomei CHENG(Department of Hand and Foot Microsurgery,Henan Provincial People’s Hospital,Zhengzhou,450003,China)

机构地区：[1]河南省人民医院手足显微外科,郑州市450000

出　　处：《中华护理杂志》2019年第7期965-969,共5页Chinese Journal of Nursing

基　　金：河南省科技厅科技攻关项目(82102310092)

摘　　要：目的调查创伤后截肢患者在不同时间节点的应激障碍和社会支持状况,分析二者变化趋势及相互关系,为患者的心理护理提供科学的理论依据。方法采用便利抽样法选取创伤后截肢患者47例,应用一般情况调查表、社会支持量表及创伤后应激障碍量表平民版于患者截肢术后第3天、第28天、第84天及第168天进行调查分析。结果截肢患者4个时间节点的创伤后应激障碍阳性率分别为42.59%、51.06%、53.19%、38.30%,其中第3天、第28天和第84天创伤后应激障碍量表平民版得分呈上升趋势,第168天时显著降低,不同时间点比较,差异具有统计学意义(P<0.05);4个时间节点的积极社会支持均高于消极社会支持(P<0.05),且积极社会支持和消极社会支持呈下降趋势(P<0.05),不同时间点比较,差异具有统计学意义(P<0.05);创伤后应激障碍与各时间节点的积极社会支持呈显著负相关,与各时间节点的消极社会支持呈显著正相关;各时间节点的积极社会支持与消极社会支持之间存在显著的负相关关系。结论创伤后截肢患者应激障碍阳性率较高,且承受着较高水平的消极社会支持。患者消极社会支持越多,积极社会支持越少,越趋向于出现创伤后应激障碍。Objective To investigate the status of post-traumatic stress disorder (PTSD) and social support in amputated patients at different time points,and to analyze the trajectory of change and relationship between them,so as to provide a scientific theoretical basis for psychological nursing of patients.Methods Forty-seven patients with amputation were selected by convenience sampling. The general information questionnaire,Social Support Scaling Questionnaire and Post-traumatic Stress Checklist-Civilian Version(PCL-C) were used to investigate and analyze the patients on the 3rd day,28th day,84th day,and 168th day after amputation.Results The detection rates of PTSD at four time points were 42.59%,51.06%,53.19% and 38.30%,respectively. The scales of PCL-C in 3rd day,28th day and 84th day showed an upward trend,with a significant decrease at 168th day(P<0.05). The positive social support at four time points was always higher than the negative social support(P<0.05),and both positive social support and negative social support were decreasing(P<0.05). PTSD was negatively correlated with the positive social support at all time points,and positively correlated with the negative social support at all time points. There was a significant negative correlation between positive social support and negative social support.Conclusion The positive rate of PTSD among amputated patients is relatively high and patients bear a higher level of negative social support. The more negative social support patients perceive,the less positive social support they have,and the more likely they show PTSD symptoms.

关 键 词：截肢术 应激障碍 创伤后 社会支持 心理护理 纵向研究 

分 类 号：R473.6[医药卫生—护理学]