眼外伤患者创伤后应激障碍症状特征及社会心理因素  

Symptom characteristics of post-traumatic stress disorder in patients with ocular trauma and analysis of social-psychosocial factors

作　　者：仝彤 贺广秀[1] 李素华[1] TONG Tong;HE Guangxiu;LI Suhua(Department of Ophthalmology,Nanyang Central Hospital,Nanyang 473009,China)

机构地区：[1]河南省南阳市中心医院眼科,473009

出　　处：《中国健康心理学杂志》2021年第7期996-1001,共6页China Journal of Health Psychology

基　　金：2019年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20190196)。

摘　　要：目的:探讨眼外伤患者创伤后应激障碍(PTSD)症状特征,分析影响眼外伤患者PTSD的社会心理相关因素。方法:选取2016年7月至2019年12月在某院确诊的眼外伤患者161例。自行设计问卷收集患者的一般临床资料。1个月后进行随访,采用PTSD自评量表(PTSD-SS)评估眼外伤患者PTSD症状特征,采用社会支持评定量表(SSRS)评估眼外伤患者的社会支持度,采用心理弹性量表中文版(CD-RISC)评估眼外伤患者的心理弹性水平。采用单因素分析和多元logistic回归模型分析眼外伤患者PTSD的影响因素。结果:眼外伤患者PTSD-SS各维度得分从高到低依次为对创伤事件的主观评定、警觉性增高、回避症状、反复重现体验和社会功能受损;PTSD-SS得分高于国内常模(t=11.864,P<0.001)。眼外伤患者SSRS得分高于国内常模(t=19.141,P<0.001)。眼外伤患者CD-RISC各维度得分从高到低依次为力量、坚韧和乐观;CD-RISC得分低于国内常模(t=-13.525,P<0.001)。眼外伤PTSD阳性症状患者58名(37.18%)。单因素分析表明,性别、年龄、致伤后视力、对社会支持的利用度、坚韧、乐观均会影响眼外伤患者PTSD症状(χ^(2)=10.189,6.466,6.447,5.566,5.784,10.541;P<0.05)。多因素logistic分析表明,男性、对社会支持的利用度高、坚韧、乐观均为眼外伤患者PTSD的独立保护因素(OR=0.528,0.414,0.501,0.403;95%CI=0.321~0.904,0.237~0.864,0.405~0.912,0.210~0.745;P<0.05)。结论:眼外伤患者PTSD的发生率较高,症状较一般人群严重。眼外伤患者的社会支持度高、心理弹性差。男性、对社会支持的利用度高、坚韧、乐观的眼外伤患者更不容易出现PTSD。Objective:To discuss the symptom characteristics of post-traumatic stress disorder(PTSD)in patients with ocular trauma,and analyze the psychosocial factors affecting PTSD in ocular trauma patients.Methods:From July 2016 to December 2019,161 patients with ocular trauma diagnosed in our hospital were selected.Self-designed questionnaire was used to collect general clinical data of patients.Follow up after 1 month,PTSD self-rating scale(PTSD-SS)was used to evaluate the symptom characteristics of PTSD in patients with ocular trauma;Social support rating scale(SSRS)was used to evaluate the social support degree of patients with ocular trauma;Connor-Davidson resilience scale(CD-RISC)of psychological resilience scale was used to evaluate the psychological resilience level of patients with ocular trauma.Single factor analysis and multiple logistic regression model was used to analyze the influencing factors of PTSD in patients with ocular trauma.Results:PTSD-SS scores of ocular trauma patients ranged from high to low for subjective assessment of traumatic events,increased alertness,avoidance of symptoms,recurring experiences and impaired social function;The PTSD-SS score was higher than that of domestic norm(t=11.864,P<0.001).The SSRS scores in ocular trauma patients was higher than that of domestic norm(t=19.141,P<0.001).The scores of CD-RISC in ocular trauma patients ranged from high to low for strength,tenacity and optimism;the CD-RISC score was lower than that of domestic norm(t=-13.525,P<0.001).58(37.18%)ocular traumapatients had positive of PTSD.Single factor analysis showed that gender,age,post-traumatic vision,utilization of social support,tenacity and optimism all affected PTSD symptoms in patients with ocular trauma(χ^(2)=10.189,6.466,6.447,5.566,5.784,10.541;P<0.05).Multivariate logistic analysis showed that male,high utilization of social support,tenacity and optimism were independent protective factors for PTSD in ocular trauma patients(OR=0.528,0.414,0.501,0.403;95%CI=0.321~0.904,0.237~0.864;0.405~0.912,0.

关 键 词：眼外伤 创伤后应激障碍 社会心理因素 社会支持 心理弹性 

分 类 号：R749.92[医药卫生—神经病学与精神病学]