TIMBER对意外创伤肢体功能障碍康复期患者创伤后应激症状的影响  

Effect of TIMBER on post-traumatic stress symptoms in rehabilitation patients with limb dysfunction after accidental trauma

作　　者：刘洋[1] 黄英 陈翰 韩亚楠 许辰 李敏[1] LIU Yang;HUANG Ying;CHEN Han;HAN Yanan;XU Chen;LI Min(Department of Military Medical Psychology,Faculty of Medical Psychology;Department of Rehabilitation Medicine,First Affiliated Hospital,Army Medical University(Third Military Medical University),Chongqing,400038,China)

机构地区：[1]陆军军医大学(第三军医大学)医学心理系军事心理学教研室,重庆400038 [2]陆军军医大学(第三军医大学)第一附属医院康复医学科,重庆400038

出　　处：《陆军军医大学学报》2024年第4期396-402,F0003,共8页Journal of Army Medical University

基　　金：陆军军医大学大学生培育项目(2022XBK22);陆军军医大学军事科研项目(2021XJS11)。

摘　　要：目的 探讨基于正念的消退和再巩固创伤干预(trauma interventions using mindfulness based extinction and reconsolidation, TIMBER)对意外创伤肢体功能障碍康复期患者创伤后应激症状的影响。方法 采用方便取样的方法,选取2022年3月至2023年5月陆军军医大学第一附属医院康复医学科收治的创伤康复期患者(impact of event scale-revised, IES-R总分≥33分)46例,采用随机数字表法分为干预组和对照组,干预组接受TIMBER干预,对照组进行心理健康相关知识宣教。在干预前(T1)、干预结束时(T2)和干预结束后1个月(T3)使用事件影响量表修订版(IES-R)、医院焦虑抑郁量表(HADS)、睡眠状况自评量表(SRSS)对所有被试进行测量,比较两组患者创伤后应激症状、焦虑症状、抑郁症状和睡眠的变化。结果 两组患者人口统计学信息及各心理学变量在T1时差异均无统计学意义(P>0.05);干预组在T2和T3时的IES-R总分及各维度评分、焦虑、抑郁和睡眠评分显著低于对照组(P<0.05);干预组在T2和T3时的IES-R总分及各维度评分、焦虑、抑郁和睡眠评分显著低于T1(P<0.01);与T1相比,对照组T2、T3时的回避、闯入2个维度评分及IES-R总分有一定程度降低,差异有统计学意义(P<0.05),而高警觉、焦虑、抑郁和睡眠评分差异无统计学意义(P>0.05)。结论 TIMBER可以显著改善意外创伤肢体功能障碍康复期患者的创伤后应激症状、焦虑抑郁症状及睡眠。Objective To explore the impact of trauma interventions using mindfulness based extinction and reconsolidation(TIMBER)on post-traumatic stress symptoms in rehabilitation patients with limb dysfunction after accidental trauma.Methods Convenient sampling was used to select 46 rehabilitation patients with limb dysfunction after accidental trauma(impact of event scale-revised,IES-R total score≥33)admitted to Department of Rehabilitation Medicine of the First Affiliated Hospital from March 2022 to May 2023.They were randomly divided into an intervention group(TIMBER intervention)and a control group(health education of knowledge about mental health).IES-R,Hospital Anxiety and Depression Scale(HADS),and Self-Rating Scale of Sleep(SRSS)were employed to survey the participants before(T1),at the end of(T2),and 1 month after intervention(T3).The changes in post-traumatic stress symptoms,anxiety symptoms,depression symptoms,and sleep were compared between the 2 groups of patients.Results There were no statistically differences in demographic information and various psychological variables between the 2 groups at T1(P>0.05).The intervention group got their total and various dimensional scores of IES-R,and scores of anxiety,depression,and sleep at T2 and T3 significantly decreased when compared with these scores at T1(P<0.01),and all the scores at T2 and T3 were obviously lower in the intervention group than the control group(P<0.05).Compared with T1,the avoidance and intrusion scores and total IES-R score were declined in the control group at T2 and T3,with statistical significance(P<0.05),while no such differences were observed in the scores of high alertness,anxiety,depression,and sleep(P>0.05).Conclusion TIMBER significantly improves the post-traumatic stress symptoms,anxiety symptoms,depression symptoms,and sleep in rehabilitation patients with limb dysfunction after accidental trauma.

关 键 词：正念 消退与再巩固干预 创伤后应激症状 创伤康复 

分 类 号：R395.2[哲学宗教—心理学] R641[医药卫生—医学心理学] R749.2[医药卫生—基础医学]