地震灾区医务人员述情障碍及应对方式与心理健康的相关性研究

目的：探讨震后2a灾区医务人员心理健康状况与述情障碍以及应对方式的相关性。方法对174名灾区医务人员采用症状自评量表、多伦多述情障碍量表和特质应对问卷进行测评分析。结果灾区医务人员症状自评量表总分与积极应对、消极应对及多伦多述情障碍量表评分呈显著正相关（P＜0．01）;多伦多述情障碍量表总分与消极应对评分呈正显著相关（P＜0．01）;症状自评量表总分与多伦多述情障碍量表总分及消极应对分量表评分呈显著正相关（P＜0．01）。结论述情障碍和应对方式是影响地震灾区医务人员心理健康的重要因素,消极应对方式在述情障碍中发挥重要的中介作用。     

地震灾区医务人员创伤事件应对方式与心理健康相关性研究

目的：探讨汶川地震2a后灾区医务人员心理健康状况及其与心理创伤、应对方式的相关性。方法对180名灾区医务工作者（研究组）和144名非灾区医务工作者（对照组）采用症状自评量表、埃森创伤问卷以及简易应对方式问卷进行测评分析。结果研究组症状自评量表评分和埃森创伤问卷总分及闯入、回避和分离症状评分均显著高于对照组（ P＜0．05或0．01）;两组积极应对和消极应对维度分比较差异无显著性（P＞0．05）;相关分析显示,研究组消极应对维度分与症状自评量表评分和埃森创伤问卷评分呈显著正相关（ P＜0．05或0．01）,积极应对维度分与症状自评量表总分及4个因子分呈显著正相关（ P＜0．05或0．01）,对照组无显著相关性（P＞0．05）。结论经历过地震的灾区医务人员的心理健康水平低于非灾区医务人员,不同应对方式对创伤后应激反应症状的发生有重要影响,可能会进一步影响应激者的心理健康水平。     

2013年甘肃省岷县、漳县60例地震重症伤员受伤部位及其影像学特点

目的对2013年甘肃省岷县、漳县地震重症伤员的受伤部位及其影像学特点进行分析。方法回顾性收集在地震发生7天内送往兰州市各大医院的岷县、漳县60例地震重症伤员的临床资料,采用Excel软件录入数据并进行分析。结果 60例地震伤员中,20例为单部位损伤,40例为多部位损伤,受伤部位共计120处。四肢伤41例,共53个部位骨折,其中上肢11例(12个部位),下肢34例(41个部位)。头颅伤14例,共16个部位。脊柱伤13例,共累及14个椎体,20个部位,其中10例伴有脑和脊髓损伤。胸部伤17例,伴有肋骨骨折6例,骨折27处。另外,7例伤员伴有内脏损伤,累及腹部4个部位。结论此次地震伤以全身多部位、多器官损伤为多,其中以四肢骨折多见,腹部损伤少见。影像检查有助于地震伤员的筛查及分类治疗。     

心理干预对32例地震后老年高血压合并焦虑障碍患者的临床治疗分析

目的 探讨雅安地震后老年高血压患者情绪和血压的变化,以及心理干预对其焦虑情绪及血压的影响.方法 对雅安地震后56例老年高血压患者进行汉密尔顿焦虑量表（HAMA）的评分,并同时测量其血压的水平,将其随机分为2组,心理干预组32例,对照组24例,2组均接受常规降压药物治疗,其中心理干预组给予常规降压治疗的同时增加心理疏导及健康教育,治疗8周时再次对2组患者的血压变化及HAMA分值进行评价.结果 56例老年高血压患者在雅安地震后均出现了不同程度的焦虑情绪,并且血压随之出现波动.治疗8周后心理干预组患者血压控制的效果优于对照组（P＜0.05）;心理干预组HAMA分值的改善也显著优于对照组（P＜0.05）.结论 地震应激易导致老年人群出现不同程度的焦虑情绪,并使老年高血压患者的血压水平不稳定.对出现明显焦虑情绪的老年高血压患者在常规降压治疗的同时,给予积极的心理干预措施,不仅能消除患者心理障碍,促进康复,改善患者对治疗的态度和依从性,还能明显提高血压控制率,改善患者HAMA分值,提高临床疗效.     

青海玉树地震胸部损伤的影像学表现及其相关临床特点分析

目的：着重从影像学的角度探讨2010年4月14日青海玉树大地震中胸部压砸伤伤员胸部损伤的影像学特征与高海拔地震的关系,以及对临床急救手术的意义。方法：对地震发生后4月14日—4月23日陆续送至青海省人民医院治疗,因地震致有胸部损伤史的130名伤员行胸部X线及CT检查,对其中阳性的63名伤员的影像学特征、临床资料进行回顾性分析。结果：130名伤员中,63名检查结果为阳性,阳性率为48.5%,37例（28.5%）为多系统多发伤,33例（25.4%）为多种类型胸部伤同时存在,其中胸廓骨折54例（85.7%）,胸膜损伤56例（88.9%）,肺损伤54例（85.7%）,肺内合并症37例（58.7%）,肺外合并症35例（55.6%）。结论：青海玉树地震患者胸部损伤范围广,合并症多,临床症状重,与震区建筑、地理环境以及高海拔独特的气候关系密切,掌握影像学特征对临床急救手术具有重要指导意义。     

The roles,barriers and experiences of rehabilitation therapists in disaster relief: post-earthquake Haiti 2010

Abstract

Purpose: This article describes the roles and experiences of rehabilitation therapists involved in disaster relief work (DRW) in Haiti after the 2010 earthquake. The results of a pilot study and phenomenological study are presented. Method: A phenomenological study of rehabilitation providers’ experiences in post-disaster relief care is presented along with preliminary pilot study results. The phenomenological study explored the experiences of therapists from a lived experience perspective through the roles they played in DRW. Results: Participants provided disaster relief through direct patient care, adaptive equipment sourcing and allocation, education and training, community outreach and logistic or administrative duties. Barriers and challenges included: (1) emotions: ups and downs; (2) challenges: working at the edge of practice; (3) education: key to success and sustainability; (4) lessons learned: social responsibility is why we go; and (5) difficulty coming home: no one understands. Conclusions: Therapists play a key role in disaster relief situations. Data presented should encourage organizations to include therapists from early planning to implementation of relief services. Further studies are needed to evaluate the impact of rehabilitation interventions in disaster settings.

• Implications for Rehabilitation

• Understanding the roles and experiences of therapists in disaster relief setting is important

• Certain barriers to providing care in post-disaster settings exist

• Those participating in disaster response should be well prepared and aware of that they might be asked to do

     

Before and after the 1999 Chi-Chi earthquake: traumatic events and depressive symptoms in an older population

Natural disasters, such as earthquakes, can have deleterious consequences for physical and psychological health. In this study, we investigate variability in resilience to depressive symptoms in the aftermath of a massive earthquake that struck Taiwan in 1999. We analyze data on 1160 older individuals from a national, longitudinal survey with interviews before and after the earthquake. This survey contains extensive information on physical and cognitive function, depressive symptoms, socio-demographic characteristics and earthquake-related exposure and experiences. We estimate regression models to identify risk factors associated with the presence of depressive symptoms after the disaster, controlling for health status and the presence of depressive symptoms beforehand. We pay special attention to how socio-demographic factors moderate the psychological impact of the earthquake. Results indicate that persons of low socioeconomic status (SES), socially isolated individuals, and women reported higher levels of depressive symptoms than their respective counterparts, as did persons who experienced damage to their homes. The psychological effects of damage were strongest among those aged 54-70. The findings suggest that people who experience damage to their home during a disaster are at risk of experiencing depressive symptoms, with the elderly being more resilient than the near-elderly.     

地震后26个月灾区高三学生生命质量调查

目的调查汶川地震后26个月灾区高三学生生命质量。方法采取整群抽样的方法,用WHO生命质量量表简化版(WHOQOL-BREF)、创伤后应激障碍检查量表(PCL-C)和自编量表对559例灾区高三学生进行问卷调查。结果①灾区高三学生生命质量得分(12.78±3.13)低于常模(13.38±2.91),差异有统计学意义(t=-4.51,P<0.01);在生理、心理、社会关系领域均低于常模,差异有统计学意义(t=-18.61,-11.40,-3.03,P<0.05);②女性在生理、心理、社会关系领域均低于男性,差异有统计学意义(F=15.83,11.14,4.44,P<0.05);③有心理咨询需求和没有的学生在生理领域、心理领域、社会关系领域、环境领域和总的生存质量与健康状态方面都存在显著性差异(F=33.01,35.18,21.76,16.23,10.58,P<0.01);④PTSD高分组与低分组在生理领域、心理领域、社会关系领域、环境领域和总的生存质量与健康状态方面也存在显著性差异(F=73.89,77.92,17.11,36.94,45.19,P<0.01)。结论震后26个月灾区高三学生生命质量仍旧低,受心理健康水平影响,且女性低于男性。     

创伤后成长量表在汶川地震灾民中的修订与初步应用

目的:旨在5.12汶川地震灾民群体中修订创伤后成长量表,探索其因子结构,进行信效度分析。方法:研究1采用方便取样,在四川省国家级一般灾区的某个灾后安置点中,抽取了来自4个板房区的两组样本。样本群体包括工人、农民、商人和无业人员等。用创伤后成长量表施测。样本1(n=195)进行探索性因素分析,样本2(n=294)进行验证性因素分析。研究2在四川多所中学的学生中对所得创伤后成长量表进行效标效度检验(n=339)。结果:3因素(个人改变、人际改变和具体改变)模型在地震灾民群体中的拟合性(χ2=312.74,df=101,χ2/df=3.089,RMSEA=0.084,NN-FI=0.93,CFI=0.94,GFI=0.88,AGFI=0.84)优于5因素模型(χ2=667.8,df=178,χ2/df=3.752,RMSEA=0.097,NNFI=0.92,CFI=0.94,GFI=0.82,AGFI=0.77)。修订版创伤后成长量表的信度指标良好(α=0.87)。量表与抑郁、生活满意度指数、正性情绪有中等程度的显著相关,具有良好的效标效度。结论:创伤后成长量表在创伤相关群体中使用具有较好的信效度。     

玉树地震卫生应急指挥绩效分析

目的 评价玉树地震卫生应急指挥绩效,为进一步加强和改进应急医疗救援决策提供依据.方法 收集玉树地震后1年内国家及卫生部下发的各种文件、信息通报、工作报告,以及国务院新闻办公室、卫生部、国家地震局、青海省政府、青海省卫生厅等官方网站发布的信息,并计算机检索CNKI数据库,回顾性分类整理资料后进行描述性分析.结果 基于汶川地震医疗救援经验,玉树地震卫生应急指挥具有以下特点:①迅速启动一级响应;②建立和完善了军、警、地一体化工作机制;③实现准确信息指导下的精确指挥.结论 作为全球罕见的高海拔地区大规模医疗卫生救援成功先例,玉树地震医疗救援补充和丰富了汶川地震医疗救援经验,可资今后国内外灾害医学应急救援借鉴.