传染性非典型肺炎患者与疫区公众创伤后应激障碍的特征差异

背景已有报道SARS一线医务人员在SARS事件后均出现了不同程度的创伤后应激障碍症状,然而做为直接受害者SARS患者以及处于疫区的公众是否出现此症状,研究报道较少.目的调查SARS患者、疫区公众创伤后应激障碍的发生情况及主要影响因素.设计抽样调查.单位山西医科大学第一医院.对象选择2003-08/09太原市的114例SARS患者,93例疫区公众.方法采用自编的应激源-认知问卷、经修订的事件影响量表、领悟社会支持量表、简易应对方式问卷、自尊量表、艾森克个性问卷对114例SARS患者,93例疫区公众进行测试,并作相关统计分析.主要观察指标①SARS患者及疫区公众创伤后应激障碍可疑者检出率.②两类人群闪入、回避、警觉因子得分的比较.③SARS患者及疫区公众两组人群经修订的事件影响量表分与影响因素的相关分析.结果创伤后应激障碍可疑者检出率SARS患者高于疫区公众(55.1%,31%,P=0.000);SARS患者闪人、回避、警觉因子得分明显高于疫区公众(11.37±9.54,10.28±7.67,6.55±6.20;5.64±4.68,5.58±4.74,4.43±4.63,P=0.000);相关分析结果SARS患者、疫区公众创伤后应激障碍可疑者发生率不同的主要原因是应激源强度与特征的不同;消极应对方式是SARS患者、公众的危险因素,自尊是SARS患者的保护因素.结论①SARS事件应激暴露强度不同,相关人群中均产生了创伤后应激障碍症状,SARS患者创伤后应激障碍可疑者检出率和闪人、回避、警觉症状较高.②组间差异的主要原因是应激源强度的不同,不同人群产生创伤后应激障碍的影响因素不完全相同.

Difference ofposttraumatic stress disorder between severe acute respiratory syndrome patients and thepublic in epidemic area

BACKGROUND: It is reported that the first line medical staff have experienced posttraumatic stress disorder(PTSD) symptoms after severe acute respiratory syndrome (SARS) events. However, there are few reports regarding the PTSD symptoms among SARS patients and the public in epidemic area. OBJECTIVE: To investigate the occurrence and main influence factors of PTSD among SARS patients and the public in epidemic area.DESIGN: Sampling investigation.SETTING: First Hospital of Shanxi Medical University. PARTICIPANTS: Totally 114 SARS patients and 93 people were selected from the epidemic area of Taiyuan city from August to September in 2003.METHODS: Self-made stressor-cognition questionnaire, edited impact of event scale-revised (IES-R), perceived social support scale (PSSS), simple cope scale questionnaire(SCSQ), self-esteem scale(SES) and eysenck personality questionaire(EPQ) were conducted to 114 SARS patients and 93 common people in epidemic area. Correlative analysis was performed as well.MAIN OUTCOME MEASURES: ① Detection rate of PTSD among SARS patients and the public in epidemic area. ② The score of intrusion factor,avoidance factor and hyperarousal factor of two populations. ③ The correlative analysis between IES-R score and influence factor among SARS patients and the public in epidemic area.RESULTS: The detection rate of suspect of PTSD among SARS patients was higher than that in public of epidemic area(55.1% , 31%, P = 0.000)The score of intrusion, avoidance and hyperarousal factor of SARS patients ( 11.37±9.54, 10.28±7.67, 6.55±6.20) was much higher than those of the public in epidemic area(5.64±4.68,5.58±4.74, 4.43 ±4.63,P = 0. 000) . The correlative analysis showed that the difference on PTSD incidence between SARS patients and the public of epidemic area might be due to the different stressor intensity and features. The negative response mode was the risk factor of both SARS patients and the public of epidemic area while self-esteem was the protective factor of SARS patients. CONCLUSION: ① PTSD symptoms had appeared among all the correlative populations although the exposure intensity of SARS event stress was different. The detection rate of PTSD and symptoms of intrusion, avoidance and hyperarousal were much common among SARS patients; ② The difference between groupswas due to the different stressor intensity as well as the different influence factors of different population.