5·12汶川地震后一年半医务人员创伤后应激障碍影响因素研究和症状分析

目的:随访5·12汶川地震后一年半震区一线医务工作者创伤后应激障碍(PTSD)的发病率,症状特点和影响因素。方法:应用德国埃森创伤问卷(ETI)对四川什邡地区4家医院一线医务工作者进行调查,并以临床医师专用PTSD量表(CAPS)进行诊断。结果:①震后一年半医护群体PTSD发病率为1.8%。②PTSD的特征性症状群中,最突出的为高激惹症状。女性在PTSD总分上与男性无显著差别,但在睡眠问题、未来希望是否破灭或者理想能否实现、情绪改变上得分显著高于男性。③初始暴露程度在PTSD总分和所有特征症状群得分上没有显著差异,初始暴露程度高者在高激惹症状上更为突出。④PTSD总分及症状得分影响因素是籍贯和初始暴露程度。结论:震区一线医务工作者震后一年半PTSD状况与半年时有同有异,心理工作者应该给出针对性的预防和干预措施。

A Survey of PTSD in Health-care Workers One and a Half Years after the Wenchuan Earthquake

Objective:To investigate the incidence rate,symptoms,and influencing factors of Post-traumatic Stress Disorder (PTSD) among medical staff one year and a half after the Wenchuan Earthquake. Methods: The German Essen Trauma questionnaire (ETI) and the Clinician-Administered PTSD Scale (CAPS) were used to diagnose PTSD among the first-line medical workers in four hospitals of Shifang. Results: The incidence rate of PTSD among the medical workers was 1.8%. Comparing the four symptom clusters,hyper-arousal was the most prominent one. Although there was no significant difference between the males and females in the PTSD total score,the scores of sleep disorders,hope for the future or ideal and emotional changes in females were significantly higher than that in males. The initial exposure level showed no significant influence on the PTSD total score and symptom clusters scores. However,people with a high degree of initial exposure were more prominent in irritation symptoms between the two groups. The factors affecting PTSD total score and symptom scores were birthplace and initial exposure level. Conclusion: The first-line health care workers showed some changes in PTSD at one and a half years following the earthquake compared with that at half a year following the earthquake. Psychological staff should apply individual prevention and intervention measures.