都江堰友爱学校地震伤员康复状况调查分析

目的分析全国首家无障碍学校——四川省都江堰友爱学校地震伤员的伤情、功能障碍、康复现状及需求,为下一步康复医疗提供依据。方法对105例在校伤员进行现场功能评估,采用截肢身体意象评估量表(AB IS),对40名截肢伤员进行问卷调查。结果 105例伤员中,骨折44例(41.9%)、截肢40例(39%)、挤压伤15例(14.2%)、脑外伤6例(5.7%);大都存在的不同程度、多种功能障碍问题,其中肌力减退62例(59.1%),肌肉萎缩32例(30.2%),关节活动度(ROM)受限49例(46.7%),瘢痕粘连增生70例(66.7%),感觉障碍14例(13.3%),关节挛缩32例(30.5%),步态异常23例(21.9%),生活不能完全自理26例(24.8%)。结论 105例伤员均有不同程度的康复需求,需要进一步的康复指导与治疗;伤员的心理状况也需要关注。     

四川江油地震伤员康复状况分析

目的: 分析江油地区地震伤员的人数、伤情及功能障碍、康复现状及需求,指导下一步康复医疗工作。方法: 对江油地区8所医院、卫生院188例伤员进行现场调查与分析。结果：伤员分类为：骨折86.2%、截肢2.1%、颅脑损伤2.7%、脊髓损伤1.1%、其他8.0%。部分伤员已经全部恢复功能,仍然有104例伤员(55.3%)有显著日常生活活动能力和参与能力障碍,需要进一步康复医疗;162例骨折伤员中15%需要再次手术。结论: 地震伤员目前仍然有很大的比例需要继续康复医疗。骨折后功能障碍是康复重点。需要高度重视骨折不愈合的再次手术和康复问题。     

地震伤员心理状况及康复护理心理干预措施效果评价

目的探讨不同年龄段的地震伤员恢复期和康复期心理护理。方法90例地震伤员按年龄分为4组分别进行心理护理,震后1年评估伤员是否存在创伤后应激障碍（PTSD）。结果震后1年伤员未发生PTSD。结论心理护理能改善地震伤员心理应激能力。     

110例四川汶川地震灾区伤员心理状况调查研究

目的调查四川汶川地震灾区伤员的心理状况,探讨重大自然灾害事件对灾区伤员心理状况的影响情况。方法采用90项症状自评量表(SCL-90)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、自制的灾区伤员一般情况调查表、睡眠情况调查表以及心理应激调查表,对110例四川汶川灾区伤员的心理状况进行调查。结果灾区伤员SCL-90各因子分均高于正常人群,差异有显著性(P<0.05),其中,躯体化、抑郁、焦虑和恐怖性因子分与常模相比较,差异十分显著(P<0.01)。HAMA总分>14分的有16例(14.5%);HAMD总分>20分的有21例(19.1%);睡眠量表总分>7分的有65例(59.1%);应激量表总分>10分的有51例(46.4%);具有明显的创伤后综合症并且符合中国精神障碍分类与诊断标准第3版(CCMD-3)中创伤后应激障碍(PTSD)症状学标准的有9例(8.2%);符合CCMD-3脑器质性精神障碍诊断标准的1例。结论地震对灾区伤员心理的影响是普遍而严重的,为灾区伤员提供早期的确当的心理治疗和干预是十分必要的。     

110例四川汶川地震灾区伤员心理状况调查研究

目的调查四川汶川地震灾区伤员的心理状况,探讨重大自然灾害事件对灾区伤员心理状况的影响情况。方法采用90项症状自评量表（SCL-90）、汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）、自制的灾区伤员一般情况调查表、睡眠情况调查表以及心理应激调查表,对110例四川汶川灾区伤员的心理状况进行调查。结果灾区伤员SCL-90各因子分均高于正常人群,差异有显著性（P〈0．05）,其中,躯体化、抑郁、焦虑和恐怖性因子分与常模相比较,差异十分显著（P〈0．01）。HAMA总分〉14分的有16例（14．5％）;HAMD总分〉20分的有21例（19．1％）;睡眠量表总分〉7分的有65例（59．1％）;应激量表总分〉10分的有51例（46．4％）;具有明显的创伤后综合症并且符合中国精神障碍分类与诊断标准第3版（CCMD-3）中创伤后应激障碍（PTSD）症状学标准的有9例（8．2％）;符合CCMD-3脑器质性精神障碍诊断标准的1例。结论地震对灾区伤员心理的影响是普遍而严重的,为灾区伤员提供早期的确当的心理治疗和干预是十分必要的。     

76名芦山地震伤员创伤后应激障碍情况调查分析

目的了解2013年4月20日芦山地震后伤员创伤后应激障碍的发生情况,从而为灾难性事件后的心理支持提供依据。方法对76名在四川省某三甲医院骨科接受治疗的芦山地震伤员,采用自行设计的一般资料调查表和国内广泛应用的创伤后应激障碍自评量表进行调查,以了解地震后伤员创伤后应激障碍的发生情况。资料采用SPSS 18.0统计软件进行分析处理,用百分比进行统计描述,独立样本t检验进行统计推断。结果地震伤员的创伤后应激障碍得分为(44.22±17.92)分,创伤后应激障碍的发生率约29%,其中轻度占11%,中重度占18%。86%的伤员出现反复重现体验症状,67%的伤员出现警觉性增高症状,57%的伤员出现回避症状。结论芦山地震对伤员的心理产生了严重的负性影响,医务人员在进行救援的同时,应关注其心理创伤,促进其全面的康复。     

玉树地震伤员急性应激期睡眠问题分析

目的 了解和分析玉树地震伤员急性应激期睡眠问题.方法 2010年4月,对90例玉树地震伤员的急性应激反应采用创伤后应激障碍症状清单平民版(PCL-C)17项量表进行筛查评估,并应用SPSS 17.0软件进行统计学分析.结果 在PCL-C 17个条目中,提示睡眠障碍的条目2和条目13发生率分别为61.10%、63.30%...     

四川绵竹地区地震伤员社区康复需求调查分析

目的 了解四川绵竹地区地震伤员出院返家后的功能障碍、家居环境、职业回归及心理状况,为社区康复的开展提供依据.方法 对四川绵竹地区123例出院伤员进行家庭回访,评估其功能障碍、家居环境情况,对其职业回归、经济收入、心理情况进行问卷调查.结果 123例伤员中,骨折66.7%、脊髓损伤17.1%、挤压伤及周围神经损伤11.4%、截肢3.2%、脑外伤1.6%,其中56.9%需要接受家庭康复指导.85.7%的脊髓损伤伤员需要家居环境改造.65.5%的18～59岁男性没有就业并愿意接受职业培训.123例伤员中,8.9%创伤后应激障碍综合征阳性.结论 四川绵竹地区地震伤员返家后仍需要进一步的社区康复,及时全面的社区康复对其家庭回归和社会回归意义重大.     

地震挤压伤截肢伤员的康复护理

目的：结讨论地震挤压伤截肢伤员的康复护理干预措施。方法：对5·12地震后我科地震康复中心收治的30例截肢伤员,由治疗小组成员进行康复评定,对存在的护理问题进行综合康复护理干预,干预前后进行比较。结果：接受综合康复综合护理干预后,地震截肢伤员在生理、心理、社会功能等方面均有显著改善（P〈0．05）。结论：针对地震伤员的护理问题进行综合康复护理干预,可有效提高伤员的残损功能,改善伤员的整体康复效果,促进其早日回归社会。     

汶川大地震后1年北川干部生存质量状况调查

目的调查汶川大地震1年后北川县干部的生存质量状况,为进一步开展心理干预、改善生存质量提供科学依据。方法采用世界卫生组织生存质量测定量表简表、震后受灾干部基本状况调查表及PCL-C对北川县事业单位的2 055名干部的生存质量状况、社会人口学特征以及精神创伤状况进行横断面调查。结果①北川干部的社会关系领域得分(14.31±2.59)高于国内常模(P<0.01),但生存质量各维度得分[生理领域得分(14.16±2.43)、心理领域得分(13.79±2.59)、环境领域得分(11.20±2.74)]均低于常模,差异有统计学意义(P均<0.01);②30岁以下群体心理、环境领域得分均高于其他年龄组;男性心理领域得分高于女性;丧偶群体各领域得分均低于其他组;汉族各领域得分均高于羌族;小学文化组社会关系领域得分低于其他文化组;亲人、房屋和身体丧失或损害者其各领域得分均低于非丧失者;PCL-C得分越高,各领域得分越低(P均<0.05)。结论汶川大地震1年后,地震给北川县干部在生理、心理及环境领域方面造成严重影响,尤其以女性、羌族、年长、丧失明显和心理创伤症状突出的干部生存质量更差,因此持续的心理服务和其他措施更应关注这些干部群体。社会关系领域得分高于一般人群的结果提示,政府和民间及时有效的援助,以及板房区的集中安置,对社会关系的满意具有很重要的促进作用。     

汶川大地震受灾者创伤后应激症状及危险因素

目的:探讨大地震受灾者的心理健康状况、创伤后应激障碍(PTSD)症状及其影响因素,为心理救助及康复提供依据。方法:2008年四川汶川大地震1个月后,采用事件影响量表(IES)、症状自评量表(SCL-90)和受灾情况表对57例受灾者进行创伤后应激障碍症状、情绪障碍及人口学资料调查,根据诊断分为PTSD组与非PTSD组进行对照比较,并与60例医院健康体检人群进行对照比较。结果:①地震受灾组的IES总分、闯入因子、回避因子、警觉性因子、躯体化、抑郁、焦虑和其他项目因子分均高于正常对照组,差异有显著性意义(P<0.01),地震受灾组的SCL-90总分和抑郁因子分高于正常对照组,差异有显著性意义(P<0.05);②PTSD组的教育程度在小学及以下的比例、被困比例和伤残比例均高于非PTSD组,差异有显著性意义(P<0.05),PTSD组的一级亲属死亡比例、无家人支持比例均高于非PTSD组,差异有显著性意义(P<0.01)。结论:地震受灾者灾后1个月存在明显创伤后应激症状、躯体化、抑郁、焦虑、眠差等表现,心理救助和康复较为必要,应重点关注导致伤残、教育程度低、有被困经历、丧失亲人、缺少家庭支持的地震受灾个体。     

康复护理对地震伤员日常生活活动能力的影响因素分析

[目的]分析康复护理对地震伤员日常生活活动能力(ADL)的影响及其影响因素。[方法]将地震伤术后康复期病人分为观察组和对照组,观察组选取给予康复护理的伤员,对照组选取给予常规护理的伤员,比较两组ADL评分。[结果]观察组ADL改善情况优于对照组(P=0.002),年长、肾衰竭、焦虑、脊柱骨折、上肢骨折、下肢骨折、复合型骨折为影响ADL的危险因素。[结论]对地震伤员早期介入康复护理是促进其日常生活活动能力恢复的重要措施,注意年长、肾衰竭、复合型骨折和焦虑等多种因素对疗效有负面影响。     

康复护理对地震伤员日常生活活动能力的影响因素分析

[目的]分析康复护理对地震伤员日常生活活动能力（ADI。）的影响及其影响因素。[方法]将地震伤术后康复期病人分为观察组和对照组,观察组选取给予康复护理的伤员,对照组选取给予常规护理的伤员,比较两组ADI。评分。[结果]观察纽ADI．改善情况优于对照组（P=0．002）,年长、肾衰竭、焦虑、脊柱骨折、上肢骨折、下肢骨折、复合型骨折为影响ADL的危险因素。[结论]对地震伤员早期介入康复护理是促进其日常生活活动能力恢复的重要措施,注意年长、肾衰竭、复合型骨折和焦虑等多种因素对疗效有负面影响。     

Symptoms of posttraumatic stress disorder in worker's compensation patients attending a work rehabilitation program

Posttraumatic stress disorder (PTSD) is a psychological consequence of traumatic work-related hand injury. In the current study, we investigated this relationship by examining the prevalence, of PTSD symptoms in 121 Worker's Compensation patients enrolled in a work rehabilitation program following a wide array of work-related injuries. Eighty-eight men and 33 women, ranging in age from 16 to 78 (M=40.9,SD=10.2), completed the Injury Adjustment Survey, a measure of PTSD symptoms, psychological/behavioral changes following injury, and desire for psychological treatment. We found that the majority of patients reported difficulties sleeping, a diminished sense of future, loss of interest, and increased anger. Twenty percent of patients endorsed symptoms from criteria B (reexperiencing the trauma), C (persistent avoidance or numbing), and D (inreased arousal) for PTSD according to the DSM-IV. PTSD symptoms did not significantly, relate to age, gender, locations of injury, type of injury, seeing the injury occur, or length of time since injury. PTSD symptoms did significantly relate to psychological/behavioral changes or difficulties and the desire to seek psychological treatment. Discussion of the results proceeds from within a psychotraumatological framework. In general, our research confirmed that PTSD symptoms appear to be a clinically significant problem for patients suffering from a variety of work-related injuries.     

Lessons from the 2015 earthquake(s) in Nepal: implication for rehabilitation

Purpose: There has been an increase in the number of natural disasters in recent history, and the rate of disability is increasing among survivors. The most recent major natural disaster was the earthquake(s) that occurred in Nepal on 25 April 2015 and 12 May 2015. In total, more than 8500 people were killed and over 18?500 people were left injured. This article aims to demonstrate the role of rehabilitation professionals in post-disaster relief and beyond in Nepal. Method: This is an experiential account of physiotherapists present during the earthquake and participating in the post-disaster relief. Results: Rehabilitation professionals played an important role in the acute phase post-disaster by providing essential services and equipment. However, discharge planning emerged as an important role for rehabilitation providers in the early days of post-disaster and signaled a relatively new and innovative function that facilitated the heavy imbalance between little supply and tremendous demand for care. In the coming years, rehabilitation will need to support local initiatives that focus on minimizing the long-term effects among people with a newly acquired disability. Conclusions: Rehabilitation serves an important role across the continuum in post-disaster relief from the initial stages to the months and years following an event.

• Implications for Rehabilitation

• Driven by medical advances in acute field medicine, the relative proportion of casualties following natural disasters is decreasing, while relative rates of disability are rising among survivors.

• In post-disaster settings, the growing number of people with newly acquired disabilities will be added to the existing proportion of the population who lived with disabilities, creating a significant growth in the total number of people with disabilities (PWDs) in communities that are often ill prepared to provide necessary services.

• Rehabilitation interventions in the initial stages of emergency humanitarian response can minimize the long-term effects among people with newly acquired disabilities through early activation and prevention of secondary effects.

• Rehabilitation providers thus appear to have an important mediating effect on outcomes of disabilities in the early stages, but must also be strong partners with PWDs to advocate for social and political change in the long term.

     

Cognitive processing of trauma cues in rape victims with post-traumatic stress disorder

Rape victims with post-traumatic stress disorder (PTSD) (n =12), rape victims without PTSD (n =12), and nontraumatized control subjects (n =12) performed a computerized Stroop color-naming task in which they named the colors of high-threat words (e.g., RAPE), moderate-threat words (e.g., CRIME), positive words (e.g., LOYAL), and neutral words (e.g., TYPICAL). In contrast to rape victims without PTSD and to nontraumatized control subjects, those with PTSD were slower to color-name high-threat words than moderate-threat, positive, and neutral words. Rape victims without PTSD nevertheless exhibited greater Stroop interference for high-threat words than did nontraumatized subjects. Interference for high-threat words was correlated with scores on the Impact of Events Scale —Intrusion subscale, but not with scores on the Avoidance subscale. These findings suggest that interference for trauma cues may provide a nonintrospective index of intrusive cognitive activity. Preparation of this article was supported, in part, by grants from the Henry and Ramsey Pevsner Fund in Neuropsychology and Behavioral Medicine and the American Association of University Women — Aurora, Illinois, Chapter awarded to Karen Lynn Cassiday, and National Institute of Mental Health grant MH43809 awarded to Richard J. McNally.This study was part of the first author's doctoral dissertation, conducted under the supervision of the second author. It was conducted when the authors were at the Department of Psychology, University of Health Sciences/The Chicago Medical School. A shorter version of this paper was presented at the annual meeting of the Association for Advancement of Behavior Therapy, San Francisco, November, 1990.