康复介入前的病程对四肢骨折工伤患者心理状态及就业意愿的影响

目的:探讨康复介入前的病程长短对四肢骨折工伤患者心理状态及就业意愿的影响。方法:将200例于本院行康复治疗的四肢骨折工伤患者,按照伤后康复介入前的病程长短分为A组和B组,A组为伤后2个月内即开始接受康复治疗,B组为受伤2个月后开始接受康复治疗。用汉密尔顿抑郁量表(HAMD)24项版本和汉密尔顿焦虑量表(HAMA)对患者心理状况进行评定,用改良林氏就业准备量表(LASER)评估工伤患者回归工作的意愿。结果:A、B2组患者分别有38.6%、75.0%的患者存在不同程度的抑郁情绪,分别有60.2%、83.9%的患者存在不同程度的焦虑情绪,B组抑郁及焦虑情绪发生率均高于A组(P<0.05)。LASER结果中处于考虑前阶段的患者占比最高,B组高于A组(P<0.05);处于考虑阶段的患者占比次之,A组高于B组(P<0.05)。结论:工伤患者人群普遍存在抑郁和焦虑情绪,并且康复介入越晚心理障碍越明显,同时身心的障碍使其逃避工作,相应地其重返工作的积极性也越差。

Influence of course of disease before rehabilitation intervention on mental state and employment willingness of industrial injury patients with limb fractures

Objective:To explore the influence of the course of disease before rehabilitation intervention on the mental state and employment willingness of the industrial injury patients with limb fractures.Methods:200 industrial injury patients with limb fractures admitted to our hospital for rehabilitative treatment were divided into two groups(group A and group B)according to the course of disease before rehabilitation intervention.Patients in group A all received rehabilitative treatment in two months after the work injury,and those in group B were given rehabilitative treatment two months after the industrial injury.Hamilton depression scale(HAMD)and Hamilton anxiety scale(HAMA)were used to assess the industrial injury patients in both group A and group B to explore their psychological status.Meanwhile,we used Lam Assessment of Stages of Employment Readiness(LASER)to evaluate the employment willingness of all patients.Results:In group A and group B,38.6% and 75.0% of the industrial injury patients had different degrees of depression respectively.60.2%of the patients in group A suffered from varying levels of anxiety,and 83.9% of the patients in group B had different levels of anxiety,too.Both the incidence rates of depression and anxiety in group B were significantly higher than those in group A(P<0.05).The LASER results showed that the proportion of LASER results in the precontemplation stage was the highest in both the two groups with the data of group B being higher than that of group A,at the same time the difference in the proportion in the precontemplation stage between the two groups was statistically significant(P<0.05).The proportion of LASER results in the contemplation stage was second in both the two groups,and that in group A was significantly higher than that in group B(P<0.05).Conclusion:Depression and anxiety are common in patients with work-related injuries.The later rehabilitation intervention is,the more obvious the psychological disorder is.At the same time,the physical and mental handicap caused the patients to escape from work.So the later rehabilitation intervention is,the less motivation they are to return to work.