摘要
目的探讨基于循证构建的心理弹性干预对严重烧伤患者创伤后应激障碍发生的影响。方法选取2015年1月~2018年1月在联勤保障部队第909医院住院接受治疗的120例严重烧伤患者作为研究对象,随机分为对照组(60例)和实验组(60例);对照组给予入院常规护理,实验组在常规护理基础上采取基于循证构建的心理弹性干预。采用创伤后应激障碍症状清单--平民版(PTSD Checklist-Civilian Version,PCL-C)和Conner-Davidson心理弹性量表(CD-RISC)对研究对象进行问卷调查。结果严重烧伤患者PCL-C得分为39~74分,总分为(52.49±6.52)分,以PCL-C≥44分作为划界患者PTSD的标准,其PTSD阳性率为67.5%(81/120)。严重烧伤患者心理弹性CD-RISC量表总分为(47.82±5.70)分,明显低于国内常模(65.4±13.9),P<0.05。在CD-RISC量表3个维度中,坚韧维度得分为(26.44±5.25)分,自强维度得分为(16.46±3.82)分,乐观维度得分为(4.73±2.14)分。干预前两组患者心理弹性CD-RISC量表得分和PCL-C量表得分比较,差异无统计学意义(P>0.05)。干预后,实验组患者心理弹性3个维度得分和总分均高于对照组(P<0.05)。干预后,实验组患者回避/麻木症状群、警觉性增高症状群这2个维度得分和PCL-C总分均低于对照组(P<0.05)。结论严重烧伤患者PTSD的发生率较高,采取基于循证构建的心理弹性干预加强患者心理弹性,可以有效提高患者的心理弹性水平,改善PTSD的发生。
Objective To investigate the effects of evidence-based psychological resilience intervention on posttraumatic stress disorder in severely burned patients.Methods One hundred and twenty severely burned patients hospitalized at Joint Logistics Support Unit 909 Hospital from January 2015 to January 2018 were selected as the study objects.General data of patients were collected and randomly divided into the control group(60 patients)and the experimental group(60 patients);the control group was given routine nursing on admission,while the experimental group was given evidence-based psychological resilience intervention based on routine nursing.PTSD Checklist-Civilian Version(PCL-C)and Conner-Davidson resilience scale(CD-RISC)were used for questionnaire survey on the study objects.Results The PCL-C score of the severely burned patients was 39 to 74 points,and the total score was(52.49±6.52)points.PCL-C≥44 points was used as the criterion for delimiting patients with PTSD,and the PTSD positive rate was 67.5%(81/120).The total score of the CD-RISC scale for severely burned patients was(47.82±5.70)points,which was significantly lower than the domestic norm of(65.4±13.9),P<0.05.In the three dimensions of CD-RISC scale,the score of toughness dimension was(26.44±5.25),the score of self-improvement dimension was(16.46±3.82),and the score of optimism dimension was(4.73±2.14).Before intervention,there was no statistically significant difference in the scores of CD-RISC scale and PCL-C scale between the two groups of patients(P>0.05).After intervention,the scores and total score of the three dimensions for psychological resilience of patients in the experimental group were higher than those in the control group(P<0.05).After intervention,the scores of the two dimensions of avoidance/numbness symptom group and increased alertness symptom group and the total score of PCL-C of patients in the experimental group were lower than those in the control group(P<0.05).Conclusion Severely burned patients have a higher incidence of PTSD.Using evidencebased psychological resilience intervention to strengthen patients’psychological resilience can effectively improve patients’psychological resilience level and improve the occurrence of PTSD.
作者
查晓慧
曾秀仁
黄美霞
ZHA Xiaohui;ZENG Xiuren;HUANG Meixia(Department of Burns,Joint Logistics Support Unit 909 Hospital of the Chinese PLA,Fujian,Zhangzhou 363000,China)
出处
《中国医药科学》
2020年第7期119-122,共4页
China Medicine And Pharmacy
关键词
循证
烧伤
创伤后应激障碍
心理弹性
Evidence-based
Burns
Post-traumatic stress disorder
Psychological resilience
