住院谵妄患者照料者的急性应激反应调查
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摘要
目的:调查谵妄患者照料者住院期间目睹谵妄发病后的急性应激和抑郁症状。方法:给予40名谵妄患者照料者社会支持评定量表(SSRS)进行主观社会支持的评估;通过访谈完成事件影响量表修订版(IES)和患者健康问卷-9(PHQ-9)的评估。结果:根据创伤性应激反应判断标准,19名(47. 5%)照料者出现急性应激症状(IES> 33); 17名(42. 5%)照料者出现轻至重度抑郁症状(PHQ-9≥5); IES评分与较严重抑郁症状(PHQ-9≥9)呈正相关(P=0. 01);目睹亲属谵妄发作的照料者创伤反应更强烈(r=0. 317,P <0. 05)。结论:目睹谵妄发作的照料者产生严重急性创伤和抑郁症状体验风险更高;发生创伤性疾病的风险也更高。
Objective: To investigate the acute stress and depression symptoms in caregivers who witnessed delirium of families under their care during hospitalization. Method: The subjective social support was assessed by social support assessment scale( SSRS) in 40 carers of delirium patients; and they also were assessed with revised incident impact scale( IES) and the patient's health questionnaire-9( PHQ-9) through interviews. Results: According to the criteria for critical stress assessment,19 caregivers( 47. 5%) had significant acute stress symptoms( IES > 33); 17 caregivers( 42. 5%) developed mild to severe depressive symptoms( PHQ-9≥5). There was a positive correlation between IES score and more severe depressive symptoms( PHQ-9≥9)( P = 0. 01). The caregiver who witnessed the onset of the relative's delirium had experienced a more intense trauma response( r = 0. 317,P < 0. 05). Conclusion: Caregivers who witness delirium episodes have a higher risk of severe acute trauma and depressive symptoms experience. The risk of traumatic disease is also higher.
Objective: To investigate the acute stress and depression symptoms in caregivers who witnessed delirium of families under their care during hospitalization. Method: The subjective social support was assessed by social support assessment scale( SSRS) in 40 carers of delirium patients; and they also were assessed with revised incident impact scale( IES) and the patient's health questionnaire-9( PHQ-9) through interviews. Results: According to the criteria for critical stress assessment,19 caregivers( 47. 5%) had significant acute stress symptoms( IES > 33); 17 caregivers( 42. 5%) developed mild to severe depressive symptoms( PHQ-9≥5). There was a positive correlation between IES score and more severe depressive symptoms( PHQ-9≥9)( P = 0. 01). The caregiver who witnessed the onset of the relative's delirium had experienced a more intense trauma response( r = 0. 317,P < 0. 05). Conclusion: Caregivers who witness delirium episodes have a higher risk of severe acute trauma and depressive symptoms experience. The risk of traumatic disease is also higher.
引文
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[2]孔繁钟. DSM-IV精神疾病的诊断与统计[M].台湾:合记图书出版社,1997.
[3]黄河清,韩布新.事件影响量表修订版在四川灾区老年人群中的信度效度分析[C].全国心理学学术大会,2009.
[4] Kroenke K,Spitzer RL,Janet B,et al. The patient health questionnaire somatic,anxiety,and depressive symptom scales:a systematic review[J]. General Hospital Psychiatry,2010,32(4):345-359.
[5]陈然,王瑜,余建英,等. PHQ-9在综合医院住院患者中信效度研究[J].四川精神卫生,2017(2):149-153.
[6] IBM. IBM SPSS statistics for windows,version 21. 0[M]. Armonk,NY:IBM,2012.
[7] Nugent NR,Koenen KC,Bradley B. Heterogeneity of posttraumatic stress symptoms in a highly traumatized low income,urban,african American sample[J]. J Psychiatric Research,2012,46(12):1576-1583.
[8] Breitbart W,Gibson C,Tremblay A. The delirium experience:delirium recall and delirium-related distress in hospitalized patients with cancer,their spouses/caregivers,and their nurses[J]. Psychosomatics,2002,43(3):183-194.
[9] Bryant RA. Acute stress disorder as a predictor of posttraumatic stress disorder:a systematic review[J]. J Clinical Psychiatry,2011,72(2):233-239.
[10] Rothbaum BO,Foa EB,Riggs DS,et al. A prospective examination of post-traumatic stress disorder in rape victims[J]. J Traumatic Stress,1992,5(3):455-475.
[11]刘久香.健康宣教对精神科陪护人员心理状况的影响及分析[J].社区医学杂志,2012,10(14):18-20.