ICU病人创伤后应激障碍调查及相关危险因素的回归分析
摘要
[目的]探讨重症监护室(ICU)病人创伤后应激障碍(PTSD)的影响因素。[方法]选取2017年2月—2018年2月入住我院ICU病房并治愈出院的病人为对象,采用个体因素及相关影响因素调查表进行相关因素的调查,创伤后应激障碍检查表(PCL-C)用以评价病人经历的创伤事件对其影响的严重程度。采用多因素线性回归分析筛选出影响ICU病人创伤后应激障碍的主要因素。[结果]在回归分析中,性别、机械通气时间,入住ICU时间为影响ICU病人创伤后应激障碍的主要因素。[结论]女性病人、机械通气时间及入住ICU时间长是PTSD的促发因素,应引起ICU医务人员的注意。
引文
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[9] LI S H,GRAHAM B M.Why are women so vulnerable to anxiety,trauma-related and stress-related disorders?The potential role of sex hormones [J].Lancet Psychiatry,2017,4(1):73-82.
[10] ROFFEY P,THANGATHURAI D.Delayed endotracheal extubation and PTSD in ICU patients [J].Psychosomatics,2011,52(2):194.
[11] 黄丽.ICU相关记忆与创伤后应激障碍危险因素的研究[D].福州:福建医科大学,2016.
[12] WARLAN H,HOWLAND L.Posttraumatic stress syndrome associated with stays in the intensive care unit:importance of nurses' involvement[J].Crit Care Nurse,2015,35(3):44-52.
[13] EGEROD I,CHRISTENSEN D.Analysis of patient diaries in Danish ICUs:a narrative approach [J].Intensive Crit Care Nurs,2009,25(5):268-277.
[14] PATEL M B,JACKSON J C,MORANDI A,et al.Incidence and risk factors for intensive care unit-related post-traumatic stress disorder in veterans and civilians [J].Am J Respir Crit Care Med,2016,193(12):1373-1381.
[15] KOWALCZYK M,NESTOROWICZ A,FIJALKOWSKA A,et al.Emotional sequelae among survivors of critical illness:a long-term retrospective study [J].Eur J Anaesthesiol,2013,30(3):111-118.
[2] PATTISON N.Psychological implications of admission to critical care [J].Br J Nurs,2005,14(13):708-714.
[3] 王孟成,隋双戈,李捷华,等.创伤后应激障碍检查表-平民版在地震灾区初中生中的信效度 [J].中华行为医学与脑科学杂志,2010,19(6):566-568.
[4] HASKELL S G,GORDON K S,MATTOCKS K,et al.Gender differences in rates of depression,PTSD,pain,obesity,and military sexual trauma among connecticut war veterans of lraq and afghanistan [J].J Womens Health (Larchmt),2010,19(2):267-271.
[5] BRYANT R A,FELMINGHAM K L,SILOVE D,et al.The association between menstrual cycle and traumatic memories[J].J Affect Disord,2011,131(113):398-401.
[6] NILLNI Y I,PINELES S L,PATTON S C,et al.Menstrual cycle effects on psychological symptoms in women with PTSD [J].J Trauma Stress,2015,28(1):1-7.
[7] HAYLEY S,DU L,LITTELJOHN D,et al.Gender and brain regions specific differences in brain derived neurotrophic factor protein levels of depressed individuals who died through suicide [J].Neurosci Lett,2015,600(1):2-6.
[8] WADDELL J,HANSCOM M,SHALON EDWARDS N,et al.Sex differences in cell genesis,hippocampal volume and behavioral outcomes in a rat model of neonatal HI [J].Exp Neurol,2016,275(2):285-295.
[9] LI S H,GRAHAM B M.Why are women so vulnerable to anxiety,trauma-related and stress-related disorders?The potential role of sex hormones [J].Lancet Psychiatry,2017,4(1):73-82.
[10] ROFFEY P,THANGATHURAI D.Delayed endotracheal extubation and PTSD in ICU patients [J].Psychosomatics,2011,52(2):194.
[11] 黄丽.ICU相关记忆与创伤后应激障碍危险因素的研究[D].福州:福建医科大学,2016.
[12] WARLAN H,HOWLAND L.Posttraumatic stress syndrome associated with stays in the intensive care unit:importance of nurses' involvement[J].Crit Care Nurse,2015,35(3):44-52.
[13] EGEROD I,CHRISTENSEN D.Analysis of patient diaries in Danish ICUs:a narrative approach [J].Intensive Crit Care Nurs,2009,25(5):268-277.
[14] PATEL M B,JACKSON J C,MORANDI A,et al.Incidence and risk factors for intensive care unit-related post-traumatic stress disorder in veterans and civilians [J].Am J Respir Crit Care Med,2016,193(12):1373-1381.
[15] KOWALCZYK M,NESTOROWICZ A,FIJALKOWSKA A,et al.Emotional sequelae among survivors of critical illness:a long-term retrospective study [J].Eur J Anaesthesiol,2013,30(3):111-118.