中华手外科杂志
中華手外科雜誌
중화수외과잡지
CHINESE JOURNAL OF HAND SURGERY
2014年
3期
220-223
,共4页
陈靖%谭军%陈情忠%龚炎培
陳靖%譚軍%陳情忠%龔炎培
진정%담군%진정충%공염배
手损伤%疼痛%创伤后心理应激障碍%医疗费用
手損傷%疼痛%創傷後心理應激障礙%醫療費用
수손상%동통%창상후심리응격장애%의료비용
Hand injuries%Pain%Posttraumatic stress disorder%Health care cost
目的 调查急性手外伤患者心理疾病的发生率并探讨心理状态、社会因素与手功能恢复的相关性.方法 随访231例急性手外伤患者,调查记录其一般社会资料及受伤时状态,通过创伤后心理应激障碍症状访谈量表(posttraumatic stress disorder symptom scale-interview,PSS-I)、贝克抑 郁自评量表(Beck depression inventory,BDI)、焦虑自评量表(self-rating anxiety scale,SAS)、社会支持评定量表、改良手损伤程度评分表(modified hand injury severity scoring system,MHISS)以及上肢功能评分表(disability of arm,shoulder and hand,DASH)评估患者术后(平均15个月)的心理状态、社会支持度和手功能,利用SPSS 17.0软件研究三者间相关性.结果 231例患者中创伤后心理应激障碍(posttraumatie stress disorder,PTSD)发生率为40.7％,焦虑发生率为22.9％,抑郁发生率为39.8％;手功能恢复与焦虑(P =0.025)、抑郁(P＜ 0.001)、PTSD(P=0.002)和损伤程度(P=0.040)密切相关,疼痛与焦虑(P=0.007)、抑郁(P=0.005)、PTSD(P=0.004)、社会支持(P=0.043)和损伤程度(P=0.036)密切相关;医疗费用支付方式不同,PTSD(P=0.046)和疼痛(P=0.043)情况显著不同.结论 手外伤患者心理疾病的发生率高于普通人群,手功能恢复和疼痛与心理因素和社会支持密切相关,社会因素中医疗费用的支付方式与PTSD和疼痛密切相关.
目的 調查急性手外傷患者心理疾病的髮生率併探討心理狀態、社會因素與手功能恢複的相關性.方法 隨訪231例急性手外傷患者,調查記錄其一般社會資料及受傷時狀態,通過創傷後心理應激障礙癥狀訪談量錶(posttraumatic stress disorder symptom scale-interview,PSS-I)、貝剋抑 鬱自評量錶(Beck depression inventory,BDI)、焦慮自評量錶(self-rating anxiety scale,SAS)、社會支持評定量錶、改良手損傷程度評分錶(modified hand injury severity scoring system,MHISS)以及上肢功能評分錶(disability of arm,shoulder and hand,DASH)評估患者術後(平均15箇月)的心理狀態、社會支持度和手功能,利用SPSS 17.0軟件研究三者間相關性.結果 231例患者中創傷後心理應激障礙(posttraumatie stress disorder,PTSD)髮生率為40.7％,焦慮髮生率為22.9％,抑鬱髮生率為39.8％;手功能恢複與焦慮(P =0.025)、抑鬱(P＜ 0.001)、PTSD(P=0.002)和損傷程度(P=0.040)密切相關,疼痛與焦慮(P=0.007)、抑鬱(P=0.005)、PTSD(P=0.004)、社會支持(P=0.043)和損傷程度(P=0.036)密切相關;醫療費用支付方式不同,PTSD(P=0.046)和疼痛(P=0.043)情況顯著不同.結論 手外傷患者心理疾病的髮生率高于普通人群,手功能恢複和疼痛與心理因素和社會支持密切相關,社會因素中醫療費用的支付方式與PTSD和疼痛密切相關.
목적 조사급성수외상환자심리질병적발생솔병탐토심리상태、사회인소여수공능회복적상관성.방법 수방231례급성수외상환자,조사기록기일반사회자료급수상시상태,통과창상후심리응격장애증상방담량표(posttraumatic stress disorder symptom scale-interview,PSS-I)、패극억 욱자평량표(Beck depression inventory,BDI)、초필자평량표(self-rating anxiety scale,SAS)、사회지지평정량표、개량수손상정도평분표(modified hand injury severity scoring system,MHISS)이급상지공능평분표(disability of arm,shoulder and hand,DASH)평고환자술후(평균15개월)적심리상태、사회지지도화수공능,이용SPSS 17.0연건연구삼자간상관성.결과 231례환자중창상후심리응격장애(posttraumatie stress disorder,PTSD)발생솔위40.7％,초필발생솔위22.9％,억욱발생솔위39.8％;수공능회복여초필(P =0.025)、억욱(P＜ 0.001)、PTSD(P=0.002)화손상정도(P=0.040)밀절상관,동통여초필(P=0.007)、억욱(P=0.005)、PTSD(P=0.004)、사회지지(P=0.043)화손상정도(P=0.036)밀절상관;의료비용지부방식불동,PTSD(P=0.046)화동통(P=0.043)정황현저불동.결론 수외상환자심리질병적발생솔고우보통인군,수공능회복화동통여심리인소화사회지지밀절상관,사회인소중의료비용적지부방식여PTSD화동통밀절상관.
Objective To investigate the incidence of psychological diseases in patients with occupational hand injury and the correlation of psychological status and social factors with hand function recovery.Methods A total of 231 patients with occupational hand injuries were involved in this study.Sociodemographic characteristics of the patients and severity of the injury were collected.Modified hand injury severity scoring system (MHISS) was used to document severity of the injury.Psychological status was assessed using the posttraumatic stress disorder symptom scale-interview (PSS-Ⅰ),the Beck depression inventory (BDI) and the self-rating anxiety scale (SAS).Social support was assessed using Social Support Questionnaire.Hand function was assessed using Disability of Arm,Shoulder and Hand (DASH).The SPSS 17.0 was used to analyze the correlation of the factors.Results Of the 231 patients,the incidence of posttraumatic stress disorder (PTSD) was 40.7％,anxiety was 22.9％ and depression was 39.8％.Hand function was closely negatively correlated with anxiety (P =0.025),depression (P ＜ 0.001),PTSD (P =0.002) and severity of hand injury (P =0.040).Pain was closely correlated with anxiety (P =0.007),depression (P =0.005),PTSD (P =0.004),social support (P =0.043) and severity of hand injury (P =0.036).The situation of PTSD (P =0.046) and pain (P =0.043) was significantly different among patients with different payment options for hospitalization cost.Conclusion The incidence of psychological problems was significantly higher in patients with acute hand injuries.The psychological status and social support were closely correlated with hand function recovery and pain.The payment option for hospitalization cost was the most significant social factor that affected PTSD and pain.
