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创伤后应激障碍症状对生活质量的预测价值:一项针对非家庭暴力身体受伤受害者的纵向研究。

The predictive value of post-traumatic stress disorder symptoms for quality of life: a longitudinal study of physically injured victims of non-domestic violence.

作者信息

Johansen Venke A, Wahl Astrid K, Eilertsen Dag Erik, Weisaeth Lars, Hanestad Berit R

机构信息

Faculty of Health Buskerud University College, Drammen, Norway.

出版信息

Health Qual Life Outcomes. 2007 May 21;5:26. doi: 10.1186/1477-7525-5-26.

Abstract

BACKGROUND

Little is known about longitudinal associations between post-traumatic stress disorder (PTSD) and quality of life (QoL) after exposure to violence. The aims of the current study were to examine quality of life (QoL) and the predictive value of post-traumatic stress disorder (PTSD) for QoL in victims of non-domestic violence over a period of 12 months.

METHODS

A single-group (n = 70) longitudinal design with three repeated measures over a period of 12 months were used. Posttraumatic psychological symptoms were assessed by using the Impact of Event Scale, a 15-item self-rating questionnaire comprising two subscales (intrusion and avoidance) as a screening instrument for PTSD. The questionnaire WHOQOL-Bref was used to assess QoL. The WHOQOL-BREF instrument comprises 26 items, which measure the following broad domains: physical health, psychological health, social relationships, and environment. Results of the analysis were summarized by fitting Structural Equation Modelling (SEM).

RESULTS

For each category of PTSD (probable cases, risk level cases and no cases), the mean levels of the WHOQOL-Bref subscales (the four domains and the two single items) were stable across time of assessment. Individuals who scored as probable PTSD or as risk level cases had significantly lower scores on the QoL domains such as physical health, psychological health, social relationships and environmental than those without PTSD symptoms. In addition, the two items examining perception of overall quality of life and perception of overall health in WHOQOL showed the same results according to PTSD symptoms such as QoL domains. PTSD symptoms predicted lower QoL at all three assessments. Similarly PTSD symptoms at T1 predicted lower QoL at T2 and PTSD symptoms at T2 predicted lower QoL at T3.

CONCLUSION

The presence of PTSD symptoms predicted lower QoL, both from an acute and prolonged perspective, in victims of non-domestic violence. Focusing on the individual's perception of his/her QoL in addition to the illness may increase the treatment priorities and efforts.

摘要

背景

关于创伤后应激障碍(PTSD)与遭受暴力后的生活质量(QoL)之间的纵向关联,人们了解甚少。本研究的目的是在12个月的时间里,考察非家庭暴力受害者的生活质量(QoL)以及创伤后应激障碍(PTSD)对生活质量的预测价值。

方法

采用单组(n = 70)纵向设计,在12个月的时间内进行三次重复测量。创伤后心理症状通过事件影响量表进行评估,这是一份包含15个条目的自评问卷,由两个分量表(侵入和回避)组成,作为PTSD的筛查工具。使用世界卫生组织生活质量简表(WHOQOL - Bref)来评估生活质量。WHOQOL - BREF工具包含26个条目,测量以下广泛领域:身体健康、心理健康、社会关系和环境。通过拟合结构方程模型(SEM)总结分析结果。

结果

对于PTSD的每一类(可能病例、风险水平病例和无病例),WHOQOL - Bref分量表(四个领域和两个单项)的平均水平在评估期间保持稳定。被评定为可能患有PTSD或处于风险水平的个体,在身体健康、心理健康、社会关系和环境等生活质量领域的得分显著低于没有PTSD症状的个体。此外,WHOQOL中考察总体生活质量感知和总体健康感知的两个条目,根据PTSD症状,在生活质量领域显示出相同的结果。在所有三次评估中,PTSD症状都预示着较低的生活质量。同样,T1时的PTSD症状预示着T2时较低的生活质量,T2时的PTSD症状预示着T3时较低的生活质量。

结论

从急性和长期的角度来看,PTSD症状的存在预示着非家庭暴力受害者的生活质量较低。除了关注疾病本身,关注个体对其生活质量的感知可能会增加治疗的优先级和力度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c1a9/1892772/f0abeea9fe0a/1477-7525-5-26-1.jpg

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