Twigg E, Humphris G, Jones C, Bramwell R, Griffiths R D
Psychological Services (Paediatrics), Royal Liverpool Children's Hospital, Liverpool, UK.
Acta Anaesthesiol Scand. 2008 Feb;52(2):202-8. doi: 10.1111/j.1399-6576.2007.01531.x. Epub 2007 Nov 14.
Although rates vary across studies, research in recent years shows that prevalence of post-traumatic stress disorder (PTSD) following intensive care unit (ICU) can be high. Presently no screening tool assessing all three PTSD symptom categories has been validated in ICU patients. The aim of the study was to conduct a preliminary validation of such a measure, the UK- Post-Traumatic Stress Syndrome 14-Questions Inventory (UK-PTSS-14).
A case series cohort study performed at two ICUs in two UK district general hospitals. The UK-PTSS-14 was administered at three time-points (4-14 days, 2 months and 3 months post-ICU discharge). At time-point three participants also completed the Post-traumatic Stress Diagnostic Scale (PDS) and the Impact of Events Scale (IES).
Forty-four patients completed the 3-month follow up. The UK-PTSS-14 was internally reliable at all three time-points (Cronbach's alpha=0.89, 0.86 and 0.84, respectively). Test-retest reliability was highest between time-points two and three (ICC=0.90). Concurrent validity at time-point three was high against the PDS (r=0.86) and the IES (r=0.71). Predictive validity was highest at time-point two (r=0.85 with the PDS and r=0.71 with the IES). Receiver operator characteristic curve analysis suggested the highest levels of sensitivity (86%) and specificity (97%) for diagnosis of PTSD were at time-point two, with an optimum decision threshold of 45 points.
This preliminary validation study suggests that the UK-PTSS-14 could be reliably used as a screening instrument at 2 months post-discharge from the ICU to identify those patients in need of referral to specialist psychological services.
尽管不同研究中的发生率有所差异，但近年来的研究表明，重症监护病房（ICU）后创伤后应激障碍（PTSD）的患病率可能很高。目前，尚无评估所有三种PTSD症状类别的筛查工具在ICU患者中得到验证。本研究的目的是对这样一种测量工具——英国创伤后应激综合征14项问卷（UK-PTSS-14）进行初步验证。
在英国两家地区综合医院的两个ICU进行了一项病例系列队列研究。UK-PTSS-14在三个时间点进行施测（ICU出院后4 - 14天、2个月和3个月）。在第三个时间点，参与者还完成了创伤后应激诊断量表（PDS）和事件影响量表（IES）。
44名患者完成了3个月的随访。UK-PTSS-14在所有三个时间点内部一致性良好（Cronbach's α分别为0.89、0.86和0.84）。重测信度在第二个和第三个时间点之间最高（组内相关系数ICC = 0.90）。在第三个时间点，与PDS（r = 0.86）和IES（r = 0.71）相比，同时效度较高。预测效度在第二个时间点最高（与PDS的r = 0.85，与IES的r = 0.71）。受试者工作特征曲线分析表明，诊断PTSD的最高敏感性（86%）和特异性（97%）出现在第二个时间点，最佳决策阈值为45分。
这项初步验证研究表明，UK-PTSS-14可在ICU出院后2个月可靠地用作筛查工具，以识别那些需要转介至专业心理服务的患者。
