Chang Chia-Ming, Lee Li-Ching, Connor Kathryn M, Davidson Jonathan R T, Lai Te-Jen
Department of Psychiatry and Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Psychiatry Res. 2008 Mar 15;158(2):164-71. doi: 10.1016/j.psychres.2006.07.015. Epub 2008 Feb 6.
This study aims to investigate the modification effects of coping strategies on the relationships between rescue effort and psychiatric morbidity (i.e. general psychiatric morbidity and post-traumatic morbidity) in earthquake rescue workers. Firefighters (n=193) who were involved in the rescue effort after the Taiwan Chi-Chi earthquake were invited to complete a questionnaire which contained questions on demographics, exposure to rescue work, general psychiatric morbidity, post-traumatic morbidity, and coping strategies. Multivariate regression models with interaction terms were carried out to investigate the modification effect of coping strategies on the relationships between rescue effort and psychiatric morbidities. Older age and longer job experiences (>3 years) were associated with both general psychiatric and post-traumatic morbidities. Coping strategies such as confrontive coping, distancing, seeking social support, accepting responsibility, escape-avoidance, planful problem solving, and positive appraisal significantly modified the effect of exposure to dead bodies on general psychiatric morbidity. Furthermore, confrontive coping, distancing, and planned problem solving significantly modified the effect of exposure to direct rescue involvement on general psychiatric morbidity. However, coping strategies were not observed to buffer the effect of rescue involvement or contact with dead bodies on post-traumatic morbidity. More frequent use of coping strategies could reduce the effect that exposure to rescue efforts has on the incidence of general psychiatric morbidity in rescue workers. However, coping strategies do not seem to reduce the influence of such exposure on trauma-related morbidities. This suggests that coping strategies can be used to prevent general psychiatric morbidity but not trauma-related morbidities.
本研究旨在调查应对策略对地震救援人员救援工作与精神疾病发病率（即一般精神疾病发病率和创伤后疾病发病率）之间关系的调节作用。邀请参与台湾集集地震后救援工作的消防员（n = 193）填写一份问卷，问卷内容包括人口统计学、救援工作暴露情况、一般精神疾病发病率、创伤后疾病发病率以及应对策略等问题。采用带有交互项的多元回归模型来研究应对策略对救援工作与精神疾病发病率之间关系的调节作用。年龄较大和工作经验较长（> 3年）与一般精神疾病和创伤后疾病发病率均相关。对抗性应对、疏离、寻求社会支持、承担责任、逃避、有计划地解决问题和积极评价等应对策略显著调节了接触尸体对一般精神疾病发病率的影响。此外，对抗性应对、疏离和有计划地解决问题显著调节了直接参与救援工作对一般精神疾病发病率的影响。然而，未观察到应对策略能缓冲救援参与或接触尸体对创伤后疾病发病率的影响。更频繁地使用应对策略可降低救援工作暴露对救援人员一般精神疾病发病率的影响。然而，应对策略似乎并未降低此类暴露对创伤相关疾病发病率的影响。这表明应对策略可用于预防一般精神疾病发病率，但不能预防创伤相关疾病发病率。
