Oflaz Fahriye, Hatipoğlu Sevgi, Aydin Hamdullah
Gülhane Military Medical Academy, School of Nursing, Etlik, Ankara, Turkey.
J Clin Nurs. 2008 Mar;17(5):677-87. doi: 10.1111/j.1365-2702.2007.02047.x.
The aim of the study was to examine the effectiveness of a psychoeducation intervention based on Peplau's approach, including problem-solving compared with intervention with medication on post-traumatic stress disorder (PTSD) symptoms and coping of earthquake survivors.
Post-traumatic reactions and recovery are the result of complex interactions among biological, personal, cultural and environmental factors. Both psychosocial and psychopharmacological methods have been advised to treat PTSD. The general goal of treatment is to decrease the anxiety and to support these patients in regaining normal daily functions.
The study used a pretest to posttest quasi-experimental design with three comparison groups.
The sample of the study included 51 survivors of the Marmara Earthquake who met diagnostic criteria for PTSD. Comparison groups were made up as psychoeducation only, medication only and psychoeducation with medication (PEM). Six semi-structured psychoeducation sessions were conducted individually. Patients in the 'medication only' group did not participate in these sessions. The Clinician Administered PTSD Scale, Hamilton Depression Scale and Coping Strategies Scale were used for the measurements.
There was a significant difference between the 'PEM' group and the 'medication only' group with the first group showing greater relief of symptoms. Generally, there were no differences between the 'medication only' and 'psychoeducation only' groups. Avoidance as a coping strategy had significant positive correlations with PTSD and depression outcomes.
Patients with PTSD seem to take more advantage from the combined treatment model. Nurses can help the patients with PTSD by teaching them to cope with the symptoms.
The number and variety of catastrophic events in the world are increasing. Psychiatric nurses should therefore take responsibility regarding the effects of trauma and investigate the ways of working with people who experienced trauma in more detail and develop interventions based on scientific evidence.
本研究旨在探讨基于佩普劳方法的心理教育干预措施（包括解决问题）与药物干预相比，对创伤后应激障碍（PTSD）症状及地震幸存者应对方式的有效性。
创伤后反应与恢复是生物、个人、文化和环境因素之间复杂相互作用的结果。心理社会和心理药物学方法均被建议用于治疗PTSD。治疗的总体目标是减轻焦虑，并帮助这些患者恢复正常的日常功能。
本研究采用了前测至后测的准实验设计，设有三个比较组。
研究样本包括51名符合PTSD诊断标准的马尔马拉地震幸存者。比较组分为仅接受心理教育组、仅接受药物治疗组和心理教育与药物联合治疗组（PEM）。单独进行了六次半结构化心理教育课程。“仅接受药物治疗”组的患者未参加这些课程。使用临床医生评定的PTSD量表、汉密尔顿抑郁量表和应对策略量表进行测量。
“PEM”组与“仅接受药物治疗”组之间存在显著差异，第一组症状缓解更为明显。总体而言，“仅接受药物治疗”组和“仅接受心理教育”组之间没有差异。回避作为一种应对策略与PTSD和抑郁结果呈显著正相关。
PTSD患者似乎从联合治疗模式中获益更多。护士可以通过教导患者应对症状来帮助PTSD患者。
世界上灾难性事件的数量和种类正在增加。因此，精神科护士应承担起关于创伤影响的责任，更详细地研究与经历创伤者合作的方式，并基于科学证据制定干预措施。
