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肌肉骨骼创伤后创伤后应激障碍的种族差异。

Ethnic differences in posttraumatic stress disorder after musculoskeletal trauma.

作者信息

Williams Allison E, Smith Wade R, Starr Adam J, Webster Denise C, Martinez Ruby J, Vojir Carol P, Sakalys Jurate A, Morgan Steven J

机构信息

Eastern Colorado Health Care System, Denver, Colorado, USA.

出版信息

J Trauma. 2008 Nov;65(5):1054-65. doi: 10.1097/TA.0b013e318184a9ec.

Abstract

BACKGROUND

Psychological distress is known to contribute to poor outcomes in orthopedic patients. Limited information exists concerning ethnic differences in psychological sequelae after musculoskeletal injury. This study examined ethnic variations in prevalence of posttraumatic stress disorder (PTSD) after musculoskeletal trauma.

METHODS

A secondary analysis was conducted using data collected for a study examining PTSD after musculoskeletal trauma. Two hundred eleven consecutive patients with musculoskeletal injuries were enrolled. Psychological status was assessed using the Revised Civilian Mississippi Scale for PTSD. A chart review was completed to gather demographic and injury information. Independent samples t tests, Fisher's exact, Chi-square, and logistic regression analyses were performed to assess differences.

RESULTS

Ninety-six (45.5%) Hispanic and 115 (54.5%) non-Hispanic White adults participated. Few significant demographic or health differences were found. No significant differences were found regarding injury characteristics. Fisher's exact tests indicated a higher prevalence of PTSD symptomatology among Hispanics than non-Hispanic Whites (p < 0.01). Additionally, U.S. born Hispanics were more likely than non-U.S. born Hispanics to have PTSD symptomatology (p = 0.004). Odds ratios indicated that women (OR = 2.2), persons with a psychiatric comorbidity (OR = 5.1), Hispanics (OR = 6.6), and persons born in the United States (OR = 3.7) had an increased likelihood of PTSD symptomatology.

CONCLUSIONS

Results indicate an ethnic difference in prevalence of PTSD symptomatology after musculoskeletal injury. Hispanic participants were nearly seven times more likely to be positive for PTSD symptomatology. Furthermore, U.S. born Hispanic participants had a higher prevalence of PTSD symptomatology. Future research should explore factors contributing to these differences.

摘要

背景

心理困扰已知会导致骨科患者预后不良。关于肌肉骨骼损伤后心理后遗症的种族差异,现有信息有限。本研究调查了肌肉骨骼创伤后创伤后应激障碍(PTSD)患病率的种族差异。

方法

对一项关于肌肉骨骼创伤后PTSD的研究收集的数据进行二次分析。连续纳入211例肌肉骨骼损伤患者。使用修订后的平民版密西西比PTSD量表评估心理状态。完成病历审查以收集人口统计学和损伤信息。进行独立样本t检验、Fisher精确检验、卡方检验和逻辑回归分析以评估差异。

结果

96名(45.5%)西班牙裔和115名(54.5%)非西班牙裔白人成年人参与。未发现显著的人口统计学或健康差异。在损伤特征方面未发现显著差异。Fisher精确检验表明,西班牙裔中PTSD症状的患病率高于非西班牙裔白人(p < 0.01)。此外,在美国出生的西班牙裔比非美国出生的西班牙裔更有可能出现PTSD症状(p = 0.004)。优势比表明,女性(OR = 2.2)、患有精神疾病合并症的人(OR = 5.1)、西班牙裔(OR = 6.6)和在美国出生的人(OR = 3.7)出现PTSD症状的可能性增加。

结论

结果表明肌肉骨骼损伤后PTSD症状患病率存在种族差异。西班牙裔参与者出现PTSD症状呈阳性的可能性几乎是非西班牙裔白人的七倍。此外,在美国出生的西班牙裔参与者中PTSD症状的患病率更高。未来的研究应探索导致这些差异的因素。

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