Department of Psychosocial and Behavioural Research, Association of Dutch Burns Centres, Beverwijk, The Netherlands.
PLoS One. 2012;7(7):e41532. doi: 10.1371/journal.pone.0041532. Epub 2012 Jul 24.
This study investigated traumatic stress symptoms in severely burned survivors of two fire disasters and two comparison groups of patients with "non-disaster" burn injuries, as well as risk factors associated with acute and chronic stress symptoms. Patients were admitted to one out of eight burn centers in The Netherlands or Belgium. The Impact of Event Scale (IES) was administered to 61 and 33 survivors respectively of two fire disasters and 54 and 57 patients with "non-disaster" burn etiologies at 2 weeks, 3, 6, 12 and 24 months after the event. We used latent growth modeling (LGM) analyses to investigate the stress trajectories and predictors in the two disaster and two comparison groups. The results showed that initial traumatic stress reactions in disaster survivors with severe burns are more intense and prolonged during several months relative to survivors of "non-disaster" burn injuries. Excluding the industrial fire group, all participants' symptoms on average decreased over the two year period. Burn severity, peritraumatic anxiety and dissociation predicted the long-term negative outcomes only in the industrial fire group. In conclusion, fire disaster survivors appear to experience higher levels of traumatic stress symptoms on the short term, but the long-term outcome appears dependent on factors different from the first response. Likely, the younger age, and several beneficial post-disaster factors such as psychosocial aftercare and social support, along with swift judicial procedures, contributed to the positive outcome in one disaster cohort.
本研究调查了两起火灾中严重烧伤幸存者以及两组“非灾难”烧伤患者的创伤后应激症状,以及与急性和慢性应激症状相关的风险因素。患者被收入荷兰或比利时的 8 家烧伤中心之一。事件发生后 2 周、3 个月、6 个月、12 个月和 24 个月,分别对两起火灾中的 61 名和 33 名幸存者以及两组“非灾难”烧伤病因的 54 名和 57 名患者使用事件影响量表(IES)进行了评估。我们使用潜在增长模型(LGM)分析来研究两组灾难幸存者和两组对照组的应激轨迹和预测因素。结果表明,与“非灾难”烧伤幸存者相比,严重烧伤的灾难幸存者在几个月内初始创伤性应激反应更为强烈和持久。排除工业火灾组后,所有参与者的症状在两年期间平均呈下降趋势。烧伤严重程度、创伤前焦虑和分离预测仅在工业火灾组中与长期负面结果相关。总之,火灾幸存者在短期内似乎经历了更高水平的创伤后应激症状,但长期结果似乎取决于与最初反应不同的因素。可能是年轻的年龄,以及一些有益的灾后因素,如心理社会康复和社会支持,以及迅速的司法程序,促成了一个灾难队列的积极结果。