Division of Trauma, Baylor University Medical Center, Dallas, Texas 75246, USA.
J Trauma Acute Care Surg. 2013 Jul;75(1):179-84. doi: 10.1097/ta.0b013e3182984a7d.
Symptoms identical to posttraumatic stress disorder (PTSD) have been shown to occur in caregivers of trauma patients. Secondary traumatic stress (STS) characterizes those who exhibit PTSD symptoms related to indirect exposure to a stressor. We hypothesized that caring for trauma patients is associated with symptoms of PTSD/STS.
Surgeons in various specialties (n = 133) were surveyed from January to May 2012 at two regional surgical conferences. Symptoms of PTSD were identified using the Secondary Traumatic Stress Scale (STSS) using specific diagnostic criteria to measure the psychological impact of exposure to trauma patients. Resilience was measured using the Connor-Davidson Resilience Scale 10 items. The amount of time caring for trauma patients was used as a measure of risk exposure. The relationship between STSS, resilience, and exposure to trauma patients was measured with p < 0.05 considered significant.
Twenty-eight surgeons (22%) met diagnostic symptom criteria for PTSD as measured by the STSS. Approximately two thirds of the surgeons (86 of 133, 65%) exhibited at least one symptom of STS. However, the magnitude of exposure to trauma patients was similar between surgeons with and without PTSD symptoms (p = 0.2177). Higher resilience scores were associated with lower STS scores (r = -0.369, p < 0.0001). Most importantly, surgeons who met symptom criteria for PTSD exhibited significantly lower resilience scores (31 [3.4] vs. 34 [3.9], p < 0.0001).
Symptoms of PTSD as measured by the STSS were reported in two thirds of study participants but did not correlate with time spent for caring for trauma patients. One in five reported symptoms consistent with a PTSD. Lower resilience scores correlated with risk of symptoms and may be used to identify those surgeons most at risk. Efforts to better identify, address, and moderate these psychological consequences of surgical care may improve both the emotional well-being and the vocational performance of surgeons.
已证明创伤患者的照料者会出现与创伤后应激障碍（PTSD）相同的症状。继发性创伤应激（STS）是指那些因间接暴露于应激源而表现出与 PTSD 相关症状的人。我们假设照顾创伤患者与 PTSD/STS 症状有关。
2012 年 1 月至 5 月，在两次区域性外科会议上对各专科的外科医生（n=133）进行了调查。使用二次创伤应激量表（STSS）通过特定的诊断标准来识别 PTSD 症状，以测量接触创伤患者的心理影响。使用 Connor-Davidson 韧性量表 10 项来衡量韧性。使用照顾创伤患者的时间来衡量风险暴露程度。使用 p<0.05 来衡量 STSS、韧性和接触创伤患者之间的关系。
28 名外科医生（22%）根据 STSS 测量符合 PTSD 诊断症状标准。大约三分之二的外科医生（133 名中的 86 名，65%）表现出至少一种 STS 症状。然而，具有 PTSD 症状和无 PTSD 症状的外科医生的创伤患者暴露程度相似（p=0.2177）。较高的韧性评分与较低的 STS 评分相关（r=-0.369，p<0.0001）。最重要的是，符合 PTSD 症状标准的外科医生表现出明显较低的韧性评分（31[3.4]与 34[3.9]，p<0.0001）。
使用 STSS 测量的 PTSD 症状在三分之二的研究参与者中报告，但与照顾创伤患者的时间无关。五分之一的人报告了与 PTSD 一致的症状。较低的韧性评分与症状风险相关，可能用于识别那些风险最高的外科医生。努力更好地识别、解决和缓解手术护理的这些心理后果可能会改善外科医生的情感幸福感和职业表现。
