Cremeans-Smith Julie K, Greene Kenneth, Delahanty Douglas L
a Department of Psychology , Kent State University at Stark , N Canton , OH , USA.
Psychol Health. 2015;30(9):1005-16. doi: 10.1080/08870446.2014.1001391. Epub 2015 Jan 27.
Research concerning the impact of trauma history on individuals' ability to cope with subsequent events is mixed. While many studies find that trauma history increases vulnerability for conditions such as post-traumatic stress disorder and chronic pain, others reveal that there are benefits associated with moderate levels of stress (e.g. development of coping skills).
The present study investigated whether the experience of prior traumatic stressors would serve as a risk or resilience factor based on physical and emotional outcomes among patients recovering from total knee replacement surgery (TKR).
110 patients undergoing unilateral, TKR completed surveys before surgery, as well as one and three months following the procedure.
Contrary to hypotheses, patients who reported more prior traumas experienced less severe pain and functional limitations at one- (β = -.259, p = .006) and three-month follow-up assessments (β = -.187, p = .04). A similar pattern emerged when specific types of traumas (e.g. interpersonal) were examined in relation to physical recovery. Further, patients' trauma history was negatively related to symptoms of post-traumatic stress three-months following surgery (e.g. Avoidance: β = -.200, p = .037).
Trauma history represents a source of resilience, rather than vulnerability, within the context of arthroplastic surgery.
关于创伤史对个体应对后续事件能力的影响的研究结果不一。虽然许多研究发现创伤史会增加患创伤后应激障碍和慢性疼痛等疾病的易感性,但其他研究表明,适度的压力也有好处(例如发展应对技能)。
本研究调查了既往创伤性应激源的经历是否会根据全膝关节置换术(TKR)康复患者的身体和情绪结果成为风险因素或恢复力因素。
110例接受单侧TKR的患者在手术前以及术后1个月和3个月完成了调查。
与假设相反,报告有更多既往创伤的患者在1个月(β = -0.259,p = 0.006)和3个月随访评估时经历的疼痛和功能限制较轻(β = -0.187,p = 0.04)。在检查特定类型的创伤(如人际创伤)与身体恢复的关系时,也出现了类似的模式。此外,患者的创伤史与术后3个月的创伤后应激症状呈负相关(例如回避:β = -0.200,p = 0.037)。
在关节置换手术的背景下,创伤史是恢复力的来源,而不是易感性的来源。