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烧伤幸存者创伤后应激症状的患病率及预测因素:一项系统评价与荟萃分析

Prevalence and Predictors of Posttraumatic Stress Symptomatology Among Burn Survivors: A Systematic Review and Meta-Analysis.

作者信息

Giannoni-Pastor Anna, Eiroa-Orosa Francisco Jose, Fidel Kinori Sara Guila, Arguello Jose Maria, Casas Miguel

机构信息

From the *Servei de Psiquiatria, Hospital Universitari Vall d'Hebron, CIBERSAM, Department of Psychiatry, Universitat Autònoma de Barcelona; †Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Catalonia, Spain; ‡School of Psychology, University of East London, United Kingdom; and §Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain.

出版信息

J Burn Care Res. 2016 Jan-Feb;37(1):e79-89. doi: 10.1097/BCR.0000000000000226.

Abstract

Burns can be a traumatic and stressful experience, although each patient may respond in very different ways. The aim of this study was to explore the variability on posttraumatic stress disorder (PTSD) and acute stress disorder (ASD) prevalence and evaluate the specific weight of different variables on PTSD development among adult burn patients. A systematic review was carried out to explore the prevalence of ASD and PTSD and identify their predictors. Meta-analytical methods were used to explore the strength of association between PTSD and the latter. From an initial pool of 190 studies, 24 were used in the systematic review, and only 19 studies could be used for the meta-analysis because of different methodological limitations. The prevalence of ASD at baseline ranged from 2 to 30% and prevalence of PTSD ranged from 3 to 35% at 1 month, 2 to 40% between 3 and 6 months, 9 to 45% in the year postinjury and ranged 7 to 25% more than 2 years later. Life threat perception was the strongest predictor for PTSD occurrence, followed by acute intrusive symptoms and pain associated with burn injuries. Predictive variables identified in this research may be useful in targeting burn patients who are at risk for developing posttraumatic stress symptoms and stress-related psychological symptoms.

摘要

烧伤可能是一种创伤性且压力巨大的经历,尽管每位患者的反应可能大不相同。本研究的目的是探讨成人烧伤患者创伤后应激障碍(PTSD)和急性应激障碍(ASD)患病率的变异性,并评估不同变量对PTSD发生的具体影响程度。开展了一项系统综述,以探究ASD和PTSD的患病率并确定其预测因素。采用荟萃分析方法来探究PTSD与后者之间的关联强度。在最初的190项研究中,24项被用于系统综述,由于不同的方法学局限性,仅有19项研究可用于荟萃分析。基线时ASD的患病率在2%至30%之间,1个月时PTSD的患病率在3%至35%之间,3至6个月时在2%至40%之间,受伤后1年内为9%至45%,2年多后为7%至25%。对生命威胁的感知是PTSD发生的最强预测因素,其次是急性侵入性症状和与烧伤相关的疼痛。本研究中确定的预测变量可能有助于针对有发展为创伤后应激症状和与压力相关心理症状风险的烧伤患者。

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