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2015年尼泊尔地震后医务人员的创伤后应激障碍

Post-traumatic Stress Disorder among Medical Personnel after Nepal earthquake, 2015.

作者信息

Shrestha R

机构信息

Emergency Department, Manmohan Memorial Teaching Hospital, Swoyambhu, Kathmandu, Nepal.

出版信息

J Nepal Health Res Counc. 2015 May-Aug;13(30):144-8.

Abstract

BACKGROUND

Health professionals involved in a disaster are not immune to the stressors. However, little attention is given on the psychological consequences among these professionals. This study has explored the frequency of posttraumatic stress disorder (PTSD) among them after the Nepal earthquake 2015.

METHODS

A descriptive cross sectional study was carried out amongst the medical professionals at Manmohan Memorial Teaching Hospital, Kathmandu to assess the PTSD among them after the Nepal earthquake 2015. Two months after the post disaster the standard PTSD Checklist for DSM-5 (PCL 5) was administered to medical personnel of a hospital(n=64) along with demographic features, disaster related experience and working hours. PTSD was defined by two ways: 1.using DSM V diagnostic criteria (the presence of at least one intrusion, one avoidance, two negative alterations in cognitions/mood and two alterations in arousal and reactivity symptoms); and 2. a cutoff score of 30.

RESULTS

The overall prevalence of PTSD was 21.9% and 17.1% using cutoff score and diagnostic criteria respectively. Females scored significantly higher than males. No significant difference was observed according to age, marital status, profession, previous disaster experience, tragic events with relatives. Those who were present in the hospital during the initial influx of victims, witnessed patients suffering, worked extra time were at significantly high risk for development of PTSD.

CONCLUSIONS

This study suggest that PTSD is highly prevalent among healthcare professionals after disaster management and therefore it highlights the need for targeted interventions to specific staff who respond to large disasters to reduce the psychological burden.

摘要

背景

参与灾难救援的卫生专业人员也难免受到压力源的影响。然而,这些专业人员的心理后果却很少受到关注。本研究探讨了2015年尼泊尔地震后这些专业人员中创伤后应激障碍(PTSD)的发生频率。

方法

在加德满都的曼莫汉纪念教学医院对医学专业人员进行了一项描述性横断面研究,以评估2015年尼泊尔地震后他们中的创伤后应激障碍情况。灾后两个月,对一家医院的医务人员(n = 64)发放了DSM-5标准创伤后应激障碍检查表(PCL 5),同时收集了人口统计学特征、与灾难相关的经历和工作时间。创伤后应激障碍通过两种方式定义:1. 使用DSM-V诊断标准(至少存在一种侵入性症状、一种回避症状、两种认知/情绪的负面改变以及两种觉醒和反应性症状的改变);2. 临界值为30分。

结果

分别使用临界值和诊断标准时,创伤后应激障碍的总体患病率分别为21.9%和17.1%。女性得分显著高于男性。在年龄、婚姻状况、职业、以前的灾难经历、与亲属相关的悲惨事件方面未观察到显著差异。在最初受害者涌入医院时在场、目睹患者受苦、加班工作的人员患创伤后应激障碍的风险显著较高。

结论

本研究表明,在灾难管理后,创伤后应激障碍在医护人员中高度普遍,因此突出了对应对重大灾难的特定工作人员进行有针对性干预以减轻心理负担的必要性。

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