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伊朗卡尚重症监护病房出院患者创伤后应激障碍的患病率及相关因素

Prevalence of Posttraumatic Stress Disorder and Related Factors Among Patients Discharged From Critical Care Units in Kashan, Iran.

作者信息

Sadat Zohreh, Abdi Mohammad, Aghajani Mohammad

机构信息

Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, IR Iran.

Department of Nursing, School of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran.

出版信息

Arch Trauma Res. 2015 Nov 1;4(4):e28466. doi: 10.5812/atr.28466. eCollection 2015 Dec.

Abstract

BACKGROUND

Posttraumatic Stress Disorder (PTSD) is a severe anxiety disorder occurred due to past adverse experiences. Several researches have demonstrated that PTSD is quite common among patients discharged from critical care unit.

OBJECTIVES

This study aimed to investigate the prevalence of PTSD and its related factors among patients discharged from critical care units in Kashan, Iran, during 2014.

PATIENTS AND METHODS

A descriptive prospective study was performed on 332 patients admitted to critical care units of Kashan Shahid Beheshti Hospital using a convenience sampling method. Data were collected in wards during hospitalization and one month after their discharge from hospital using questionnaires on demographic, medical information and PTSD Checklist (PCL). The PCL scores of 45 or more were considered as PTSD. Data were analyzed using chi-square, t-test, Mann-Whitney U and logistic regression.

RESULTS

From a total of 332 patients, 160 cases (48.2%) had PTSD and the mean total PCL score in participants was 44.24 ± 19.89. There was a significant difference between the total score of PTSD and its domains in patients with and without PTSD. the univariate analysis showed a significant association between PTSD and increasing age, increased length of hospital stay, more children, having additional comorbidities, unemployed, use of mechanical ventilation (P < 0.001), drug abuse (P = 0.003) and single patients (P = 0.028). However, there was no significant association between PTSD and gender, type of the critical care unit, level of education and admission due to trauma. However, in multivariate analysis using logistic regression, factors associated with PTSD were older age of the participants, use of mechanical ventilation having additional comorbidities, unemployed (P<0.001) and being single (P=0.04).

CONCLUSIONS

Prevalence of PTSD is high among patients discharged from ICUs and some medical individual factors such as elderly, unemployed, being single, using mechanical ventilation and pre-existing diseases are risk factors. Therefore, it is recommended to perform appropriative educational plan for these patients to reduce the risk of PTSD.

摘要

背景

创伤后应激障碍(PTSD)是一种因过去的不良经历而发生的严重焦虑症。多项研究表明,PTSD在重症监护病房出院的患者中相当常见。

目的

本研究旨在调查2014年伊朗卡尚地区重症监护病房出院患者中PTSD的患病率及其相关因素。

患者与方法

采用便利抽样法,对卡尚沙希德·贝赫什提医院重症监护病房收治的332例患者进行描述性前瞻性研究。在患者住院期间及出院后1个月,通过病房问卷调查收集人口统计学、医疗信息和创伤后应激障碍检查表(PCL)等数据。PCL得分45分及以上被视为患有PTSD。采用卡方检验、t检验、曼-惠特尼U检验和逻辑回归分析数据。

结果

在总共332例患者中,160例(48.2%)患有PTSD,参与者的PCL总均分是44.24±19.89。患有和未患有PTSD的患者在PTSD总分及其各维度上存在显著差异。单因素分析显示,PTSD与年龄增长、住院时间延长、子女较多、有其他合并症、失业、使用机械通气(P<0.001)、药物滥用(P = 0.003)和单身患者(P = 0.028)之间存在显著关联。然而,PTSD与性别、重症监护病房类型、教育程度和因创伤入院之间无显著关联。然而,在使用逻辑回归的多因素分析中,与PTSD相关的因素是参与者年龄较大、使用机械通气、有其他合并症、失业(P<0.001)和单身(P = 0.04)。

结论

重症监护病房出院患者中PTSD的患病率较高,一些个体医学因素如老年人、失业、单身、使用机械通气和既往疾病是危险因素。因此,建议对这些患者实施适当的教育计划以降低PTSD的风险。

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