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创伤后应激症状在瑞典产科医生和助产士在严重产科事件后:横断面回顾性调查。

Post-traumatic stress symptoms in Swedish obstetricians and midwives after severe obstetric events: a cross-sectional retrospective survey.

机构信息

Department of Women's and Children's Health/Obstetrics & Gynaecology, Uppsala University, Uppsala, Sweden.

Department of Gynaecology and Obstetrics, Skåne University Hospital, Malmö, Sweden.

出版信息

BJOG. 2017 Jul;124(8):1264-1271. doi: 10.1111/1471-0528.14259. Epub 2016 Aug 26.

Abstract

OBJECTIVE

To examine post-traumatic stress reactions among obstetricians and midwives, experiences of support and professional consequences after severe events in the labour ward.

DESIGN

Cross-sectional online survey from January 7 to March 10, 2014.

POPULATION

Members of the Swedish Society of Obstetrics and Gynaecology and the Swedish Association of Midwives.

METHODS

Potentially traumatic events were defined as: the child died or was severely injured during delivery; maternal near-miss; maternal mortality; and other events such as violence or threat. The validated Screen Questionnaire Posttraumatic Stress Disorder (SQ-PTSD), based on DSM-IV (1994) 4th edition, was used to assess partial post-traumatic stress disorder (PTSD) and probable PTSD.

MAIN OUTCOME MEASURES

Partial or probable PTSD.

RESULTS

The response rate was 47% for obstetricians (n = 706) and 40% (n = 1459) for midwives. Eighty-four percent of the obstetricians and 71% of the midwives reported experiencing at least one severe event on the delivery ward. Fifteen percent of both professions reported symptoms indicative of partial PTSD, whereas 7% of the obstetricians and 5% of the midwives indicated symptoms fulfilling PTSD criteria. Having experienced emotions of guilt or perceived insufficient support from friends predicted a higher risk of suffering from partial or probable PTSD. Obstetricians and midwives with partial PTSD symptoms chose to change their work to outpatient care significantly more often than colleagues without these symptoms.

CONCLUSIONS

A substantial proportion of obstetricians and midwives reported symptoms of partial or probable PTSD after severe traumatic events experienced on the labour ward. Support and resilience training could avoid suffering and consequences for professional carers.

TWEETABLE ABSTRACT

In a survey 15% of Swedish obstetricians and midwives reported PTSD symptoms after their worst obstetric event.

摘要

目的

调查产科医生和助产士的创伤后应激反应,以及在产房发生严重事件后他们的支持体验和职业后果。

设计

2014 年 1 月 7 日至 3 月 10 日进行的横断面在线调查。

人群

瑞典妇产科医师学会和瑞典助产士协会的成员。

方法

潜在创伤性事件定义为:分娩过程中婴儿死亡或严重受伤;产妇接近死亡;产妇死亡;以及其他事件,如暴力或威胁。采用基于 DSM-IV(1994 年第 4 版)的经过验证的 Screen 问卷创伤后应激障碍(SQ-PTSD)来评估部分创伤后应激障碍(PTSD)和可能的 PTSD。

主要观察指标

部分或可能的 PTSD。

结果

产科医生的回应率为 47%(n=706),助产士的回应率为 40%(n=1459)。84%的产科医生和 71%的助产士报告在产房至少经历过一次严重事件。两职业中有 15%报告出现部分 PTSD 症状,而 7%的产科医生和 5%的助产士出现符合 PTSD 标准的症状。经历过内疚感或感到朋友支持不足的情绪预示着患部分或可能 PTSD 的风险更高。出现部分 PTSD 症状的产科医生和助产士选择转行至门诊护理的比例显著高于没有这些症状的同事。

结论

在一项调查中,15%的瑞典产科医生和助产士在产房经历严重创伤性事件后报告出现部分或可能的 PTSD 症状。支持和弹性培训可以避免职业护理人员遭受痛苦和后果。

推文摘要

在一项调查中,瑞典 15%的产科医生和助产士在经历最严重的产科事件后出现 PTSD 症状。

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