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烧伤患者创伤后应激障碍的早期评估与识别、外观满意度及应对方式

Early assessment and identification of posttraumatic stress disorder, satisfaction with appearance and coping in patients with burns.

作者信息

Dahl Oili, Wickman Marie, Björnhagen Viveca, Friberg Mona, Wengström Yvonne

机构信息

Department of Molecular Medicine and Surgery, Section of Reconstructive Plastic Surgery, Karolinska Institutet, SE-171 77 Stockholm, Sweden.

Department of Molecular Medicine and Surgery, Section of Reconstructive Plastic Surgery, Karolinska Institutet, SE-171 77 Stockholm, Sweden.

出版信息

Burns. 2016 Dec;42(8):1678-1685. doi: 10.1016/j.burns.2016.09.012. Epub 2016 Oct 1.

Abstract

BACKGROUND

The first year after severe burn is a psychologically challenging period for the patient. Patients may still struggle with burn-related physical and psychological problems such as posttraumatic stress disorder (PTSD) and body image dissatisfaction (BID).

AIM

This study investigates the presence of PTSD, BID and coping, at three, six and twelve months after discharge for early identification of patients in need of focused support during rehabilitation.

METHODS

Fifty-two adult patients with different degrees of burns were followed at three, six and twelve months after discharge and 36 patients completed all assessment points. A standardized clinical protocol was used for systematic assessment of PTSD (IES-R), BID (SWAP-Swe) and Coping (CBQ). The follow-up included an intervention with a burn nurse as a complement to the existing program.

RESULTS

Approximately half of the patients had a risk of developing PTSD three months after discharge from hospital, and body image dissatisfaction was found to potentially predict risk of PTSD during follow-up.

CONCLUSIONS

The findings suggest that it is important to include patients with less extensive burns in follow-up as this group is at risk of development of PTSD. Using standardized questionnaires in early follow-up along with assessment of body image dissatisfaction may facilitate detection of psychological problems.

摘要

背景

严重烧伤后的第一年对患者来说是一个心理挑战期。患者可能仍在与烧伤相关的生理和心理问题作斗争,如创伤后应激障碍(PTSD)和身体形象不满(BID)。

目的

本研究调查出院后三个月、六个月和十二个月时创伤后应激障碍、身体形象不满和应对方式的情况,以便在康复期间早期识别需要重点支持的患者。

方法

对52例不同程度烧伤的成年患者在出院后三个月、六个月和十二个月进行随访,36例患者完成了所有评估点。采用标准化临床方案对创伤后应激障碍(IES-R)、身体形象不满(SWAP-Swe)和应对方式(CBQ)进行系统评估。随访包括由烧伤护士进行干预,作为现有项目的补充。

结果

约一半患者在出院后三个月有患创伤后应激障碍的风险,且发现身体形象不满可能预测随访期间创伤后应激障碍的风险。

结论

研究结果表明,将烧伤程度较轻的患者纳入随访很重要,因为这组患者有患创伤后应激障碍的风险。在早期随访中使用标准化问卷以及评估身体形象不满可能有助于发现心理问题。

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