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严重机动车事故受害者创伤后应激障碍的预测因素

Predictors of Post-Traumatic Stress Disorder among Victims of Serious Motor Vehicle Accidents.

作者信息

Khodadadi-Hassankiadeh Naema, Dehghan Nayeri Nahid, Shahsavari Hooman, Yousefzadeh-Chabok Shahrokh, Haghani Hamid

机构信息

Department of Community Health Nursing Group, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Int J Community Based Nurs Midwifery. 2017 Oct;5(4):355-364.

Abstract

BACKGROUND

Compelling evidence has shown that motor vehicle accidents have an enormous impact on mental health. Post-traumatic Stress Disorder (PTSD) is one of the most common psychological consequences in adult survivors of accidents, so it is important to understand the prevalence and predictors of this issue since delay causes damage to crucial daily functioning. This study aimed at investigating the prevalence and predictors of PTSD after motor vehicle accident.

METHODS

This cross-sectional study was conducted on 528 injured patients six weeks to six months after motor vehicle accident in Imam Reza Clinic of Poursina hospital, Rasht in 2015. Data collection tools were three questionnaires including post-traumatic stress-self report (PSS), Beck Depression Inventory (BDI-II), and the Numeric Rating Scale (NRS) for pain. The data were analyzed in SPSS (Version 19) using Chi-square, Fischer's exact test and multivariate logistic regression. Significance level was considered P≤0.05.

RESULTS

The prevalence of PTSD and depression was 30.49% and 19.89% in participants, respectively. Chi-square test indicated a significant relationship among age (P=0.02), sex (P<0.001), education level (P<0.001), work status (P<0.001) and PTSD. Participants who reported pain (P<0.001) and depression (P<0.001) were more likely to have high score of PTSD than the others. Multivariate logistic regression showed this significance in sex, depression, age, educational status and pain, as constant risk factors in developing PTSD after accident.

CONCLUSION

This study suggests that primary care setting should be readily prompted for diagnosis of these disorders in non-treatment seeking individuals in the community.

摘要

背景

有力证据表明,机动车事故对心理健康有巨大影响。创伤后应激障碍(PTSD)是事故成年幸存者中最常见的心理后果之一,因此了解该问题的患病率及预测因素很重要,因为延误对关键的日常功能会造成损害。本研究旨在调查机动车事故后PTSD的患病率及预测因素。

方法

2015年,在拉什特市波尔西纳医院伊玛目礼萨诊所,对528名机动车事故后6周至6个月的受伤患者进行了这项横断面研究。数据收集工具是三份问卷,包括创伤后应激自评量表(PSS)、贝克抑郁量表(BDI-II)和疼痛数字评定量表(NRS)。数据在SPSS(19版)中使用卡方检验、费舍尔精确检验和多因素逻辑回归进行分析。显著性水平设定为P≤0.05。

结果

参与者中PTSD和抑郁症的患病率分别为30.49%和19.89%。卡方检验表明,年龄(P=0.02)、性别(P<0.001)、教育程度(P<0.001)、工作状态(P<0.001)与PTSD之间存在显著关系。报告有疼痛(P<0.001)和抑郁症(P<0.001)的参与者比其他人更有可能PTSD得分高。多因素逻辑回归显示,性别、抑郁症、年龄、教育状况和疼痛在事故后发生PTSD方面具有显著意义,是持续的风险因素。

结论

本研究表明,基层医疗环境应随时促使社区中未寻求治疗的个体对这些疾病进行诊断。

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