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颌面创伤后的心理社会支持及其对创伤复发的影响。

Psychosocial Support Following Maxillofacial Trauma and its Impact on Trauma Recurrence.

作者信息

Lee Kai H, Chua Jason

机构信息

1Oral & Maxillofacial Surgery Unit (Western Health), Department of Surgery (University of Melbourne), Melbourne, Australia.

2Royal Darwin Hospital, Tiwi, Australia.

出版信息

J Maxillofac Oral Surg. 2018 Mar;17(1):32-37. doi: 10.1007/s12663-016-0979-2. Epub 2016 Oct 18.

Abstract

BACKGROUND

Injuries sustained to the maxillofacial region can result in significant physical trauma and long lasting psychosocial impairment. Maxillofacial trauma has been reported in literature to be a potentially recurrent disease. Patients who suffer maxillofacial trauma can benefit from psychological support.

AIM

This study aims to identify maxillofacial trauma patient characteristics, investigate maxillofacial re-injury rate after provision of psychological support and report incidence of post traumatic stress disorder symptoms after maxillofacial trauma.

METHOD

A total of 100 patients were identified from the departmental trauma database over two time periods at Royal Darwin Hospital; 50 patients did not have psychosocial intervention and 50 patients received intervention. Data on demographics, trauma pattern and aetiology were collected. A brief counselling session was conducted on second patient group by a trained mental health nurse and a survey using Trauma Screening Questionnaire was completed one month following injury.

RESULTS

The most common cause of injuries was assault in both groups followed by falls and the most common site of injuries was in the mandible in both groups. Almost half of all patients were in the15-24 and 25-34 age groups. 17 % of patients in pre-intervention period and 4 % of patients in intervention period had injury recurrence at 3 year follow up. Patient groups at risk of developing post traumatic symptoms included male, non-indigenous population, employed group with no alcohol involvement.

CONCLUSION

Maxillofacial trauma can cause considerable psychological morbidity and expose the patient to high risk of post traumatic disorder symptoms. This type of injury was found to affect particular groups of population and is associated with high rate of recurrence. Psychological support should be provided to these patients as a routine part of trauma aftercare.

摘要

背景

颌面区域遭受的损伤可导致严重的身体创伤和长期的心理社会功能障碍。文献报道颌面创伤可能是一种复发性疾病。遭受颌面创伤的患者可从心理支持中获益。

目的

本研究旨在确定颌面创伤患者的特征,调查提供心理支持后颌面再次受伤的发生率,并报告颌面创伤后创伤后应激障碍症状的发生率。

方法

在皇家达尔文医院的两个时间段内,从科室创伤数据库中识别出100例患者;50例患者未接受心理社会干预,50例患者接受了干预。收集了人口统计学、创伤模式和病因学数据。由一名经过培训的心理健康护士对第二组患者进行了简短的咨询,并在受伤后一个月使用创伤筛查问卷完成了一项调查。

结果

两组中最常见的受伤原因都是袭击,其次是跌倒,两组中最常见的受伤部位都是下颌骨。几乎所有患者中有一半在15 - 24岁和25 - 34岁年龄组。在3年随访中,干预前期17%的患者和干预期4%的患者出现损伤复发。有创伤后症状风险的患者群体包括男性、非原住民、无酒精摄入的就业群体。

结论

颌面创伤可导致相当大的心理发病率,并使患者面临创伤后应激障碍症状的高风险。发现这类损伤会影响特定人群,并与高复发率相关。应将心理支持作为创伤后续护理的常规部分提供给这些患者。

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本文引用的文献

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Alcohol and interpersonal violence may increase the severity of facial fracture.酒精和人际暴力可能会增加面部骨折的严重程度。
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Maxillofacial trauma in major trauma patients.重大创伤患者的颌面创伤
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Controlling alcohol problems among hospitalized trauma patients.控制住院创伤患者的酒精问题。
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