尼泊尔地震成年幸存者的创伤后应激障碍和应对策略。
Post traumatic stress disorder and coping strategies among adult survivors of earthquake, Nepal.
机构信息
Pokhara Nursing Campus, Tribhuvan University, Institute of Medicine, Pokhara, Nepal.
Gandaki Medical College Teaching Hospital and Research Centre, Tribhuvan University, Pokhara, Nepal.
出版信息
BMC Psychiatry. 2019 Apr 18;19(1):118. doi: 10.1186/s12888-019-2090-y.
BACKGROUND
Post traumatic stress disorder (PTSD) is the most frequently reported psychiatric morbidity among the survivors of natural disasters. It is the main hindrance to rehabilitate their life. However its prevalence particularly in Nepal is largely unknown.
AIMS AND OBJECTIVES
To investigate the prevalence of post traumatic stress disorder and use of coping strategies among the adult survivors of earthquake.
METHODS
A cross- sectional descriptive study was carried out on a sample of 291 adult survivors after 10 months of Nepal Earthquake 2015. Study setting was Nuwakot district with multistage sampling (cluster sampling and systematic random sampling) method. PTSD checklist-5 was used to measure PTSD, and adapted and modified brief cope scale was used to assess coping strategies. Data were analyzed using descriptive and inferential statistics (independent t-test and one-way ANOVA) at 5% level of significance.
RESULTS
Study findings revealed that PTSD was prevalent among 24.10% of adult survivors with highest intrusion symptoms (3.24 ± 0.71). It was significantly associated with age (p = 0.017), sex (p = 0.013), education (p < 0.0001) and injury to self (p = 0.003). Elderly, females, illiterates and those who were injured during earthquake are at more risk for PTSD. Highest used coping strategy was active coping (2.92 ± 0.51). Survivors not having PTSD scored more on active coping (p < 0.0001) and self distraction coping (p = 0.006) while those with PTSD mostly used passive coping (p < 0.0001), religious coping (p < 0.0001) and substance use coping (p < 0.0001).
CONCLUSION
Earthquake poses significant impact on mental health of the survivors. After 10 months of devastating earthquake, prevalence of PTSD among the survivors is high. Maladaptive coping strategies further increase possibility of PTSD. Effective screening and awareness program regarding promotion of positive coping strategies among the vulnerable groups should be reinforced for prevention of psychiatric morbidity among the survivors of earthquake.
背景
创伤后应激障碍（PTSD）是自然灾害幸存者中最常报告的精神疾病。它是他们恢复生活的主要障碍。然而，其在尼泊尔的流行程度很大程度上是未知的。
目的和目标
调查地震后成年幸存者中创伤后应激障碍的患病率和应对策略的使用情况。
方法
对 2015 年尼泊尔地震 10 个月后 291 名成年幸存者进行了横断面描述性研究。研究地点是努瓦科特区，采用多阶段抽样（聚类抽样和系统随机抽样）方法。使用创伤后应激障碍检查表 5 来衡量 PTSD，使用适应性和修改后的简短应对量表来评估应对策略。使用描述性和推断性统计（独立 t 检验和单向方差分析）在 5%的显著性水平上分析数据。
结果
研究结果表明，24.10%的成年幸存者患有 PTSD，其中最高的侵入症状为 3.24±0.71。它与年龄（p=0.017）、性别（p=0.013）、教育（p<0.0001）和自我受伤（p=0.003）显著相关。老年人、女性、文盲和地震中受伤的人患 PTSD 的风险更高。使用最多的应对策略是积极应对（2.92±0.51）。没有 PTSD 的幸存者在积极应对（p<0.0001）和自我分心应对（p=0.006）方面得分更高，而 PTSD 患者大多使用被动应对（p<0.0001）、宗教应对（p<0.0001）和物质使用应对（p<0.0001）。
结论
地震对幸存者的心理健康造成了重大影响。在毁灭性地震发生 10 个月后，幸存者中 PTSD 的患病率很高。适应不良的应对策略进一步增加了 PTSD 的可能性。应加强针对弱势群体的有效筛查和提高认识计划，以促进积极应对策略的使用，从而预防地震幸存者的精神疾病。
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