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工作场所创伤性死亡致哀家庭中的创伤后应激障碍、抑郁症和持续性悲伤障碍:对充分信息和支持的需求

Posttraumatic Stress Disorder, Depression, and Prolonged Grief Disorder in Families Bereaved by a Traumatic Workplace Death: The Need for Satisfactory Information and Support.

作者信息

Matthews Lynda R, Quinlan Michael G, Bohle Philip

机构信息

Work and Health Research Team, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia.

School of Management, UNSW Business School, University of New South Wales, Sydney, NSW, Australia.

出版信息

Front Psychiatry. 2019 Aug 30;10:609. doi: 10.3389/fpsyt.2019.00609. eCollection 2019.

Abstract

The impact of traumatic workplace death on bereaved families, including their mental health and well-being, has rarely been systematically examined. This study aimed to document the rates and key correlates of probable posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and prolonged grief disorder (PGD) in family members following a workplace injury fatality. The hidden nature of the target population necessitated outreach recruitment techniques, including the use of social media, newspaper articles, radio interviews, and contact with major family support organizations. Data were collected using a cross-sectional design and international online survey. The PCL-C (PTSD), the PHQ-8 (MDD), and PG-13 (PGD) were used to measure mental health disorders. All are well-established self-report measures with strong psychometric qualities. Participants were from Australia (62%), Canada (17%), the USA (16%), and the UK (5%). The majority were females (89.9%), reflecting the gender distribution of traumatic workplace deaths (over 90% of fatalities are male). Most were partners/spouses (38.5%) or parents (35%) and over half (64%) were next of kin to the deceased worker. Most deaths occurred in the industries that regularly account for more than 70 percent of all industrial deaths-construction, manufacturing, transport, and agriculture forestry and fishing. At a mean of 6.40 years (SD = 5.78) post-death, 61 percent of participants had probable PTSD, 44 percent had probable MDD, and 43 percent had probable PGD. Logistic regressions indicated that a longer time since the death reduced the risk of having each disorder. Being next of kin and having a self-reported mental health history increased the risk of having MDD. Of the related information and support variables, having satisfactory support from family, support from a person to help navigate the post-death formalities, and satisfactory information about the death were associated with a decreased risk of probable PTSD, MDD, and PGD, respectively. The findings highlight the potential magnitude of the problem and the need for satisfactory information and support for bereaved families.

摘要

工作场所创伤性死亡对遗属家庭的影响,包括其心理健康和幸福状况,很少得到系统研究。本研究旨在记录工作场所工伤死亡后家庭成员中可能患创伤后应激障碍(PTSD)、重度抑郁症(MDD)和持续性悲伤障碍(PGD)的发生率及关键相关因素。目标人群的隐匿性使得有必要采用外展招募技术,包括使用社交媒体、报纸文章、电台访谈以及与主要家庭支持组织联系。数据通过横断面设计和国际在线调查收集。使用PCL-C(用于PTSD)、PHQ-8(用于MDD)和PG-13(用于PGD)来测量心理健康障碍。这些都是具有良好心理测量学特性的成熟的自我报告测量工具。参与者来自澳大利亚(62%)、加拿大(17%)、美国(16%)和英国(5%)。大多数为女性(89.9%),这反映了工作场所创伤性死亡的性别分布情况(超过90%的死亡者为男性)。大多数是伴侣/配偶(38.5%)或父母(35%),超过一半(64%)是已故工人的近亲。大多数死亡发生在通常占所有工业死亡人数70%以上的行业——建筑、制造、运输以及农林渔业。在死亡后平均6.40年(标准差 = 5.78)时,61%的参与者可能患有PTSD,44%可能患有MDD,43%可能患有PGD。逻辑回归表明,自死亡以来时间越长,患每种障碍的风险越低。作为近亲以及有自我报告的心理健康史会增加患MDD的风险。在相关信息和支持变量方面,得到家人的满意支持、有一个人帮助处理死亡后的手续以及获得关于死亡的满意信息,分别与可能患PTSD、MDD和PGD的风险降低相关。研究结果凸显了该问题的潜在严重性以及为遗属家庭提供满意信息和支持的必要性。

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