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严重烧伤的长期心理健康后果:对2015年台湾八仙乐园水上乐园火灾灾难的5年随访

Long-term mental health outcomes of severe burn injury: A 5-year follow-up of the 2015 Formosa Fun Coast Water Park fire disaster.

作者信息

Su Yi-Jen, Liang Sophie Hsin-Yi

机构信息

Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan, Department of Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.

Section of Department of Child and Adolescent Psychiatry, Department of Psychiatry, Chang Gung Memorial Hospital at Taoyuan, , Chang Gung University College of Medicine, Taoyuan, Taiwan.

出版信息

Gen Hosp Psychiatry. 2022 Mar-Apr;75:10-16. doi: 10.1016/j.genhosppsych.2022.01.007. Epub 2022 Jan 22.

Abstract

OBJECTIVE

Severe burn injuries have profound mental health impacts on individuals, such as posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). Many burn survivors also report positive psychosocial changes, termed posttraumatic growth (PTG). This study investigated long-term mental health of severe burn injury (i.e., PTSD, MDD, and PTG) and the longitudinal influences of coping strategies and social support.

METHODS

Ninety-nine adult burn survivors of the 2015 Formosa Fun Coast Water Park fire disaster participated in the 5-year follow-up (Wave 3, W3), with 93% completing the earlier 2- (Wave 1, W1) and 3-year follow-up (Wave 2, W2). Participants averaged 22.1 years of age at burn, and 62.6% were females. The mean total body surface area burned (TBSA) was 50.3%, with a mean length of hospital stay of 87.6 days.

RESULTS

Five years after the 2015 fire disaster, 13.1%, and 14.1% of the survivors met probable DSM-5 PTSD and MDD, while 51.5% reported significant PTG. After controlling for demographic, burn-specific, and baseline outcome variables, avoidance coping at W2 prospectively predicted PTSD and depressive symptoms at W3 (p = .003 and 0.04), with medium-to-large and medium effect sizes (sr = 0.10 and 0.05). Approach coping at W2 prospectively predicted PTG at W3 (p = .014), with a medium-to-large effect size (sr = 0.07).

CONCLUSION

Rates of probable PTSD and MDD were still relatively high in long-term burn survivors. However, PTG continued to be highly prevalent. Our findings highlight the importance of coping in affecting the long-term mental health of severe burn injury.

摘要

目的

严重烧伤对个体有深远的心理健康影响,如创伤后应激障碍(PTSD)和重度抑郁症(MDD)。许多烧伤幸存者也报告了积极的心理社会变化,即创伤后成长(PTG)。本研究调查了严重烧伤后的长期心理健康状况(即创伤后应激障碍、重度抑郁症和创伤后成长)以及应对策略和社会支持的纵向影响。

方法

99名2015年台湾八仙乐园水上乐园火灾灾难的成年烧伤幸存者参与了为期5年的随访(第3波,W3),其中93%完成了早期的2年(第1波,W1)和3年随访(第2波,W2)。参与者烧伤时的平均年龄为22.1岁,62.6%为女性。平均烧伤总面积(TBSA)为50.3%,平均住院时间为87.6天。

结果

2015年火灾灾难发生5年后,13.1%和14.1%的幸存者符合可能的DSM-5创伤后应激障碍和重度抑郁症标准,而51.5%报告有显著的创伤后成长。在控制了人口统计学、烧伤特异性和基线结局变量后,第2波时的回避应对方式前瞻性地预测了第3波时的创伤后应激障碍和抑郁症状(p = 0.003和0.04),效应大小为中到大和中等(sr = 0.10和0.05)。第2波时的积极应对方式前瞻性地预测了第3波时的创伤后成长(p = 0.014),效应大小为中到大(sr = 0.07)。

结论

长期烧伤幸存者中可能患创伤后应激障碍和重度抑郁症的比例仍然相对较高。然而,创伤后成长仍然非常普遍。我们的研究结果强调了应对方式在影响严重烧伤长期心理健康方面的重要性。

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