Rodrigues Carlos Manoel Lopes, Barletta Janaína Bianca, Nery Héwelyn de Moura
Faculdade de Ciências da Saúde, Centro Universitário de Brasília, Brasília, DF, Brazil.
Faculdade de Filosofia Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
Rev Bras Med Trab. 2021 Sep 30;19(3):332-341. doi: 10.47626/1679-4435-2021-624. eCollection 2021 Jul-Sep.
Major accidents are defined as accidents whose consequences spread spatially and temporally from acute events related to production activities. Exposure to these accidents has psychological impacts on individuals, including the development of mental disorders such as posttraumatic stress disorder. Thus, the aim of this study was to identify and analyze the evidence available in the literature on the relationship between exposure to major accidents and the development of posttraumatic stress disorder. To that end, a systematic literature review was conducted using the Web of Science and Google Scholar databases, followed by a meta-analysis based on the results of the selected studies. Twenty-six articles were selected, related to 14 major accidents, including 11 longitudinal and 15 cross-sectional studies. The studies were conducted from 2 months to 36 years after the major accident, comprising 24,276 participants. The methods, techniques and instruments used varied between studies. The meta-analysis indicated a prevalence of posttraumatic stress disorder of 18.57% (confidence interval 13.80-23.87; I = 96.22%). Posttraumatic stress disorder symptoms persisted over the years after the accident. The prevalence of posttraumatic stress disorder after exposure to major accidents was found to be higher compared to that of the general population. Risk factors for posttraumatic stress disorder included intensity of exposure, occurrence of physical damage, lack of social support, and economic losses. The results indicate the need for planned, rapid start and long-term interventions.
重大事故被定义为其后果在空间和时间上从与生产活动相关的急性事件扩散开来的事故。接触这些事故会对个人产生心理影响，包括创伤后应激障碍等精神障碍的发展。因此，本研究的目的是识别和分析文献中关于接触重大事故与创伤后应激障碍发展之间关系的现有证据。为此，使用科学网和谷歌学术数据库进行了系统的文献综述，随后根据所选研究的结果进行了荟萃分析。共筛选出26篇文章，涉及14起重大事故，包括11项纵向研究和15项横断面研究。这些研究在重大事故发生后的2个月至36年进行，共有24276名参与者。不同研究使用的方法、技术和工具各不相同。荟萃分析表明，创伤后应激障碍的患病率为18.57%（置信区间13.80 - 23.87；I² = 96.22%）。事故发生后的数年里，创伤后应激障碍症状持续存在。与普通人群相比，接触重大事故后创伤后应激障碍的患病率更高。创伤后应激障碍的风险因素包括接触强度、身体损伤的发生、缺乏社会支持和经济损失。结果表明需要进行有计划、快速启动和长期的干预。
