柬埔寨肢体残疾者心理困扰和创伤后应激障碍的发生率及相关因素。
Rates and correlates of psychological distress and PTSD among persons with physical disabilities in Cambodia.
机构信息
School of Social Policy, Social Work and Social Justice, University College Dublin, Dublin 4, Ireland.
School of Social Sciences, Education and Social Work, Queen's University Belfast, Belfast, Northern Ireland.
出版信息
Int J Equity Health. 2023 Feb 10;22(1):30. doi: 10.1186/s12939-023-01842-5.
BACKGROUND
Compared to the general population, persons with disabilities are at increased risk of poor mental health. The aim of this study was to determine the rates and correlates of psychological distress and post-traumatic stress disorder (PTSD) among persons with physical disabilities in Cambodia.
METHODS
From July to December 2021 data were collected as part of a mental health screening programme for persons with physical disabilities who access prosthetic and orthotic services. Psychological distress was measured using the Kessler-10 (K-10) and PTSD using the PC-PTSD-5. Bivariate and multiple linear regression analyses were conducted to identify factors associated with levels of psychological distress and PTSD among this population.
RESULTS
Our study found a high prevalence of psychological distress and PTSD in this patient cohort. Of the 213 participants, 31.5% were likely to be experiencing mild to moderate psychological distress indicative of a mental health disorder, with 13.6% likely to have a severe mental health disorder. Sixty-five percent of patients reported experiencing PTSD symptoms, with forty-six percent meeting the criteria for probable PTSD. Psychological distress was associated with pathological worry, rumination, and facets of mindfulness. Rumination and pathological worry were found to be significant predictors of psychological distress. PTSD symptoms were associated with pathological worry but not facets of mindfulness or rumination. Facets of mindfulness and pathological worry were found to be significant predictors of PTSD.
CONCLUSION
Integration of mental health services within the disability sector is required to address psychological distress and PTSD symptoms among people with physical disabilities in Cambodia. Health system interventions, such as screening, referral, and the training of health providers, need to be strengthened. Further studies focussing on the psychosocial determinants of mental health of persons with disabilities in Cambodia are required.
背景
与一般人群相比，残疾人心理健康不良的风险增加。本研究的目的是确定柬埔寨肢体残疾者的心理困扰和创伤后应激障碍（PTSD）发生率和相关因素。
方法
2021 年 7 月至 12 月，作为为使用假肢和矫形服务的肢体残疾者进行心理健康筛查计划的一部分，收集了数据。使用 Kessler-10（K-10）测量心理困扰，使用 PC-PTSD-5 测量 PTSD。进行了单变量和多线性回归分析，以确定该人群中与心理困扰和 PTSD 水平相关的因素。
结果
我们的研究发现该患者队列中存在较高的心理困扰和 PTSD 发生率。在 213 名参与者中，31.5%可能存在轻度至中度心理困扰，表明存在精神健康障碍，13.6%可能存在严重精神健康障碍。65%的患者报告有 PTSD 症状，其中 46%符合 PTSD 的可能标准。心理困扰与病理性担忧、反刍和正念的各个方面有关。反刍和病理性担忧被发现是心理困扰的显著预测因素。PTSD 症状与病理性担忧有关，但与正念的各个方面或反刍无关。正念的各个方面和病理性担忧被发现是 PTSD 的显著预测因素。
结论
需要在柬埔寨残疾部门整合精神卫生服务，以解决肢体残疾者的心理困扰和 PTSD 症状。需要加强卫生系统干预措施，如筛查、转介和卫生提供者的培训。需要进一步研究柬埔寨残疾人人心理健康的社会心理决定因素。
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