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创伤后应激障碍患者的日常生活参与:模式与相关因素的初步研究

Daily life participation in PTSD: pilot study on patterns and correlators.

作者信息

Shapira Ruth, Baris Ginat Yisca Jessica, Lipskaya-Velikovsky Lena

机构信息

Day care ward, School of Occupational Therapy, Faculty of Medicine, the Hebrew University, Jerusalem, Israel.

The Jerusalem Mental Health Center, Jerusalem, Israel.

出版信息

Front Psychiatry. 2024 Jul 25;15:1429647. doi: 10.3389/fpsyt.2024.1429647. eCollection 2024.

Abstract

INTRODUCTION

Participation in daily life activities with both the personal and community meaning is an important component of health and well-being. Even though there are mounting reports on the challenges in various aspects of daily-life functioning among individuals with post-traumatic stress disorder (PTSD), to date little research has been conducted on their comprehensive patterns of participation. The study aimed to describe objective and subjective participation dimensions in PTSD compared to healthy controls and investigate the association between personal and environmental factors and participation.

METHODS

Sixty-one individuals were enrolled in two groups: PTSD (=31; age: =34.3; women:77.4%) and healthy controls matched by age and gender. The PTSD group completed standard assessments for symptom severity, general cognition, executive function (EF), sensory processing, self-efficacy, functional capacity, and environmental properties. Both groups completed a participation questionnaire.

RESULTS

Individuals with PTSD participated with low intensity and diversity, more occupations were abandoned (-4.73<t<5.73, <0.05), and less meaning was found in the included occupations. Participation objective dimensions were associated with self-reported EF (-0.47<r<-0.42, <0.05), sensory modulation profile (2.51<t<2.81, p<0.05), and environmental properties (-0.44<r<0.5, <0.05), but not with PTSD symptom severity, and objective measures of cognition and functional capacity. No correlators were identified for subjective participation dimensions.

DISCUSSION

The study demonstrates profound restrictions in participation in PTSD raising serious concerns. There are unique patterns of association between objective participation dimensions, subjective cognitive indices, sensory modulation, and environmental factors, suggesting a need for PTSD feature-specific intervention approaches to advance the participation of those with PTSD as a means of promoting health and well-being.

摘要

引言

参与具有个人和社会意义的日常生活活动是健康和幸福的重要组成部分。尽管有越来越多的报告指出创伤后应激障碍(PTSD)患者在日常生活功能的各个方面面临挑战,但迄今为止,关于他们全面的参与模式的研究却很少。本研究旨在描述与健康对照组相比,PTSD患者的客观和主观参与维度,并调查个人和环境因素与参与之间的关联。

方法

61名个体被分为两组:PTSD组(n = 31;年龄:M = 34.3;女性:77.4%)和年龄及性别匹配的健康对照组。PTSD组完成了症状严重程度、一般认知、执行功能(EF)、感觉处理、自我效能、功能能力和环境特性的标准评估。两组都完成了一份参与问卷。

结果

PTSD患者的参与强度和多样性较低,放弃的活动更多(-4.73 < t < 5.73,p < 0.05),并且在所参与的活动中发现的意义较少。参与的客观维度与自我报告的EF(-0.47 < r < -0.42,p < 0.05)、感觉调节概况(2.51 < t < 2.81,p < 0.05)和环境特性(-0.44 < r < 0.5,p < 0.05)相关,但与PTSD症状严重程度以及认知和功能能力的客观测量无关。未发现主观参与维度的相关因素。

讨论

该研究表明PTSD患者在参与方面存在严重限制,令人严重担忧。客观参与维度、主观认知指标、感觉调节和环境因素之间存在独特的关联模式,这表明需要针对PTSD特征的干预方法,以促进PTSD患者的参与,作为促进健康和幸福的一种手段。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fa3/11306126/8e15481b8f4b/fpsyt-15-1429647-g001.jpg

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