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背景:烧伤是一种心身创伤,烧伤后的心理创伤反应的强弱与个性、个人经历、社会支持可能有关。目的:调查急性期烧伤患者的心理应激反应、社会支持程度、明尼苏达多相人格特点,分析心理应激反应的影响因素。设计:横断面调查。单位:四川大学华西精神卫生中心,绵阳市中心医院烧伤科,攀枝花钢铁公司总医院烧伤科。对象:选择2003-04/2005-04绵阳市中心医院、攀钢总医院烧伤专科的住院患者104例,均为轻、中、重度热力烧伤,男92例,女12例;年龄12～60岁。方法:于烧伤后3d内进行量表评定,包括汉密顿抑郁量表、汉密顿焦虑量表、明尼苏达多相人格调查表、社会支持评定量表及临床一般资料。按汉密顿抑郁量表、汉密顿焦虑量表的分值(焦虑>7分,抑郁>8分是焦虑抑郁情绪),分为有焦虑抑郁情绪组51例和正常情绪组53例。以汉密顿焦虑量表和汉密顿抑郁量表得分为因变量,进行逐步回归分析,筛选出影响患者焦虑和抑郁的主要因素。主要观察指标:①两组患者各项量表评分及一般临床资料比较。②影响烧伤患者抑郁、焦虑情绪的逐步回归分析。结果:104例患者均进入结果分析。①烧伤急性期有焦虑抑郁情绪患者焦虑评分为10.4±2.46、抑郁评分为16.8±5.94,均明显高于正常组(4.29±2.26,5.48±2.06)(P=0.00)。②抑郁的主要影响因素为烧伤总面积和社会支持利用度,焦虑的主要影响因素为年龄、烧伤总面积、社会支持的利用度、主观社会支持度。③明尼苏达多相人格调查表测试结果,在焦虑抑郁情绪组中各分量表T分均在正常范围,在正常组中诈分、轻躁狂、精神分裂、精神衰弱、偏执分量表T分大于60分。结论:烧伤对于患者来说是心理危机,可引起机体的个性偏移或情绪反应。烧伤后的焦虑抑郁情绪与烧伤的面积正相关,与社会支持利用度呈负相关。良好的家庭支持系统更有利于患者渡过心理危机期。
Background: Burn is a psychosomatic trauma. The strength and weakness of psychological trauma after burn injury may be related to individuality, personal experience and social support. Objective: To investigate the psychological stress response, social support, polyphasic personality in Minnesota and the influencing factors of psychological stress response in acute burn patients. Design: Cross-sectional survey. Unit: West China Mental Health Center of Sichuan University, Department of Burn, Mianyang Central Hospital, Panzhihua Iron and Steel Company General Hospital Department of Burn. PARTICIPANTS: A total of 104 inpatients with burn specialist at Mianyang Central Hospital and Panzhihua General Hospital were selected from April 2003 to April 2005, all of whom were mild, moderate and severe thermal burns. There were 92 males and 12 females, aged from 12 to 60 years . Methods: The scales were assessed within 3 days after burn, including the Hamilton Depression Inventory, Hamilton Anxiety Inventory, Minnesota Multiphasic Personality Inventory, Social Support Rating Scale and general clinical data. According to the Hamilton Depression Inventory and the Hamilton Anxiety Scale (anxiety> 7 points, depression> 8 points were anxiety and depression), 51 patients were divided into anxiety depression group and 53 normal emotion group. With the Hamilton Anxiety Scale and the Hamilton Depression Scale as the dependent variables, stepwise regression analysis was conducted to screen out the main factors affecting anxiety and depression in patients. MAIN OUTCOME MEASURES: ①Comparison of scales and general clinical data of two groups of patients. ② Stepwise regression analysis of depression and anxiety affecting the burn patients. Results: All 104 patients entered the result analysis. ①Anti-anxiety and depression in patients with acute phase of anxiety score was 10.4 ± 2.46, depression score was 16.8 ± 5.94, were significantly higher than the normal group (4.29 ± 2.26,5.48 ± 2.06) (P = 0.00). ② The main influencing factors of depression were the total area of burns and the utilization of social support. The main influencing factors of anxiety were age, total area of burns, utilization of social support, and subjective social support. ③ Minnesota multiphasic personality questionnaire test results, in the anxiety and depression group scores in the normal range, sub-points in the normal group, light mania, schizophrenia, mental weakness, paranoid subscale scores greater than 60 Minute. Conclusion: Burn is a psychological crisis for patients and can cause the body’s personality to shift or emotional response. The anxiety and depression after burn were positively correlated with the area of burns and negatively correlated with the utilization of social support. Good family support system is more conducive to patients through the psychological crisis.