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目的了解汶川地震后60个月救灾志愿者替代性创伤状况,并探讨其影响因素。方法采用方便抽样法,于2013年8—10月,在唐山地区选取参加过汶川地震的救灾志愿者200例,均在地震后3个月接受过替代性创伤问卷(VTS)简易应对方式问卷、社会支持评定量表调查,并与其地震后60个月的数据进行比较。相关性分析采用Pearson相关分析;影响因素分析采用多元线性回归分析。结果地震后60个月4例(2.0%)救灾志愿者替代性创伤总分超过理论中值。200例救灾志愿者地震后60个月情绪反应、认知反应、生理反应得分及VTS总分低于地震后3个月,行为反应得分高于地震后3个月,差异有统计学意义(P<0.05);积极应对、消极应对、对社会支持利用度得分及社会支持评定量表总分低于地震后3个月,主观支持、客观支持得分高于地震后3个月,差异有统计学意义(P<0.05)。VTS总分与消极应对得分呈正相关(P<0.05),而与主观支持、客观支持、对社会支持利用度得分及社会支持评定量表总分呈负相关(P<0.05)。消极应对是地震后60个月救灾志愿者替代性创伤的影响因素(Y=108.758-1.080×消极应对得分,P<0.05)。结论救灾志愿者在地震后60个月仍存在着一定程度的替代性创伤,但与地震后3个月相比,替代性创伤程度降低。同时其采用消极应对方式次数越少,产生替代性创伤程度越低。
Objective To understand the status of alternative trauma and its influencing factors in relief volunteers 60 months after the Wenchuan earthquake. Methods Using convenient sampling method, 200 disaster relief volunteers who participated in the Wenchuan earthquake were selected in Tangshan from August to October 2013, all of whom received the VTS easy coping style questionnaire at 3 months after the earthquake. Social support rating scale survey, and compared with the 60-month data after the earthquake. Correlation analysis using Pearson correlation analysis; influential factor analysis using multiple linear regression analysis. Results In the 60 months after the earthquake, 4 (2.0%) relief volunteers had more total surrogate trauma than the theoretical median. The scores of emotional reaction, cognitive reaction, physiological response score and VTS score of the 200 relief volunteers at 60 months after the earthquake were lower than 3 months after the earthquake and their behavioral response scores were higher than those of 3 months after the earthquake (P <0.05). Positive coping and negative coping, the score of social support utilization and social support rating scale were lower than 3 months after the earthquake, with subjective support and objective support scores higher than 3 months after the earthquake, the difference was statistically significant Significance (P <0.05). VTS score was positively correlated with negative coping score (P <0.05), but negatively correlated with subjective support, objective support, social support utilization score and social support rating scale (P <0.05). Negative coping was the influencing factor of alternative trauma to relief volunteers 60 months after the earthquake (Y = 108.758-1.080 × negative coping score, P <0.05). Conclusion The relief volunteers still have some degree of alternative trauma in the 60 months after the earthquake, but the degree of alternative trauma is lower than that in the three months after the earthquake. At the same time, the fewer the number of negative coping styles, the lower the degree of alternative trauma.