Symptoms Of Posttraumatic Stress Disorder And Its Associated Factors Analysis In Patients With Fracture

Objective:To investigate the occurrence of posttraumatic stress disorder (PTSD) of patients with fracture from Jinan level 3 first-class hospital.and to explore the relationship between PTSD symptoms and demographic characteristics, disease characteristics, injury severity scores and pain factors and find out the main influencing factors.The conclusions of this paper will provide scientific basis for the future research of psychological intervention in fracture patients.Methods:Adopt the method of questionnaire survey, follow the principle of informed consent and confidentiality, survey in 6～122015 Jinan level 3 first-class hospital patients with fracture. Applicated homemade general data questionnaire.disease information questionnaire, injury severity scores(ISS) and posttraumatic stress disorder cheklist-civilian version (PCL-C), and numerical rating scale (NRS) as measuring tools,through the cross-sectional survey, determining all symptoms of posttraumatic stress disorder and total scores and the relation-ship between the variables, exploring the main influencing factors of PTSD in patients with fracture.Using SPSS 17.0 data analysis software for statistical data analysis, statistical analysis technique including descriptive analysis, variance analysis, t-test, correlation analysis,regression analysis, etc.Results:(1) The research object with an average age of 41.90±16.32, PTSD scores is 31.12 ±11.71. Fracture patients with PTSD positive rate is 27.5%.The occurrence rate of re-experiencing, avoidance, high alert are 69.5%,32.5%,53.5%, respectively.The frequency of the highest three entries are in turn:" trouble falling asleep or easy to wake up", "irritability or outbreak of anger ", "heart palpitations, shortness of breath,sweating" when thingking of the event.(2) There are statistically significant differences in the three major symptoms and the total scores of PTSD between different professional status,payment methods and educational level (P<0.01);There are significant difference between different genders in re-experiencing symptoms and the total scores of PTSD. (P<0.01, P<0.05);There are significant difference between having or not having religious belief in re-experiencing symptoms,high alert symptoms and the total scores of PTSD (P=0.01, P<0.01, P<0.01.In the professional situation, the scores of service industry, civil servants in the re-experiencing symptoms are lower than workers and farmers,workers, farmers and technicians are lower than unemployed; The scores of service industry, civil servants and technicians in the avoidance symptoms,high alert symptoms and the total scores of PTSD are lower than workers and farmers,workers and farmers are lower than unemployed; In educational level, the scores of bachelor degree in patients with re-experiencing symptoms are lower than the illiteracy, primary school, junior high school, high school patients, the scores of college degree in patients with re-experiencing symptoms are lower than the primary school, junior high school patients; The scores of bachelor degree in patients with avoidance symptoms are lower than the high school patients, high school patients are lower than the primary school, junior high school patients, the scores of college degree in patients with avoidance symptoms are lower than the junior high school patients; The scores of bachelor degree and college degree in patients with high alert symptoms are lower than the illiteracy, primary school, junior high school, high school patients, the scores of junior high school in patients with high alert symptoms are lower than the primary school patients; The PTSD total scores of bachelor degree in patients are lower than the the illiteracy, primary school, junior high school, high school patients, the PTSD total scores of college degree in patients are lower than the primary school, junior high school patients; In the way of paying fees,the scores of re-experiencing symptoms with public medical care patients are lower than those of the patients at their own expense, new rural cooperative medical insurance and medical insurance;The scores of avoidance symptoms with public medical care and new rural cooperative medical insurance patients are lower than the patients at their own expense and medical insurance;The scores of high alert symptoms and the total scores of PTSD with public medical care and new rural cooperative medical insurance and patients at their own expense are lower than medical insurance patients; Female’s re-experiencing symptoms scores and PTSD total scores are higher than male,patients who having religious believes in the symptoms of re-experiencing, high alert and the total score of PTSD are higher than those of non religious beliefs.(3) There is statistical significance (P< 0.01) in the presence of the injured area in terms of re-experiencing symptoms, avoidance symptoms, and PTSD total score;There is statistical significance in the cause of injury in terms of the re-experiencing symptoms, high alert symptoms and PTSD total score (P< 0.01, P< 0.05, P< 0.05). In the injured area, spinal fractures, lower limb area fractures in patients with re-experiencing symptoms scores lower than the upper limb area fracture and complex fracture patients;The scores of avoidance symptoms in patients with fracture of lower limb area are lower than those with complex fracture; PTSD total scores of lower limb area fracture and spinal fracture are lower than that of complex fracture; In the cause of injury, the occupational injuries, traffic accidents, falls injuries in patients with re-experiencing symptoms scores are lower than those of violence and other cause injuries;Patients with occupational injuries,traffic accidents, falls injuries and other cause injuries of high alert symptoms and PTSD total scores are lower than violence injuries patients; Other cause injuries in Patients with high alert symptoms scores are lower than falls injuries patients, traffic accidents in patients of PTSD total scores are lower than other cause injuries patients.(4) Gender and re-experiencing symptoms and PTSD total score is significantly positively correlated,the correlation coefficient is 0.159,0.273; Religious and re-experiencing symptoms, high alert symptoms and PTSD total score is significantly positively correlated, the correlation coefficient is 0.171-0.181; The degree of education is negatively correlated with the re-experiencing symptoms, avoidance symptoms, high alert symptoms and PTSD total score,the correlation coefficient is -0.154～-0.243;The pain intensity score is significantly positively correlated with the symptoms of re-experiencing, high alertness and PTSD total score,the correlation coefficient is 0.164-0.226.(5) The pain score, the degree of culture, the injured area and the occupation entered the PTSD total score of the linear regression equation.Conlusion:(1) The incidence of PTSD symptoms in fracture patients was 27.5%,re-experienc-ing are the highest incidence of symptoms.(2) Patients with the higher occupational status, the higher level of education, having public health care with milder PTSD symptoms,Female fracture patients with PTSD symptoms are more severe than male,PTSD symptoms of religious believers are more heavier.(3) PTSD symptoms of patients with complex fracture are heavier than that of patients with lower limb area fracture and spinal fracture.Violence injuries in patients with PTSD symptoms are heavier than that of patients of occupational injuries, traffic accidents, falls injuries and other cause injuries patients.(4) Patients with the higher the pain score, the higher the level of PTSD symptoms.