Empirical Research On Psychological Crisis Intervention Of Relatives Of The Dead In The Emergency Department

In recent years, the amount of patients in the emergency department is increasing dramatically. The patients in the emergency department have the emergent, critical and severe properties and a higher mortality. Their relatives usually suffer by this kind of stress and experience the negative feelings of the risk or the truth of loss. Loss is an inescapable part of life, but one who has this experience will definitely endure the endless bereavement. Bereavement can be defined as an integrated compound of a poor mental state and a worsen procedure, which include the reaction of grief and mourning. Therefore, it is very important to make clear the mental health state of the relatives of the dead in emergency department and to give the relevant crisis intervention, which could help the relatives adjust their mental health, alleviate their harmful stress reaction and rebuild the confidence of the future life. In this study, the relatives of 175 dead cases in the emergency department of a polyclinic were involved in this study and their state of mental health were assessed using Symptom Checklist 90 (SCL-90) and the scores (167 valid cases)were compared with the nation norm. Based on the priciples, theoretical models and methods established by researchers, such as Caplan, Belkin, Gilliland & James, and Mitchell, a four-step procedure of crisis intervention was applied to help these relatives and the effectiveness of this intervention was evaluated as well.Results:1. The gross score and all subscales score of SCL-90 of 167 relatives were significantly greater than the nation norm (p<0.05). Some subscales, such as interpersonal sensitivity, hostility and paranoid ideation were independent with gender, age and educational background. Female relatives showed significant worse gross state and more somatization symptoms than that of male relatives(p<0.05). The gross score and scores of somatization, obsessive-impulsive, depression and psychoticism were significantly tested between the group with age from 60yrs to 75yrs and age from 35yrs to 59yrs(p<0.05) the former ones got the higher scores. In addition, the gross score and score of somatization, obsessive-impulsive, depression, anxiety, phobia anxiety and psychoticism were significantly higher to the group with poor educational background that those of good educational background (p<0.05).2. Two groups of subjects (intervention group and control group) showed better mental health state by compareing the gross score and all subscales score of SCL-90(p<0.05), but this result could not explain directly the effectiveness of the intervention because of not excluding the possibility of self-cure. So, the regression analysis was applied to retest the effectiveness of the intervention with the group as independent variable and the changing of the observation scores of SCL-90 as dependent variable. Results showed that the gross score and the subscore of somatization, depression, anxiety and phobia anxiety had significant relations with the intervention (p<0.05).Conclusions:1. Acute death is a typical stress to the relatives, which could be seriously influence their mental health and arouses the stress-relevant psychological responses.2. The mental state of the relatives of the dead will be influenced by some relevant factors, such as gender, age and educational background. In all, the mental health level of female relatives, the older relatives and the relatives with poor educational background are worse. The results suggest that the relatives of acute death should be intervened.3. The four-step procedure of crisis intervention used in this study could effectively improve the mental health level of the relatives of the dead, and could alleviate the bad reaction of somatic symptoms, depression, anxiety and phobia anxiety.