Symptoms Of Posttraumatic Stress Disorder And Its Associated Factors In Patients After Cardiac Surgery Via Extracorporeal

Objectives:The purpose of this study was to describe symptoms of posttraumatic stress disorder (PTSD) in patients after Cardiac Surgery via Extracorporeal Circulation and its association with general anxiety/depression and to explore its associated factors.Methods:A cross-sectional descriptive design was employed. Following the principle of informed consent and confidentiality, patients from two hospitals of Jinan in Jul-Oct 2010 were interviewed by the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C), Hospital Anxiety and Depression Scale (HADS), Connor-Davidson Resilience Scale (CD-RISC), Childhood Trauma Questionnaire (CTQ) and self-made questionnaires (asking demographic situation, illness information, proximal life events, perceived stressors).26.7% of the patients entered the study and 92 valid questionnaires were collected. All data obtained were statistically analyzed by software package SPSS 17.0 for windows.Results:1 The average age of the participants was 44.03±16.56, scores of PCL-C were 27.92±10.59.7.61% of the patients after cardiac surgery via extracorporeal circulation had symptoms of PTSD,41.30% had re-experiencing symptoms,19.57% had avoidance symptoms,28.26% had arousal symptoms.The most frequently reported items were " feels terrible when recalling(things about cardiac surgery)", "feels that the future life seems to be shortened", "have trouble in sleep".2 39(42.39%) patients had general anxiety symptoms,57(61.96%)patients had depression symptoms. All the patients who are positive for PTSD symptoms also had general anxiety. Comorbid rate of PTSD symptoms and depression was 5.43%.3 Patients with income 2000～2999 RMB per month had lower Scores on PCL-C, avoidance, arousal symptoms than the ones with income 1000～1999 RMB and had lower Scores on PCL-C, arousal symptoms compared to the ones with income under 1000 RMB (P<0.05). Unmarried patients had lower scores on re-experiencing symptoms (P<0.05). Total scores of PCL-C and prevalent rates of PTSD symptoms increased among congenital heart disease group, rheumatic heart disease group, Coronary Artery Disease group.4 Total scores of perceived stressors and scores on disease related stressors,surgery related stressors,ICU related stressors factors were significantly positively correlated with total scores of PCL-C(r=0.289～0.492, P<0.01).5 Scores on proximal life events were positively correlated with total scores of PCL-C(r=0.222, P<0.05). Total scores on childhood trauma and scores on emotional abuse, physical abuse, sexual abuse, emotional neglect were positively correlated with total scores of PCL-C(r=0.280～0.445,P<0.01).6 Scores on resilience were negatively correlated with total scores of PCL-C(r=-0.424, P<0.01).7 Linear regression analyses indicated that perceived stressors, childhood trauma, resilience were associated with PTSD symptoms, which explained 37.5% of total variance.Conclusion:1 PTSD symptoms existed among patients after cardiac surgery via extracorporeal circulation, with re-experiencing symptom most prevalent.2 Relatively good economic condition helped to protect patients from PTSD symptoms.3 Patients with more perceived stressors or childhood trauma were likely to have higher level of PTSD symptoms. Patients with better Resilience had lower PTSD symptoms.