肢體受傷住院勞工罹患創傷後壓力症候群現況調查

Posttraumatic stress disorder among limbs injured, hospitalized workers

林慶華(Ching-Hua Lin)

指導教授 ： 王榮德

共同指導教授 ： 杜宗禮

國立臺灣大學/公共衛生學院/職業醫學與工業衛生研究所/碩士(2005年)

https://doi.org/10.6342/NTU.2005.00900

摘要

現今對於受傷勞工的處理，不論是一般原因受傷或者是因為工作相關原因受傷的勞工，多半僅僅偏重於生理傷勢的診治與復健，對於受傷本身可能導致的心理障礙，如創傷後壓力障礙（posttraumatic stress disorder, PTSD），則多半被忽略。本研究之目的便在於探討受傷勞工可能存在的心理問題程度，以作為各個有關單位在服務受傷勞工或者制定相關政策時的參考。研究對象為臺大醫院骨科病房在民國九十三年七月到民國九十四年二月之間，於肢體外傷發生後七天以內住院的勞工，共47位，回收率69.1%。填寫問卷內容包括基本資料、中文版Mini-International Neuropsychiatric Interview（M.I.N.I.）問卷的PTSD部分以及中文版Brief Symptom Rating Scale-5（BSRS-5）問卷。其中27位傷者於受傷後一個月接受第二次調查，回收率57.4%。結果發現在受傷後立即受訪的傷者中，僅有兩位符合PTSD的診斷條件，與一般民眾的罹病率大致相符。然而卻有高達43%的傷者在BSRS-5的得分大於或等於6分，似乎比過去相關的研究要高，而且這個趨勢一直到受傷後一個月仍然一致。此外，對於PTSD亞型（subsyndromal PTSD）的盛行率則由立即受傷後的19%上升到一個月後的41%，主要可能來自於重複經驗（re-experience）的增加。因此，本研究結果初步顯示在協助處理受傷勞工的時候，勞工可能同時罹患的精神方面疾病與subsyndromal PTSD及其相關症狀將是必須被注意的課題。

關鍵字

受傷勞工 ； 創傷後壓力障礙 ； 精神疾病

並列摘要

Background: It has been known that while planning rehabilitation and treatment services for work-related injured workers, it is important to consider physical, social and personal factors. Consequently, psychiatric problems, especially post- traumatic stress disorder(PTSD), might play important roles for injured workers in return to work.
Objective: To investigate the prevalence of PTSD and other psychiatric diseases among limbs injured workers.
Methods: 47 limbs injured workers admitted in the Orthopedic ward of a teaching hospital in Taipei were recruited during July 2004 to February 2005. We interviewed those subjects within seven days after the injuries happened. Inform consents were signed. Basic information was collected using a questionnaire combined with the Chinese version of PTSD subschedule of the Mini-International Neuropsychiatric Interview(M.I.N.I.) and the Brief Symptom Rating Scale-5(BSRS-5) to explore the prevalence of PTSD and psychiatric comorbidities. 27 subjects were interviewed again one month after the injuries happened.
Results: Immediately after injuries, only two subjects fulfilled the full criteria of PTSD defined by the M.I.N.I., similar to the prevalence among general population, and 43% of the subjects got BSRS-5 scores equal to or greater than 6, which indicated that those subjects might have some kinds of psychiatric diseases and was estimated to be higher than that of previous studies. The condition still existed one month after injuries. Besides, the subsyndromal PTSD was much more prevalent among those subjects one month after injuries than immediately after injuries(41% vs. 19%), which was significantly different proved using McNemar’s test (p=0.01).
Conclusion: This primitive study suggested that psychiatric co-morbidities and subsyndromal PTSD might be important issues in treating limbs injured workers.

並列關鍵字

injured worker ； posttraumatic stress disordes ； psychiatric comorbidity

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