《中国康复理论与实践》

《中国康复理论与实践》 ›› 2015, Vol. 21 ›› Issue (06): 717-722.

• 特稿 • 上一篇    下一篇

斯坦福急性应激反应问卷在创伤性骨折患者中的应用

李阳，陈长香   

  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2015-06-25 发布日期:2015-06-25

Application of Stanford Acute Stress Reaction Questionnaire in Trauma Fracture

LI Yang, CHEN Chang-xiang   

  1. College of Nursing and Rehabilitation, North China University of Science and Technology, Tangshan, Hebei 063000, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2015-06-25 Online:2015-06-25

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摘要： 目的 探讨斯坦福急性应激反应问卷(SASRQ)中文版在创伤性骨折患者中的应用情况。方法 以河北省唐山市第二医院创伤性骨折患者96例作为被试，在创伤后2周内采用SASRQ中文版进行评测，间隔2 d后进行第2次评测。后期应用SASRQ中文版、创伤严重度评分法AIS-ISS(Abbreviated Injury Scale-Injury Severity Score)调查496例创伤性骨折患者。结果 SASRQ中文版的Cronbach α 系数为0.930。各维度Cronbach α 系数为0.729~0.812 (P<0.01)；重测相关系数为0.980(P<0.01)。应用SASRQ评测创伤性骨折患者存在应激障碍(ASD)者 133例(26.8%)。根据单个条目≥3为阳性筛查，有分离症状者 157例(31.7%)；有创伤再体验症状者 246(占 49.6%)；有回避症状者 196例(39.5%)；有焦虑或醒觉性增高症状者 375例(75.6%)。ASD阳性组 SASRQ总分(t=37.807,P<0.001)及各维度分(t值分别为 36.503, 29.019, 31.111, 19.369, P<0.001)显著高于阴性组。不同年龄组的 SASRQ总分及各维度分有非常高度显著性差异(F值分别为112.319, 94.109, 95.099, 103.291, 61.497, P<0.001)，老年组的急性应激症状较轻。女性SASRQ总分及各维度分显著高于男性(t值分别为7.707, -6.190, -8.944, -7.221, -9.949, P<0.001)。不同创伤类型的SASRQ总分及各维度分有非常高度显著性差异(F值分别为68.516, 44.464, 59.725, 48.966, 54.827, P<0.001)，车祸伤患者较非车祸伤患者急性应激症状严重。不同创伤程度的SASRQ总分及各维度分有非常高度显著性差异(F值分别为63.584, 69.704, 51.569, 43.669, 33.911, P<0.001)，轻度创伤组的急性应激症状较轻。结论 创伤性骨折患者急性应激障碍发生率较高，存在着显著的性别和年龄差异。

关键词: 创伤性骨折, 斯坦福急性应激反应问卷, 信度, 急性应激障碍

Abstract: Objective To discuss the application of Chinese version of Stanford Acute Stress Reaction Questionnaire (SASRQ) in traumatic fracture patients. Methods 96 patients with traumatic fracture in the Second Hospital of Tangshan City were recruited in the early stage. All the subjects were assessed with SASRQ in 2 weeks after trauma for the first time, and then they were assessed with SASRQ for the second time after an interval of 2 days. 496 patients with traumatic fracture completed SASRQ and Abbreviated Injury Scale-Injury Severity Score (AIS-ISS) assessment. Results The Cronbach's alpha was 0.930 in SASRQ, and were 0.729~0.812 in each dimension (P<0.01). Test-retest reliability at 2-day intervals was 0.980 (P<0.01). 133 cases (26.8%) were detected with acute stress disorder (ASD). According to a single entry ≥3 as a positive screening, 31.7% suffered separation symptoms, 49.6% suffered re-experience traumatic symptoms, 39.5% suffered avoidance symptoms, 75.6% suffered symptoms of anxiety or increased awareness. The scores of SASRQ (t=37.807, P <0.05) and each dimension (t=36.503, 29.019, 31.111, 19.369, respectively, P<0.001) was significantly higher in the ASD positive group than in the negative group. There was significantly difference in the score of SASRQ and each dimension in different age groups (F=112.319, 94.109, 95.099, 103.291, 61.497, respectively, P<0.001), the acute stress symptoms were lighter in the older group than in the other groups. There was significantly difference in the score of SASRQ and each dimension between men and women (t= 7.707, -6.190, -8.944, -7.221, -9.949, respectively, P<0.001), the acute stress symptoms were lighter in men than women. There was significantly difference in the score of SASRQ and each dimension in different trauma types (F=68.516, 44.464, 59.725, 48.966, 54.827, P< 0.001), the acute stress symptoms were severer in the traffic accident patients group than in the other groups. There was significantly difference in the score of SASRQ and each dimension in different trauma degrees (F=63.584, 69.704, 51.569, 43.669, 33.911, respectively, P< 0.001), the acute stress symptoms were lighter in the lighter group than in the other groups. Conclusion There is a high incidence and clear gender and age differences of ASD in patients with traumatic fracture.

Key words: traumatic fracture, Stanford Acute Stress Reaction Questionnaire, reliability, acute stress disorder