产妇产后创伤后应激障碍的现状及影响因素研究

The Research on the Current Situation and Influencing Factors of Postpartum Post-Traumatic Stress Disorder

摘要: 目的：调查产妇产后创伤后应激障碍的现状并分析其影响因素。方法：采用便利抽样法抽取某市产后1年内的妇女进行问卷调查，问卷包括自编一般人口学资料调查表、城市分娩创伤量表、领悟社会支持量表、简易应对方式测定量表，共回收有效问卷273份。结果：产妇产后创伤后应激障碍总均分为11.00 (5.00~22.00)分，处于中度水平；领悟社会支持总分为61.00 (49.00~71.00)分；积极应对得分2.00 (1.67~2.25)分，消极应对得分1.38 (1.00~1.75)分。单因素分析显示，初中学历的产妇产后创伤后应激障碍水平要高于高中以上学历的产妇。产后使用药物镇痛的产妇产后创伤后应激障碍得分要高于产后未使用药物阵痛的产妇。认为分娩是创伤性事件的产妇产后创伤后应激障碍得分高于否认分娩是创伤性事件的产妇。Spearman相关分析显示，领悟社会支持与创伤后应激障碍呈负相关(P < 0.05)，应对方式中积极应对与产后创伤后应激障碍中的一般症状维度呈负相关(r = −0.156, P < 0.01)。回归分析显示，产后使用药物镇痛、认为分娩是创伤性事件及家庭支持是产妇产后发生创伤后应激障碍的主要影响因素。结论：产妇产后创伤后应激障碍得分处于中等水平，临床护理过程中应关注学历较低、产后使用药物镇痛和认为分娩是创伤性事件的产妇，给予早期干预，进行分娩知识的宣教，及时给予患者止痛治疗，通过增强产妇的家庭支持，来降低产妇创伤后应激障碍的水平。

Abstract: Purpose: To investigate the current situation of postpartum post-traumatic stress disorder and analyze its influencing factors. Methods: A questionnaire survey was conducted among the postpartum women in a city within 1 year by convenient sampling method. The questionnaire included self-designed general demographic data questionnaire, City Birth Trauma Scale, perceptive social support scale and Simplified Coping Style Questionnaire. A total of 273 valid questionnaires were collected. Results: The total score of postpartum post-traumatic stress disorder was 11.00 (5.00~22.00), which was in the moderate level. Perceived Social Support score: 61.00 (49.00~71.00); The positive coping score was 2.00 (1.67~2.25) and the negative coping score was 1.38 (1.00~1.75). Univariate analysis showed that puerperal post-traumatic stress disorder level of junior high school diploma was higher than that of high school education or above. Post-traumatic stress disorder scores were higher in women who used drugs to relieve pain after delivery than in women who did not use drugs after delivery. Women who thought the birth was a traumatic event scored higher for post-traumatic stress disorder than those who denied it. Spearman correlation analysis showed that perceived social support was negatively correlated with post-traumatic stress disorder (P < 0.05), positive coping was negatively correlated with the general symptom dimension of posttraumatic stress disorder (r = −0.156, P < 0.01). Regression analysis showed that postpartum analgesia use, the perception of childbirth as a traumatic event, and family support were the main influencing factors for postpartum post-traumatic stress disorder. Conclusion: The scores of post-partum post-traumatic stress disorder are in the medium level. Medical personnel should pay attention to those who have low educational background, use drugs to relieve pain after childbirth, and consider childbirth to be a traumatic event, and provide early intervention, education on child-birth knowledge, timely analgesic treatment, and enhancing family support to reduce the level of postpartum post-traumatic stress disorder.