| ObjectiveQuestionnaire survey was used to investigate the occurrence of acute stress disorder symptoms in patients with occupational hand trauma.To analyze the relationship between acute stress disorder and demographic characteristics,disease characteristics,anxiety,depression,mental resilience,social support and coping style of patients with occupational hand trauma,and to provide scientific basis for early and targeted nursing intervention measures to reduce the occurrence of acute stress disorder.MethodsThis research is a cross-sectional study.Using the objective sampling method,from June 2018 to July 2019,a Grade 3 A hospital in Jinan,Shandong province,which met the inclusion and exclusion criteria,was selected as the research object to conduct a questionnaire survey.The survey tools included the patient general information questionnaire,the Hospital Anxiety and Depression Scale(HAD),Social Support Rating Scale(SSRS),Chinese version of Conner-Davidson Resilience Scale(CD-RISC),Medical Coping Modes Questionnaire(MCMQ),and the Acute Stress Disorder Scale(ASDS).SPSS 21.0 software was used for data statistics and analysis,the methods mainly included the descriptive statistical analysis,Nonparametric test,T-test,Spearman correlation analysis and multiple linear regression analysis.Results1.In this study,a total of 257 patients with occupational hand trauma were investigated,and 250 valid questionnaires were returned,with an effective rate of 97.2%.The average age is 35.70±4.12.There were 166 male patients(66.4%).93 cases(37.2%)of high school and technical secondary school education;Extroversion 93 cases(37.2%);The family income was mainly 3,001-4,000 yuan in 95 cases(38.0%).The sources of medical expenses were mainly new rural cooperative medical care(NCMS)in 97 cases(38.8%).186 patients(74.4%)had complications.There were 161 cases of right hand trauma(64.4%).149 patients(59.6%)with fear symptoms at the time of trauma.2.The results of this study showed that the incidence of acute stress disorder was 30.4%.The total score of ASDS was 44.00(28.00,58.00),among which,the score of separation symptom was9.00(6.00,12.00)reexperience symptom was 9.00(6.00,13.00),avoidance symptom was 8.00(4.00,14.00),and the score of high alert symptom was 16.00(11.00,20.00).3.The total score of SSRS was(30.55±5.13),including(12.92±2.30)points for subjective support,(11.23±2.40)points for objective support,and(6.40±2.31)points for utilization of support.The total psychological resilience score was(64.89±16.96)points,among which the resilience score was(33.19±9.17),strength score was(20.90±6.08),optimism score was(10.80±2.92).The scores of medical response-face,medical response-avoid and medical response-yield were(18.25±5.43),(14.33±4.64)and(8.53±3.97)respectively.There were 134 patients(53.6%)with anxiety symptoms,70 patients(28%)with depression symptoms,65 patients(26%)with both anxiety and depression symptoms,with anxiety symptom score(8.37±5.02)and depression symptom score was(5.22±3.46).4.According to the univariate analysis,there were statistically significant differences in gender(P<0.001),personality(P<0.001),family income(P<0.05),complications(P<0.001),injured hand(P<0.001)and post-trauma fear(P<0.001).5.Spearman correlation analysis showed that the score of ASDS was negatively correlated with total scores of mental resilience(r=-0.685,P<0.01),strength(r=-0.724,P<0.01),resilience(r=-0.631,P<0.01)and optimism(r=-0.486,P<0.01).It was negatively correlated with total social support score(r=-0.496,P<0.01),subjective support(r=-444,P<0.01),objective support(r=-0.271,P<0.01),and utilization of support(r=-0.278,P<0.01).It was negatively correlated with coping score(r=-0.368,P<0.01),positively correlated with coping score(r=0.794,P<0.01)and avoidance score(r=0.519,P<0.01).And anxiety scores(r=-0.830,P<0.01)and depression scores(r=0.685,P<0.01).6.Multiple linear regression analysis showed that anxiety,complications,accompanied by fear after trauma,subjective support and yield entered the regression equation of the total ASDS score,with significant differences(P<0.05),which could explain the total variation of 70.2%.Conclusions1.The incidence rate of acute stress disorder in occupational hand trauma patients is high.It is suggested that medical staff and family members should increase the psychological counseling of occupational hand trauma patients and take active and effective countermeasures to promote their physical and mental recovery.Depression scores(r=0.685,P<0.01)were positively correlated2.For women,introverted personality,low family income,complications,fear after trauma patients should focus on timely communication,understand the inner needs of patients,early intervention measures should be provided.3.The incidence rate of anxiety and depression symptoms in occupational hand trauma patients is high,and some patients adopt avoidance and surrender coping methods,which suggests that medical staff should timely evaluate the level of anxiety and depression in patients,take effective emotional management methods,and help patients to face the disease optimistically and actively cooperate with treatment.4.Subjective support is the protective factor of acute stress disorder.yield,anxiety,fear after trauma and complications are the risk factors of acute stress disorder.Therefore,patients with occupational hand trauma are encouraged to communicate with the outside world more and get emotional support.Understand the needs of the patient and encourage the family members to give emotional and material support to the patient so that the patient feels respected,understand and cared for.Medical staff actively take intervention measures such as group therapy to reduce patients’ anxiety,improve patients’ cognition of the disease through various ways,help patients face the disease bravely,and reduce symptoms of acute stress. |
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