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Journal Article

Citation

Wu H, Zhang F, Cheng W, Lin Y, Wang Q. Shanghai Arch. Psychiatry 2017; 29(2): 77-84.

Affiliation

Department of Trauma Orthopedics, the First People's Hospital affiliated to Shanghai Jiao Tong University, Shanghai, China.

Copyright

(Copyright © 2017, Shanghai Mental Health Center)

DOI

10.11919/j.issn.1002-0829.216070

PMID

28765678

PMCID

PMC5518264

Abstract

BACKGROUND: Those injured in accidents commonly have strong emotional reactions to their situation. However, despite the large number of patients who are admitted to general hospitals each year for orthopedic injuries due to an accident, research focusing on psychological disorders due to these injuries is lacking.

OBJECTIVE: To investigate the presentation and factors related to depression and acute anxiety among inpatients being treated for injury on a Trauma Orthopedics Unit.

METHODS: 323 patients with orthopedic trauma were evaluated using the Injury Severity Score (ISS), Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD).

RESULTS: In this study, a total of 323 inpatients (213 males and 110 females) had a mean (sd) age of 44.3 (13.2) years old. Mean (sd) time in the hospital was 11.1 (5.7) days with a range of 2 to 40 days. Among these patients, 299 had mild trauma, 20 had moderate trauma, and 4 had severe trauma. Patients had a mean (sd) score of 8.1 (4.9) with a range of 1 to 38. The top three most reported symptoms from the HAMA were sleep disorder, gastrointestinal symptoms and anxiety. The top three most reported symptoms from the HAMD were sleep disorder, depression and anxiety. Non-conditional logistic regression analysis showed that being female (anxiety: OR=2.738, 95%CI=1.511-4.962; depression: OR=2.622, 95%CI=1.504-4.570) and duration of hospitalization (anxiety: OR=1.091, 95%CI=1.040-1.145; depression: OR=1.093, 95%CI=1.044-1.144) were risk factors for anxiety and depression among these orthopedic trauma patients.

CONCLUSION: The main acute symptoms of anxiety and depression in these orthopedic trauma inpatients were sleep disorder, gastrointestinal symptoms, anxious mood and depressed mood. Female patients had stronger emotional reactions to injuries than males. Persistent anxiety and depression symptoms were associated with the duration of hospitalization. All these suggest the need for early psychological assessment and intervention for orthopedic trauma inpatients. 背景: 意外伤害事件易致受伤者产生强烈的情绪反应。 国内对此类心理状况变化越来越重视,但针对该人群 情绪反应的调查不足。综合医院骨科病房存在大量意 外伤患者,目前缺少针对该人群情绪反应调查。. 目的: 探讨意外伤骨科住院患者急性焦虑抑郁表现及 影响因素。. 方法: 对323 例意外伤骨科住院患者进行创伤严重度 评分(Injury Severity Score,ISS)、汉密尔顿焦虑量表 (Hamilton anxiety scale, HAMA)、汉密尔顿抑郁量表 (Hamilton depression scale, HAMD)评估。. 结果: 本调查共入组患者323 例,其中男性213 例, 女性110 例,平均年龄44.32 (13.17) 岁;住院时间2-40 天,平均住院时间11.09 (5.64) 天。轻度创伤299 人, 中度创伤20 人,重度创伤4 人。ISS 评分1-38 分,平 均8.09(4.86)分。HAMA 量表报告人数最多的前3 位 症状分别为睡眠障碍、胃肠道症状和焦虑心境;HAMD 量表报告人数最多的前三位症状为睡眠障碍、抑郁情 绪和精神性焦虑。非条件Logistic 回归分析显示女性(焦 虑:OR=2.738, 95%CI=1.511-4.962; 抑郁:OR=2.622, 95%CI=1.504-4.570)、住院时间长(焦虑:OR=1.091, 95%CI=1.040-1.145; 抑郁:OR=1.093, 95%CI=1.044-1.144)为骨科意外伤患者发生焦虑抑郁的危险因素。. 结论: 意外伤骨科住院患者急性焦虑抑郁症状集中在 睡眠紊乱、胃肠道症状和焦虑抑郁情绪,女性患者对 于意外伤的情绪反应较男性更强烈,焦虑抑郁症状持 续存在与患者住院时间长相关,提示需要对意外伤骨 科住院患者进行早期心理评估及干预。.


Language: en

Keywords

accidental injury; anxiety; depression; inpatient

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