人工流产患者创伤后应激障碍现况及相关影响因素研究

发布时间：2018-05-31 09:21

本文选题：人工流产 + PTSD　；参考：《昆明医科大学》2017年硕士论文

【摘要】：[目的]对到云南省三家医院人工流产门诊进行复查或手术的人工流产患者进行调查,了解PTSD发生现状,并对应对方式以及焦虑、抑郁心理进行测评,旨在分析人工流产后出现的心理状况和采取的应对方式,探讨人工流产患者PTSD现状及相关影响因素,为降低人工流产率,减少患者PTSD的发生,为开展人工流产后关爱服务提供理论依据及对策。[方法]选择云南省昆明医科大学第一附属医院,昆明市妇幼保健院(丹霞院区)以及昆明城东医院三所医院的妇科门诊作为研究现场,将2016年6月至2017年3月该时间段自愿到上述三所医院妇科门诊进行复查(手术一个月以后)或手术(两年内有过人工流产史)的人工流产患者作为研究对象。采用自制调查表和量表进行调查。自制调查表内容包括:(1)人工流产女性社会人口学特征(年龄、婚姻状况、民族、职业等);(2)生育史;(3)性生活史;(4)人工流产史及人工流产原因;(5)性行为、对人工流产的态度;(6)人工流产相关心理、需求与行为;量表包括创伤后应激障碍自评量表(PCL-C)评测PTSD状况,简易应对方式量表(SCSQ)评测应对方式,医院焦虑抑郁量表(HADS)评测焦虑、抑郁状况。资料录入使用Epidata3. 1数据双录入,采用SPSS17. 0进行统计分析。[结果]本次调查共计180人,剔除填写不全,逻辑错误问卷后,有效问卷159份,合格率为88. 3%;年龄最小为15岁,最大为46岁,平均年龄为(27. 50±6. 25)岁,25岁以上的人数居多(65.4%),多数是已婚状态(66%);大多数首次性行为年龄为20～24岁,共86人(54. 1%),多数患者为首次妊娠,共64人(40. 3%),大多数还没有孩子,共88人(55. 3%),既往有过人工流产史的有79例(49. 7%),大多数人的性伴数为1个(61.0%)。不同心理状况人流患者应对方式得分有所不同;PTSD阳性检出者共计25人(15. 7%)。抑郁阳性检出者70人(44%),焦虑阳性检出者86人(54.1%)。以PTSD为因变量,年龄,婚姻状况,月收入,职业状况,文化程度等可能影响因素作为自变量进行Logistics回归分析,结果显示:生活满意度,创伤史,家庭经济状况,焦虑检出率对PTSD发生有正效应(P0.05),户口所在地对PTSD发生有负效应(P0.05)。[结论]人工流产人群年龄偏低,未婚女性所占比例高,重复人工流产率高且间隔时间短;人工流产患者心理问题普遍存在,PTSD阳性检出者共病焦虑抑郁比例高,人工流产是否增加PTSD患病风险尚无定论。
[Abstract]:[objective] to investigate the incidence of PTSD in patients undergoing reexamination or operation in three hospitals of Yunnan Province, and to evaluate the coping style, anxiety and depression. In order to reduce the rate of induced abortion and reduce the incidence of PTSD in patients with induced abortion, the psychological status and coping styles were analyzed, and the present situation of PTSD in patients with induced abortion and the related influencing factors were discussed in order to reduce the incidence of PTSD in patients with induced abortion. To provide theoretical basis and countermeasures for developing care services after induced abortion. [methods] the gynecological outpatients of the first affiliated Hospital of Kunming Medical University, Kunming Maternal and Child Health Hospital (Danxia District) and three hospitals of Kunming Chengdong Hospital were selected as the research site. Patients who voluntarily visited the gynecological clinics of the three hospitals during the period from June 2016 to March 2017 for reexamination (after one month of operation) or surgery (with a history of induced abortion in two years) were selected as the subjects of the study. Self-made questionnaire and scale were used to investigate. The contents of the self-made questionnaire include: 1) Social demographic characteristics (age, marital status, nationality, occupation, etc.) Social demographic characteristics (age, marital status, nationality, occupation, etc.) birth history of female patients (3) sexual history / 4) induced abortion history and causes of induced abortion (5) sexual behavior. Attitude to induced abortion: psychological, demand and behavior related to induced abortion; PTSD status was assessed by PCL-C scale, coping style was assessed by simple coping style scale, and anxiety was assessed by Hospital anxiety and Depression scale (HADS). Depression. Data entry using Epidata 3. 1 data double input, using SPSS 17. 0. [results] A total of 180 people were investigated, excluding incomplete filling and logical error questionnaire, 159 valid questionnaires, the qualified rate was 88. The minimum age is 15 years old, the maximum is 46 years old, the average age is 27. 5%. 50 卤6. 25) the majority of people aged 25 and over are 65.4%, most of whom are married; most of them have sex for the first time at the age of 20 to 24, or 86 persons. Most of the patients were pregnant for the first time, with a total of 64 patients with 40. 4% of the total. Most of them had no children, and there were 88 men. There were 79 cases with previous history of induced abortion. Most people have a sexual partner of 61.0. The scores of coping style of patients with different psychological status were different. The total number of patients who were positive for PTSD was 15. 5%. Seven. There were 70 patients with depression and 86 with anxiety. With PTSD as dependent variable, age, marital status, monthly income, professional status, education and other possible factors as independent variables, Logistics regression analysis showed that: life satisfaction, trauma history, family economic status, There was a positive effect on the occurrence of PTSD in anxiety detection rate and a negative effect on the occurrence of PTSD in the location of household registration (P 0.05). [conclusion] the age of induced abortion is low, the proportion of unmarried women is high, the rate of repeated abortion is high and the interval is short. Whether abortion increases the risk of PTSD is not conclusive.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R169.42

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