Posttraumatic stress disorder in hemodialysis patients
Posttraumatic stress disorder in hemodialysis patients
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DOI：
10.1053/j.ajkd.2007.06.018
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发表时间：
2007-10-01
影响因子：
13.2
通讯作者：
Senf, Wolfgang
中科院分区：
文献类型：
--
作者：
Tagay, Sefik;Kribben, Andreas;Senf, Wolfgang
背景资料：我们的目标是评估接受长期血液透析（HD）患者创伤后应激障碍（PTSD）的患病率和严重程度，并调查其与抑郁、焦虑、健康相关生活质量和服务利用的相关性。研究设计、设置和参与者：在一项横断面研究中，我们招募了144名HD患者（年龄，63.1 ± 14.2岁; 50.7%为男性）来自5个透析单位。因素：PTSD，根据事件影响量表修订版和创伤后应激诊断量表的标准定义。结果：身体健康、心理健康、抑郁、焦虑、生活满意度、服务利用。测量：事件影响量表修订版、创伤后应激诊断量表、医院焦虑和抑郁量表、简明健康调查表。结果：77.8%的HD患者报告至少1次创伤事件。PTSD的终生患病率为17%，与创伤类型无关。仅将HD作为潜在创伤事件的PTSD患病率为10.4%。女性报告更多的无助和更密集的经验，恐惧或恐怖比男性方面的压力A标准。PTSD患者的心理健康水平显著低于非PTSD患者（P < 0.01）。此外，更大的抑郁，焦虑，生活满意度较低，更多的服务利用与更大的创伤后症状。身体健康与创伤后症状无相关性。在偏相关分析调整抑郁症，创伤后症状，心理健康和焦虑之间的关联仍然robust.Limitations：其他设置，没有控制组，study power.Conclusions：PTSD是常见的HD患者，但很少有工作已经做了探索与PTSD相关的变量。数据表明，创伤后应激障碍是诊断不足和治疗不足的血液透析患者。干预措施应针对这些患者，目标是改善福祉和生活质量。
Background: We aim to assess the prevalence and severity of posttraumatic stress disorder (PTSD) in patients who receive long-term hemodialysis (HD) and investigate its correlation with depression, anxiety, health-related quality of life, and service utilization.Study Design, Setting & Participants: In a cross-sectional study, we recruited 144 HD patients (age, 63.1 +/- 14.2 years; 50.7% men) from 5 dialysis units.Factor: PTSD, defined in accordance with criteria of the Impact of Event Scale-Revised and Posttraumatic Stress Diagnostic Scale.Outcomes: Physical health, mental health, depression, anxiety, life satisfaction, service utilization.Measurements: Impact of Event Scale-Revised, Posttraumatic Stress Diagnostic Scale, Hospital Anxiety and Depression Scale, Short-Form Health Survey.Results: 77.8% of HD patients reported at least 1 traumatic event. The lifetime prevalence for PTSD, independent from trauma type, was 17%. PTSD prevalence only with regard to HD as a potential traumatic event was 10.4%. Women reported more helplessness and more intensive experiences of fear or horror than men with respect to the stressor A criterion. Patients with PTSD showed substantial decreases in mental health in comparison to patients without PTSD (P < 0.01). Additionally, greater depression, anxiety, less life satisfaction, and more service utilization were associated with greater posttraumatic symptoms. There was no correlation of physical health with posttraumatic symptoms. In partial correlation analyses adjusting for depression, associations between posttraumatic symptoms, mental health, and anxiety remained robust.Limitations: Generalizability to other settings, absence of control group, study power.Conclusions: PTSD is common in HD patients, but little work has been done to explore the variables associated with PTSD. Data suggest that PTSD is underdiagnosed and undertreated in HD patients. Interventions should target these patients with the goal to improve well-being and quality of life.