| Summary: | 碩士 === 國立台北護理學院 === 護理研究所 === 90 === Abstract
The purpose of this study is assessing the changes of the posttraumatic stress disorder (PTSD) symptoms ,depression and quality of life following accidentally injured patients. The study is an exploring and correlational design. Sixty subjects are chosen from orthopedic and traumatic units at two major Medical Centers in Taipei. Inclusion criteria include accidental injured without burn, head and spinal cord injury, age 18-65 years old, at least elementary graduated , no severe illness and psychiatry disorder, no psychiatric family history, and agree to attend this study . Data are collected at two stages, first time data are collected when patients are hospitalized 2-7 days following the accidents, then data will be collected again 6 weeks s by the interview at home . The instruments include Patients’ demographic and disease related variables, New Injury Severity Scale (NISS), Posttraumatic Stress Disorder Reaction Index (PTSD-RI), Beck Depression Inventory (BDI), State Anxiety Inventory（SAI）,SF-36 of the Medical Outcomes Study Questionnaire (SF-36). SPSS10.0 software were used for coding and data analysis. Statistic methods include mean, standard deviation, percentile, independent sample t- test, ANOVA, pearson’s correlation and stepwise regressions.
The results showed that the rate of PTSD at 1-week and 6-week were 87.5﹪and 82.8﹪, subjects with other disease and alcohol intoxication had a significantly lower score of PTSD-RI. There was no significant difference between two time point of PTSD. The rate of depression at 1-week and 6-week were 78.1﹪ and 62.5﹪. There was significant lower score of BDI at 6-week. Subjects with PTSD, no work, frnacial provider in family had significant higher score of BDI. The mean of SAI were 50.95（SD= 12.34）at 1-week and 45.59（SD= 12.73）at 6-week. There was significant lower score of SAI at 6-week. Quality of life was significantly improved at 6-week, including physical component health and mental component health, especially physical function, pain, role limit induced by emotion and activity. Subjects with depression and no work were significant poorer quality of life, with PTSD was significant poorer mental component health at 1-week. There were positive correlation between PTSD and depression( r= .70, p< .001), anxiety( r= .57, p< .001). There were negative correlation between PTSD and quality of life( r= -.47, p< .001), physical component health（ r= -.28, p= .037）, mental component health( r= -.57, p< .001). The stepwise regression analysis showed depression could explain 25﹪of the variance for PTSD at 6-week, 19﹪of the variance for the quality of life at 6-week. Anxiety and other disease could explain 19﹪of the variance for physical component health.Depression and litigation could explain 39﹪of the variance for mental component health. The result of this study benefits to understand influencing factors of PTSD, depression and anxiety, and predictors of PTSD, quality of life, physical component health and mental component health. Results of this research provide important information for health care professionals to design interventions for patients following traumatic injury.
Keywords：traffic accident, PTSD, depression, anxiety, quality of life.
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