【摘要】目的對一線臨床科室參與汶川地震抗震救災的外援護士和本土護士的社會支持系統進行調查研究。方法隨機抽取抗震救災一線科室(ICU、骨科、急診)外援護士及本土護士各175名,設為外援組和本土組,采用對地震的自我認知問卷及社會支持評定量表(SSRS)進行測評。結果兩組護士對地震相關知識的知曉情況、響應抗震救災的行為表現、地震對專業的影響等方面無明顯差異(Pgt;0.05);兩組護士的社會支持總分均低于國內常模 (Plt;0.01),除外援組主觀支持維度得分與國內常模無顯著差異(Pgt;0.05)外,兩組的社會支持其它各維度得分均低于國內常模,外援組的社會支持總分及主觀支持、客觀支持得分均高于本土組(Plt;0.01),兩組對支持的利用度無明顯差異(Pgt;0.05)。結論為抗震救災一線科室護士提供積極的社會支持是保證心理健康的重要措施。【Abstract】ObjectiveTo evaluate the difference of psychological state between local and nonlocal nurses during the Wenchuan Earthquake. Methods A total of 175 local nurses and 175 nonlocal nurses were randomly selected and investigated by SSRS and the earthquake questionnaire. Results There were no significant differences in their knowledge about the earthquake, professional identity and action (Pgt;0.05). The total and the three dimensions scores of SSRS of the two groups were lower than those of the domestic norms (Plt;0.01) except the subjective support dimensions. The total scores, objective support and subjective support dimensions scores of nonlocal group were higher than that in the local group (Plt;0.01). In coping style questionaire, there were significant differences in solving problems and retreat factor(Plt;0.01)and no significant differences in remorse, salvation and illusion(Pgt;0.05). Conclusion The earthquake affected mental health of the nurses and their psychological state need to be much concerned,especially the nonlocal ones.
Objective To explore the effect of a teamwork intervention during their rehabilitation process for patients who had undergone an amputatation after an earthquake. Methods A total of 85 patients undergoing amputation were included in the study. A rehabilitation team consisting of orthopaedic doctors, orthopaedic nurses, physical therapists, professional therapists, psychology consultants, volunteers, social workers, patients and their relatives participated in the comprehensive rehabilitation program. The outcome of this teamwork intervention was evaluated. Results Statistically significant improvement was observed in terms of patients’ physiological, psychological and social roles after the teamwork intervention ( Plt;0.05). Conclusion The teamwork intervention can improve the overall outcome of rehabilitation, including quality of life, in amputated patients following an earthquake.
ObjectivesTo explore the using status of psychological assessment instruments including checklists, questionnaires and scales after earthquake, so as to provide baseline data for establishing a standard method and process in developing earthquake-related population psychological screening and assessment instruments in future. MethodsWe searched WanFang Data, CNKI, VIP, PubMed, EMbase, The Cochrane Library and CiNii databases, as well as special websites about earthquake and disaster management from inception to July 30th, 2014 to collect studies evaluating the population psychological health conditions with assessment instruments after earthquakes. The earthquake countries/regions, the main assessment institutions, the time of assessment, the objects of assessment, and the instruments used were analyzed. ResultsA total of 794 studies were included, of which 87.4% were from mainland China, and 78.0% were related to the Wenchuan earthquake. Most of assessments were conducted by universities (47.9%) and hospitals (46.9%) in Sichuan, Beijing and Guangdong provinces of China. The psychological assessments conducted in the first year after quake were found in 537 studies (67.6%), of which 244 studies (45.4%) reported the psychological assessments results in the first month after quake. The top five assessment objects were children/teenagers, survivors, wounded, military rescuers, and medical staff. In the 794 included studies, a total of 217 instruments were used. In the 244 studies reported the assessment results in the first month after quake, a total of 73 instruments were used. 122 of the 244 studies reported only one instrument was used, and the other 122 of the 244 studies reported two or more instruments were used. Most of the instruments were translation versions and developed for mental disorders. The top 5 instruments were Symptom Checklist 90, Self-Rating Depression Scale, Self-Rating Anxiety Scale, PTSD Checklist-Civilian Version and Impact of Event Scale Revised, respectively. ConclusionAll the psychological assessment instruments are not developed for assessing earthquake-related psychological health problem, so a simple, economic, feasible and specialized instrument for earthquake-related population should be developed. It's needed to organize professionals to design a local guideline and training material for earthquake survivors and rescuers, and to establish a standardized, sustainable normal training base and trainer's team, so as to standardize the psychological aid work.
Shortly after Wenchuan earthquake, the leader group of the West China Second Hospital accurately defined the role of the hospital during the medical rescue work and ensured the safety of the inpatients. It cooperated with West China Hospital, going to the main battlefield to rescue the injured people, congregating the main medical resources to the disaster areas for medical rescue. The model of the hospital was immediately transformed from the regular state into a double-track emergent state. Scientific allocation and dispatch of the resources were ensured to meet the ever-changing demands from all levels of rescue work. Assembling the elite, 12 medical teams and 148 medical staff in all were dispatched to Beichuan, Mianyang, Shifang and Dujiangyan as well as other severe disaster areas. Up to June 2nd, 329 patients from the disaster area had been treated, of whom 132 were admitted into the inpatient department, no one died. Moreover, even during such a period of time, the routine medical service had been offered as regular to patients other than the wounded in the disaster.
Objective To discuss the treatment of craniocerebral injuries caused by earthquake. Methods Retrospective analysis of clinical information for 256 patients with craniocerebral injury caused by an earthquake. Results The ‘Classification and Treatment’ was applied to the patients, whether or not they were operated on. A total of 146 patients were cured, 68 improved, 24 remained dependent on the care of others, and 8 died. The mortality rate was 3.13%. Conclusion Applying the ‘Classification and Treatment’ to patients with craniocerebral injury following an earthquake supported the use of medical resources and was associated with a low rate of death and disability.
Objective To observe the effect of mental nursing for operation patients with earthquake trauma on their rehabilitation. Methods Eighty operation patients with earthquake trauma were randomly divided into two groups: mental nursing group and conventional nursing group. Psychological consult was used in the mental nursing group. Results were recorded by psychologic test, investigation questionnaire and nursing statistics. The measuring scales included SCL-90, HAMD and HAMA. Results The degree of satisfaction in the mental nursing group was obviously higher than that in the conventional nursing group. The scores of depression and anxiety in the mental nursing group were lower than these in the conventional nursing group. The length of hospital stay in the mental nursing group was also shorter (Plt;0.05). Conclusion Mental nursing could reduce dysphrenia in operation patients with earthquake trauma and facilitate their rehabilitation.
During the medical rescue of Wenchuan earthquake, on the condition of ensuring the security of producing environment and food, following the four concepts including standard production, instant cooling technology, networking management and nutrition guidance, the CPU of West China Hospital stopped the production of possibly uncontrolled food, developed a reasonable plan for materials in stock, reinforced the inspection of sources of raw materials and quality of food, adjusted styles of dishes, proviced made special food for the wounded and their relatives from different districts and nationalities, new dishes for the wounded and the medical staff, so as not only to assure the nutrition for the slightly wounded, but also to provide the individualized nutrition treatment for the severely wounded. A total of 70 077 person-times for the wounded from the disaster area (36 330 person-times for the wounded and 33 747 person-times for their family members), and 36 273 person-times for doctors and nurses have been served. Meanwhile, the food service has also been offered as regular to other patients and hospital staff, with a maximum of 18 372 person-times per day.
Objectives To evaluate the effectiveness, safety, applicability and economy of psychological assessment instruments including checklists, questionnaires and scales used in population exposed to earthquake. MethodsWe searched PubMed, EMbase, The Cochrane Library, CBM, CNKI, VIP, WanFang Data, and CiNii databases, as well as special websites about earthquake and disaster management from inception to July 30th, 2014 to collect studies related to psychological assessment of population exposed to earthquake in the first month after quake. A descriptive analysis was conducted to analyze the positive detection rate of psychological problems, rate of informed consent, and effective response rate in population exposed to earthquake, as well as the cost of psychological assessment. ResultsA total of 67 studies were included which involved 4 instruments including Symptom Checklist 90 (SCL-90), Self-Reporting Questionnaire-20 (SRQ-20), Chinese Psychosomatic Health Scale-134 (CPSHS-134) and 12-item General Health Questionnaire (GHQ-12). SCL-90 was the most commonly used scale. Forty-five studies reported the positive detection rate of psychological problems in population exposed to earthquake. The positive detection rates by using SCL-90, GHQ-12 and SRQ-20 were 8.6% to 77.8%, 65.6% to 89.9% and 65.6% to 89.9%, respectively. Informed consent was reported in 27 studies, and effective response rate was reported in 20 studies with the highest one 99.56% for CPSHS-134. No study reported the cost of psychological assessment. ConclusionSCL-90, RQ-20, CPSHS-134 and GHQ-12 are mainly used instruments for assessing psychological problems in population exposed to earthquake in the first month after quake. The reporting of important information related to effectiveness, safety, applicability and economy of psychological assessment instruments is insufficient and not standardized. A concise and authoritative psychological assessment instrument for population exposed to earthquake is warranted.
Objective To systematically analyze and compare the casualties’ medical evacuation (ME) in Wenchuan and Yushu earthquakes, so as to provide useful references for earthquake casualties’ ME in the future. Methods The data about casualties’ ME in Wenchuan and Yushu earthquakes were collected from the field research, work statement of the Ministry of Health, official websites, and literatures. And the descriptive analysis was then performed. Results From Wenchuan to Yushu, the principle of ME tended to be “early evacuation, all evacuation”; the evacuation level was gradually simplified, the casualties were evacuated directly from the disaster area to the rear hospital through highway and railway, or air evacuation became the major method of ME; triage became less prominent, while specialist treatment was strived as early as possible. Conclusion The early establishment of appropriate evacuation principles, building of a simplified evacuation system, ensuring adequate medical transport capacity, and scientific assessment of treatment capacity at all levels are the main issues of effective and safe ME after earthquakes that require to be solved urgently.
Objective To comparatively analyze the rationality of emergency medication after Wenchuan earthquake with that after Lushan earthquake in West China Hospital of Sichuan University, based on the use of medicine of the victim’s disease spectrum. Method By using Excel, defined daily dose system (DDDs) and drug utilization index (DUI) were used as the evaluation indexes to analyze the rationality of emergency medication in West China Hospital of Sichuan University within one month after Wenchuan earthquake and Lushan earthquake. Results Within one month after Wenchuan and Lushan earthquake, there were 1 839 and 488 victims treated in the hospital, respectively. Within one month after the two earthquakes, the variation tendency of DDDs of drugs and number of victims was consistent, and the consistency was better in Lushan earthquake than that in Wenchuan earthquake. Among the 60 drugs which DDDs were ranked top five in their pharmacological class (top ten for antimicrobials) in Wenchuan earthquake, the majority of them were injections (injections vs. non-injections: 70.0% vs. 30.0%); the results showed that the medication (DUI=1) only accounted for 10.0%, the medication (DUI<1) accounted for 28.3%, which implied that the use of drugs was insufficient, the medication (DUI>1) accounted for 61.7%, which implied that drugs were overused; the average of DUI was 1.61. And in Lushan earthquake, injections also accounted for a larger proportion than non-injections (63.3%vs. 36.7%); the results showed that the medication (DUI=1) accounted for 15.0%, the medication (DUI<1) accounted for 38.3%, the medication (DUI>1) accounted for 46.7%; the average of DUI was 1.30. Conclusions Base on the DUI, we draw the conclusion that the rationality of emergency drug use and the timeliness of emergency drug supply were better in Lushan earthquake than those in Wenchuan earthquake. But the rationality of using the DUI, which is an evaluation index for normal conditions, to evaluate the emergency conditions still needs to be further verified.