勞工職業傷害三個月發生創傷後壓力症候群之初步研究

A Pilot Study of Post-traumatic Stress Disorder among Workers Three Months after Occupational Injury

10.7005/JOSH.201109.0480

林冠含(Kuan-Han Lin)；胡佩怡(Pei-Yi Hu)；郭乃文(Nai-Wen Guo)；廖士程(Shi-Cheng Liao)；郭純雅(Chun-Ya Kuo)；黃耀輝(Yaw-Huei Hwang)；郭育良(Yue-Liang Leon Guo)；徐儆暉(Jin-Huei Hsu)

職業傷害 ； 創傷後壓力症候群 ； 重鬱症 ； 共病症 ； Occupational injury ； Major depression ； Post-traumatic stress disorder PTSD ； Comorbidity

勞工安全衛生研究季刊

19卷3期（2011 / 09 / 01）

480 - 501

繁體中文

職災後所引起之精神方面損傷是造成勞工無法回復正常工作一個很重要的因素，在回到工作後因精神損傷而再度離職的比例也不容忽視。本研究計畫之目標為追蹤發生職業外傷之勞工，以了解他們發生創傷後壓力症候群的發生率。本研究使用之評量工具為簡式精神症狀自陳量表(Brief Symptom Rating Scale, BSRS-50)、中文版簡式創傷後壓力疾患量表（簡稱SPAN-C）、與中文版迷你國際神經精神會談工具(the Chinese version of the Mini-international Neuropsychiatric Interview, MINI)。本研究分為兩階段評估調查，第一階段在勞工受傷發生之後的三個月以郵寄BSRS-50與SPAN-C問卷方式寄給3143位勞工填答，對未完整填答者，再以電話追蹤以達成完整填答。共完成1424位，回收率為45.3%。第二階段則是針對問卷初篩SPAN-C大於等於5分，或BSRS-50之綜合嚴重度指數大於2個標準差或其他次分項得分大於3個標準差者，共有308位(21.6%)，再由精神科專科醫師使用MINI作電話訪談，進行診斷。共有139位完成MINI電話訪視，有27位(19.4%)有創傷後壓力症候群(PTSD)，有26位(18.7%)有重鬱症。而兩者共病者有15位，因此罹患PTSD或重鬱症者共有38位(27%)。接受MINI電訪的139位與未接受電訪的169位之BSRS及SPAN-C得分無顯著差異。本研究結果顯示職傷對於勞工不僅僅是身體外傷的影響，心理的創傷也需要及時介入，做為預防的依據。

The workers who have been exposed to a traumatic event may display significant psychiatric disorders that make them unable to return to the workplace. This study aimed to determine the prevalence rates of PTSD and related mental conditions in the workplace after occupational injuries. A two-stage questionnaire investigation was conducted. The first stage of investigation involved a self-reported questionnaire, including the Brief Symptom Rating Scale (BSRS-50) and SPAN (an acronym for four items: startle, physiological arousal, anger, and numbness)-C (Chinese version), which was sent to injured workers at 3 months after injury, for screening of mental conditions. Those who scored at or higher than 2 standard deviations higher than norm were included for the second stage phone interview using a Mini-international Neuropsychiatric Interview (MINI) by psychiatrists. A total of 1424 workers had completed the self-report questionnaire (response rate 45.3%). Among them, 308 (21.6%) scored high in the screening questionnaire and were recruited, and finally 139 were finished the MINI interview. Among these MINI interviews, 27 were PTSD, 26 were major depression, and 15 were comorbid with PTSD and major depression. This study showed that occupational injuries may be related to PTSD and major depression.

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