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A Prospective Study on Psychological Crisis Intervention to On-the-Spot Rescuers in Accidental Disaster Event

Author: RenQingTao
Tutor: XuLingZhong;LiuYuQin
School: Shandong University
Course: Social Medicine and Health Management
Keywords: Sudden catastrophic events Site rescue personnel Acute Stress Disorder Post-traumatic stress disorder Psychological Crisis Intervention Impact factors and strength
CLC: B844.2
Type: Master's thesis
Year: 2009
Downloads: 815
Quote: 2
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Abstract


Research background of human society is always difficult to avoid natural disasters (such as \severity. The event of sudden disaster psychology affected population is divided into five levels, the second level of the crowd scene rescue workers are often ignored, after a disaster, they will be immediately put into the rescue work, due to their particular work environment, to face the painful picture , combined with work overload, emotional, cognitive and behavioral activities will produce psychological changes, this group of high-risk groups. Numerous studies documented psychological crisis intervention is not timely, there will be a series of serious psychological problems, therefore, timely psychological crisis intervention, it is very necessary to promote the psychological rebuilding them. Objective To study the effect of sudden catastrophic events in the psychological condition of the rescue workers at the scene and its psychological crisis intervention assessment, explore effective interventions psychological crisis; factors and to explore the impact of mental health in different time periods and its intensity. In order to actively prevent timely control and psycho-social impact caused by the disaster mitigation, to reduce the incidence and psychosocial functioning aftermath of mental illness, to prevent the generalization of psychological problems, and promote the reconstruction of post-disaster mental health, mental health protection of on-site rescue personnel deal with similar emergency event for future the psychology reference, as well as establish and improve China, provide the basis for scientific and psychological crisis intervention system. Determine the second level of the crowd in the psychological affected population in a the sudden disaster event (\177) for the target population. General condition survey of the target population in 1 week, structured interview survey of psychological crisis and acute stress disorder (ASD) diagnosis, as focus groups, in line with ASD, screening out the armed police fire officers and men (69), medical and rescue personnel (56) and (55), a total of 180 volunteers. Were randomly divided into two groups, the intervention group were 35,28 and 27, a total of 90 non-intervention group were 34,28 and 28, a total of 90. 1 week following psychological assessment of two groups: post-traumatic stress disorder symptom checklist (PCL-C) Anxiety Rating Scale (SAS), Self-Rating Depression Scale (SDS), quality of life, comprehensive assessment questionnaire (GQOLI ), Social Disability Screening Scale (SDSS), Social Support Rating Scale (SSRS), Simplified Coping Style Questionnaire (SCSQ), Eysenck Personality Questionnaire (EPQ). Non-intervention group psychological crisis management; intervention group from the psychological, social, biological angle the comprehensive psychological crisis intervention (psychological first aid, psychological interviews, stable emotions technical, relaxation techniques, cognitive behavioral therapy, eye movement desensitization and reprocessing therapy, supportive psychotherapy, psychological catharsis, coping styles, drug intervention, and so on), emphasize the multidimensional nature of the intervention, emergency psychological crisis intervention in the post-disaster four weeks the most urgent, in stages according to the results of the assessment after four weeks and then develop the appropriate psychological crisis intervention strategies, timely adjustment of intervention programs. And different populations, different stress scenarios do depth and expand, to play a specific effect of intervention. Different intervention model to support the resources to be integrated, so that the effects of interventions to achieve the best level. In a month after the intervention, three months and six months, and then the two groups above psychological assessment, diagnosis parallel post-traumatic stress disorder (PTSD). Comparisons between groups and longitudinal observation study psychological crisis intervention, short-term effects and long-effect group. And on-site rescue personnel in the different stages of psychological conditions influencing factors and strength using multivariate logistic regression analysis to investigate the risk factors and protective factors. Psychological crisis of the major findings (1) structured interviews findings show scene rescue workers there is a big psychological behavioral problems, nearly half of the on-site rescue workers have panic broke into nightmares, difficulty sleeping, anxiety and tension, 1/3 ruminating shocked reaction, headache, fatigue and depression. (2) of ASD clinical detection rate of 28.80%, armed police fire officers and men of 29.24% and 26.41%, medical and rescue personnel, volunteers 31.07%. (3) of the intervention group after the intervention of a month, three months, six months on the three measurement points PCL-C total score and subscale score decreased with the non-intervention group, the differences were statistically significant; The intervention group after the intervention one month, three months, six months, three measuring points on the PCL-C total score and subscale scores decreased compared with before the intervention, the differences were statistically significant. PTSD rate three measurement points (4) after the intervention, the intervention group decreased, with the non-intervention group, the differences were statistically significant. (5) in the intervention, the intervention group after three measuring points on SAS, SDS score decreased with the non-intervention group, the differences were statistically significant; intervention group after the intervention of the three measuring points on the SAS and SDS score gradually decreased. Compared with before the intervention, the differences were statistically significant. (6) three measuring points after the intervention, the intervention group GQOLI total score and dimension scores gradually increased, with the non-intervention group, the differences were statistically significant; be on GQOLI three measuring points in the intervention group after the intervention score and each dimension score gradually increased, compared with before the intervention, there were significant differences. (7) the intervention group after the intervention on the three measurement points SDSS score decreased compared with the non-intervention group, the differences were statistically significant; SDSS score three measuring points in the intervention group after the intervention decreased with intervention , the differences were statistically significant. (8) the intervention group after the intervention of the three measurement points on SSRS score and factor scores gradually increased, with the non-intervention group, the differences were statistically significant; intervention group after the intervention on the three measurement points SRSS total score and factor scores gradually increased, compared with before the intervention, the differences were statistically significant. (9) on the three measuring points after the intervention, the intervention group SCSQ actively respond to the score gradually increased, while negative coping scores decreased, and the non-intervention group, the differences were statistically significant; intervention group after the intervention three the measurement point SCSQ actively respond score gradually increased, while negative coping scores decreased compared with before the intervention, there were significant differences. (10) PCL-C total score as the dependent variable, and 21 as independent variables, logistic regression analysis. 7 results before the intervention, and finally into the regression equation of risk factors in order from strong to weak continuous working time, EPQ-N, on-site contact time, career; protective factors from strong to weak order EPQ-E seniority or soldiers age, stress history. A month after the intervention, and finally into the regression equation 9 risk factors in order from strong to weak continuous working time, EPQ-N, negative coping, on-site contact time; protective factors from strong to weak order psychological crisis intervention, EPQ-E, social support, and utilization of, and actively respond to the stress history. 6 months after the intervention, the last nine included in the regression equation, including the risk factors in order from strong to weak negative coping, EPQ-N, continuous working time, on-site contact time; protective factors from strong to weak order psychological crisis intervention, and actively respond to social support and utilization, EPQ-E, stress history. Conclusions and Recommendations Conclusions: sudden catastrophic event extensive and severe psychological impact of the on-site rescue workers, nearly 1/3 of the ASD incidence. Psychological crisis intervention can significantly reduce on-site rescue personnel PTSD symptoms, reduce the incidence of PTSD. Significant improvement in anxiety and depression, and significantly improve their quality of life and improve its social function. Social support, objective and subjective support and support utilization significantly enhanced. Can effectively improve the utilization of active coping styles, reducing the use of passive coping style. Through the psychological crisis intervention, not only to prevent the further development of the site rescue personnel crisis, but also to help them learn new coping skills, and the strength of the negative emotions into psychological rehabilitation, psychological balance is restored to pre-crisis levels even more than . Analysis of influencing factors, occupation only as a risk factor for the intervention of the mental health impact from strong to weak order of volunteers, armed police fire officers and soldiers, field ambulance personnel; seniority or soldiers age only prior to the intervention as a protective factor; EPQ -N and EPQ-E before the intervention, after the intervention of three measuring points on 1 month and 6 months, respectively, as the risk factors and protective factors; site contact time and continuous work time as a risk factor for the three measurement points; should the stimulated History as protective factors in the three measurement points; social support and its utilization, and actively respond the way and psychological crisis intervention as protective factors in the two measuring points on 1 month and 6 months after the intervention, while negative coping style as risk factors in the process of psychological crisis intervention to reduce or avoid the risk factors, the use of protective factors to promote mental health recovery. Recommendation: psychological crisis intervention for sudden catastrophic event from the following three aspects: First, the establishment of a crisis intervention system, and actively carry out psychological assistance; Second, is to carry out a study of psychological stress, build social support system (epidemic of stress-related mental disorders science and clinical research, stress response, assessment tools and mental health relief plan research); create a positive psychological quality, and foster public mental endurance. Through this study, we can get the following revelations: First, build the psychosocial emergencies early warning system; build emergency psychological crisis intervention network; integrate various support resources, and the establishment of a coordination mechanism; fourth is to strengthen intervention of the crowd; strengthen the professional training of the staff of the psychological crisis intervention, establish a training mechanism; six the sound psychological intervention system (including advance the prevention, intervention in the matter and the subsequent correction mechanisms); Seventh establish psychological trauma interfere with the work of a long-term mechanism to strengthen the mental plan of return visits and reconstruction; eight security system, establish and improve laws and regulations. Moreover, the psychological crisis intervention work is a systematic project, which requires multi-sectoral linkage, one is the proposed government-led coordination of relevant departments, emergency start \they recognize the psychological obstacles, to master the psychological crisis intervention skills. Use of executive power, and encourage them to find and help more people in need of psychological help around, in order to receive timely intervention to promote reconstruction work to better carry out. Second, the to intensify scientific propaganda, psychological knowledge of the popularity of high-risk groups, organizations, and improve their ability to deal with psychological crisis, and to reduce the occurrence of negative life events. Depth psychological treatment of persons with serious psychological problems. Psychological services to extend the implementation of the special high-risk groups to the general population, and the popularity of the knowledge of psychology, psychological counseling and group counseling, individual depth counseling and treatment organically combined, so the popularity of both surface and little bit more in-depth, the main contents include post-traumatic stress disorder, depression, suicide recognition and control. Five technical work by medical institutions have the ability to undertake, emergency additional mental health sub-centers of the Centers for Disease Control, and create the appropriate working conditions.

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