Acil servis travma hastalarında travma şiddetinin peritravmatik stres ölçeği özelinde değerlendirilmesi
[ X ]
Tarih
2025
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Alanya Alaaddin Keykubat Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışma, acil servise başvuran travma hastalarında travma şiddeti ile peritravmatik dissosiyatif tepkiler arasındaki ilişkiyi değerlendirmek amacıyla planlanmıştır. Travma şiddeti Injury Severity Score (ISS) ile, dissosiyatif yanıt düzeyi ise Peritraumatic Dissociative Experiences Questionnaire (PDEQ) ile ölçülmüş; veriler tanımlayıcı, karşılaştırmalı, korelasyon ve regresyon analizleri yoluyla değerlendirilmiştir. Araştırmaya Alanya Alaaddin Keykubat Üniversitesi Tıp Fakültesi Acil Servisi'ne travma nedeniyle başvuran 200 hasta dahil edilmiştir. Katılımcıların yaş ortalaması 37,47 ± 14,95 yıl olup, %64'ü erkektir. Ortalama ISS skoru 7, PDEQ skoru ise 16 olarak saptanmıştır. Travma şiddeti arttıkça dissosiyatif tepkilerde anlamlı bir artış gözlenmiş, ISS değeri yüksek bireylerde PDEQ ?20 olasılığı anlamlı düzeyde artmıştır (OR = 3,44; p = 0,004). ROC analizine göre ISS için AUC değeri 0,677 olarak bulunmuş, en iyi ayırıcı eşik değeri ISS = 10 olarak hesaplanmıştır. Cinsiyet değişkeni dissosiyatif etkilenim açısından anlamlı bulunmuş, kadınlarda PDEQ skorları daha yüksek saptanmıştır. Çoklu regresyon analizinde ISS ve cinsiyet bağımsız parametre olarak öne çıkarken, yaşın etkisi anlamlı bulunmamıştır. AIS dağılımı ekstremite ve yüz bölgelerinde yoğunlaşmakta olup, baş-boyun travmalarında belirgin sayıda orta-yüksek şiddette yaralanma tespit edilmiştir. Sonuç olarak, kadın cinsiyette travma şiddeti arttıkça stres düzeyi artmaktadır. Yaş ise stres düzeyini etkilememektedir. Yalnızca fiziksel travma şiddetinin değil, bireysel ve psikososyal değişkenlerin de peritravmatik dissosiyasyonun gelişiminde etkili olduğunu göstermektedir. Acil servis ortamında travma sonrası psikolojik etkilenimi erken dönemde belirlemeye yönelik değerlendirmelerin yapılması, bütüncül sağlık hizmeti sunumu açısından önem arz etmektedir. Anahtar Kelimeler: Dissosiyasyon; Travma Şiddeti; ISS Skoru; PDEQ; Acil Servis
This study was designed to evaluate the relationship between trauma severity and peritraumatic dissociative responses in patients admitted to the emergency department due to trauma. Trauma severity was assessed using the Injury Severity Score (ISS), while dissociative responses were measured with the Peritraumatic Dissociative Experiences Questionnaire (PDEQ). The data were analyzed through descriptive, comparative, correlational, and regression-based statistical methods. A total of 200 patients who presented to the Emergency Department of Alanya Alaaddin Keykubat University School of Medicine due to trauma were included in the study. The mean age of the participants was 37.47 ± 14.95 years, and 64% were male. The mean ISS and PDEQ scores were calculated as 7 and 16, respectively. A significant increase in dissociative responses was observed as trauma severity increased, and the likelihood of having a PDEQ score ?20 was significantly higher in individuals with elevated ISS values (OR = 3.44; p = 0.004). Receiver Operating Characteristic (ROC) analysis yielded an Area Under the Curve (AUC) value of 0.677 for the ISS, with the optimal cut-off determined as 10. Gender was found to be significantly associated with dissociative responses, with females exhibiting higher PDEQ scores. In multivariate regression analysis, ISS and gender emerged as independent predictors, whereas age did not show a statistically significant effect. The AIS (Abbreviated Injury Scale) distribution revealed a predominance of injuries in the extremities and facial regions, while a considerable number of moderate-to-severe injuries were also identified in the head and neck areas. As a result, as the severity of trauma increases in the female gender, the stress level increases. Age does not affect the stress level. That not only physical trauma severity but also individual and psychosocial factors contribute to the emergence of peritraumatic dissociation. Early assessment of psychological responses following trauma in the emergency setting is essential for providing integrated and comprehensive healthcare services. Keywords: Dissociation; Trauma Severity; ISS Score; PDEQ; Emergency Department
This study was designed to evaluate the relationship between trauma severity and peritraumatic dissociative responses in patients admitted to the emergency department due to trauma. Trauma severity was assessed using the Injury Severity Score (ISS), while dissociative responses were measured with the Peritraumatic Dissociative Experiences Questionnaire (PDEQ). The data were analyzed through descriptive, comparative, correlational, and regression-based statistical methods. A total of 200 patients who presented to the Emergency Department of Alanya Alaaddin Keykubat University School of Medicine due to trauma were included in the study. The mean age of the participants was 37.47 ± 14.95 years, and 64% were male. The mean ISS and PDEQ scores were calculated as 7 and 16, respectively. A significant increase in dissociative responses was observed as trauma severity increased, and the likelihood of having a PDEQ score ?20 was significantly higher in individuals with elevated ISS values (OR = 3.44; p = 0.004). Receiver Operating Characteristic (ROC) analysis yielded an Area Under the Curve (AUC) value of 0.677 for the ISS, with the optimal cut-off determined as 10. Gender was found to be significantly associated with dissociative responses, with females exhibiting higher PDEQ scores. In multivariate regression analysis, ISS and gender emerged as independent predictors, whereas age did not show a statistically significant effect. The AIS (Abbreviated Injury Scale) distribution revealed a predominance of injuries in the extremities and facial regions, while a considerable number of moderate-to-severe injuries were also identified in the head and neck areas. As a result, as the severity of trauma increases in the female gender, the stress level increases. Age does not affect the stress level. That not only physical trauma severity but also individual and psychosocial factors contribute to the emergence of peritraumatic dissociation. Early assessment of psychological responses following trauma in the emergency setting is essential for providing integrated and comprehensive healthcare services. Keywords: Dissociation; Trauma Severity; ISS Score; PDEQ; Emergency Department
Açıklama
Anahtar Kelimeler
Acil Tıp, Emergency Medicine
