RESUMO
Introduction: les troubles post-traumatiques survenant à la suite d'un accident de la route ont un impact tant sanitaire qu'économique. Méthodes: notre étude prospective, vise à déterminer la prévalence de ces troubles, et de dégager leurs facteurs de risque auprès de sujets victimes d'accidents de la route et hospitalisés au service de chirurgie orthopédique et de traumatologie du Centre Hospitalo-Universitaire de Sfax-Tunisie. Résultats: soixante-dix sujets ont été inclus dans notre étude. La prévalence de l'état de stress aigu était de 37,1% et il a été associé au sexe féminin, au niveau scolaire bas, à la présence d'antécédents médicochirurgicaux, à la passivité au cours de l'accident, à la sévérité des lésions, et à la présence d'une symptomatologie anxieuse et dépressive. Le trouble stress post traumatique était constaté chez 40% des sujets et il a été associé au milieu de résidence urbain, à la passivité au cours de l'accident, et à la symptomatologie anxieuse et dépressive. Des scores faibles des stratégies de coping fonctionnelles et des scores élevés des stratégies de coping dysfonctionnelles ont été significativement associés à ces deux troubles. Le niveau scolaire bas, la résidence en milieu urbain, un niveau élevé d'anxiété et de dépression et la stratégie de coping de déni apparaissent comme des facteurs de risque indépendants de l'état de stress aigu et du trouble stress post traumatique. Conclusion: il s'avère ainsi important de déterminer un profil de personnes plus exposées aux troubles post-traumatique afin de permettre un dépistage précoce par les médecins avec lesquels les accidentés pourraient avoir des contacts dans les suites de leurs accidents.
ntroduction: Post-traumatic stress disorder following a road accident has both a health and an economic impact. Methods: we conducted a prospective study to determine the prevalence of this disorder, and to identify risk factors in subjects victims of road accidents and hospitalized in the Department of Orthopedic Surgery and Traumatology of the University Hospital Center of Sfax-Tunisia. Results: a total of sixty-ten subjects were included in this study. The prevalence of acute stress was 37.1% and was associated with female sex, low educational level, previous medical and surgical history, passivity during the accident, severity of injuries and the presence of anxious and depressive symptoms. Post-traumatic stress disorder was observed in 40% of subjects and was associated with urban residential environment, passivity during the accident and anxious and depressive symptoms. Low scores for functional coping strategies and high scores for dysfunctional coping strategies were significantly associated with both disorders. Low educational level, urban residential environment, high levels of anxiety and depression, and denial coping strategy appear to be independent risk factors for acute stress and post-traumatic stress disorder. Conclusion: It is therefore important to determine the profile of people at greater risk of post-traumatic stress disorder, to enable early diagnosis in victims of road accidents.
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PrevalênciaRESUMO
Background: The chronic hemodialysis imposes various limitations on patients that may affect their quality of life. However, Tunisian studies on this matter remain scarce
Aims: To assess the quality of life among hemodialysis patients and to identify the factors influencing their quality of life
Methods: We performed a cross-sectional study which included 71 outpatients, during the month of January 2013, in the department of Nephrology at Hedi Chaker Sfax university hospital in Tunisia. We used the specific scale Kidney Disease Quality of Life Short-Form [KDQOL-SF[Trade Mark sign]] to assess the patient's quality of life. This instrument combines the short form 36 health survey questionnaire [SF-36] and a specific module adapted to renal function. Regression analysis was used to adjust for confounding factors
Results: The global average score, according to KDQOL-SF and the SF-36 were respectively 51.6 and 38.2. The QOL was impaired in 90% of the cases. The logistic regression identified six variables to be correlated with impaired QOL. These six factors in descending order of importance were: lack of autonomy, a dialysis rhythm of thrice a week, an age over 60 years, a comorbid diabetes, low social economic level and living in rural areas
Conclusion: Our study highlights the high frequency of QOL impairment upon patients on hemodialysis underlining the interest of a systematic effort to assess the quality of life in those patients. It also shows the interest of acting upon modifiable factors correlated with the alteration of the quality of life. In this way, the professional integration of the patients should be favored as well as peritoneal dialysis