入住NICU新生儿家长的心理健康问题调查及对策

目的探讨入住NICU新生儿家长的心理健康问题及对策。方法采用症状自评量表和自编问卷对120位家长进行调查,并与国内常模进行比较。结果家长在患儿住院期间,躯体化、强迫症状、人际关系、抑郁、焦虑、敌对、恐惧、紧张等因子分明显高于国内常模,偏执、精神病性因子分与常模相比无明显差异。结论入住NICU新生儿家长在患儿住院期间心理问题较多,需有针对性地实施心理护理。     

护理访谈对首发精神分裂症病人家属心理状况的影响

目的:评价护理访谈对首发精神分裂症病人家属心理健康状况的影响。方法:在入院时、住院期间、出院前对80例首发精神分裂症病人家属实施护理访谈,采用SCL-90对家属进行心理健康测评。结果:首发精神分裂症病人家属SCL-90各项因子分与常模比较,访谈前,其人际关系、焦虑、抑郁、偏执、敌对、恐怖和躯体化7项因子分比较有差异(P<0.05);病人的配偶有4项因子分得分高于病人的子女或父母的得分(P<0.05)。干预后,各项因子分与国内常模比较无差异(P>0.05)。结论:护理访谈能改善首发精神分裂症病人家属,尤其是配偶的心理健康状况,缓解家属的心理压力,给病人一个良好的家庭康复环境,有利于促进病人早日康复。     

首发精神分裂症患者父母的焦虑状态

采用状态焦虑量表(SAI)和精神症状自评量表(SCL-90)对住院的首发精神分裂症患者父母共100人进行测评。结果患者父母8种情感的应对方式与SAI得分呈正相关关系,SAI的评分越高,焦虑程度越高。患者父母经SCL-90测定结果显示除偏执、敌对因子分与常模相仿外,其余7项因子分明显高于国内常模。     

住院精神病患者配偶心理健康状况调查及护理干预

目的探讨住院精神病患者配偶心理健康状况，为临床护理干预提供依据。方法对30名住院精神病患者配偶，于患者入院时及出院时采用症状自评量表测评其心理健康状况，并与国内成人常模进行对比分析，提出护理干预措施。结果症状自评量表评分，人院时配偶各因子分均显著高于国内成人常模（P〈0.01），除恐怖和精神病性因子外，其余各因子分均显著高于出院时（P〈0．01）；出院时配偶躯体化、强迫、焦虑、抑郁、精神病性因子分仍显著高于国内常模（P〈0．01～0．05），而人际关系因子分显著低于国内常模（P〈0．05）。结论精神病患者配偶存在不同程度的心理问题，应及时给予有效的心理干预，提高其心理健康水平。     

神经内科住院患者心理状况调查分析

目的:调查神经内科住院患者心理状况并进行相关因素分析。方法:对39例神经内科住院患者应用症状自评量表(SCL-90)进行问卷调查。结果:神经内科住院患者SCL-90量表中躯体化因子分值显著高于国内常模(P<0.01),人际关系敏感因子分值低于国内常模(P<0.01)。其中脑卒中、非脑卒中患者躯体化因子分值均高于国内常模(P<0.05),人际关系敏感因子分值低于国内常模(P<0.05),但两者比较差异无统计学意义(P>0.05)。男性患者躯体化和其他因子分分值高于国内常模(P<0.05);女性患者躯体化因子分值高于国内常模(P<0.05),强迫和人际关系敏感因子分值低于国内常模(P<0.01)。神经内科住院患者心理反应依次为焦虑、躯体化症状和其他症状及精神病性症状。结论:在积极治疗原发病同时,医护人员及患者家属均应对神经内科住院患者心理状况给予密切关注,以早期发现和解决问题,提高患者生活质量。     

社区人群的心理状况调查与分析

目的 探讨社区人群的心理健康状况。方法 选择在我社区学习、生活居住和工作的人群4181例,其中初二学生649例,高二学生510例,成人3022例。用症状自评量表(SCL90)进行问卷调查。结果 高二学生与初二学生SCL90得分比较差异有显性,高二学生有5个因子分高于国内常模;成人中离退休人员7个因子分均高于国内常模。按职业分工人中有6个因子分高于国内常模。干部、个体业主、下岗人员有3个因子分高于国内常模;营业员、无业和其他人员有2个因子分高于国内常模;技术人员和国家公务员有1个因子分高于国内常模。结论 需要重视社区心理卫生知识的宣传和普及,制定干预措施,提高社区人群的心理健康水平。     

脑卒中患者家属角色、性别、文化程度和居住地差异对其心理健康的影响

目的:调查脑卒中患者家属的心理状况,分析其不同角色、性别、文化程度及其居住地的差异,并与相关国内常模比较。方法:选择2003-07/2004-12中国医科大学附属第一医院神经内科收治的脑卒中患者的家属71名,入组时均知情同意,自愿参加,且无精神疾病及其他严重疾病。采用症状自评量表及自制一般资料调查问卷对其进行调查。症状自评量表以躯体化、强迫、人际关系、抑郁、焦虑、敌对、恐惧、偏执、精神病性等9个因子分作为本调查的心理状况指标,评估标准为总分≥160分或阳性项目≥43项或任意一项因子分≥2,可考虑筛查阳性,提示可能有比较明显的心理问题。自制一般情况调查问卷包括性别,年龄,职业,文化程度,居住地,与患者的关系(配偶或子女)等自然情况。在神经内科发放统一制作的量表及问卷,被试家属现场填写,当场收回。结果:共发放73份量表及问卷,收回合格问卷71份,合格71份,有效率97.2%。①脑卒中患者家属的症状自评量表各因子得分均高于国内常模,除人际关系、恐怖、精神病性因子外,其他各因子得分与国内常模比较差异明显(P<0.01)。②患者子女躯体化、抑郁、焦虑3因子得分明显高于配偶得分犤(2.11±0.64,2.30±0.65,2.17±0.60);(1.65±0.56,1.93±0.59,1.75±0.58),P<0.05犦。③女性在躯体化、抑郁因子分明显     

首发精神分裂症患者父母的焦虑状态

采用状态焦虑量表(SAI)和精神症状自评量表(SCL-90)对住院的首发精神分裂症患父母共100人进行测评。结果患父母8种：情感的应对方式与SAI得分呈正相关关系，SAI的评分越高，焦虑程度越高。患父母经SCL-90测定结果显示除偏执、敌对因子分与常模相仿外，其余7项因子分明显高于国内常模。     

不同子女数量、住院次数老年住院患者社会支持、生活质量和应对方式的研究

目的探讨不同子女数量、住院次数的老年住院患者的社会支持、生活质量和应对方式。方法选择愿意配合调查的164例老年住院患者,采用社会支持评定问卷（SSAS）,生活质量综合评定问卷（GQOLI）和特质应对问卷,对其进行调查访谈。结果164例老年患者中子女〈2人的老年患者客观支持得分（13．57±2．52）分,低于／〉2个子女的老年患者得分（11．73±2．25）分,差异有统计学意义（P〈0．05）,住院次数对社会支持得分无明显影响。子女〈2人的老年患者的物质生活、心理健康和GQOLI总分低于≥2个子女的老年患者（P〈0．01）。子女〈2人的老年患者在探索、幻想和消极应对（NC）的评分高于常模（P〈0．01）,而子女≥2人的老年患者在幻想、逃避和消极的评分高于常模,其家庭支持度评分低于子女〈2人的老年患者;住院次数〈2次和≥2次的老年患者探索、幻想、逃避和消极应对的评分高于常模。结论子女〈2人的老年住院患者得到的客观支持相对较少,其心理健康状况低于≥2个子女的老年患者;而多次住院影响老年患者的心理健康;老年患者的应对方式受到子女多少、住院次数等因素的影响。     

吸毒者在强制戒毒期间的SCL-90测试及心理治疗

目的对吸毒者在戒毒期间进行戒毒前后心理状态分析及心理治疗。方法对246例吸毒者在强制戒毒期间，采用SCL-90症状自评量表进行测试。结果吸毒者戒毒前SCL-90测试结果示其抑郁、焦虑、敌对3项因子分与国内常模相比差异有非常显著性（P〈0．001）；躯体化、强迫、人际关系敏感及偏执等因子分差异有非常显著性（P〈0．01）；精神病因子分高于常模（P〉0．05），恐怖因子分无明显差异。吸毒者戒毒后SCL-90测试结果显示在躯体化、强迫、人际关系敏感、抑郁、焦虑、敌对等6项因子分显著高于常模（P〈0．01），偏执因子分高于常模（P〈0．05），恐怖及精神因子分无明显差异。吸毒者戒毒前后SCL-90测试结果显示躯体化、强迫、抑郁、焦虑、敌对等5项因子分戒毒前后差异有非常显著性（P〈0．01），强迫症状明显好转，人际关系敏感、恐怖、偏执、精神病性因子分无明显差异（P〉0．05）。结论心理问题以躯体化、强迫、抑郁、焦虑、敌对最为突出，因此对于戒毒者不能仅限于解除躯体依赖，更重要的是心理治疗，以促进他们早日康复，回归社会。     

The physical health of rural mothers and their low birth weight children

The purpose of this research was to examine the physical health of rural mothers and their low birth weight children (< 2,500 gm). The health of rural mothers is of concern because rural families have poorer health than urban ones, and as the primary caregiver for the low birth weight child, mother's health affects the child's care and potentially the child's health. In this cross-sectional, exploratory study, in-home interviews were conducted with 48 mothers between 2 weeks and 18 months after their children were discharged from their birth hospitalization. Mothers' physical health and their perceptions of their children's health were assessed. The mothers were more concerned about their children's health than their own (p = .0005). The concerns included uncertainty about the children's future health, growth, and development. Suggestions for community health care providers are addressed.     

Pulse oximetry to identify a high-risk group of children with wheezing

To investigate the value of pulse oximetry in children with wheezing presenting for emergency medical treatment, initial oxygen saturations (OSAT) were measured in 1,101 of 1,235 patients presenting to a pediatric ED over a 5-month period with wheezing-associated respiratory illnesses. The mean OSATs were 95.4% for wheezing children and 98.7% for controls. An initial OSAT of 95% or more indicated a low need for hospitalization. An initial OSAT less than 85% indicated a high need for hospitalization (positive predictive value, 90%). Pulse oximetry may be useful in identifying children with wheezing who are at high risk, as demonstrated by the need for hospitalization, during the early phase of an ED encounter, at which time more aggressive therapeutic interventions may be considered.     

农村留守老人的心理健康状况及其影响因素的研究进展

随着我国工业化的发展和老龄化社会的到来,农村留守老人已成为我国一个重要的特殊群体,其心理健康状况引起了人们的关注,影响其心理健康状况的主要因素有性别、年龄、文化程度、经济条件、劳动强度、留守方式、子女探亲联系间隔时间以及留守老人自身身体状况。     

Place and space: the where and why of drug-use location among rural African American women

Increasing drug use among rural African American women and its effect on children warrants investigation. This article describes drug-use locations of rural African American women who use cocaine and construct their lives to conceal it from children. During 4 years, a 30-respondent ethnography was conducted. Data from in-depth interviews and field notes were analyzed for recurrent themes and patterns of drug-use location using NVivo. Most respondents with children used most often outside their households. One third (n = 10) used within their households when children were away or in designated spaces off limits to children. More respondents (n = 11) without children at home used in non-designated spaces; in contrast, few respondents (n = 2) with children at home used in non-designated spaces within the household. Most respondents thought they were successful at concealing their cocaine use. Implications for choice of space and place of drug use for themselves and their children are discussed.     

农村肺结核病病人心理健康影响因素分析

目的调查分析农村肺结核病病人心理健康影响因素,为促进农村肺结核病病人的身心健康提供理论依据。方法采用便利抽样的方法选取沂水县结核病防治所就诊的农村肺结核病病人130例。应用症状自评量表（SCL-90量表）对其进行问卷调查,分析农村肺结核病病人的心理健康状况及其影响因素。结果农村肺结核病病人SCL-90量表项目总分（142.47±47.63）明显高于全国常模（129.96±38.76）,差异有显著性（t=3.20,P〈0.01）。主要表现在躯体化、抑郁、焦虑、恐怖、精神病性等方面。单因素分析显示,性别、文化程度、咯血情况、胸部X线片有无空洞、婚姻状况、经济水平以及肺结核病对劳动能力的影响均为农村肺结核病病人心理健康的影响因素。多因素Logistic回归分析显示,咯血情况（OR=7.07,95%CI2.02~24.75）、经济水平（OR=2.73,95%CI1.27~5.85）以及肺结核病对劳动能力的影响（OR=3.05,95%CI1.42~6.55）是农村肺结核病病人心理健康的最主要危险因素。结论农村肺结核病病人的心理健康状况不良,多与咯血、经济水平以及肺结核病对劳动能力的影响有关。对农村肺结核病病人应加强心理维护。     

Caring for adoptive families: lessons in communication

PURPOSE: To describe the experiences of families whose adopted children were hospitalized and to compare those experiences to the experiences of families of hospitalized biological children. METHOD: The parents of 10 adopted and 55 biological children participated in the study in which the source and intensity of stress for parents and the level of distress demonstrated by the children during their hospitalization were measured and compared. RESULTS: Adopted children hospitalized for the first time were significantly more distressed during hospitalization than biological children hospitalized for the first time. Adoptive parents experienced significantly more stress than biological parents related to how staff communicated with them about their child's illness. Concerns identified by several adoptive families included difficulties associated with having limited information about their child's family medical history and concerns about attachment issues. CONCLUSIONS: Health care providers need to be aware of adoptive parents' concerns about their child's response to hospitalization, attachment issues, and limited family medical history. The quality of communication with adoptive parents is especially important.     

儿童反复肺炎相关危险因素分析

目的探讨儿童反复患肺炎的相关危险因素,筛查高危人群,指导医生对儿童反复肺炎早期预防及临床干预。方法采用病例-对照研究方法,对103例反复肺炎患儿,及同期就诊的103例非反复肺炎的患儿进行研究,采用单因素χ2检验及多因素logistic回归模型调查反复肺炎的危险因素。结果经过χ2检验显示组间存在明显差异的变量为早产史、反复上呼吸道感染史、既往住院史、每天户外活动时间少于30 min)、居住平房、被动吸烟史。多因素lo-gistic回归分析结果显示:反复上呼吸道感染史(OR=4.006,95%CI:1.827～8.786)、既往住院史(OR=9.408,95%CI:4.419～20.030)、每天户外活动时间少于30 min(OR=2.934,95%CI:1.289～6.679)、居住平房(OR=3.441,95%CI:0.786～15.060)、被动吸烟(OR=2.23,95%CI:1.030～4.861)是儿童反复肺炎的独立危险因素。结论反复上呼吸道感染、既往住院史、居住环境差、每天户外活动时间少、被动吸烟等可以增加儿童患反复肺炎的风险。     

Delayed first medical contact to reperfusion time increases mortality in rural emergency medical services patients with ST-elevation myocardial infarction

Background

ST-elevation myocardial infarction (STEMI) guidelines recommend an emergency medical services (EMS) first medical contact (FMC) to percutaneous coronary intervention (PCI) time of ≤90 min. The primary objective of this study was to evaluate the association between FMC to PCI time and mortality in rural STEMI patients.

Methods

We conducted a cohort study of patients ≥18 years old with STEMI activations from January 2016 to March 2020. Data were obtained from a rural North Carolina Regional STEMI Data Registry, which included eight rural EMS agencies and three PCI centers, the National Cardiovascular Data Registry, and the EMS electronic health record. Prehospital and in-hospital time intervals were digitally abstracted. The outcome of index hospitalization mortality was compared between patients who did and did not meet FMC to PCI time goal using Fisher's exact tests. Negative predictive value (NPV) for index hospitalization death was calculated with 95% confidence intervals (CIs). A receiver operating characteristic curve was constructed and an optimal FMC to PCI time goal was identified by maximizing NPV to prevent index hospitalization death.

Results

Among 365 rural EMS STEMI patients, 30.1% (110/365) were female with a mean ± SD age of 62.5 ± 12.7 years. PCI was performed within the 90-min time goal in 60.5% (221/365) of patients. Among these patients, 3% (11/365) died during initial STEMI hospitalization, with 1.4% (3/221) mortality in the group that met the 90-minute time goal compared to 5.6% (8/144) in patients exceeding the time goal (p = 0.03). Meeting the 90-min time goal yielded a 98.6% (95% CI 96.1%–99.7%) NPV for index death. A 78-min FMC to PCI time was the optimal cut point, yielding a NPV for index mortality of 99.3% (95% CI 96.1%–100%).

Conclusions

Death among rural patients with STEMI was four times more likely when they did not receive PCI within 90 min.     

不同临床类别手足口病危险因素分析

目的 了解不同临床类别手足口病危险因素,为手足口病防控提供科学依据.方法 收集2009年3月至2010年4月浙江省手足口病疫情资料,轻症、重症与死亡病例个案资料,以及手足口病实验室检测结果,使用SPSS13.0 软件进行分析.结果 散居儿童、流动人口、居住在农村或城乡结合部、病前7天去过接种门诊,以及患者家14岁以下儿...     

Mediating functions of maternal anxiety and participation in care on young children's posthospital adjustment

The purpose of this study was to determine whether maternal anxiety and mothers' participation in their children's care during hospitalization mediated the effects of a child behavior informational intervention for mothers on their children's posthospital negative behavioral change. Participants were 49 mothers and their young children, ages 24-68 months, who were unexpectedly hospitalized with unplanned medical or surgical conditions. These participants were drawn from a larger study of the separate and combined effects of child behavior information and parent role information on the process and outcomes of maternal and child coping with unplanned hospitalization. Findings indicated that the effects of child behavior information on children's posthospital negative behavioral change were mediated by maternal anxiety and participation in their children's care during hospitalization. Results of this study provide support for targeting mothers with informational interventions in order to enhance outcomes in hospitalized children.