教师婚姻质量与心理健康状况及其相关性研究

目的 探讨教师群体的婚姻质量与心理健康状况及其相关性.方法 采用婚姻质量问卷(ENRICH)及症状自评量表(SCL-90)对500名教师进行问卷调查.结果 不同任教学校教师婚姻质量差异无显著性意义(均P＞0.05),但大学教师呈现出婚姻质量下降的趋势.男性对婚姻质量的评价显著低于女性(P＜0.05).年龄在25～39岁的教师对婚姻质量的评价相对高于其他年龄段.SCL-90评分高者其婚姻质量评分相对较低.教师SCL-90与婚姻质量呈显著负相关.结论 高心理健康水平的教师婚姻质量是满意的;婚姻质量与心理健康之间呈显著负相关.建议管理者及教师个体共同努力,提高心理健康水平及婚姻质量.     

妊娠剧吐患者的心理健康水平及其相关因素研究

目的 探讨妊娠剧吐（HG）患者的个性、应对、社会支持等心理社会因素与心理健康水平的相关性，为有效实施心理干预提供依据。方法 以艾森克个性问卷、简易应对方式问卷、社会支持评定量表和症状自评量表（SCL-90）为工具，对41例HG患者进行调查分析，并与46例无妊娠剧吐孕妇（对照组）进行比较。结果 HG患者的SCL-90总分及各因子得分显著高于对照组（均P〈0．01）；情绪的稳定性与SCL-90总分及所有的因子呈显著正相关（均P〈0．01）；内外倾向性与总分及大部分因子呈显著负相关（P〈0．05，P〈0．01）；HG患者的应对方式、主观支持、支持的利用度及支持总分显著低于对照组（P〈0．05，P＜0．01）。结论 HG患者的心理健康水平较低，需针对影响其心理健康水平的相关因素实施早期心理行为干预。     

初产妇及其配偶心理健康水平和相关性分析

目的探讨产褥期初产妇及其配偶的心理健康水平及两者之间的相关性，为社区护理工作提供依据。方法采用症状自评量表（SCL-90）分别对198名初产妇及其配偶进行调查并分析其相关性。结果初产妇SCL-90评分中除偏执、精神病性外其他因子评分显著高于国内常模（P〈0．05，P〈0．01），初产妇配偶的躯体化、人际关系敏感、抑郁、焦虑因子评分显著高于国内常模（均P〈0．01）；初产妇及其配偶SCL-90总分及各因子评分呈显著正相关（均P〈0．01）。结论初产妇及其配偶的心理健康水平均较低，产妇分娩同样影响配偶的心理健康，护理工作者应重视配偶的心理需求，使其保持身心健康，更好地完成照顾母婴的任务，从而也可间接减少初产妇产后抑郁的发生。     

森田疗法对厌学中学生心理健康及自尊水平的影响

目的探讨森田疗法对厌学中学生心理健康及自尊水平的影响。方法对30例住院的厌学中学生用森田疗法治疗，疗程8～12周。应用症状自评量表（SCL-90）和自尊量表（SES）分别于治疗前后施测并进行对照分析。结果治疗前后厌学中学生SCL-90中除精神病性外，其他因子评分显著降低（P〈0．01，P〈0．05）；SES评分显著提高（P〈0．01）。结论森田疗法对促进厌学中学生心理健康及提高自尊水平有显著疗效。     

恶性肿瘤患者放疗前心理健康状况与应对方式调查分析

目的探讨恶性肿瘤患者放疗前的心理健康状况和应对方式，为制定肿瘤患者的护理措施提供理论依据。方法采用特质应对方式问卷（TCSQ）和症状自评量表（SCL-90）对60例恶性肿瘤患者（肿瘤组）在放疗前和30例健康对照组进行测试，并分析肿瘤组患者应对方式与心理状况的相关性。结果肿瘤患者存在严重的心理问题。应对方式中消极应对得分显著高于对照组（P〈0．01），积极应对得分与对照组比较，差异无显著性意义（P〉0．05）。肿瘤组SCL-90各因子分均显著高于对照组，突出表现在躯体化、焦虑、抑郁及精神病性、其他等方面（P〈0．05，P〈0．01）。积极应对得分与SCL-90总分、总均分、阳性症状均分、强迫症状及其他因子呈显著负相关（P〈0.05，P〈0．01），消极应对得分除阳性症状均分、躯体化、偏执等因子外，与SCL-90呈显著正相关（P〈0．05，P〈0．01）。结论恶性肿瘤患者放疗前存在诸多方面的心理问题，应对方式是影响患者心理健康的重要因素，在患者放疗前给予护理干预非常重要。     

现阶段护理人员心理健康状况调查分析

目的 了解现阶段护理人员心理健康状况。方法 采用SCL-90症状自评量表及应对方式量表对256名护士进行调查。结果 护理人员SCL-90评分除在人际敏感因子上低于常模外，躯体化、抑郁、焦虑、敌对、恐怖、精神病性以及总分均高于常模（P〈0．05、P〈0．01）；非手术科室护理人员除躯体化、恐怖因子外SCL-90评分均优于手术科室（P〈0．05，P〈0．01）。护理人员积极应对评分显著低于常模，消极应对评分显著高于常模（均P〈0．01）。结论 现阶段护理人员心理健康状况不容乐观，应采取有效措施予以疏导、调整。     

老年康复中心护工的心理健康状况调查

目的 调查老年康复中心护工的心理健康状况。方法 采用症状自评量表（SCL-90）对74名护工进行测评。结果老年康复中心的护工SCL-90总分及躯体化、人际关系、抑郁、焦虑、敌对和偏执因子评分显著高于常模（P〈0．05，P〈0．01）。不同性别、护理不同生活自理能力患者的护工，其心理健康水平比较，差异有显著性意义（P〈0．05，P〈0．01）。结论 老年康复中心护工的心理健康状况不容乐观，尤其是对男护工和护理生活不能自理患者的护工，应进行有针对性的心理干预。     

女性更年期综合征与心理健康的相关性研究

目的了解女性更年期症状与心理健康之间的关系,为提高其生活质量提供依据。方法随机对800名更年期女性进行无记名调查,心理健康状况调查采用SCL-90量表,更年期症状评定采用公认改良的Kuperman评分法。结果719名（89．88％）女性有不同程度的更年期症状。除关节痛、头痛有无症状者敌对因子评分潮热症状精神病性及心悸症状偏热评分,差异无统计学意义（均P〉0．05）外,有症状者SCL-90各因子分显著高于无症状者（P〈0．05,P〈0．01）。症状重者SCL-90评分显著高于中、轻度者,中度者显著高于轻度者（均P〈0．01）。城乡更年期女性肢体麻木、激动、抑郁、心悸4个症状评分比较,差异有统计学意义（均P〈0．01）。结论女性更年期症状及症状程度与个体心理健康状况相关,随着更年期症状加重,其心理状况更加恶化,且城乡更年期女性在某些更年期症状发生上存在差异。因此,采取积极措施缓解女性更年期症状,加强心理护理干预,有助于更年期女性保持心理健康状态,提高其生活质量。     

临床护士心理健康水平与应对方式调查

采用症状自评量表(SCL-90)和特质应对方式问卷对176名护士进行心理健康水平及应对方式调查。结果 护士SCL-90各因子分均显著低于健康成人，护士采用积极应对方式显著多于健康成人；积极应对方式与SCL-90总水平、各因子呈负相关，差异有显著性意义(均P＜0.01)；消极应对方式与SCL-90总水平、抑郁和敌对因子呈正相关，差异有显著性意义(均P＜0．05)。提示临床护士具有良好的心理健康水平，且较多采用积极应对方式；积极应对方式有利于提高临床护士心理健康水平。     

非医学指征剖宫产孕产妇术前心理社会状况调查

目的探讨非医学指征剖宫产孕产妇术前心理社会因素,并进行相关综合分析,以指导选择合适的分娩方式。方法对待产孕妇（36-40周）461例采用症状自评量表（SCL-90）、支森克个性问卷（EPQ）及社会支持评定量表（SSRS）评定分析。结果孕妇产前SCL－90总分及其焦虑、恐怖、抑郁、偏执因子分显著高于常模（均P〈0．01）;孕妇EPQ各因子分与常模存在显著差异（P〈0．05,P〈0．01）;试产时改为剖宫产组客观支持及总分显著低于试产时自然分娩组（均P〈0.01）;SCL-90总分与EPQ中P、N分及与SSRS客观支持分呈显著相关（P〈0．05,P〈0．01）;EPQ中的N分与客观支持评分及社会支持总分呈显著负相关（P〈0．05,P〈0．01）,而外向分仅与社会支持总分呈显著正相关（P〈0．05）。结论孕产妇的心理社会状况影响其对分娩方式的抉择,应采取有效措施加以干预。     

Perioperative and long-term morbidity and mortality after above-knee and below-knee amputations in diabetics and nondiabetics

We performed a retrospective review of a vascular surgery quality assurance database to evaluate the perioperative and long-term morbidity and mortality of above-knee amputations (AKA, n = 234) and below-knee amputations (BKA, n = 720) and to examine the effect of diabetes mellitus (DM) (181 of AKA and 606 of BKA patients). All patients in the database who had AKA or BKA from 1990 to May 2001 were included in the study. Perioperative 30-day cardiac morbidity and mortality and 3-yr and 10-yr mortality after AKA or BKA were assessed. The effect of DM on 30-day cardiac outcome was assessed by multivariate logistic regression and the effect on long-term survival was assessed by Cox regression analysis. The perioperative cardiac event rate (cardiac death or nonfatal myocardial infarction) was at least 6.8% after AKA and at most 3.6% after BKA. Median survival was significantly less after AKA (20 mo) than BKA (52 mo) (P < 0.001). DM was not a significant predictor of perioperative 30-day mortality (odds ratio, 0.76 [0.39-1.49]; P = 0.43) or 3-yr survival (Hazard ratio, 1.03 [0.86-1.24]; P = 0.72) but predicted 10-yr mortality (Hazard ratio, 1.34 [1.04-1.73]; P = 0.026). Significant predictors of the 30-day perioperative mortality were the site of amputation (odds ratio, 4.35 [2.56-7.14]; P < 0.001) and history of renal insufficiency (odds ratio, 2.15 [1.13-4.08]; P = 0.019). AKA should be triaged as a high-risk surgery while BKA is an intermediate-risk surgery. Long-term survival after AKA or BKA is poor, regardless of the presence of DM.     

Body composition assessment and methodology in nonathletic and athletic adolescent and adult males and females

The purpose of this review is to outline methodology for assessing body composition utilizing anthropometric and densitometric techniques. The objective of body composition assessment is to measure body fat and lean body mass. The quantity of these components varies due to growth, physical activity, dietary regimens, and aging. Anthropometric techniques incorporate selected skinfolds, circumferences, skeletal widths, or other variables to estimate body composition within k2.0-4.0%. These techniques are adequate for field testing of groups or individuals, but are population specific. Densitometry measures body volume irrespective of physique, sex, or age. This laboratory technique estimates body composition within 1.0-2.0%, is more difficult to administer, but is not population specific. Some limitation exists with any present technique due to biological variability and incomplete research of reference body composition in children, females, and the aged. J Orthop Sports Phys Ther 1984;5(6):336-347.     

Postoperative nausea and vomiting and opioid-induced nausea and vomiting: guidelines for prevention and treatment

Postoperative nausea and vomiting (PONV) causes patient discomfort, lowers patient satisfaction, and increases care requirements. Opioid-induced nausea and vomiting (OINV) may also occur if opioids are used to treat postoperative pain. These guidelines aim to provide recommendations for the prevention and treatment of both problems. A working group was established in accordance with the charter of the Sociedad Espa?ola de Anestesiología y Reanimación. The group undertook the critical appraisal of articles relevant to the management of PONV and OINV in adults and children early and late in the perioperative period. Discussions led to recommendations, summarized as follows: 1) Risk for PONV should be assessed in all patients undergoing surgery; 2 easy-to-use scales are useful for risk assessment: the Apfel scale for adults and the Eberhart scale for children. 2) Measures to reduce baseline risk should be used for adults at moderate or high risk and all children. 3) Pharmacologic prophylaxis with 1 drug is useful for patients at low risk (Apfel or Eberhart 1) who are to receive general anesthesia; patients with higher levels of risk should receive prophylaxis with 2 or more drugs and baseline risk should be reduced (multimodal approach). 4) Dexamethasone, droperidol, and ondansetron (or other setrons) have similar levels of efficacy; drug choice should be made based on individual patient factors. 5) The drug prescribed for treating PONV should preferably be different from the one used for prophylaxis; ondansetron is the most effective drug for treating PONV. 6) Risk for PONV should be assessed before discharge after outpatient surgery or on the ward for hospitalized patients; there is no evidence that late preventive strategies are effective. 7) The drug of choice for preventing OINV is droperidol.