住院精神病人家属探视情况及对病人的影响

目的 了解住院精神病病人家属探视频率对病人的影响.方法 自制问卷,对160例病人和160位家属进行探视状况调查.结果 35.2%北京病人及42.86%的外地病人在住院期间处于极少探视或无探视状态.48.75%的病人在无探视时出现负性情绪,76.25%的病人探视后心情愉快.53.75%的家属没有意识到病人心理需求的重要性.结论 住院精神病病人家属探视率低,医护人员需对家属进行心理辅导,转变家属对病人和对探视的态度,良好的家庭支持和关怀有利于病人疾病的治疗和康复.     

无陪护精神病病人的探视须知

精神病病人住院治疗大多无陪护，且处于封闭性环境之中。家属适时探视，对病人是一种心理支持。但有些病人家属对精神卫生知识和病房管理不了解，探视时扰乱病房工作程序，影响病人病情，并对病房的管理带来安全隐患。为此，应加强病人家属探视方面的健康教育。笔者特制订无陪护精神病痛人探视须知，现介绍如下。     

精神病病人家属探视需求调查与护理对策

目的 了解精神病病人家属的探视需求,采取有效的护理对策,满足需求。方法 采用问卷形式,对120名家属进行了探视心理调查。结果 对于我们传统的探视方法提出了新的要求。结论 针对家属探视心理需求,采用相应的护理对策,改进管理模式,提供人性化管理。     

住院女精神病人探视最佳时机的探讨

精神病患者住院后,家属、亲友、同事相继来医院探望,这是人际关系中很平常的事情。同时对病人在精神上、心理上是一种安慰,在生活上是一种补充,又是一种心理治疗。然而,探视时机掌握得是否恰当,却涉及到能否影响疾病的复发问题。究竟什么时间探视为宜?我们对接受探视的140例住院女精神病人进行了统计、分     

住院精神病患者首次被探视后的观察及护理

目的 探讨住院精神病患者首次被探视后的病情变化及护理方法。方法 随机观察160例住院精神病患者首次被探视后的病情变化，分析其临床特征，并根据具体情况进行护理。结果 首次被探视后72例（45％）出现病情反复，针对性地护理能有效减少意外事件的发生。结论 加强对住院精神病患者首次被探视后的观察和护理具有重要意义。     

住院精神病患者亲属探视的护理干预

总结亲属探视对住院精神病患者治疗的影响,认为亲属探视对精神病患者的心理治疗有着重要作用,因此需要对亲属探视时间和安慰方式的护理干预进行探究,帮助亲属与患者建立正常的、良好的探视模式。一方面医护人员需要对家属探视予以足够重视,另一方面,医护人员需要科学地引导家属探视,从而提高精神病患者治疗效果。     

住院精神病患者家属心理状态调查及护理干预

目的探讨住院精神病患者家属的心理状态及心理护理干预效果。方法采用自行设计的调查表对56例住院精神病患者家属进行调查，针对他们的心理状态实施心理护理干预措施1个月，干预前后采用抑郁自评量表（SDS）和焦虑自评量表（SAS）进行评定。结果精神病患者家属的心理状态以抑郁（64％）和焦虑（73％）为主。主要的影响因素为对精神病知识缺乏、外界压力、经济负担等。心理干预后患者家属的SDS、SAS总分显著下降（P〈0．001）。结论精神病患者家属存在不同程度的情绪障碍，心理护理干预对之有效。     

从探视后精神病人自杀谈如何加强病房管理

通过对６例精神病人自杀资料分析认为，部分病人的自杀死亡在一定程度上与其家属探视后病人思想上造成一定的压力，引起一系列心理变化有关，因此，提示医护人员补发家属探视前应向其交待探视须知，探视后应向病人和家属了解探视的谈话内容，病人的思想状况，情绪等，酌情进行心理护理，并进行交班重点护理。     

探视对不同住院时间精神病患者的影响

目的了解家属在不同阶段探视住院精神病患者对其病情的影响。方法将149例精神病患者按病程分为入院初期组42例,病情稳定组51例,康复组56例,采用护士用简明精神病量表对患者在家属探视前后进行测量,观察3组患者和各类疾病患者探视前后该量表得分并进行比较。结果对入院初期的精神分裂症、情感性障碍、复发性躁狂患者进行探视,患者的总体病情变化和敌对激惹因子有显著性差异(P<0.01或P<0.05),而在病情稳定期除情感性障碍有变化外,对其他疾病以及康复期的患者探视没有质的变化。结论在患者入院初期不宜探视,在病情稳定期和康复期的探视也有必要限制。     

住院精神病病人外走原因分析及护理对策探讨

目的:探讨住院精神病病人外走原因及方式,旨在有针对性的采取相应措施杜绝此现象,保证病人安全.方法:选择 2010年1月-2011年12月我院精神科住院治疗的有外走行为的130例病人(观察组)与随机抽取的130例无外走行为的住院病人(对照组)的临床资料进行整理和分析.结果:观察组和对照组病人在自知力缺乏、不能耐受锥体外系反应、受幻觉妄想支配、意识及定向力障碍方面有统计学意义(P＜0.05,P＜0.01).观察组130例外走住院精神病病人中,外走方式为尾随工作人员、在检查及治疗途中、借探视开放时间、撬开门锁外走、破坏门窗外走及陪护病区家属大意给病人外走机会外走,占总外走比例依次为32.31％,23.08％,15.38％,11.54％,10.77％,6.92％.结论:针对住院精神病病人外走行为的危险因素进行综合预防及护理措施可减少外走行为的发生.     

亲子心理干预在精神分裂症患者探视期的效果研究

目的观察亲子心理干预在住院精神分裂症患者探视期的应用效果,为防范探视后意外事件积累临床资料。方法采用亲子心理干预方法,对研究组30例住院精神分裂症患者及其探视者（父母或子女）在探视期分别实施心理干预和健康教育,维持有效的药物治疗,观察探视期间意外事件发生情况及治疗依从性,并与30例未实施亲子干预的患者对照。结果在病情相当和探视时机相似且在有效药物治疗的基础上,研究组患者探视后意外事件显著少于对照组（P〈0.05）,治疗依从性显著好于对照组（P〈0.01）。结论亲子心理干预对防范精神分裂症患者探视后意外事件的发生和提高治疗依从性有一定效果。     

Scientific monitoring of the visitation procedure in inpatient rehabilitation centres of the German statutory pension insurance fund--the "Visit II" Project

Visitation procedures are an established method of external quality assurance. They have been conducted for many years in the German statutory pension insurance's medical rehabilitation centres and have continuously been refined and standardized. The overall goal of the visitation procedure implemented by the German statutory pension fund is to ensure compliance with defined quality standards as well as information exchange and counselling of rehabilitation centres. In the context of advancing the visitation procedure in the German statutory pension funds' medical rehabilitation centres, the "Visit II" Project was initiated to evaluate the perspectives and expectations of the various professional groups involved in the visitations and to modify the materials used during visitations (documentation form and manual). Evaluation data from the rehabilitation centres visited in 2008 were gathered using both written surveys (utilization analysis) and telephone-based interviews with administration managers and chief physicians. The utilization analysis procedure was evaluated with regard to its methodological quality. In addition, the pension insurance physicians in charge of patient allocation during socio-medical assessment were surveyed with regard to potential needs for revision of the visitation procedure. Data collection was complemented by expert panels with auditors. Interviews with users as part of the formative evaluation of the visitation procedure showed positive results regarding acceptance and applicability of the visitations as well as of the utilization analysis procedures. Various suggestions were made with regard to modification and revision of the visitation materials, that could be implemented in many cases. Documentation forms were supplemented by current scientifically-based topics in rehabilitation (e. g., vocationally oriented measures), whereas items with minor relevance were skipped. The manual (for somatic indications) was thoroughly revised. The transparent presentation of visitation processes and visitation criteria has proven to be a useful basis for strengthening the cooperation between the statutory pension insurance funds and the rehabilitation centres. Moreover, it is a helpful tool for the systematic and continuous advancement of this complex method by including all parties involved.     

咽部定植菌与住院精神病人呼吸道医院感染相关性的研究

目的探讨咽部定植菌与住院精神病人呼吸道医院感染的相关性及预防控制对策。方法将符合入组条件的新入院精神病人纳为研究对象,分别在入院后24 h、第4 d、第21 d时取咽拭子送检做细菌培养和药敏试验,并对其住院期间的医院感染情况进行统计分析。结果咽部有病原菌定植组病人呼吸道医院感染率达53.84%,与无定植组的16.98%比较,有极显著差异(P<0.01),定植菌耐药情况严重。结论咽部病原菌定植是住院精神病人呼吸道医院感染的主要潜在危险因素之一,抗精神病药物的副反应和约束护理是引起高感染率的主要原因;临床应重视咽拭子培养和药敏结果来指导预防和治疗住院精神科病人呼吸道医院感染。     

住院精神病患者自杀相关因素分析及防范措施

目的探讨住院精神病患者自杀的原因，制订防范措施。方法对住院精神病患者发生自杀行为的73例病例进行回顾性统计分析。结果73例自杀者中男性明显多于女性；年龄以20-30岁最多；多在病后1年之内发生；多发生于疾病的初期与缓解期；以抑郁症、精神分裂症多见；自缢是自杀的常见方式；自杀时间多在午夜以后。结论住院精神病患者自杀具有一定的规律性，加强安全措施，强化重点班次护理，及早对患者实施护理干预，可将精神病患者自杀率减少到最低。     

咽拭子培养对精神科呼吸道医院感染患者治疗效果的临床分析

目的探讨咽拭子培养对精神科呼吸道医院感染患者治疗效果的临床意义。方法查阅2004年1月至12月合并呼吸道医院感染的住院精神病患者的病历资料，对其咽拭子培养和治疗情况进行统计分析。结果56例诊断为呼吸道医院感染患者的咽拭子共分离出59株病原菌，革兰阴性菌33株占55．9％，革兰阳性菌26株占44．1％；其中有16例同时进行咽拭子＋痰液培养，病原菌一致的有11例，占68．5％；在抗生素使用符合咽拭子培养药敏结果与不符合药敏结果的患者中治疗有效率分别为71．1％和40．9％，两组数据比较有极显著性意义（P〈0．01）。结论咽拭子培养对精神科呼吸道医院感染患者的治疗有重要参考价值；临床应尽量避免经验用药。     

Evaluation of a substance use treatment program for forensic psychiatric inpatients

There have been few evaluations of substance use interventions for forensic psychiatric patients. In this study, we evaluated a manualized substance use treatment for forensic inpatients by comparing 35 treatment completers (who attended 75% or more of their sessions) and 30 non-completers (less than 75%) on self-report and urinalysis measures. The treatment completer group showed significant increases in substance-related knowledge and self-reported relapse prevention skills, but there was no significant difference between completers and non-completers in time to first substance use (if any) or in having a positive urine screen result 12 or 24 months after participation in the program. The results indicated improvement in knowledge and self-reported skills, but this did not translate to decreased substance use as measured by urinalysis. Implications for substance use treatment are discussed.     

腹式呼吸对住院女性精神障碍患者焦虑抑郁情绪的影响

目的探讨腹式呼吸对住院女性精神障碍患者焦虑、抑郁情绪的影响。方法将80例住院女性精神障碍患者根据随机数随机分为研究组和对照组各40例,对照组进行常规治疗,研究组除进行常规治疗外,同时进行腹式呼吸干预,时间为8周。采用焦虑自评量表（SAS）和抑郁自评量表（SDS）分别于干预前后对两组患者进行评定。结果干预前与干预后比较研究组患者焦虑（48．75±8．17比37．60±7．30）和抑郁情绪（56．50±7．91比43．20±9．22）得分明显降低,差异有统计学意义（t分别为10．092,9．321;P均〈0．05）;研究组与对照组患者干预后焦虑得分（37．60±7．30比48．25±7．76）比较差异有统计学意义（t=-10．410,P〈0．05）,抑郁得分（43．20±9．22比55．55±7．14）比较差异有统计学意义（t=-9．248,P〈0．05）。结论腹式呼吸训练可有效缓解住院女性精神障碍患者的焦虑、抑郁情绪,从而有利于患者的康复。     

Novel simple and practical nutritional screening tool for cancer inpatients: a pilot study

Background

There is lack of consensus on how nutritional screening and intervention should be provided to cancer patients. Nutritional screening and support of cancer patients are not well established in the Middle East. We report our systematic and practical experience led by a qualified specialist dietician in a cancer inpatient setting, using a novel nutritional screening tool.

Methods

Ninety-seven consecutive inpatients underwent nutritional screening and categorised into three nutritional risk groups based on oral intake, gastrointestinal symptoms, body mass index (BMI) and weight loss. Nutritional support was introduced accordingly. Statistical tests used included ANOVA, Bonferroni post hoc, chi-square and log rank tests.

Results

Median age was 48 (19–87)?years. Patients were categorised into three nutritional risk groups: 55 % low, 37 % intermediate and 8 % high. Nutritional intervention was introduced for 36 % of these patients. Individually, weight, BMI, oral intake, serum albumin on admission and weight loss significantly affected nutritional risk and nutritional intervention (all significant P values). Eighty-seven, 60 and 55 % of patients admitted for chemotherapy, febrile neutropenia and other reasons, respectively, did not require specific nutritional intervention. There was a statistically significant relationship between nutritional risk and nutritional intervention (P?=?0.005). Significantly more patients were alive at 3 months in low (91 %) than intermediate (75 %) than high (37 %)-risk groups.

Conclusions

About a third of cancer inpatients require nutritional intervention. The adopted nutritional risk assessment tool is simple and practical. The validity of this tool is supported by its significant relation with known individual nutritional risk factors. This should be confirmed in larger prospective study and comparing this new tool with other established ones.