京津冀老年人心理健康与心理需求的关系

目的调查京津冀老年人的心理健康状况及心理健康和心理需求的关系。方法采用老年人基本信息调查表、老年人心理健康问卷和老年人心理需求量表,对京津冀145名老年人进行调查。结果心理健康处于中等偏高水平,心理需求处于中等偏低水平。心理健康总分及部分维度、心理需求总分及部分维度在居住地、退休前职业差异均有统计学意义(P0.05)。心理健康总分和心理需求总分呈显著负相关。且得出了以老年人心理健康总分为因变量,心理需求总分及其各维度为因变量的通径模型。结论老年人心理健康与心理需求呈负相关,老年人心理需求得到满足后心理才会越健康。     

亚健康状态老年人血白细胞介素18和白细胞介素10水平变化及意义

目的探讨白细胞介素18（IL-18）、白细胞介素10（IL-10）在老年亚健康状态发生发展中的作用及相互关系。方法应用酶联免疫吸附法测定45例亚健康状态老年人（≥60岁）血浆IL-18和血清IL-10水平,以42例亚健康状态老年前期（50～59岁）和30例健康老年人（≥60岁）作比较,分析它们之间的关系。结果亚健康状态老年人血浆IL-18水平显著高于健康老年人（P〈0.01）,以及亚健康老年前期组（P〈0.05）,血清IL-10水平则显著低于对照组（P〈0.01）和老年前期组（P〈0.05）;血浆IL-18水平与血清IL-10水平之间呈负相关（r=-0.882,P〈0.01）。结论 IL-18和IL-10可能共同构成一局部网络,并可能参与亚健康状态的发生发展过程。     

5·12地震灾区老年人的抑郁情绪和生活满意度及其相关因素调查

目的探讨5·12地震灾区老年人的抑郁情绪、生活满意度及其相关因素。方法5·12地震后8个月,采用Sel-90抑郁分量表、躯体化分量表、生活满意度量表以及心理韧性量表和社会支持量表对灾区的70名老年组被试和139名青年对照组被试进行施测。结果灾区老年人的抑郁得分略高于青年人（t=1.68,P=0.09）,躯体化得分显著高于青年人（t=3.198,P〈0.01）,生活满意度得分显著高于青年人（t=6.20,P〈0.001）,老年人的心理韧性得分也显著高于青年人（t=3.11,P〈0.01）,而社会支持得分显著低于青年人（t=-3.29,P〈0.01）;心理韧性正向预测生活满意度（β=0.34,P〈0.001）,而与抑郁、躯体化无关,社会支持负向预测抑郁情绪（β=-0.33,P〈0.001）,同时正向预测生活满意度（β=0.19,P〈0.001）和韧性（β=0.22,P〈0.001）。结论与灾区青年人相比,灾区老年人同时表现出较高的抑郁情绪、躯体化和较高的生活满意度,这与老年人拥有较低的社会支持和较高的心理韧性有关,但心理韧性并不能帮助他们缓解抑郁情绪和躯体化,甚至还受到社会支持减少的潜在影响。     

医院中专生护士心理健康状况及系统心理干预的影响

目的：了解医院中专生护士心理健康状况,探讨通过系统心理干预对提高医院中专生护士心理健康水平的意义。方法：采用症状自评量表（SCL-90）对医院241名中专生护士进行心理测试,以此作为心理健康指标,与医院190名大专生护士比较;以心理教育、心理训练、心理咨询等方法对医院中专生护士进行系统的心理干预,并分别做干预前后观察组与对照组的组间、组内比较。结果：干预前医院中专生护士SCL-90除人际关系和抑郁因子外其余各因子分均显著高于医院大专生护士（P〈0．01）;干预一年后,观察组SCL-90总分、阳性项目数及各因子分明显下降（P〈0．01）,阳性项目均分无显著差异（P〉0．05）,除敌对分仍显著高于对照组外（P〈0．05）,其余所有指标与对照组无显著差异（P〉0．05）。结论：医院中专生护士心理健康状况较差,系统心理干预对提高医院中专生护士的心理健康水平有显著作用。     

心理行为干预对血液透析患者生存质量及心理健康状况的影响

按照世界卫生组织生存质量测定量表、症状自评量表（SCL-90）、焦虑自评量表（SAS）及抑郁自评量表（SDS）对24例维持性血液透析治疗患者心理干预前后进行测评.结果 与对照组比较,心理干预患者干预后4、8周SAS、SDS评分显著降低（P＜0.05）;干预8周后,患者抑郁、焦虑、恐怖、偏执及其他因子评分显著低于对照组（P＜0.05）,生理领域、心理领域、社会领域评分显著高于对照组（P＞0.05或＜0.01）.认为心理行为干预可改善透析患者的负性情绪及心理健康状况,提高其生存质量.     

觉察压力与脑梗死康复治疗患者心理健康状况的相关性分析

目的：探讨觉察压力与脑梗死康复治疗患者心理健康状况的相关性。方法采用觉察压力量表和症状自评量表对280例脑梗死康复治疗患者进行问卷调查。结果脑梗死康复治疗患者心理不健康的发病率为57.86％；心理不健康组偏瘫、失语及无生活自理能力患者比例显著高于心理健康组，差异有统计学意义（ P＜0.05）；心理不健康组觉察压力总分、预测感、控制感及超载感评分均显著高于心理健康组，差异均有统计学意义（均 P＜0.01）。Logis-tic回归分析显示，偏瘫、无生活自理能力及觉察压力均与脑梗死康复治疗患者心理健康状况关系密切（OR＝1.15～1.32，P＜0.05）。结论觉察压力是脑梗死康复治疗患者心理健康的重要影响因素。     

居家不出和抑郁对老年人健康促进行为的影响

目的了解居家不出与抑郁对老年人健康促进行为的影响。方法采用居家不出量表、老年抑郁量表(GDS-15)、健康促进生活方式评定量表(HPLP-Ⅱ)及自编的一般情况问卷对1 455名社区老年人进行问卷调查。结果与非居家不出组相比,居家不出组的老年人健康促进行为总分得分显著降低(P0.05)。抑郁程度越高的老年人健康促进行为得分显著降低(P0.05)。居家不出和抑郁与老年健康促进行为呈显著负相关(r=-0.468、-0.608,P0.05)。多元逐步回归分析显示,文化程度、月收入、慢性病、居家不出、抑郁是老年人健康促进行为的影响因素(均P0.05)。结论居家不出和抑郁影响老年人健康促进行为。     

心理干预对糖尿病抑郁病人的影响

采用Zung的抑郁自评量表和自制的糖尿病健康知识测评表对116例糖尿病患者在心理干预前后进行心理健康评分、糖尿病健康知识知晓评分、空腹血糖及餐后2h血糖测定。结果实验组在心理干预3个月后均明显优于对照组（P〈0．01）。结论心理干预可提高糖尿病抑郁病人的心理应激素质。     

心理干预对糖尿病抑郁病人的影响

采用Zung的抑郁自评量表和自制的糖尿病健康知识测评表对116例糖尿病患者在心理干预前后进行心理健康评分、糖尿病健康知识知晓评分、空腹血糖及餐后2h血糖测定。结果实验组在心理干预3个月后均明显优于对照组（P〈0．01）。结论心理干预可提高糖尿病抑郁病人的心理应激素质。     

原发性高血压患者胰岛素抵抗指数、瘦素、脂蛋白水平的变化及意义

目的通过检测原发性高血压（EH）患者胰岛素抵抗（IR）指数及血清瘦素（Leptin）、脂蛋白水平变化,探讨EH患者IR指数与血清Leptin、脂蛋白的相关性及其临床价值。方法采用ELISA法测定EH患者及健康对照者的血清Leptin,测定IR指数（采用稳态模式评估公式HOMA-IR计算）及外周血Leptin、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）水平,并在不同分期及是否合并IR患者之间进行比较。结果 EH患者IR指数、血清Leptin及LDL-C水平均显著高于健康对照者,HDL-C水平显著低于健康对照者（P均〈0.05）;EHⅡ期与EHⅠ期比较,IR指数、血清Leptin及LDL-C水平均显著增高,HDL-C水平显著降低（P均〈0.05）;EH-IR者与EH非IR者比较,血清Leptin及LDL-C水平均显著增高,HDL-C水平显著降低（P均〈0.05）。EH患者IR指数与外周血Leptin、LDL-C水平呈显著正相关（r=0.572、0.416,P均〈0.05）,与HDL-C水平呈显著负相关（r=-0.313,P〈0.05）;EH患者外周血Leptin水平与LDL-C水平呈显著正相关（r=0.501,P〈0.05）,与HDL-C水平呈显著负相关（r=-0.315,P〈0.05）。结论 EH患者体内存在IR及Leptin、HDL-C、LDL-C的异常表达,其变化与血压分级有关,IR指数、Leptin与脂蛋白具有相关性。IR指数、Leptin、LDL-C及HDL-C可作为EH的辅助诊断及治疗的指标之一。     

Identifying the relationship among mental status, functional independence and mobility level in Turkish institutionalized elderly: gender differences

The purpose of this study was to examine gender differences in older people living at a rest home in terms of functional independence, mental status and mobility level and to describe the relationship among the three outcome variables. One hundred and thirty-three elderly people (60 women, 73 men), aged 65 years and above were included in the study. The average age was 75.3 +/- 6.7 years (range, 65-90 years). Mental status was assessed using the Hodkinson Mental Test (HMT). Functional independence was measured using Functional Independence Measurement (FIM). Mobility level was evaluated using the Rivermead Mobility Index (RMI). Elderly women had lower scores regarding all the outcome variables when compared to older men. The older men had higher cognitive performance than women. In addition, women were at low level of mobility and depended upon the daily living activities (p < 0.05). Both genders showed a significant negative correlation between mental status and functional independence or mobility level, while the correlation between functional independence and mobility level was significantly positive. The data showed that mental impairment decreases both functional status and mobility level of the institutionalized elderly people. Gender difference was found to be an important factor affecting the outcome variables of the study.     

新型冠状病毒肺炎疫情下中老年人的心理健康状况

目的研究中老年人在新型冠状病毒肺炎(COVID-19)疫情下心理健康状况及其影响因素。方法采用在线问卷方法调查全国范围内50~65岁的中老年人心理健康状态,问卷内容包括心理健康自评问卷(SRQ-20)、健康问卷抑郁量表(PHQ-9)、广泛性焦虑障碍量表(GAD-7)和失眠严重程度指数量表(ISI),分别用以评估应激反应、抑郁情绪、焦虑情绪、睡眠障碍状态。采用SPSS 20.0软件进行统计分析。多重线性回归分析相关因素对疫情下中老年人心理健康状态的影响。结果有效回收问卷1501份(nSRQ-20=1377,nPHQ-9=1241,nGAD-7=1204,nISI=1209),经分析发现24.5%出现了心理应激,18.5%表现出中重度抑郁状态,10.7%表现出中重度焦虑状态,10.8%表现出中重度失眠。多重线性回归分析显示,身体健康状况、对疫情的担忧、教育程度和年龄对疫情下中老年人心理健康状态的影响较大,4个因素在PHQ-9、GAD-7、SRQ-20及ISI模型中的决定系数R2分别为0.190、0.176、0.232和0.137,其中以身体健康状况最为显著,标准化β值依次为0.374、0.368、0.406、0.322(均P<0.01)。进一步分析不同健康状况(良好、一般及欠佳3组)间心理状态的差异,发现3组在应激反应、抑郁、焦虑、睡眠4个维度上的差异具有统计学意义(P<0.001)。结论中老年人在此次COVID-19疫情下较平时更易出现心理健康问题,身体健康情况差者心理健康问题更明显。     

高血压患者的生活满意度与心理健康水平的关系

目的：探讨高血压患者的生活满意度和精神卫生状况间的关系。方法：以生活满意度调查表和SCL-90为测量工具，对98例高血压患者进行对照研究和直线相关分析。结果：高血压患者生活满意度平均得分23．4，处于中等偏下水平，除居住和子女孝顺外与正常对照均有显著性差异（P〈0．01）。精神卫生状况除强迫症和精神病性外与正常对照均有显著性差异（P〈0．01）。直线相关分析提示生活满意度低导致患者抑郁、焦虑、人际敏感和躯体化症状多。结论：高血压的发病与心理应激和生活满意度有关，家庭和睦、社会保障体系健全、良好的人际关系和经济状况，是减少应激和提高患者精神卫生状况的重要环节。     

Factors associated with mental health of graduate nursing students in China

The increasing number of graduate nursing students in China has resulted in the wide concern for their mental health problems. Quantitative studies using validated questionnaires on mental health of graduate nursing students are rare. This study aimed to investigate the factors potentially involved in the level of mental health of graduate nursing students.The sample consisted of 339 graduate nursing students from 5 universities of China. The participants were evaluated using the Symptom Checklist-90 (SCL-90) and Chinese Perceived Stress Scale (CPSS) between March and November 2020. Multivariate stepwise linear regression analysis and spearman correlation test were performed to assess the association between various factors associated with mental health.The SCL-90 total score was 109.00 (96.00 –134.00) and psychological abnormalities (total score > 160) accounted for 14.2%. The highest score in the nine dimensions was compulsion dimension. The positive detection rate of compulsion dimension was 21.5% (dimensions score > 2),and the average of compulsion score was 1.50(1.20 –2.00). Multivariable stepwise linear regression analysis showed that grade, environmental adaptation level, number of good friends were independently associated with lower SCL-90 scores (both P < .05). SCL-90 scores were correlated with Chinese Perceived Stress Scale (r = .159, P = .003).Results indicate that learning about ways to adapt to the environment, strengthening good friends support and alleviating perceived stress can help improve graduate nursing students’ level of mental health. The conclusions of this study can provide a reference to improve the psychological intervention strategies for graduate nursing students.     

不同养老方式下老年人心理健康状况的比较研究

目的 比较不同养老方式下老年人的心理健康状况，并分析其相关因素。方法 采用自编老年心理健康问卷，评定对象为441例年龄55～106岁集中养老者和1010倒年龄55～96岁北京城区居家养老者。结果 两类养老方式下老年人的心理健康状况具有类似特点；心理健康水平有随教育程度的提高而改善的趋势；年龄差异不显著，居家养老者心理健康状况明显好于集中养老者。结论 两类养老方式最大区别在于养老机构中亲情纽带作用减弱。老年人缺少天伦之乐，容易产生负性情绪。使心理健康水平下降，这提示当前养老机构应重视对老年人的精神慰藉，物质与精神养老相结合已提到日程     

Embedding HIV Mentoring Programs in HIV Research Networks

In Spain little research has focused on assessment of health indicators, both physical and psychological, in people living with HIV. The aim of this study is to evaluate a set of different indicators that allow us to identify psychological factors that may be influencing the quality of life of these people. The sample consist of 744 people infected with HIV aged between from 18 to 82 years (M = 43.04; SD = 9.43). Results show that factors such as self-esteem and leading a healthy lifestyle act as protectors in both, physical and mental health. On the other hand, financial problems, body disfigurement, and depressive mood could have harmful effects on both, physical and mental health. The structural model reveals depressed mood as the factor with greatest influence upon mental health, which in turn can be largely explained by factors such as the stress generated by HIV and personal autonomy. This work has allowed us to identify the vulnerability and protective factors that play a significant role in the physical and mental HRQOL of persons with HIV, providing guidelines for design and implementation of psychological intervention programs aimed to improve HRQOL in this population.     

Medium-term Influence of the Coronavirus Disease 2019 Pandemic on Patients with Diabetes: A Single-center Cross-sectional Study

Objective This study evaluated the lifestyle changes in patients with diabetes and their independent associations with glycemic and body weight control. In addition, the correlation between changes in mental health and lifestyles was evaluated. Methods This single-center cross-sectional study included 340 patients with diabetes who periodically visited our department. Changes in dietary habits, activities of daily living, and mental health before and during approximately six months after the onset of the coronavirus disease 2019 (COVID-19) pandemic were evaluated using a questionnaire, including the International Physical Activity Questionnaire-Short Form. Results Approximately 20%, 30%, and over 50% of patients had worsened dietary habits, decreased activities of daily living, and deteriorated mental health, respectively. A multiple regression analysis showed that irregular meal timing was significantly associated with change in HbA1c (β=0.328, p=0.001), and decreased walking time was significantly associated with changes in body weight (β=-0.245, p=0.025). The change in fear and anxiety was positively associated with changes in meal timing regularity (r=0.129, p=0.019) and carbohydrate consumption (r=0.127, p=0.021). Subsequently, the change in depressed mood was positively associated with changes in carbohydrate (r=0.142, p=0.010) and alcohol (r=0.161, p=0.037) consumption, and the change in psychological stress was positively associated with changes in carbohydrates (r=0.183, p=0.001) and snack (r=0.151, p=0.008) consumption as well as sedentary time (r=0.158, p=0.004). Conclusion The COVID-19 pandemic has had a considerable medium-term impact on the lifestyle and mental health of patients with diabetes. Lifestyle changes were associated with glycemic and body weight control, and mental health changes were associated with lifestyle changes. These findings may provide important information on diabetes care during the pandemic.     

基于能力评估的城市养老机构入住老年人服务需求调查

目的了解城市养老机构入住的不同能力等级老年人对不同服务的需求程度。 方法选取全国9个省的18家养老机构中的674名老年人作为调查对象,根据行业标准《老年人能力评估》评定其能力等级,通过自行设计的《养老机构入住老年人服务需求调查表》调查其相关需求情况,并对不同能力等级老年人的不同服务需求（包括日常生活照料服务、医疗健康服务、休闲娱乐服务、心理慰藉服务）进行比较分析。多组间需求评分的比较采用方差分析。 结果674例被调查者中以70～89岁（82.2%）、无配偶（61.3%）、自费入住（86.8%）的老年人为主,入住养老机构的主要原因（占58.9%）是子女亲属无时间照顾。日常生活照料服务、医疗健康服务、心理慰藉指导服务需求得分均随老年人身体受损程度的加重而逐渐上升,休闲娱乐服务需求得分明显下降,差异均有统计学意义（F=177.546、11.269、4.484、10.097,均P<0.01）。不同能力等级老年人所有日常生活照料服务各子项（穿衣服务、修饰服务、口腔清洁、饮食照料、排泄护理、皮肤清洁护理、压疮预防、膳食服务、清洁服务、洗涤服务、帮助购物、房间布置与装扮）的需求得分均随老年人身体受损程度的加重逐渐上升（F=150.468、123.718、129.496、78.739、138.319、160.589,均P<0.01）。在医疗健康服务项目中除健康教育和中医保健服务外,不同能力等级老年人其余各子项（定期健康体检服务、健康指导和督促服务、健康教育服务、基础护理服务、中医保健服务、诊断治疗服务、康复训练服务、安全用药指导）的需求得分均随老年人身体受损程度的加重逐渐上升（F=8.648、7.948、13.009、10.388、7.703、16.342,均P<0.01）。不同能力等级老年人休闲娱乐服务项目各子项（文化类娱乐活动、体育类娱乐活动、娱乐活动的提供或指导）的需求得分均随老年人身体受损程度加重明显下降（F=3.287、16.570、4.127,均P<0.05或0.01）,心理慰藉服务项目中增加探视次数的需求得分的差异有统计学意义（F=7.198,P<0.01）。老年人能力等级与日常生活照料服务、医疗健康服务及心理慰藉服务需求均呈正相关（r=0.606、0.214、0.108,均P<0.01）,与休闲娱乐服务需求呈负相关（r=-0.197,P<0.01）。 结论城市养老机构入住老年人身体能力等级与日常生活照料服务、医疗健康服务、休闲娱乐服务的需求程度存在相关性且不同等级间需求差异明显,养老机构应重视老年人能力评估工作,并依据相应需求科学开展功能区域划分、照护方案制定、个性服务提供等工作。     

Association of individual activities of daily living with self-rated health in older people

OBJECTIVE: to evaluate the associations of 18 activities of daily living with self-rated health in older people. DESIGN AND SETTING: cross-sectional study of a representative sample of 781 people aged 65 or over (response rate: 89.9%). METHODS: self-rated health was assessed by the question: "Overall, how would you rate your current health status-very good, good, fair, poor or very poor?" We used the Barthel index and Lawton and Brody's index for basic and instrumental activities of daily living, respectively. We classified subjects into three groups according to their Barthel index score: level 1 (score 100), level 2 (score 91-99) and level 3 (score 0-90). Logistic regression was used to identify associations between each activity and self-rated health. RESULTS: use of stairs [odds ratio (OR) = 4.28, 95% confidence interval (95% CI): 2.82-6.52], ambulation (OR = 3.67, 95% CI: 2.39-5.64) and chair/bed transfer (OR = 3.00, 95% CI: 1.68-5.36) were the basic activities of daily living best associated with self-rated health. Among instrumental activities of daily living, ability to handle finances (OR = 2.20), laundry (OR = 2.15) and transport (OR = 2.12) were associated with self-rated health. On the Barthel index, only transport was associated with self-rated health in subjects at levels 1 (OR = 2.55) and 2 (OR = 2.72). For subjects with poor functional status (level 3), no instrumental activities of daily living were related to self-rated health. CONCLUSION: in terms of self-rated health, the most important activities of daily living were those involving mobility. The effect of each instrumental activity of daily living on self-rated health depends on the level of functional capacity in basic activities of daily living.     

品管圈活动对老年肿瘤化疗患者焦虑、抑郁、睡眠质量和心理健康的干预效果观察

目的观察品管圈活动对老年肿瘤化疗患者焦虑、抑郁、睡眠质量和心理健康的干预效果,为改善患者的负性精神状况提供方法。方法选取2019年7月~2020年1月于复旦大学附属华东医院日间化疗病房接受化疗的肿瘤患者120例,根据数字表法随机分为试验组(n=60)和对照组(n=60)。对照组患者接受常规护理干预,试验组患者在与对照组相同常规护理基础上,增加品管圈活动干预。分别采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、匹玆堡睡眠质量指数量表(PSQI)和症状自评量表(SCL-90),对2组干预前后的焦虑、抑郁、睡眠质量和心理健康程度进行评分和比较。结果干预前,2组的SAS评分、SDS评分、PSQI各项因子评分和SCL-90各项指标评分差异均无统计学意义(P>0.05);干预后,2组的SDS评分、SDS评分、PSQI各项因子评分和SCL-90各项指标评分均明显低于同组干预前(P<0.05),且试验组均显著低于对照组(P<0.05)。结论品管圈活动可明显改善老年化疗患者的焦虑和抑郁程度、睡眠质量和心理健康,具有一定的临床应用价值。