青少年抑郁症患者非自杀性自伤心理体验的质性研究

目的 探讨青少年抑郁症患者非自杀性自伤的心理体验,为采取针对性干预提供参考。方法 采用目的抽样法,选取15例经历过非自杀性自伤的青少年抑郁症患者进行半结构深入访谈,采用Colaizzi 7步分析法分析、归纳、提炼资料。结果 经历非自杀性自伤行为的青少年抑郁症患者的心理体验可以归纳为4个主题：来自学校的不良刺激长期蓄积,自我调节能力不足;来自家庭的关爱呵护不足,负性情绪无法释放;自伤前思想封闭拒绝交流,寻求帮助路径不畅;自伤后负性情绪得以释放,享受快感难以自制。结论 青少年抑郁症患者容易发生非自杀性自伤行为,需要学校提供良好的支持教育,家庭营造舒心的氛围,双方共同为青少年提供有效的心理支持,以避免非自杀性自伤的发生,促进青少年的身心健康。     

血液科医护人员经历患者自杀事件心理体验的研究

目的探讨血液科医护人员经历患者自杀事件后的心理体验,为减轻医护人员心理负担、完善患者自杀管理机制提供参考。方法运用现象学研究方法,对经历患者自杀的13名血液科医生和护士进行半结构化深度访谈,用Colaizzi 7步分析法分析资料。结果血液科医护人员经历患者自杀事件后的心理体验主要分为情绪体验和认知体验。情绪体验包括害怕与惊慌、沮丧与内疚、焦虑与压力感;认知体验可归纳为患者自杀征兆、患者自杀原因、医护对自身职业角色的认知、对自杀管理的思考4个主题。结论患者自杀事件给医生和护士带来不同程度的负性影响,但其也积极寻找原因、寻求解决方案来避免患者自杀事件的发生。管理者要关注经历患者自杀事件的医护人员的支持需求,避免产生职业疲溃和倦怠,确保医疗安全和质量。     

老年跌倒骨折患者跌倒恐惧体验的纵向质性研究

目的 探讨老年跌倒骨折患者跌倒恐惧体验的变化,为制订有效的针对性护理干预措施提供参考。方法 采用纵向质性研究方法,以目的抽样法选取骨科病房16例老年跌倒骨折患者进行半结构式访谈,并对资料进行横断面和纵向分析。结果 共提炼出3个主题及8个亚主题：跌倒恐惧情绪体验的变化(负向情绪发展,正向情绪调节),跌倒恐惧认知体验的变化(成因多元化,自我效能降低),跌倒恐惧应对体验的变化(保持谨慎态度,树立康复信心,提升知识储备,寻求外部支持)。结论 老年人跌倒恐惧体验是一个复杂的现象,呈现动态的变化过程,临床医护人员在跌倒预防计划中应早期识别存在跌倒恐惧的老年人,并通过多学科团队实施预防性护理干预。     

渐进式暴露结合引导式干预对急诊科自杀未遂青少年的影响

目的 提高急诊科自杀未遂青少年心理弹性,预防再自杀。 方法 将158例自杀未遂青少年随机分为对照组78例、干预组80例。对照组采取常规心理护理;干预组采取渐进式暴露结合引导式心理干预,干预至患者出院时评价效果。 结果 干预后,干预组患者自杀意念、焦虑、抑郁评分显著低于对照组,心理弹性评分显著高于对照组（均P＜0.05）。 结论 渐进式暴露结合引导式护理可降低青少年自杀意念,缓解焦虑抑郁情绪,增强心理弹性,有利于预防青少年再自杀。     

青年慢性乙型病毒性肝炎患者心理体验的质性研究

目的了解青年慢性乙型病毒性肝炎(乙肝)患者患病过程中的心理体验,为提高此类群体生活质量提供参考。方法采用质性研究中Heidegger现象学方法对10例青年慢性乙肝患者进行深入访谈,采用Colaizzi分析法进行资料分析。结果提炼出6个主题:希望得到康复信息;渴望建立长期康复的信心;产生负性情绪;社会适应的改变;缺乏社会支持感;对抗病毒治疗的特殊反应。结论慢性乙肝疾病本身和社会对乙肝的歧视给青年患者带来巨大的影响;医务人员需提供个性化健康教育,建立长效社会干预体系,提高患者自我管理能力,以减轻患者负性情绪,提高疾病的应对能力。     

身体约束护患体验的研究进展

从护理人员和患者的视角综述身体约束的体验:护理人员认为约束可接受,是保障患者安全的一项措施;在情感上存在安全和担心两种体验,希望获得指南等的支持。患者认为身体约束可以理解,在情感上存在正性(被关注、被帮助等)和负性(不适、愤怒、羞耻、焦虑等)体验。提出约束决策前应充分了解患者的认知、情感体验和对约束的建议;制定适应我国患者身体约束指南;规范约束流程,解决护理人员对患者身体约束决策困惑,促进以人为本的整体护理。     

Psychological experiences of chronic hepatitis B infection in young patients: a qualitative research

目的 了解青年慢性乙型病毒性肝炎(乙肝)患者患病过程中的心理体验,为提高此类群体生活质量提供参考.方法 采用质性研究中Heidegger现象学方法对10例青年慢性乙肝患者进行深入访谈,采用Colaizzi分析法进行资料分析.结果 提炼出6个主题:希望得到康复信息;渴望建立长期康复的信心;产生负性情绪;社会适应的改变;缺乏社会支持感;对抗病毒治疗的特殊反应.结论 慢性乙肝疾病本身和社会对乙肝的歧视给青年患者带来巨大的影响;医务人员需提供个性化健康教育,建立长效社会干预体系,提高患者自我管理能力,以减轻患者负性情绪,提高疾病的应对能力.     

恶性肿瘤患者诊疗过程心理体验及应对方式的质性研究

目的了解恶性肿瘤患者在诊断、治疗、康复过程中的心理体验及应对方式,为医护人员开展肿瘤的诊疗及康复工作提供帮助。方法以访谈形式对18例恶性肿瘤患者诊疗过程的心理体验及应对方式进行访谈,运用Colaizzi分析法进行分析、整理,提出主题。结果恶性肿瘤患者情绪反应强烈,治疗过程中精神压力和经济压力较大,角色的变化引起社会适应力改变,获得信息的愿望强烈;患者所采取的应对方式主要有回避、屈服、积极面对。结论在患者的治疗过程中,医护人员应该关注患者的身心健康,提供医疗、信息及情感等方面的支持,提高患者治疗效果及应对能力。     

慢性腰背痛患者恐惧-回避信念水平及影响因素分析

目的调查社区慢性腰背痛患者恐惧-回避信念水平并探析其影响因素。方法采用一般情况调查表、长海痛尺、中文版恐惧-回避信念量表、慢性病管理自我效能感量表、简易应对方式问卷、社会支持评定量表和综合医院焦虑抑郁量表,对南京市及常州市8个社区157例慢性腰背痛患者进行调查。结果慢性腰背痛患者病程中位数为3年,大多数时间疼痛程度为(3.76±1.27)分。在疼痛评级指数中,感觉项得分中位数为4分,情感项得分中位数为2分。疼痛发作时间模式中,"不时地、断断续续发作"最常见(61.78%)。慢性腰背痛患者恐惧-回避信念得分为48.59±16.41。多元线性回归结果显示,患者抑郁情绪、自我效能和消极应对是慢性腰背痛患者恐惧-回避信念的主要影响因素。结论恐惧-回避信念是影响慢性腰背痛转归的重要心理因素。基于恐惧-回避信念的影响因素,医护人员应关注慢性腰背痛患者抑郁情绪,尝试提升其自我效能,并避免采用消极应对方式,以期降低其恐惧-回避信念水平,改善疼痛体验。     

自杀未遂患者的心理干预

目的 探讨防止自杀未遂患者再自杀的心理干预措施.方法 干预前对35例自杀未遂患者进行症状自评量表(SCL-90)和艾森克个性问卷(EPQ)测评,同时对35名健康自愿者(对照组)进行EPQ测查.根据测评结果对自杀未遂者进行相应的心理干预,出院后6个月再次进行SCL-90测评.结果 35例自杀未遂患者均存在不同程度的心理症状,以强迫、人际敏感、敌对、抑郁情绪最为突出.SCL-90评分显著高于常模(P＜0.05,P＜0.01),EPQ中P、N因子评分显著高于对照组(均P＜0.01).心理干预后其SCL-90评分显著低于干预前,随访2年患者无再自杀行为.结论 对自杀未遂患者进行心理干预,可以减轻其心理问题,转变其思维模式,增强应激能力,预防再自杀.     

护士亲历患者自杀事件后真实体验质性研究的Meta整合

目的 系统评价护士亲身经历患者自杀事件后真实体验的质性研究,为设计有效的应对策略提供依据.方法 检索Cochrane Library、Ovid、中国知网等数据库中护士亲历患者自杀后的质性研究.采用澳大利亚JBI循证卫生保健中心质性研究质量评价标准对纳入文献的方法学进行质量评价,依据其汇集性整合方法进行结果整合.结果 共...     

Suicidality in people surviving a traumatic brain injury: Prevalence, risk factors and implications for clinical management

Background: A systematic search was conducted of the literature addressing suicidality after traumatic brain injury (TBI). Results from population-based studies found that people with TBI have an increased risk of death by suicide (3-4 times greater than for the general population), as well as significantly higher levels of suicide attempts and suicide ideation. Clinical studies have also reported high levels of suicide attempts (18%) and clinically significant suicide ideation (21-22%) in TBI samples.

Methods and Results: In reviewing risk factors, two prognostic studies using multivariate analysis were identified. Adjusted risk statistics from these studies found an elevated risk of suicide for people with severe TBI in comparison to concussion (hazard ratio 1.4, 95% CI 1.15-1.75) and an elevated risk of suicide attempts among people displaying post-injury suicide ideation (adjusted odds ratio 4.9, 95% CI 1.79-13.17) and psychiatric/emotional distress (adjusted odds ratio 7.8, 95% CI 2.11-29.04).

Conclusions: To date, little evidence exists for the role of pre-morbid psychopathology, neuropathology, neuropsychological impairments or post-injury psychosocial factors as major risk factors for post-injury suicidality. Finally, there has been little empirical examination of approaches to suicide prevention. Therefore, current best practice is based on clinical judgement and the untested extrapolation of prevention approaches from other clinical populations.     

急诊科自杀未遂患者的简要自杀风险干预

目的 探讨降低急诊科自杀未遂患者自杀意念的有效方法.方法 依据《照顾有自杀风险的成年患者——急诊科共识指南》制订简要自杀风险干预流程清单,对57例急诊科住院或留观的自杀未遂患者进行干预.结果 57例患者均未再出现自杀行为.干预前及干预后6个月患者自杀态度及自杀意念比较,差异有统计学意义(均P＜0.01).结论 实施简要...     

社区护士自杀相关态度及教育干预研究

目的了解社区护士的自杀态度、自杀预防态度,开展自杀预防教育干预,为自杀预防教育干预实施提供实证依据。方法便利取样法抽取济南市33家社区卫生服务中心的78名社区护士进行横断面调查,并选择其中的36名参加自杀预防教育干预研究。结果社区护士自杀态度得分2.88±0.31、对自杀者态度得分2.53±0.42、对自杀家属态度得分2.60±0.43,均处于中立水平,对自杀行为持排斥、歧视态度,得分3.54±0.51。社区护士自杀预防态度得分38.24±6.00,存在对自杀预防的误解。自杀预防教育干预后,社区护士对自杀态度、自杀行为态度、自杀家属态度、自杀预防态度均有改善且有统计学意义(P0.05,P0.01),但对自杀者态度改变差异无统计学意义(P0.05)。结论社区护士存在对自杀预防的误解和对自杀者的歧视,教育干预能提高社区护士积极的自杀预防态度和对自杀、自杀行为及自杀者家属的正确态度。     

肿瘤科护士自杀“守门人”培训效果评价

目的 探讨肿瘤科护士自杀“守门人”培训效果,以提高护士预防患者自杀能力。方法 选择56名肿瘤科护士作为研究对象,成立培训小组,根据自杀“守门人”Living Works培训体系,参考自杀学和肿瘤心理学相关文献制订培训方案,并对其进行自杀预防基础知识概述、自杀风险评估、自杀干预训练、随访与事后成长4次培训。结果 培训后,肿瘤科护士的自我效能感、自杀警告信号意识总分及各维度评分显著高于培训前,且自杀预防知识正确率显著高于培训前(P<0.05,P<0.01)。结论 自杀“守门人”培训有利于提升肿瘤科护士的自我效能感,增强识别自杀警告信号能力,并提高肿瘤科护士的自杀预防知识。     

综合医院住院患者自杀风险评估指标体系的建立

目的构建综合医院住院患者自杀风险评估指标体系,为临床护理人员评估自杀提供工具。方法采用文献研究法、焦点小组讨论法、德尔菲专家咨询法筛选评估指标,运用层次分析法确定指标权重,建立住院患者自杀风险评估指标体系。结果 2轮专家咨询问卷有效回收率分别为94.29%、90.91%,权威系数分别为0.849、0.857,协调系数分别为0.308、0.343;最终构建的住院患者自杀风险评估指标体系包括3个一级指标、8个二级指标及24个三级指标,并确定各级指标权重。结论住院患者自杀风险评估指标体系被专家认可,可进一步开展临床实证研究。     

Crisis intervention for attempted suicide in Shanghai,China

Suicide, which is a common problem in China, is attracting more attention from Chinese psychiatrists at present. This study reports on the demographic characteristics of 75 suicide attempters and discusses the effects of crisis intervention (CI) management of these people in Shanghai. Most of them are under 35 years of age and have very poor relationships with their partners and parents. It appears that 77.3 per cent of the attempters can improve and are able to cope with stressful events through supportive psychotherapy and brief problem-oriented psychotherapeutic management. The author suggests that CI can be an immediate, effective and practical approach when used to prevent suicide and parasuicide in the community in China.     

Post-traumatic stress disorder following a suicide attempt

How commonly does a suicide attempt lead to post-traumatic stress disorder? The terrifying nature of events before and after many suicide attempts and the increasing rates of suicide attempts in the general population suggest that PTSD as a result of a suicide attempt should not be a rare occurrence. However, a thorough review of the literature revealed no reports. We provide one case report and discuss the theoretical, clinical, and research questions linking traumatic suicide attempts to subsequent PTSD.     

综合医院护士对住院患者自杀预防认知的调查研究

目的了解综合医院护士对住院患者自杀预防认知状况,为更好地预防患者自杀提供建议。方法采用自行设计的护士对住院患者自杀预防认知调查问卷,对412名临床护士进行调查。结果护士对住院患者自杀预防认知总均分9.56±2.20,正确率45.52%,其中自杀一般知识均分6.83±1.68,正确率52.54%,自杀预防知识均分2.73±1.41,正确率34.07%。不同年龄、工作年限、职称、学历护士对住院患者自杀预防认知水平比较,差异有统计学意义(P0.05,P0.01)。有护理自杀倾向/自杀未遂患者经历的护士自杀预防知识得分高于无经历者(P0.05)。结论综合医院护士预防住院患者自杀的认知水平尚不理想,护理管理者应结合影响因素开展培训。     

Handling traumatic experiences in facially disfigured female burn survivors

BackgroundThis research deals with the impact of resilience, perceived stigmatization, social comfort and coping strategies on quality of life among female burn survivors with facial disfigurement, man many of which are found in Asian countries.MethodsUsing cross-sectional research design, female burn survivors with severe facial disfigurement (N = 100) were drawn by using purposive sampling strategy from a public sector hospital and an organization working in Lahore, Pakistan. Perceived Stigmatization Questionnaire (PSQ) (Lawrence et al., 2006), Social Comfort Questionnaire (SCQ) (Lawrence et al., 2006), State-Trait Resilience Scale, Coping with Burns Questionnaire (CBQ) (Willebrand et al., 2001) and World Health Organization Quality of Life Brief Questionnaire (WHOQOL-BREF Questionnaire; World Health Organization, 2014) were used for assessment.ResultsThe analyses showed a significant positive relationship among resilience, coping with burns and social comfort. A significant negative relationship was found between perceived stigmatization and coping with burns, resilience and social comfort. All these variables were tested for differentiation on the basis of survivor’s age (less vs. more than 30 years), occupation (housewife vs. gainfully employed), education (less vs. more than matriculation), social status (low vs. middle class), family system (nuclear vs. joint), siblings (yes vs. no), residence (living in home vs. shelter home) and psychological help received or not after the burn injury. Results indicate a mixed type of phenomenon among variable’s differentiation. Path analysis through AMOS resulted into a model showing no direct relationship of quality of life with coping with burns, perceived stigmatization and resilience; however, social comfort mediates the relationship between quality of life and coping with burns, perceived stigmatization and resilience.ConclusionIt is found that quality of life is dependent on coping with burns, perceived stigmatization and resilience through social comfort. The findings hold implications for the mental health professionals and rehabilitation service providers to emphasize on the restorative strategy for burn survivors to elevate their social comfort, to assist them in handling their injuries and develop a curative plan to support them in their coping skills.