护士职业应激与精神卫生状况分析

[目的 ]了解护士职业应激与精神卫生状况及其相关性。 [方法 ]应用抑郁自评量表(SDS)和焦虑自评量表 (SAS)及护士职业压力源量表对 779名在岗护士进行调查。 [结果 ]护士抑郁和焦虑发生率分别为3 6.3 %和 14 .2 % ,两者并存者占 11.6% ,SDS和SAS标准分均值与国内常模比较有统计学意义 (P <0 .0 1) ;护士职业应激总分 1.97分± 0 .460分 ;精神卫生与职业应激呈高度正相关 (P <0 .0 0 1)。 [结论 ]护士群体精神卫生状况低下 ,与其职业应激密切相关。管理者应在引导护士正确认识和舒缓职业应激的同时 ,考虑到女性的社会脆弱因素及其独特的生理特征     

心理干预对改善慢性乙型病毒性肝炎病人心身症状的研究

[目的 ]探讨一般支持性心理治疗和认知疗法对改善慢性乙型病毒性肝炎病人心身症状的作用。 [方法 ]将60例慢性乙型病毒性肝炎病人随机分为两组 ,实验组在临床治疗的同时采用支持性心理治疗和认知疗法。入院时、入院 2周、入院 4周用症状自评量表 (SCL -90 )、Zung焦虑自评量表(SAS)、Zung抑郁自评量表 (SDS)分别评估病人心理状况。 [结果 ]心理干预后 2周SCL -90躯体化、焦虑、精神症状得分及SAS、SDS标准分与干预前比较 ,差异有统计学意义 (P <0 .0 5 ) ;干预后 4周SCL -90各因子得分及SAS、SDS标准分与干预前比较差异均有统计学意义 (P <0 .0 5 )。对照组治疗前后SCL -90的因子得分及SAS、SDS标准分差异无变化(P >0 .0 5 )。 [结论 ]一般支持性心理治疗和认知疗法能有效改善慢性乙型病毒性肝炎病人的心身症状。     

唐山地区护理专业实践环境现状及与护士心理健康状况的关系

[目的]了解唐山地区护理专业实践环境现状及其与护士心理健康状况的关系。[方法]采用护理工作环境量表(PES)、焦虑自评量表(SAS)、抑郁自评量表(SDS)对唐山市7所三级医院2 158名临床护士进行调查。[结果]PES总分为(84.05±6.89)分,总均分为(2.52±0.35)分,SAS评分为(40.20±13.74)分,SDS评分为(44.34±10.37)分;PES总分及各维度得分与护士SAS、SDS评分呈负相关。[结论]护理工作环境与护士焦虑、抑郁水平关系密切,医院应采取有效措施改善临床护士的工作环境,提高护士心理健康水平。     

手术室护士心理健康状况及相关因素分析

目的了解手术室护士心理健康状况,寻找影响手术室护士健康状况的因素.方法采用抑郁自评量表(SDS)和焦虑自评量表(SAS)及护士职业压力源量表对5所医院100名手术室护士进行调查分析.结果手术室护士群体中SDS均值为(48.03士9.45),高于我国常模SDS标准分均值(41.88士10.57)(P＜0.01).SAS均值为(40.08±8.18),高于我国正常人均值的(33.80±5.90)(P＜0.001).抑郁症状发生率41.5%,高于我国正常人群中的抑郁症状发生率为15.1%～22.5%的报道,也高于护理人群中抑郁发生率为37.1%的报道.从压力源量表中显示,80%以上的护士认为护理工作的社会地位太低,工作量和工作压力太大.结论手术室护士抑郁症状发生率和焦虑发生率明显高于我国普通人群和普通护理人员.工作量和工作压力与社会地位不相称是影响护士心理健康的主要原因.     

手术室护士心理健康状况及相关因素分析

目的 了解手术室护士心理健康状况,寻找影响手术室护士健康状况的因素。方法 采用抑郁自评量表(SDS)和焦虑自评量表(SAS)及护士职业压力源量表对5所医院100名手术室护士进行调查分析。结果 手术室护士群体中SDS均值为(48.03±9.45),高于我国常模SDS标准分均值(41.88±10.57)(P<0.01)。SAS均值为(40.08±8.18),高于我国正常人均值的(33.80±5.90)(P<0.001)。抑郁症状发生率41.5％,高于我国正常人群中的抑郁症状发生率为15.1％～22.5％的报道,也高于护理人群中抑郁发生率为37.1％的报道。从压力源量表中显示,80％以上的护士认为护理工作的社会地位大低,工作量和工作压力太大。结论 手术室护士抑郁症状发生率和焦虑发生率明显高于我国普通人群和普通护理人员。工作量和工作压力与社会地位不相称是影响护士心理健康的主要原因。     

手术室护士心理健康状况调查分析

目的了解手术室护士的心理健康状况,寻找影响手术室护士心理健康的因素.方法采用抑郁自评量表(SDS)、焦虑自评量表(SAS)和中国护士职业压力源量表对81名手术室护士进行调查分析.结果手术室护士SDS均值为45.03±11.30,高于我国常模SDS标准分均值的41.88±10.57 (p＜0.05),SAS均值44.00±6.90,高于我国正常人的33.80±5.90(p＜0.001).抑郁症状的发生率(32%)高于焦虑症状的发生率(23%).从手术室护士压力源表中显示手术室护士压力主要来源于高强度的护理工作,手术室的环境因素及手术室护士自身因素.结论手术室护士抑郁症状的发生率和焦虑症状的发生率明显高于我国普通人群和其他专业护理人员.高强度高风险的工作压力与环境因素是影响手术室护士心理健康的主要原因.     

肿瘤医院护士疲劳综合征的相关性研究

目的探讨护士疲劳综合征与职业压力及心理健康水平之间的关系.方法应用抑郁自评量表(SDS)和焦虑自评量表(SAS)、护士工作压力源量表及疲劳综合征量表对257名肿瘤医院护士进行调查分析.结果肿瘤医院护士SDS和SAS均值为44.90±9.69和39.77±8.26;工作压力源总分1.76±0.360;疲劳综合征与压力源及心理健康状况的相关分析显示正相关.结论护士由于职业特征易罹患疲劳综合征,管理者应注重护士的行为心理管理,促进护士身心健康,保证护理质量.     

慢性乙型肝炎病人焦虑与抑郁的调查及其心理干预

[目的 ]了解慢性乙型肝炎病人的焦虑、抑郁状况 ,并进行心理干预效果评估。 [方法 ]采用焦虑自评量表 (SAS)及抑郁自评量表 (SDS)对 10 0例慢性乙型肝炎病人 (观察组 )及 10 0例健康人 (对照组 )进行问卷调查。根据调查存在的心理问题 ,对观察组实施为期 8周的心理干预 ,然后再测评SAS及SDS1次 ,并与心理干预前比较。[结果 ]观察组SAS及SDS评分均明显高于对照组 (P <0 .0 1) ,经心理干预后 ,其SAS及SDS评分分别由 3 6.82分± 6.2 4分和 41.16分± 10 .73分降为 3 2 .19分± 5 .72分和 3 5 .74分±9.16分 (P <0 .0 1) ;其焦虑及抑郁的发生率分别由 3 6.0 %和 43 .0 %降为 12 .0 %和 2 1.0 %(P <0 .0 1)。 [结论 ]慢性乙型肝炎病人存在一定程度的焦虑及抑郁 ,心理干预可缓解慢性乙型肝炎病人的焦虑及抑郁症状。     

护理人员幸福感现状及其影响因素分析

[目的]调查护理人员幸福感现状,并分析其相关因素,为科学管理提供依据。[方法]采用整群抽样方法,抽取我院823名护士,选用一般资料调查问卷、护士主观幸福感量表、护士工作压力源量表、简明健康状况量表(SF-36)、焦虑自评量表(SAS)、流调中心抑郁自评量表(CES-D)、社会支持量表进行调查。[结果]我院护理人员幸福感得分为(74.84±13.58)分,处于中等水平;年龄、压力源及SF-36、焦虑、抑郁得分进入方程。[结论]医院护理管理者可综合考虑影响护理人员总体幸福感的因素,制定针对性强的干预方案,以提升临床护理人员的总体幸福感水平,稳定护理队伍。     

家庭复原力对青光眼病人负性情绪与生活质量的影响

[目的]探讨家庭复原力对青光眼病人负性情绪与生活质量的影响。[方法]选取2017年1月—2019年1月某院收治的136例青光眼病人为研究对象。采用家庭复原力量表、焦虑自评量表(SAS)和抑郁自评量表(SDS)以及简明健康状况调查表(SF-36)评估病人家庭复原力、心理状况及生活质量。[结果]病人的家庭复原力得分为(179.69±19.56)分,其中家庭信念以及家庭力量得分分别为(61.08±9.18)分、(118.61±11.27)分。病人的SAS、SDS以及SF-36得分分别为(45.98±8.29)分、(49.46±8.47)分、(69.18±11.23)分。青光眼病人的家庭复原力、家庭信念和家庭力量得分与SAS和SDS得分呈负相关,与SF-36得分呈正相关。[结论]青光眼病人的家庭复原力偏低,焦虑、抑郁和生活质量中等,家庭复原力是影响病人情绪状况和生活质量的重要因素。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Modified micro-superior percutaneously-assisted total hip: early experiences & case reports

Because of the extensile nature and familiarity of the standard posterior-lateral approach to the hip, a family of "micro-posterior" approaches has been developed. This family includes the Percutaneously-Assisted Total Hip (PATH) approach, the Supercapsular (SuperCap) approach and a newer hybrid approach, the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach. Such approaches should ideally provide a continuum for the surgeon: from a "micro" (external rotator sparing) posterior approach, to a "mini" (external rotator sacrificing) posterior approach, to a standard posterior approach. This could keep a surgeon within his comfort zone during the learning curve of the procedure, while leaving options for complicated reconstructions for the more practiced micro-posterior surgeons. This paper details one author's experiences utilizing this combined approach, as well as permutations of this entire micro-posterior family of approaches as applied to more complex hip reconstructions.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.