夫妻暴力社会人口学及社会文化因素的研究

目的:探讨夫妻暴力的社会人口学及社会文化高危因素,为进一步心理干预夫妻暴力提供依据.方法:采用多级分层抽样方法,在湖南省郴州市抽取3087个家庭.其中有384户曾发生夫妻暴力,从中随机抽取80户,将施暴者80人作为暴力组.另外,以家庭结构相同为前提条件,选取96户无暴力行为的家庭,并从中选取与施暴者性别相同、年龄相近的96人作为对照,为非暴力组.用自编家庭暴力问卷进行访谈.结果:施暴者男性的比例(81.3%)显著高于女性(18.7%),受虐者女性的比例(81.3%)显著高于男性(18.7%)(P＜0.05);夫妻暴力家庭中3l～40岁的人数最多为60人,占37.5%;暴力组的受教育年限、经济收入低于非暴力组(P＜0.05).施暴者的经济收入高于受虐者(P＜0.05).家庭体制中暴力组家长制、自由制高于非暴力组(P＜0.01),而暴力组民主制的家庭体制低于非暴力组(P＜0.01).结论:施暴者以男性居多,受虐者以女性居多.以31～40岁年龄段夫妻暴力发生最多.受教育年限低、经济收入低较易有施暴倾向.家庭体制中家长制和自由制作风,容易引发暴力事件.     

社区人群抑郁障碍早期心理干预效果随访

目的 探索心理教育时社区抑郁障碍患者及高危人群的近期效果.方法 干预对象为社区抑郁障碍患者12例及阈下抑郁者40例.干预形式包括发放健康教育手册及讲座形式,内容包括抑郁障碍知识及认知行为治疗取向的心理教育.结果 干预后抑郁障碍知晓率显著提高,熟悉率由7.5％升至30.5％(x2=11.80,P=0.00).干预后汉密尔顿抑郁量表(HAMD)总分及应对方式消极应对分均显著降低(t=2.01,P=0.05;t=2.28,P=0.03).女性汉密尔顿抑郁(HAMD)、汉密尔顿焦虑(HAMA)减分值均显著高于男性(P分别为0.01、0.00),内向者HAMD减分值亦显著低于性格外向及一般者(F=3.38,P=0.04),女性特质应对方式问卷(TCSQ)消极应对分减分值亦显著高于男性(F=9.77,P=0.00).年龄与HAMD减分值呈显著负相关(r=-0.27,P=0.05).干预1年后随访,HAMD、HAMA总分均显著低于基线(t=3.82,2.97;P＜0.01).结论 心理教育能提高社区抑郁症患者及高危人群抑郁症知晓率,改善抑郁症状及应对方式,女性改善较佳.     

家庭暴力施暴者的心理健康状况

目的 探讨家庭男性躯体施暴者的心理健康状况,为进一步干预家庭暴力提供帮助.方法 采用病例时照研究,对156例社区家庭男性躯体施暴者和44例社区正常对照组用社会人口学指标、症状自评量表进行评定.结果 一般资料显示,家庭暴力男性躯体施暴者较对照组有更多的低教育水平者;更多的嗜烟者,且每天抽烟量大;且他们的躯体化、人际关系敏感、抑郁、敌对和偏执分值显著高于对照组(P＜0.05).结论 家庭暴力男性躯体施暴者有较多的低教育水平者和有较多的心理问题.     

权力感对亲密关系满意度的影响:社会比较倾向和冲突应对方式的链式中介作用

目的:探讨权力感对亲密关系满意度的影响及社会比较倾向和冲突应对方式的链式中介作用.方法:采用权力感量表、社会比较倾向量表、冲突应对方式量表、亲密关系满意度量表对533名处于恋爱关系的本科生和硕士研究生进行施测.结果:①相关分析显示,亲密关系满意度与权力感(r=0.107,P＜0.05)、冲突应对方式中的离开(r=0.199,P＜0.01)和忠诚(r=0.124,P＜0.01)呈显著正相关;与冲突应对方式的讨论(r=-0.452,P＜0.01)和忽视(r=-0.183,P＜0.01)呈显著负相关;社会比较倾向均与冲突应对方式下的讨论(r=0.277,P＜0.01)、离开(r=0.145,P＜0.01)、忠诚(r=0.113,P＜0.01)、忽视(r=0.165,P＜0.01)均呈显著正相关.②中介模型检验显示,权力感对亲密关系满意度的影响,仅存在社会比较倾向-冲突应对方式(讨论[-0.0206,-0.0004]、离开[0.0006,0.0109]、忽视[-0.0101,-0.001])的链式中介效应显著.结论:权力感仅通过社会比较倾向与冲突应对方式链式中介作用间接影响高校亲密关系满意度.     

婚姻中严重躯体暴力行为的个人-家庭-社会因素

目的:探讨婚姻关系中严重躯体暴力行为的个人-家庭-社会综合因素,为家庭暴力的预警和干预提供理论依据.方法:在陕西咸阳选取93名施暴者和92名无暴力者,采用自编调查表、冲突策略量表简版(CTS-2)、儿童期虐待问卷(CTQ)、酒精使用障碍筛查量表(AUDIT)和人格障碍诊断问卷第四版(PDQ-4+)评定婚姻关系中严重躯体暴力行为的个人因素(年龄、受教育程度、工作情况、是否酗酒、是否违法乱纪、人格障碍诊断情况)、家庭因素(儿童期虐待、是否目睹父母动手、夫妻权力分配、是否有经济压力)和社会因素(伴侣角色认知、对家庭暴力的认知).结果:施暴组酗酒、违法乱纪、人格障碍诊断高分者的比例均高于无暴力组(22.6％ vs.6.5％、12.9％ vs.4.3％、65.6％ vs.45.7％,均P＜0.05);施暴组CTQ的情感虐待、身体虐待得分均高于无暴力组[(8.3±2.3)vs.(6.5±2.2)、(7.7±3.0) vs.(6.0±2.3),均P＜0.05],目睹父母动手、夫妻一方专权、有经济压力比例均高于无暴力组(78.5％ vs.44.5％、57.0％ vs.15.2％、44.1％ vs.20.7％,均P＜0.05);施暴组伴侣角色认知、对家庭暴力认知的得分均高于无暴力组[(19.9±7.2) vs.(15.8±4.8),(15.8±6.9) vs.(13.2±3.9),均P＜0.05].Logistic多因素回归分析发现,有目睹父母动手、酗酒、违法乱纪、经济压力、夫妻一方专权、人格障碍诊断高分、伴侣角色认知高分、情感虐待高分情况的个体,发生严重躯体暴力行为的可能性更高(OR=1.30～16.19).结论:本研究提示,严重躯体暴力行为与个人特点、家庭环境和社会性认知的各层面综合因素相关.     

医护人员主观幸福感与人格特征及其关系

目的 研究医护人员人格特征与总体幸福感状况以及两者之间的关系.方法 运用总体幸福感量表(GWB)、艾森克人格问卷简式量表(EPQ-RSC),对128名医护人员进行测量.结果 男性总体幸福感高于女性(t=2.807,P=0.006);外科医务人员的主观幸福感显著高于妇产科(F=2.629,P=0.038).在P(精神质)、E(外倾性)量表上的得分男性显著高于女性(t=2.329,P=0.000,t=3.625,P=0.019);总体幸福感总分、精力以及松弛和紧张这几个维度与人格特质的外倾性呈显著正相关(r=0.427,0.413,0.311),与神经质呈显著负相关(r=-0.525,-0.382,-0.584).结论 医护人员的主观幸福感与人格具有密切的关系.     

民办高校大一学生社会支持与特质应对关系

目的 探讨民办高校大一学生社会支持与应对方式的状况及其关系.方法 随机抽取某民办高校大一学生309名进行社会支持和应对方式调查.结果 女性的社会支持总分、主观支持、支持利用度和消极应对方式得分高于男性(t=-2.002,-2.985,-2.549,-2.872;P＜0.05);积极应对与社会支持总分、主观支持、支持利用度呈显著正相关(r=0.263,0.240,0.266;P＜0.001),而消极应对与社会支持总分、主观支持、支持利用度呈显著负相关(r=-0.391,-0.413,-0.408;P＜0.001).结论 民办高校大一新生的社会支持水平越高,越容易采取积极应对的方式解决问题.     

The Effect of Self-efficacy on the Relationship between Trait Coping Style and Well-being of Medical College Students

目的 探讨自我效能感在医学生特质应对方式、幸福感中的作用机制.方法 对405名学生施测特质应对方式问卷( TCSQ)、一般自我效能感量表(GSES)、大学生幸福感影响因素问卷(AFW-US).采用相关分析和回归分析进行探索.结果 ①医学生幸福感与自我效能感和积极应对有显著正相关(r=0.353,0.281;P＜0.01),而与消极应对呈显著负相关(r=-0.102,P＜0.05);自我效能感与积极应对呈显著正相关(r=0.256,P＜0.01),与消极应对呈显著负相关(r=-0.261,P＜0.01);②自我效能感和特质应对方式可以显著预测医学生幸福感;自我效能感是应对方式与幸福感之间的中介变量.结论 自我效能感在特质应对方式影响医学生幸福感中具有部分中介效应.     

老年冠心病病人自尊与应对方式相关研究

目的:探讨老年冠心病病人的自尊水平及与应对方式的关系。方法:应用自尊量表(SES)及医学应对方式问卷(MCMQ)对246例社区居家及住院治疗的老年冠心病病人进行测试研究。结果:①女性老年冠心病病人的自尊水平显著高于男性(t=4.056,P=0.000);②老年冠心病病人的自尊水平与面对应对方式正相关(r=0.387,P=0.000),与屈服应对方式负相关(r=-0.425,P=0.000);③自我肯定是自尊影响面对应对方式的主要因子,自我否定与失败感是自尊影响屈服应对方式的主要因子。结论:老年冠心病病人的自尊水平会影响其应对方式的选择。     

The Relationship between Self-consistency and Congruence and Trait Coping Style of Seniors in High School

目的 考察高三学生自我和谐以及应对方式的基本情况,了解高三学生自我和谐与应对方式的相关关系.方法 采用自我和谐量表(SCCS)及特质应对方式问卷(TCSQ)对邯郸市9所高中82名高三学生进行问卷调查.结果 ①农村学生在自我和谐总分、自我与经验的不和谐量表分上低于乡镇、城市学生,具有统计学意义(d=8.680,P＜0.05);②积极应对与自我和谐呈显著负相关(r=-0.307,P＜0.01),与自我与经验的不和谐呈显著负相关(r=-0.37,P＜0.01);消极应对与自我和谐总分呈正相关(r=0.228,P＜0.05),与自我与经验的不和谐呈正相关(r=0.282,P＜0.05);③积极应对方式对自我和谐总分、自我与经验的不和谐有负向预测作用(Beta =-0.278,t=-2.615,P＜0.05;Beta=-0.334,t=-3.256,P＜0.01);消极应对方式对自我与经验的不和谐有正向预测作用(Beta=0.231,t=2.248,P＜0.05).结论 自我和谐与应对方式之间存在一定联系,特质应对方式对自我和谐有一定预测作用.     

剖宫产率与围产儿病死率相关性探讨

目的探讨剖宫产率与新生儿病死率的关系.方法对15年剖宫产率与新生儿病死率、窒息率进行回顾性分析;再按剖宫产率水平分4个组:A(＜15%)、B(≥15%)、C(≥20%)、D(≥25%),进行组间x2检验.结果15年剖宫产率与新生儿窒息率呈负相关(P＜0.01);死产率与剖宫产率比较两者呈负相关(P＜0.01);早期新生儿病死率与剖宫产率呈负相关(P＜0.01);死胎率与剖宫产率比较两者无明显相关性(P＞0.05);结论提高剖宫产率,一定程度上降低了母婴的病死率与病率,但盲目升高剖宫产率不但不能有效的进一步降低围产儿病死率反而对母体带来许多危害.建议适时的行剖宫产手术.     

湖南省家庭暴力的流行病学调查--研究方法与初步结果

目的:研究有效、切实可行的家庭暴力流行病学调查的方法,获取有关家庭暴力的流行病学数据.方法:遵照流行病学调查的基本原则,编制符合国情的流调工具,培训流调人员,强化晤谈技术.实施时争取政府相关职能部门的支持配合,广泛发动群众,结合群众需求,多方线索调查与入户调查相互印证,最后复查补遗,监控质量.结果:调查工具配对一致率为97%,灵敏度为95%,特异度为100%;家庭暴力发生率为16.2%,其中,近一年内的发生率为11.6%.结论:这是一套科学的、比较适合我国社情的调查家庭暴力的流行病学方法.家庭暴力已是不容忽视的社会问题,其发生率不低于国外报道.     

孕妇和新生儿碘缺乏病研究Ⅱ.4218例孕妇尿碘分析

本文采用硫酸铈接触法测定了４２１８例孕妇的尿碘。孕妇平均尿碘（１７４．１±１０２·６μｇ／Ｌ），低于１５００例未孕女性的平均尿碘（２００．６±１１４．１μｇ／Ｌ），两者比较差异非常显著（ｐ＜０．００１）。随着孕周的增加尿碘逐渐下降呈负相关。缺碘频率则随孕周的增加而增高呈正相关。结果表明，孕期特定的生理状态决定了孕妇碘代谢有其自身的变化规律而有别于其他群体     

麻醉期心率变异性的分形特性分析

采用关联维数、分形维数、尺度指数分析38例受试者麻醉期心率变异性信号的分形特性。结果表明:麻醉期心搏周期有显著性的分形特性变化,麻醉状态下心率变异性信号的关联维数(P<0.000001)明显低于清醒状态,而短时程尺度指数α1(P<0.0001)显著性地高于清醒状态。说明了麻醉期心率变异性信号的分形特性有明显地变化,提示运用非趋势波动分析方法分析麻醉期心率变异性信号的分形特性更适合于临床麻醉深度监测。     

Childhood Precursors of Adult Interpartner Violence

Although childhood exposure to violence in one's family of origin is one of the most consistent correlates of later adult domestic violence, little is known about the developmental pathways or specific mechanisms of in-tergenerational transmission. This article (a) reviews the current knowledge regarding early exposure to domestic violence as precursor of later domestic violence, (b) identifies developmental considerations related to the impact of exposure, and (c) describes several conceptual models of the influence of early exposure. Research on both adults and children is reviewed. Implications for research focus on operational definitions, sex differences, life-span development, relational dynamics, typologies, and mediating processes. Implications for clinical practice focus on early socialization experience in adult treatment, and the development of early prevention programs.     

Women's journey to safety – The Transtheoretical model in clinical practice when working with women experiencing Intimate Partner Violence: A scientific review and clinical guidance

Objective

Review the applicability of the Transtheoretical model and provide updated guidance for clinicians working with women experiencing intimate partner violence.

Methods

Critical review of related primary research conducted from 1990 to March 2013.

Results

Women's experiences of creating change within abusive relationships can be located within a stages of change continuum by identifying dominant behavioral clusters. The processes of change and constructs of decisional-balance and turning-points are evident in women's decision-making when they engage in change.

Conclusion

Clinicians can use the stages of change to provide a means of assessing women's movement toward their nominated outcomes, and the processes of change, decisional-balance and turning-points, to enhance understanding of, and promote women's movement across stages in their journey to safety.

Practice implications

Clinicians should assess women individually for immediate and ongoing safety and well-being, and identify their overarching stage of change. Clinicians can support women in identifying and implementing their personal objectives to enhance self-efficacy and create positive change movement across stages.The three primary objectives identified for clinician support are: 1. Minimizing harm and promoting well-being within an abusive relationship, 2. Achieving safety and well-being within the relationship; halting the abuse, or 3. Achieving safety by ending/leaving intimate relationships.     

Women's journey to safety – The Transtheoretical model in clinical practice when working with women experiencing Intimate Partner Violence: A scientific review and clinical guidance

ObjectiveReview the applicability of the Transtheoretical model and provide updated guidance for clinicians working with women experiencing intimate partner violence.MethodsCritical review of related primary research conducted from 1990 to March 2013.ResultsWomen's experiences of creating change within abusive relationships can be located within a stages of change continuum by identifying dominant behavioral clusters. The processes of change and constructs of decisional-balance and turning-points are evident in women's decision-making when they engage in change.ConclusionClinicians can use the stages of change to provide a means of assessing women's movement toward their nominated outcomes, and the processes of change, decisional-balance and turning-points, to enhance understanding of, and promote women's movement across stages in their journey to safety.Practice implicationsClinicians should assess women individually for immediate and ongoing safety and well-being, and identify their overarching stage of change. Clinicians can support women in identifying and implementing their personal objectives to enhance self-efficacy and create positive change movement across stages.The three primary objectives identified for clinician support are: 1. Minimizing harm and promoting well-being within an abusive relationship, 2. Achieving safety and well-being within the relationship; halting the abuse, or 3. Achieving safety by ending/leaving intimate relationships.     

Head injury screening and intimate partner violence: A brief report

Objective: Although the importance of traumatic brain injury has gained public attention in recent years, relatively little attention has been paid to head injuries among women who have experienced intimate partner violence (IPV). The present study screened for lifetime exposure to mild traumatic brain injuries (mTBIs) among a sample of women who had experienced recent IPV (median days since target incident = 26). Method: Participants included ethnically diverse women whose IPV experiences were reported to law enforcement. Women (n = 225) were asked about injuries to the head sustained during the target IPV incident as well as over the lifetime, and related symptoms. Results: The vast majority of women (80%) reported a lifetime head injury. More than half (56%) screened positive for mTBI, defined as at least one instance in which they experienced a change in consciousness or a period of being dazed and confused as a result of a head injury. A minority of women (13%) reported injuries to the head during the target IPV incident. Most women who had experienced a lifetime head injury reported frequent and current cognitive difficulties. Conclusion: These findings highlight the importance of assessing head injuries and related symptoms among women who have experienced IPV, pointing to important implications for policy and practice.     

男性不育相关因素对夫精人工授精妊娠率的影响

目的探讨部分男性不育相关因素对精子质量和夫精宫腔内人工授精（AIH-IUI）妊娠率、流产率的影响。方法回顾性分析2006年1月至2009年6月在我院生殖医学中心接受治疗的153对不育夫妇,250个IUI周期,分别对男性不育年龄、不育类型和年限、体重指数（BMI）、吸烟情况、精液优化后活动精子（a＋b）计数进行分组统计少弱精子症接受IUI周期所占比率、周期妊娠率（PPR）、流产率,比较分析正常精子质量和少弱精子症IUI治疗PPR和流产率。结果总治疗周期250个,妊娠数35,PPR为13.6%,流产数16,流产率45.71%。治疗前检查精子质量位于正常范围周期97个,妊娠数13,PPR为13.4%,流产数3,流产率23.08%;少弱精子症夫妇97对,治疗周期153个,妊娠数21,PPR为13.73%,流产数13,流产率61.90%。男性相关因素：年龄、体重指数、不育年限、每日吸烟量对精液质量有不良影响,相同因素PPR正常精液质量组高于少弱精症组,流产率明显低于后者,存在统计学差异（P〈0.05）。精液优化前后对PPR和流产率均有影响,优化后获得妊娠的最小活动精子（a＋b）计数为4×106/ml。结论男性年龄、体重指数、不育时间、每日吸烟量影响精子质量和IUI结局。高龄、高体重指数、吸烟的少弱精子症男性对IUI结局有不良影响。选择合适的精液优化方法最大限度回收活动精子,可以获得良好妊娠结局。     

The Etiology and Treatment of Domestic Violence Between Adult Partners

The field of family violence, although rapidly expanding, remains characterized by large gaps in knowledge regarding both etiology and effective treatment strategies. The purpose of this article is to integrate diverse research efforts in order to better understand the etiology, maintenance, and treatment of interpart-ner violence. Identified limitations include problems with definition, and the lack of integrated, multidimensional explanatory theories, well-controlled treatment outcome studies, and relational-level analyses. Identified strengths include the development of typologies and advances in measurement of interpersonal violence. The underlying theme of this article is that an integrated effort, incorporating basic research and clinical innovation, Individual and interactional perspectives, and differing theoretical orientations and advocacy positions, holds the greatest promise for effectively impacting this problem.