重症监护病房护士心理健康水平及其人格特征相关性分析

[目的]了解重症监护病房(ICU)护士心理健康状况与其基本人格特征的关系,为卫生行政主管部门进行人才选拔提供心理学依据。[方法]采用艾森克个性问卷(EPQ)、症状自评量表(SCL-90)对三级甲等医院ICU护士进行问卷调查。[结果]ICU护士有心理健康问题的检出率为7%;艾森克个性问卷中的神经质维度与心理健康显著呈正相关。[结论]具有情绪不稳定等人格特征,易造成ICU护士心理健康水平下降。相反,较稳定的情绪有助于ICU护士的心理健康。     

护士长的人格特征、社会支持、婚姻质量与心理健康的相关分析

采用艾森克个性问卷（ＥＰＱ）、社会支持评定量表（ＳＳＲＳ）、ＯＬＳＯＮ婚姻质量问卷（ＥＮＲＩＣＨ）和症状自评量表（ＳＣＬ－９０）,对３５０名护士长作个性、社会支持、婚姻质量与心理健康的相关研究。结果显示：艾森克个性问卷中的神经质维度与心理健康呈高度负相关,护士长婚姻质量问卷中的过份理想化与其心理健康呈高度负相关。神经质倾向的人格特征和过份理想化的婚姻不利于护士长的心理健康。较稳定的情绪和对婚姻较为现实的认知有助于护士长的心理健康     

聘用护士心理健康水平及其人格特征的相关性研究

目的了解聘用护士的心理健康状况及其与人格特征的相关性，为制定管理对策提供依据。方法采用症状自评量表和艾森克个性问卷对204名聘用护士进行问卷调查；并分析心理健康水平与其人格特征的相关性。结果①聘用护士症状自评量表各因子与中国常模比较，除焦虑、恐惧、精神病性3个因子外，其他因子均低于常模（P〈0．01）。②症状自评量表总分及各因子与人格特征的相关性，主要表现在与神经质维度（N分）相关性较高。艾森克个性问卷的精神质（P分）除与症状自评量表的恐惧因子无相关性外，与其他因子均呈正相关；性格内、外向（E分）除与敌对、偏执因子无关外，与其他各因子均呈负相关。结论聘用护士心理健康总体水平较好，但也存在不同程度的心理不良反应；聘用护士的心理健康水平和人格神经质的关系密切。     

稳态噪声条件下血液透析中心护士失眠状态的心理特征研究

[目的]研究稳态噪声对血液透析中心护士睡眠的影响及心理特征分析。[方法]采用症状自评量表（SCL-90）、应对方式问卷、艾森克成人个性问卷（EPQ）、成人生活事件量表测量两组护士心身健康状况。[结果]①实验组SCL-90症状自评总均分高于对照组（P〈0．05）；②实验组情绪不稳定或倾向不稳定者高达52．5％，高于对照组（20．4％）；对生活事件反应多采用不成熟的应对方式，呈现神经症性人格特点；③生活事件应激量实验组高于对照组（P〈0．01）。[结论]长期稳态噪声可导致血液透析中心护士睡眠生理紊乱和心理状态紊乱，对其生活质量有很大影响。     

传染科护士心理健康和人格特征的研究

目的探讨传染科护士的心理健康状况及人格特征,为建立传染科护士心理健康的干预策略提供科学依据。方法采用症状自评量表（SCL-90）和艾森克个性问卷（EPQ）对60名传染科护士进行问卷调查。结果传染科护士各项因子均高于国内常模,除偏执因子外,差异均有统计学意义（P〈0．05）;人格特征的内外向维度与SCL-90的躯体化等5个因子呈负相关,神经质维度与SCL-90的9个因子均呈正相关。结论传染科护士的心理健康水平低于全国成人一般水平,神经质和精神质纬度高于常模,传染科护士的心理健康与人格特征密切相关,应加强传染科护士心理健康水平的促进与维护。     

精神科护士心理健康状况及个性特征研究

目的探讨精神科不同年资护士的心理健康状况及个性特征。方法以从事精神科护理工作5年为界，将51名精神科护士分为高年资组和低年资组，采用症状自评量表和艾森克人格特征问卷进行评定并比较。结果症状自评量表测定显示低年资组护士总体心理健康水平高于高年资组护士；艾森克人格特征测定显示高年资组护士在神经质、内、外倾向、精神质3个分量表总标准平均分均高于低年资组护士，高年资组护士人格特征明显内倾不稳定。结论长期从事精神科工作的护士存在不同程度的焦虑、抑郁、躯体化症状和个性的不稳定，心理健康水平低。     

空军新兵心理健康状况与人格特征、反应能力的调查分析

[目的]探讨空军新入伍战士的整体心理健康状况及其与人格特征、反应能力的关系，为提高其心理健康水平提供依据。[方法]应用无线心理测评仪，对134名新战士进行症状自评量表（SCL-90）、艾森克人格问卷（EPQ）以及数字搜索测验。所绳资料采用SPSS软件包进行t检验和pearson相关分析。[结果]新战士SCL-90各项因子评分均显著低于军人常模（P〈O．01），SCL-90各因子结果与EPQ各维度结果具有相关性，抑郁、精神病性因子与能力测验结果有显著的负相关（P〈0．05）。[结论]空军新入伍战士的心理健康水平较好，需考虑其人格特征等特点，加强对战士心理状态的动态把握。     

整形美容受术者心理特征研究

[目的]探讨整形美容受术者心理健康状况与人格特征的关系,为采取针对性心理护理提供依据。[方法]采用症状自评量表（SCL-90）、艾森克人格问卷（EPQ）对142例整形美容受术者进行问卷调查,并将所得数据进行统计学处理。[结果]症状自评量表各因子分均高于常模（P〈0.01）。艾森克人格问卷中精神质（P）、神经质（N）、效度（L）量表分均高于常模,内外向（E）量表分低于常模,差异有统计学意义（P〈0.01）。整形美容受术者SCL-90各因子分与EPQ中N分呈正相关,强迫、人际关系、敌对、偏执和精神病性与P分呈正相关,强迫、抑郁、焦虑、恐惧与L分呈正相关,焦虑、恐惧与E分呈负相关。[结论]整形美容受术者存在较多心理症状,心理健康状况较差,具有内外向不稳定及较强的神经质和掩饰性人格特征,对受术者心理状况影响显著。在护理工作中应了解受术者的心理和人格特征,并给予针对性的心理干预。     

重症监护室护士心理健康状况的调查研究

[目的]了解重症监护室（ICU）护士心理健康状况。[方法]采用抑郁自测量表（SDS）和焦虑自测量表（SAS）对30名ICU护士心理健康进行测评。[结果]ICU护士的SAS、SDS评分均高于常模（P〈0.05）,10年～20年护龄、已婚已育、中专学历的ICU护士焦虑、抑郁情况比较明显。[结论]ICU护士压力大,存在明显的焦虑、抑郁情绪,应采取有效的措施减轻ICU护士的压力。     

护理专业大学生个性与心理健康的研究

[目的]揭示高级护理专业大学生的个性特征及心理健康状况。[方法]对某医学院校高级护理本科生采用艾森克个性问卷（EPQ）调查。从城乡、独生子女状况进行个性研究。[结果]护理专业大学生独生子女状况对个性影响主要体现在内外向特征，独生子女外向高于非独生子女。[结论]护理专业大学生个性以外向稳定型占优势，这与护理职业特点需求有一定关系。     

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.     

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.     

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.     

Prospects for the control of neglected tropical diseases by mass drug administration

The prospects for the control of neglected tropical diseases, including soil-transmitted helminthiasis, shistosomiasis, lymphatic filariasis, onchocerciasis and trachoma, through mass drug administration, are exemplified by the elimination of the trachoma as a public-health problem in Morocco. In spite of this and other striking successes, mass drug administration programs are faced with major challenges resulting from suboptimal coverage and lack of efficacy. At current suboptimal coverage rates, programs may need prolongation for an extended period, increasing costs and undermining sustainability. Community participation through health education and information appears to be crucial to improve coverage and to achieve sustainability. Implementation of complementary measures, such as vector control, improved hygiene and environmental sanitation, are important to further control transmission and to prevent re-emergence of the infection and, again, may only be achieved effectively through community-based initiatives. To reduce costs and to relieve pressure on the health system, combining neglected tropical disease programs in areas where diseases coexist and integration with existing control programs for malaria, tuberculosis and HIV/AIDS is advocated. The risk of developing drug resistance is of particular concern in view of the lack of alternative drugs, and reduced treatment efficacy due to emerging resistance is evident for the soil-transmitted helminths and onchocerciasis. Given the risk for the development of drug resistance and the need for a high degree of participation, close attention should be paid to the monitoring of the coverage and efficacy of the different program components.     

Bacterial meningitis: an update of new treatment options

The outcome of bacterial meningitis critically depends on the rapid initiation of bactericidal antibiotic therapy and adequate management of septic shock. In community-acquired meningitis, the choice of an optimum initial empirical antibiotic regimen depends on the regional resistance patterns. Pathogens resistant to antibacterials prevail in nosocomial bacterial meningitis. Dexamethasone is recommended as adjunctive therapy for community-acquired meningitis in developed countries. In comatose patients, aggressive measures to lower intracranial pressure <20 mmHg (in particular, external ventriculostomy, osmotherapy and temporary hyperventilation) were effective in a case–control study. Although many experimental approaches were protective in animal models, none of them has been proven effective in patients. Antibiotics, which are bactericidal but do not lyse bacteria, and inhibitors of matrix metalloproteinases or complement factor C5 appear the most promising therapeutic options. At present, vaccination is the most efficient method to reduce disease burden. Palmitoylethanolamide appears promising to enhance the resistance of the brain to infections.     

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.     

Imaging choices in occult hip fracture

Background: Hip fracture is a common injury, with an incidence rate of > 250,000 per year in the United States. Diagnosis is particularly important due to the high dependence on the integrity of the hip in the daily life of most people. Objectives: In this article we review the literature focused on hip fracture detection and discuss advantages and limitations of each major imaging modality. Discussion: Plain radiographs are usually sufficient for diagnosis as they are at least 90% sensitive for hip fracture. However, in the 3–4% of Emergency Department (ED) patients having hip X-ray studies who harbor an occult hip fracture, the Emergency Physician must choose among several methods, each with intrinsic limitations, for further evaluation. These methods include computed tomography, scintigraphy, and magnetic resonance imaging. Conclusion: We present an evidence-based algorithm for the evaluation of a patient suspected to have an occult hip fracture in the ED. Also outlined are future directions for research to distinguish more effective techniques for identifying occult hip fractures.     

Systematic Reviews Published in the April 2012 Issue of the Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD but monthly online. The April 2012 issue (second DVD for 2012) contains 5045 complete reviews, 2182 protocols for reviews in production, and 17,084 short summaries of systematic reviews published in the general medical literature. In addition, there are citations of 674,000 randomized controlled trials, and 15,400 cited papers in the Cochrane methodology register. The health technology assessment database contains just over 11,000 citations. One hundred and seventeen new reviews have been published in the last 3 months of which 12 have potential relevance for practitioners in pain and palliative medicine. The impact factor of the Cochrane Library stands at 6.186. Readers are encouraged to access the full report for any articles of interest as only a brief commentary is provided.     

Platelets,thrombosis, coagulation,and atherosclerosis

When I first got the invitation to join a medical delegation going to Moldova, I thought for a moment that our destination was the fictional country in the old Marx Brothers movie Duck Soup. On further checking, it turns out that entertaining place was called Freedonia. I now know that Moldova is indeed a real country, bordered on the west by Romania and on the other three sides by the Ukraine. It is a proud country, rich with traditions, and its people are warm, giving, eager to learn ways to improve their healthcare system, and deeply appreciative of our attempts to help them in the task.