精神病患者长期住院引发的心理问题与亲属探视的相关性分析及应对策略

目的探讨精神病患者长期住院引发的心理问题与亲属探视水平的相关性及应对策略。方法对53例住院患者进行亲属探视时间的期望水平调查。结果由于亲属对患者的心理需求的忽视和冷漠,94.3%的患者出现较严重的心理问题,经spearman等级相关分析,亲属探视水平与要求探视的欲望呈正相关关系(rs′=0.780,P<0.01)。结论精神病患者长期住院的心理问题应引起亲属的积极关注;应改变患者生存环境,促进康复,减少家庭成员的冷漠和高情绪表达以及给予心理护理。     

精神病患者长期住院引发的心理问题与亲属探视的相关性分析及应对策略

目的 探讨精神病患者长期住院引发的心理问题与亲属探视水平的相关性及应对策略.方法 对53例住院患者进行亲属探视时间的期望水平调查.结果 由于亲属对患者的心理需求的忽视和冷漠,94.3%的患者出现较严重的心理问题,经spearman等级相关分析,亲属探视水平与要求探视的欲望呈正相关关系(rs'=0.780,P＜0.01).结论 精神病患者长期住院的心理问题应引起亲属的积极关注;应改变患者生存环境,促进康复,减少家庭成员的冷漠和高情绪表达以及给予心理护理.     

百级层流病房探视陪伴制度的研究

目的了解层流病房住院患者及家属在探视陪伴方面的需求,探讨更具人性化的、适宜层流室的无菌环境要求的、切实可行的探视陪伴制度。方法自制调查问卷对30例层流病房住院患者和38名家属是否满意层流病房现有探视制度及主观的探视意愿进行调查。结果60％的患者和家属满意现有的探视制度,认为层流病房应该禁止进仓探视及陪护,进仓探视及陪护会增加感染几率;50％的家属和患者希望进仓探视和陪护。结论在百级层流病房的探视制度上,应秉承以人为本的理念,注重患者和家属的真正需求,实施既不违反医院探视规定,又能保护病房的无菌环境,且一定程度上满足患者和家属的探视陪护需求。     

住院精神病病人舒适状况及其影响因素研究

[目的]了解住院精神病病人舒适状况及影响因素。[方法]采用横断面问卷调查法对120例住院精神病病人进行测量。[结果]病人整体舒适度为中度舒适,自尊水平较高;精神病病人被保护时生理舒适度最低;精神疾病病人渴望得到更多的自由及更多的自主选择;精神病病人对家人的陪伴需求高;多因素分析显示,年龄和住院时间对病人的舒适有影响(P<0.05)。[结论]做好保护病人的各项护理,提供人性化的服务,另外,寻找有效的保护方法来改善和替代传统约束用具的使用;在保证安全护理的前提下,精神科医护人员应思考如何给予病人更多的自由及更多的自主选择权;临床护理管理者应重视病人陪伴及探视需求,加强病人的社会支持。     

住院癌症患者陪伴需求的调查研究

目的分析住院癌症患者陪伴需求状况、原因及相关影响因素。方法使用自制的住院患者陪伴需求及相关因素调查表对200例住院癌症患者进行问卷调查,并对数据进行统计学分析。结果 86%的患者希望获得陪伴,并且最希望获得亲属的陪伴。手术科室、受教育时间短、躯体症状明显、自理能力差及来自农村的患者对陪伴的需求较高,而离异患者对陪伴的需求较低。患者的陪伴需求原因主要来自安全需求层次和爱与归属需求层次。结论住院癌症患者对家属陪伴有较强烈的需求,应合理安排家属的探视和陪伴时间。     

民政系统精神病院长期住院精神病患者心理冲突调查

目的探讨民政系统精神病院长期住院的精神病患者在住院时期的心理冲突,了解患者的心理需求,从而为精神病患者提供更加优质的护理。方法采用自制的长期住院精神病患者心理冲突调查问卷,向本院长期住院达2年以上的精神病患者发放问卷,统计精神病患者的心理冲突。结果精神病患者对医院管理,被尊重感,家人关心等6个方面心理冲突所占比例不一。结论长期住院的精神病患者存在多方面的心理冲突,提醒精神科管理者及护理人员应重视精神病患者的心理需求,提高优质护理水平。     

住院精神病人家属探视情况及对病人的影响

目的 了解住院精神病病人家属探视频率对病人的影响.方法 自制问卷,对160例病人和160位家属进行探视状况调查.结果 35.2%北京病人及42.86%的外地病人在住院期间处于极少探视或无探视状态.48.75%的病人在无探视时出现负性情绪,76.25%的病人探视后心情愉快.53.75%的家属没有意识到病人心理需求的重要性.结论 住院精神病病人家属探视率低,医护人员需对家属进行心理辅导,转变家属对病人和对探视的态度,良好的家庭支持和关怀有利于病人疾病的治疗和康复.     

NICU患儿家长探视需求及护理对策分析

目的:探讨NICU患儿家长探视需求与其角色的关系及护理对策。方法:对我院我科2012年1～7月收治的200名足月儿家长发放调查问卷,主要调查患儿家长的探视需求、患儿家长的角色以及家长需求原因等内容。结果:87.30%的家长要求24 h陪护患儿,这可能是因为入院宣传教育工作不到位,使患儿家长对NICU认识不足造成的;患儿家长中的不同角色的探视需求不同,父母要求24 h陪护及增加探视次数方面与祖父祖母相比无统计学意义(P>0.05),而与外祖父外祖母及其他亲属相比有统计学意义(P<0.05);父母在延长探视时间方面与祖父祖母、外祖父外祖母相比无统计学意义(P>0.05),与其他亲属比较有统计学意义(P<0.05)。患儿家长提出陪护的原因主要担心患儿病情变化及担心医院照顾不周。结论:通过调查分析NICU患儿家长的探视需求,能够了解家长的心理状态,有针对性地采取相应的护理对策,消除其焦虑、无助的负面心理,在最大程度上得到患儿家长的信任与支持,确保NICU护理工作的顺利开展。     

ICU急性创伤患者家属探视分析

目的探讨ICU急性创伤患者家属对ICU陪护制度的心理反应及采取措施。方法参考国外危急重患者家属需要量表，对我院ICU126名急性创伤患者家属进行调查。结果患者家属有强烈的探视需求，目前的探视制度不能满足急性创伤患者对探视的要求。结论适当放宽探视条件，采用限制性探视能部分满足家属的心理需求，又可以有效地促进ICU病房的合理化管理。     

精神病病人家属探视需求调查与护理对策

目的 了解精神病病人家属的探视需求,采取有效的护理对策,满足需求。方法 采用问卷形式,对120名家属进行了探视心理调查。结果 对于我们传统的探视方法提出了新的要求。结论 针对家属探视心理需求,采用相应的护理对策,改进管理模式,提供人性化管理。     

Transitional care for seriously mentally ill persons: a pilot study

This article reports the results of a pilot study of a nurse-based in-home transitional care intervention for seriously mentally ill persons. The goals of the intervention were to address the lack of continuity of care in existing programs and to meet the immediate postdischarge needs of severely mentally ill persons. This article focuses primarily on the applicability and feasibility of the intervention for this population, given the challenges of engaging seriously mentally ill patients in a community-based protocol and the complexity of their illnesses. Factors that are important to community adjustment postdischarge were identified: caregiver concerns and health status impeding illness management, lack of structure/involvement in daily activities, structural and functional factors affecting adherence, and presence of symptoms after discharge. Use of an advanced practice nurse to provide transitional care can offer an alternative to patients who might otherwise be left poorly treated or untreated in the community setting.     

新型冠状病毒肺炎期间部分广西居民的心理及行为调查

目的调查部分广西居民对新型冠状病毒肺炎（COVID-19）的相关认知、心理反应及心理救助需求情况,为全科医生在开展COVID-19相关诊疗提供科学依据。 方法通过微信的形式向部分广西居民进行网络问卷调查,问卷内容包括年龄、性别、职业等一般情况,对于COVID-19相关的认知和对于COVID-19的心理反应、帮助需求,评估部分居民对COVID-19的心理反应、援助需求。 结果共收回有效问卷1803份。在COVID-19相关知识认知情况的被调查者中,具有较好认知（≥12分）为1572人（87.18%）,不同居住地、职业在COVID-19疫情认知率中差异具有统计学意义（P＜0.05）。在COVID-19疫情期间,不同性别的居民其心理及行为变化差异有统计学意义（P＜0.05）。多因素Logistic回归分析提示,不同职业对于疫情认知有影响（P＜0.05）,女性对于COVID-19疫情反应更为积极（P＜0.05）。922人（51.14%）希望了解心理方面知识,大部分居民希望通过微信、QQ群、公众号、电视、广播等渠道接受心理援助。 结论在COVID-19疫情出现后,调查中的大部分广西居民有较好的疫情认知,城市居民对COVID-19疫情的掌握程度优于乡镇及农村居民。部分居民对于疫情持乐观态度,女性对于COVID-19疫情反应更为积极。少数居民感到害怕和影响睡眠,其中大部分居民希望通过网络、电视等渠道接受心理援助。针对居民在COVID-19疫情期间所产生的心理和行为变化,特别是乡镇及农村地区的基层全科医生,可利用网络等自媒体形式,对居民进行COVID-19相关内容的科普,同时以居民健康需求为导向,针对不同需求,提供心理援助。     

The mentally disabled persons right to receive and to refuse treatment

Among the rights carved out for special groups of persons needing protection, such as children, the aged, patients, students, and women, none seem so slow in implementation as the rights of the mentally ill.     

Difficulties in the occupational incorporation of the mentally handicapped

Psychiatric clinics report great difficulties in motivating patients, on successful completion of medical rehabilitation and vocational therapy, to file an application for vocational rehabilitation. And if they do so, the mentally ill persons more frequently then other disabled persons break off the vocational rehabilitation measures taken. After a two year discussion process, a study group in Berlin (West), which consisted of representatives of different institutions involved in vocational rehabilitation, have published a memorandum stating the central obstacles for mentally ill persons to enter and remain in a "Workshop for Disabled." Proposals are made how to improve the situation.     

Risk of nursing home admission in association with mental illness nationally in the Department of Veterans Affairs

OBJECTIVE: We sought to determine whether patients with mental health diagnoses in the Department of Veterans Affairs (VA) are more likely to be admitted to nursing homes and to identify sociodemographic, utilization, and clinical characteristics, especially indicators of mental illness severity, associated with nursing home admission among mentally ill patients. METHODS: Patients receiving treatment in the VA system nationally during FY 2000 and having no evidence of nursing home utilization during FY 1999 or FY 2000 were followed through FY 2003 using administrative claims data. Three-year incidence rates and unadjusted odds ratios were estimated for each diagnosis. Logistic regression was used to examine the correlates of admission among mentally patients, including analyses stratified by age. RESULTS: Of 3,952,229 VA patients with no prior nursing home use, 15.2% received a mental health diagnosis, of which, 4.6% were eventually admitted to a nursing home. Among mentally ill patients, risk of admission was highest for those with any inpatient medical/surgical days (odds ratio [OR] = 2.28), followed by 3+ outpatient medical visits (OR = 1.48), inpatient mental health days (OR = 1.31), and outpatient mental health visits (OR = 1.09). Patients diagnosed with dementia were 58% more likely to be admitted. Patients diagnosed schizophrenia (OR = 1.26), other psychosis (OR = 1.15), and personality disorder (OR = 1.14) had the next highest probabilities. Elderly patients with bipolar disorder (OR = 1.28) were also more likely to enter. CONCLUSION: Although factors leading to nursing home entry among the mentally ill are similar to those driving entry in the general population, those with more severe mental health problems are still more likely to be admitted.     

An Analysis of the Correlates of Aggression in a Social Learning Program for Severely and Persistently Mentally Ill Inpatients

PURPOSE

This study aimed to examine the relationship between behavioral variables and aggression among severely and chronically mentally ill inpatients in a Social Learning Program (SLP) at a state psychiatric facility.

Information needs and the related variables of Japanese family caregivers of terminally ill cancer patients

The present study examined the information needs of family caregivers of terminally ill cancer patients. Data were obtained by a structured interview from 66 Japanese caregivers of cancer patients institutionalized in a palliative care unit. Needs for disease-related information (the disease, treatment and prognosis) and care-related information (the care for the patient and family members) were investigated, and demographic and situational characteristics related to individual information needs were assessed. More than 60% of family caregivers wanted disease-related information, and approximately half of these wanted patient and family care-related information. These information needs had significant correlations with the family caregiver's age and with such patient-dependent situational variables as time since diagnosis, care site before enrolling in a palliative care unit, and presence or absence of other family caregivers. The results may help health care professionals to better inform terminally ill cancer patients and their family caregivers.     

Living by themselves? Psychiatric nurses’ views on supported housing for persons with severe and persistent mental illness

The main principle directing the development of supported dwellings for persons with long-term mental illness is that to live in the community would improve their quality of life. The aim of this study was to describe psychiatric nurses' experiences of different types of supported dwelling for persons with long-term mental illness, and their views on what they consider to be important principles to provide for in order to facilitate their social integration into the community. Nine psychiatric nurses were interviewed. A qualitative content analysis revealed 'attempting to uphold the principle, respect for the patient's right to self-determination' as the main theme, which was linked to three sub-themes: the nurses' view on their moral responsibility; the nurses' views on social norms that patients must follow in order to be accepted by their neighbours; and the nurses' views on supported dwelling of good quality. The nurses perceived that personal contact between the neighbour and the mentally ill person was one essential way to reduce fear of the mentally ill person. They viewed themselves as a link between the mentally ill person and other neighbours. Without the personal contact between the mentally ill person and the neighbours, there may be a risk that the integration will fail no matter how excellent the supported dwelling is framed.     

Clinical Characteristics and Service Use of Incarcerated Males with Severe Mental Disorders: A Comparative Case-Control Study with Patients Found Not Criminally Responsible

Since the drop in the bed capacity of civil psychiatric hospitals, an increase in the bed capacity of forensic psychiatric care and prison units has been reported in the United States and Europe. However, in Canada, a decrease in the number of people with severe mental illness (SMI) during the last two decades in penitentiaries has been reported. At the same time, an increase in individuals found not criminally responsible on account of mental disorder (NCRMD) was observed in forensic hospitals. The aim of this study is to compare incarcerated severely mentally ill (I-SMI) individuals with forensic-hospitalized SMI individuals in terms of their clinical profiles and service use in the province of Quebec (Canada). A case-control study design was selected using a sample of 44 I-SMI individuals and 59 forensic-hospitalized SMI individuals. Important findings include the following: I-SMI persons had less schooling; they more often reported suicide attempts and violent and non-violent crimes; and they had a higher level of comorbidity involving Cluster B personality disorders and substance-use disorders. Forensic-hospitalized SMI persons were more likely to have been receiving psychiatric follow-up before hospitalization. The final logistic regression model showed that lifetime suicide attempts, non-violent crimes, and psychopathic traits were higher among I-SMI individuals than among forensic-hospitalized SMI individuals. In contrast, receiving regular psychiatric follow-up was associated with forensic-hospitalized SMI individuals. Differences in psychopathological characteristics and the use of mental health services were found for I-SMI persons. More research is needed to determine which new initiatives might be efficacious in addressing the mental health needs of I-SMI individuals.