无抽搐电休克治疗病人家属焦虑原因分析与护理对策

[目的]分析无抽搐电休克治疗（MECT）病人家属焦虑的原因。[方法]采用精神卫生焦虑自评量表（SAS）和自制问卷调查表对60例无抽搐电休克治疗病人家属的焦虑程度进行测评。[结果]病人家属的性别、文化程度以及对无抽搐电休克治疗知识的了解程度与其焦虑程度相关。[结论]无抽搐电休克治疗病人家属均存在不同程度的焦虑反应，无抽搐电休克治疗的护理对象不仅应包括病人．还应包括病人家属。     

人性化护理干预对无抽搐电休克治疗病人的影响

[目的]探讨人性化护理干预在行无抽搐电休克治疗病人中的应用效果.[方法]选择2009年4月-2009年12月在我院首次行无抽搐电休克治疗的病人212例,随机分成研究组105例,对照组107例.对照组实施常规护理干预措施,研究组在其基础上实施人性化护理干预措施,比较两组在无抽搐电休克治疗前的焦虑程度以及对治疗的依从性和满意度.[结果]研究组的焦虑程度明显低于对照组,更加配合治疗且满意度更高,两组差异有统计学意义(P＜0.05或P＜0.01).[结论]实施人性化护理干预措施对改善无抽搐电休克治疗病人的焦虑情绪,提高病人对无抽搐电休克治疗依从性以及护理质量的满意度具有促进作用,使病人更愿意配合治疗.     

放松训练对精神病病人行无抽搐电痉挛治疗的影响

[目的]探讨放松训练对精神病病人行无抽搐电休克治疗（MECT）的影响.[方法]将60例行无抽搐电痉挛治疗的精神病病人随机分为两组,每组30例,两组均接受常规治疗及护理,研究组在此基础上予以放松训练,在护理干预前及干预后采用汉密尔顿焦虑量表评定病人的焦虑状况,采用依从性问卷及满意度调查表测评.病人对MECT的依从性及满意度.[结果]放松训练干预后研究组汉密尔顿焦虑量表评分显著下降、病人对MECT的依从性、满意度提高（P〈0.05）,均优于对照组（P〈0.05）.[结论]对精神病病人行无抽搐电痉挛治疗前实施放松训练可缓解病人焦虑情绪,提高病人对治疗的依从性.     

临床护理路径在无抽搐电休克治疗中的应用

[目的]探讨临床护理路径(CNP)标准化管理应用于精神疾病病人无抽搐电休克治疗(MECT)中的效果。[方法]将100例病人随机分为试验组50例和对照组50例,试验组病人实行标准化CNP管理,对照组接受传统护理。出院前评估病人及家属的满意度、病人平均治疗时间与等待时间,两组护患纠纷发生情况。[结果]出院时试验组病人及家属满意度优于对照组(P<0.05),病人平均治疗时间、等待时间短于对照组;试验组无护患纠纷发生,对照组发生4起护患纠纷。[结论]无抽搐电休克治疗中应用临床护理路径标准化管理,可提高工作效率,密切护患关系,保证护理工作质量。     

放松训练对精神病病人行无抽搐电痉挛治疗的影响

[目的]探讨放松训练对精神病病人行无抽搐电休克治疗(MECT)的影响。[方法]将60例行无抽搐电痉挛治疗的精神病病人随机分为两组,每组30例,两组均接受常规治疗及护理,研究组在此基础上予以放松训练,在护理干预前及干预后采用汉密尔顿焦虑量表评定病人的焦虑状况,采用依从性问卷及满意度调查表测评。病人对MECT的依从性及满意度。[结果]放松训练干预后研究组汉密尔顿焦虑量表评分显著下降、病人对MECT的依从性、满意度提高(P0.05),均优于对照组(P0.05)。[结论]对精神病病人行无抽搐电痉挛治疗前实施放松训练可缓解病人焦虑情绪,提高病人对治疗的依从性。     

引产病人家属焦虑状况与应对方式的调查分析

[目的]了解引产病人家属焦虑状况与应对方式,分析焦虑的影响因素.[方法]采用Zung焦虑自评量表(SAS)和简易应对方式量表,对120名引产病人家属进行问卷调查.[结果]引产病人家属焦虑状况高于国内常模(P<0.01);不同性别、文化程度的家属焦虑状况存在差异(P<0.05);病人家属多采用积极应对方式,较少采用消极应对方式(P<0.01),积极应对与病人家属的焦虑水平呈显著负相关(P<0.01),消极应对与病人家属的焦虑水平呈正相关(P<0.05).[结论]引产病人家属焦虑状况高于正常人,不同文化程度、性别的家属焦虑状况存在差异;采取积极应对方式越多,其焦虑水平越低.     

无抽搐电休克治疗患者家属健康教育需求调查

目的 了解精神病无抽搐电休克治疗患者家属健康教育需求状况,为无抽搐电休克治疗健康教育提供依据.方法 采用自拟问卷对行无抽搐电休克治疗患者的70名家属进行调查.结果 患者家属对无抽搐电休克治疗的诸多相关护理知识不了解,最期望了解无抽搐电休克治疗原理及治疗方式、治疗后并发症处理相关知识以及医护人员的心理指导等.85%的家属希望通过医护人员获得个别指导,80%的家属希望医务人员编写科普手册供患者家属阅读,66.7%的家属希望听其他患者家属介绍经验.结论 患者家属需要多方面、多种形式的无抽搐电休克治疗健康教育指导,以利于提高其家庭支持度,促进患者的有效康复.     

团体认知行为治疗对无抽搐电休克治疗病人疗效影响的研究

[目的]探讨团体认知行为治疗对无抽搐电休克治疗病人疗效的影响。[方法]将100例首次进行无抽搐电休克治疗后处于康复期的精神疾病病人随机分成对照组和研究组各50例,对照组采用常规的药物治疗和心理护理,研究组在此基础上增加团体认知行为干预治疗1个月,于干预前后采用简明精神病评定量表(Brief Psychiatric Rating Scale,BPRS)、临床疗效总评量表(CGI-Severty of Illttness,CGI-SI)、焦虑自评量表(SAS)分别对两组病人进行评定。[结果]干预前两组病人BPRS、CGI-S1、SAS评分比较差异均无统计学意义(P0.05);干预1个月后,研究组病人BPRS、CGI-S1、SAS得分明显低于对照组,差异均有统计学意义(P0.05)。[结论]团体认知行为治疗能够增进临床疗效,改善病人症状。     

治疗性沟通对无抽搐电休克治疗患者家属焦虑的影响

目的探讨治疗性沟通对无抽搐电休克治疗（MECT）患者家属焦虑的影响。方法将185例MECT患者家属随机分为干预组92例和对照组93例。对照组给予临床一般沟通,干预组在对照组的基础上给予治疗性沟通。治疗前、后采用焦虑自评量表（SAS）进行评价。结果治疗前,2组焦虑程度差异无统计学意义。治疗后,干预组焦虑程度明显低于对照组。结论治疗性沟通可有效缓解MECT患者家属的焦虑情绪。     

青壮年脑外伤病人家属焦虑水平与应对方式的相关性分析

[目的]了解青壮年脑外伤病人家属在病人住院期间焦虑状况及其与应对方式的关系.[方法]采用焦虑自评量表(SAS)及应对方式量表对66例病人家属进行问卷调查.[结果]病人家属的焦虑水平高于国内常模(P<0.01),病人家属常采用积极应对方式,较少采用消极应对方式,且积极应对方式与焦虑呈负相关(P<0.05).[结论]病人家属存在焦虑情绪,面对应激事件时常采用积极应对方式,且积极应对方式可缓解其焦虑情绪.     

直肠癌经腹会阴切除术患者家属精神健康状况的评价

目的评估直肠癌经腹会阴切除术患者家属精神健康状况，以提高患者及其家属的生活质量。方法对64例直肠癌经腹会阴切除术患者家属于患者术后3d进行精神健康状况评定，采用工具为症状自评量表（SCL-90）和汉密尔顿评定量表（Hamilton rating scale for depression、hamilton rating scale for anxiety，HAMD、HAMA）。结果 直肠癌经腹会阴切除术患者家属各项量表评分均显著高于常模（P〈0．05）。结论 直肠癌经腹会阴切除术患者家属存在较为明显的心境障碍，需要给予适当的心理干预。     

肌肉松弛疗法对减轻无抽搐电休克治疗术后患者疼痛的疗效研究

目的 探讨肌肉松弛疗法改善无抽搐电休克治疗(modified electric convulsive therapy, MECT)术后患者疼痛、焦虑及睡眠的效果。 方法 选取首次接受MECT治疗的抑郁症患者90例,按随机数字表法分为对照组和研究组各45例。采用长海痛尺、汉密尔顿焦虑量表、匹兹堡睡眠质量指数量表评估干预前后患者疼痛、焦虑及睡眠状况。结果 研究组的疼痛评分明显低于对照组(F_组间=22.772,P＜0.001)。研究组干预后焦虑及睡眠评分均低于对照组(t=-4.743,P<0.001; t=-2.180,P＜0.001)。 结论 肌肉松弛疗法有助于减轻患者MECT术后疼痛,缓解患者的焦虑情绪,提高患者的睡眠质量。     

健康教育对^125I粒子植入术患者亲属焦虑的影响

目的探讨健康教育对^125I粒子植入术患者住院期间亲属焦虑的影响。方法入院时采用Zung’s焦虑自评量表对78例患者亲属进行调查,了解其焦虑程度,然后实施健康教育,于患者手术后再次进行调查。结果患者亲属入院时的焦虑状态与实施健康教育后的焦虑状态比较,差异有统计学意义（P〈0.01）。结论加强与125I粒子植入术患者亲属沟通,准确及时实施健康教育,提供信息支持有利于降低患者亲属的焦虑情绪,使其更好地配合,促进患者早日康复。     

精神病人家属对精神病学常识的了解状况调查

为调查精神病人家属对精神病学常识的了解程度,采用自制问卷对在我院就诊的500名病人的监护人进行调查。结果:调查问卷提出的13个问题中,正确回答5个问题的占60％。说明大多数病人家属对精神病学常识了解程度低下,故对精神病人家属开展健康教育,提供更多的精神病学常识,对于防止精神病人病情复发,促进康复是十分必要的。     

心理干预对截肢患者亲属心理状态的影响

目的了解截肢患者亲属的心理健康状态，并对所存在的问题进行健康指导，以期为截肢患者亲属提供及时有效的心理干预与护理。方法采用症状自评量表、汉密尔顿焦虑量表、汉密尔顿抑郁量表对1000例截肢亲属进行心理问卷调查，并对检出心理障碍者进行心理干预。结果心理干预前后患者家属其SCL-90评分、焦虑及抑郁检出率及评分均有统计学差异（均P〈0．05），其中干预后患者的SCL-90评分、焦虑及抑郁的评分均较干预前降低，焦虑及抑郁的检出率也有所下降。结论截肢患者亲属的心理健康状况均较差，亲属的心理健康状况更需要得到社会与医务人员的关注与支持。心理干预可显著改善截肢患者亲属心理健康状态，提高心理应激水平。     

Getting prepared for life at home in the discharge process--from the perspective of the older persons and their relatives

rydeman i. & törnkvist l. (2009) Getting prepared for life at home in the discharge process – from the perspective of the older persons and their relatives. International Journal of Older People Nursing 5 , 254–264
doi: 10.1111/j.1748-3743.2009.00190.x Aim. To examine how older persons in need of home-nursing care and their relatives experience the discharge process and develop a model that explains the experience. Background. The discharge process has well-known deficiencies and is therefore a challenging issue requiring improvement in many countries. Research focusing on patient-centred factors has attracted very little critical attention. Design. Grounded theory was used to analyze semi-structured interviews with 26 older persons and their relatives. Findings. The analysis resulted in a theoretical model that depicts factors determining whether the older persons and their relatives feel prepared or unprepared for life at home at the time of discharge. Conclusions. The older persons and/or their relatives felt prepared at the time of discharge if their needs were satisfied in the three significant areas of preparation. Not only were the professionals’ skills of the utmost importance in preparing the older persons/relatives, but also the latter’s own approach if the professionals were unskilled. Relevance for clinical practice. A knowledge of the preparation areas and skills can be of use for improving the quality of the discharge process from the older persons’ and their relatives’ perspective, i.e. through policies, checklists and teaching programmes.     

无抽搐电休克治疗精神分裂症患者的护理

目的探讨全程化护理方案对无抽搐电休克治疗（MECT）精神分裂症患者的实施效果。方法选择行MECT治疗的312例精神分裂症患者,制定治疗前、治疗中及治疗后全程护理方案并进行全程护理干预,治疗前后采用汉密尔顿焦虑量表（HAMA）及满意度调查表对患者进行评估。结果312例精神分裂症患者均顺利完成MECT治疗,患者满意度达93．3％。干预前HAMA评分为（20．65±4．14）分,干预后为（9．94±3．23）分,差异有统计学意义（t=35．309,P〈0．01）。结论全程化护理使MECT治疗顺利进行,可减轻精神分裂症患者焦虑情绪,提高其满意度。     

The effect of family-authored diaries on posttraumatic stress disorder in intensive care unit patients and their relatives: A randomised controlled trial (DRIP-study)

BackgroundCritical illness and mechanical ventilation may cause patients and their relatives to experience symptoms of posttraumatic stress, anxiety, and depression due to fragmentation of memories of their intensive care unit (ICU) stay. Intensive care diaries authored by nurses may help patients and relatives process the experience and reduce psychological problems after hospital discharge; however, as patients particularly appreciate diary entries made by their relatives, involving relatives in authoring the diary could prove beneficial.ObjectivesThe objective of this study was to explore the effect of a diary authored by a close relative for a critically ill patient.MethodsThe study was a multicenter, block-randomised, single-blinded, controlled trial conducted at four medical-surgical ICUs at two university hospitals and two regional hospitals. Eligible for the study were patients ≥18 years of age, undergoing mechanical ventilation for ≥24 h, staying in the ICU ≥48 h, with a close relative ≥18 years of age. A total of 116 relatives and 75 patients consented to participate. Outcome measures were scores of posttraumatic stress symptoms, anxiety, depression, and health-related quality of life three months after ICU discharge.ResultsRelatives had 26.3% lower scores of posttraumatic stress in the diary group than in the control group (95% confidence interval: 4.8–% to 52.2%). Patients had 11.2% lower scores of posttraumatic stress symptoms in the diary group (95% confidence interval: −15.7% to 46.8%). There were no differences between groups in depression, anxiety, or health-related quality of life.ConclusionA diary written by relatives for the ICU patient reduced the risk of posttraumatic stress symptoms in relatives. The diary had no effect on depression, anxiety, or health-related life quality. However, as the diary was well received by relatives and proved safe, the diary may be offered to relatives of critically ill patients during their stay in the ICU.     

Towards a more liveable life for close relatives of individuals diagnosed with bipolar disorder

The life of close relatives of persons with bipolar disorder (BD) is associated with emotional distress, depression, and a high level of use of mental health care. Illness‐related changes of their life situation endanger relationships, social life, finances, and occupational functioning. Understanding of facilitating conditions for close relatives is still a neglected research area. The aim of the present study thus was to explore what makes the life of close relatives of persons with BD more liveable. A lifeworld phenomenological approach was used. The findings reveal that keeping distance, having stability in everyday life, and strengthening equality through transparent communication are conditions that enable close relatives to influence the unpredictable and its consequences and thus make life more liveable. This implies contributions from close relatives, the person with BD, and the caring services. We propose that health‐care support should not be divided in support for the patient and/or the close relatives but instead be designed as support for the ‘patient and close relatives’ as a unit. Professional caregivers need to take responsibility for creating intersubjective settings for the person with BD and their close relatives to share their needs and make joint plans for how to influence the illness‐related life issues.