妇产科护士睡眠质量与心理健康状况调查

[目的]探讨妇产科护士睡眠质量与心理健康之间的关系。[方法]采用匹兹堡睡眠质量调查表、症状自评量表(SCL-90)对我院88名妇产科护士进行调查。[结果]88名妇产科护士中15人睡眠质量较差;对SCL-90因子分析发现,妇产科护士躯体化、强迫2个因子平均分显著高于国内常模(P<0.05);相关分析表明:匹兹堡睡眠质量评分与SCL-90各因子分及其总均分除睡眠药物外皆呈显著的正相关,睡眠质量差的护士SCL-90各因子平均分高于睡眠质量好的护士。[结论]妇产科护士睡眠质量与心理健康状况密切相关,应引起有关领导的关注。     

精神科护士睡眠质量及相关因素分析

[目的]了解精神科护士睡眠质量的影响因素。[方法]采用匹兹堡睡眠质量指数（PSQI）评定睡眠质量，症状自评量表（SCL-90）评定心理健康状况，简易应对方式问卷（湖）评定应付方式。对86名精神科护士（观察组）和60名综合科护士（对照组）进行比较及相关分析。[结果]精神科护士睡眠质量较好的占45．35％，睡眠质量较差的占22．09％，睡眠质量居中的占32．56％，不同年龄性别精神科护士的睡眠质量差异无统计学意义（P〉0．05）；日间功能、睡眠总分与应对总分有相关性；SCL-90总均分、人际关系、应对方式均与睡眠总分显著相关。[结论]精神科护士睡眠质量较差，心理状况、人际关系以及应对能力等因素都与睡眠质量有关。要改善他们的睡眠质量，必须采取综合干预。     

儿科护士心理健康状况和应对方式的研究

[目的]探讨儿科护士的心理健康状况及应对方式，以提高护理质量。[方法]采用症状自评量表（SCL-90）、特质应对方式问卷（TCSQ），对福州市58名儿科护士及59名普通科室护士进行心理健康状况和应对方式的调查。[结果]儿科护士SCL-90的强迫、抑郁及焦虑因子分高于普通科室护士因子分，差异有统计学意义（P〈0．05）；TCSQ的消极应对均分高于普通科室护士均分，差异有统计学意义（P〈0．05）；其中，儿科护士工作年限≤5年、〉20年者多采用消极应对方式。儿科护士的SCL-90总均分及部分因子分与消极应对方式均分呈正相关，差异有统计学意义（P〈0．05）。[结论]儿科护士存在一定的心理健康问题，应注重应对方式与心理状态的调整，以提高护理质量。     

12h工作制对护士睡眠质量及心理健康的影响

[目的]探讨12h工作制对护士睡眠质量及心理健康的影响。[方法]将我院试行12h工作制科室的护士作为实验组，常规排班法的相应科室的护士作为对照组，对两组在实验前后分别进行匹兹堡睡眠质量指数问卷（PSOI）、症状自评量表（SCL-90）及特质应对方式问卷（TCSQ）调查。[结果]实验前两组护士PSQI、SCL-90及TCSQ评分比较均无统计学意义（P〉0．05），实验后，实验组护士的总体睡眠质量及心理健康状况较对照组差（P〈0．05）；在应对方式上，实验组护士更多采用消极应对（P〈0．05）。[结论]12h工作制不利于护士的睡眠及心理健康，不值得推广。     

精神科轮班护士心理健康状况的调查分析及其健康维护

[目的]了解精神科轮班护士心理健康状况，探讨维护其心理健康的措施。[方法]采用症状自评量表（SCL-90）厦疲劳量表-14（FS-14），对30名精神科轮班护士及32名综合科轮班护士进行调查。[结果]轮班护士总体心理健康水平高于常模；精神科轮班护士除人际关系、敌对外，SCL-90总分及各因子分均高于综合科护士，其中强迫、抑郁、焦虑差异有统计学意义（P〈0．05），且FS-14总分高于综合科轮班护士，差异有统计学意殳（P〈0．05）；精神科轮班护士心理健康水平与护龄相关（P〈0．05）。[结论]精神科轮班护士存在明显的心理健康问题，应加强精神科轮班护士特别是护龄较长的轮班护士的心理健康维护.     

急诊科护士睡眠质量和心理健康状况的调查及分析

目的:调查分析急诊科护士的睡眠质量和心理健康状况.方法:采用匹兹堡睡眠质量指数量表(PSQI)和症状自评量表(SCL-90),对本市两所三级甲等医院68名急诊科护士和70名普通内科护士的睡眠质量和心理健康状况进行调查.结果:急诊科护士匹兹堡睡眠质量指数量表总分和各因子得分均高于普通内科护士,差异有显著性(P＜0.05,P＜0.01).症状自评量表中除敌对、偏执因子外,其余因子分及总分均高于普通内科护士,有显著性差异(P＜0.01).急诊科护士除睡眠时间这个成分外,其余匹兹堡睡眠质量指数量表各成分与症状自评量表各因子及总分间呈正相关关系.结论:急诊科护士睡眠质量和心理健康水平值得关注,需采取多种措施改善急诊科护士的睡眠质量和提高其心理健康水平,以保证护理安全和质量.     

脑外科护士心理健康状况调查与分析

目的：调查脑外科护士心理健康状况，分析其心理健康问题的影响因素。方法：采用症状自评量表（SCL-90）分别对38名脑外科护士和38名内科护士进行测评。结果：脑外科护士SCL-90各因子平均分均明显高于内科护士和中国常模，组间比较差异有统计学意义（均P〈0．05）；内科护士除了抑郁、焦虑两个因子分明显高于中国常模以外（P〈0．05），其余SCL-90因子分与中国常模比较差异均无统计学意义（P均〉0．05）。结论：脑外科护士心理健康问题既比内科护士严重，又比一般人群更加突出，应针对脑外科护士的职业特点，开展多种形式的心理健康教育，以消除职业环境的不良影响。     

护士心理健康及其相关因素调查

[目的]调查护士心理健康状况及相关因素，为制订解决对策提供依据。[方法]运用症状自评量表（SCL-90）及自编一般状况量表对182名护士进行调查，并与全国常模（女）比较，对其相关因素进行分析。[结果]182名护士躯体化、强迫因子评分显著高于常模，而人际关系敏感因子评分显著低于常模；特殊科室护士9个因子评分均显著高于常模；正式护士躯体化、强迫、敌对、偏执、抑郁、精神病性6个因子评分及总均分显著高于合同制护士；高强度下工作时间、≥6h者9个因子及总均分评分均显著高于〈6h者。[结论]护士心理健康状况较差，与科室、编制、高强度下工作时间有关，应适当采取措施改善护士心理健康状况。     

新疆某军队医院护士睡眠质量和心理健康的相关性研究

目的了解新疆某军队医院护士的睡眠和心理健康状况,分析两者之间的关系,以期为解决护士睡眠、心理健康问题提供参考依据。方法 2014年3-7月,采用便利抽样法抽取新疆某军队三级甲等医院250名护士为调查对象,采用匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)和症状自评量表(self-reporting inventory-90,SCL-90)进行调查,分析两者之间的相关性。结果军队医院护士PSQI总分及睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能障碍等各因子分及总分均高于全国常模,差异均有统计学意义(均P0.01)。SCL-90量表中除偏执成分外,其余各因子分均显著高于全国护士常模,差异均有统计学意义(均P0.01)。在PSQI量表中,军队医院护士除睡眠效率和催眠药物等部分与SCL-90因子不呈正相关以外,其余各项目与SCL-90各因子及总分间均呈正相关(P0.05或P0.01)。结论新疆某军队医院护士睡眠质量和心理健康状况水平较差,睡眠质量与心理健康水平密切相关。     

阻塞性睡眠呼吸暂停低通气综合征患者睡眠质量与心理健康的相关性研究

目的：探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者的睡眠质量与心理健康的相关关系。方法：应用匹兹堡睡眠质量指数（PSQI）和症状自评量表（SCL-90）对52例OSAHS患者和52例对照者进行睡眠质量及心理健康调查,并进行相关分析。结果：OSAHS患者PSQI总分及睡眠质量、睡眠时间、睡眠效率、睡眠障碍、日间功能障碍分高于对照组,P〈0.05;SCL-90总分及躯体化、强迫症状、焦虑、抑郁、精神病性因子高于对照组,P〈0.05;PSQI与SCL-90各因子间相关系数除睡眠药物外均存在正相关关系。结论：阻塞性睡眠呼吸暂停低通气综合征患者睡眠质量较差,影响患者的心理健康。     

现代残疾康复理念、政策与社区康复体系研究

本研究分析了当代残疾康复的理念和理论架构,构建了以国际公约、决议和政策、国内法律和政策以及操作性工具3个层次的康复理论体系;运用包容性发展,分析探讨了当代社区康复的体系和特点;就发展康复事业、为残疾人提供全面系统的康复服务提出相关的政策建议。     

Comparison of short-term and long-term protocols for stabilization and preservation of RNA and DNA of Leishmania, Trypanosoma, and Plasmodium

Molecular tools continue to be important in the prevention and control of parasitic diseases. However, using these techniques directly in the field remains a major challenge. Therefore, the preservation of clinical samples collected from endemic field areas for later analysis remains an important preanalytical process. This study aimed at identifying a suitable protocol for stabilization and preservation of RNA and DNA in bioclinical specimens for Trypanosoma, Leishmania, and Plasmodium research. Both spiked and unspiked blood samples were preserved in 7 protocols (different media; storage temperatures). Samples were evaluated for possible degradation of DNA and RNA along the storage duration up to the 10th week. Nucleic acid targets were assessed as follows: (i) Trypanosoma and Plasmodium RNA analysis was done using real-time nucleic acid sequence-based amplification (RT-NASBA) for 18S rRNA and for stage-specific Pfs25 mRNA, respectively; (ii) Trypanosoma DNA assessment analysis was conducted by using a conventional PCR for 18S rDNA; (iii) Leishmania RNA analysis was performed with a quantitative NASBA for 18S rRNA and Leishmania DNA assessment with an RT-PCR for 18S rDNA. Findings suggested that a newly developed L3™ buffer proved to be reliable and suitable for both short- and long-term preservation of parasite nucleic acid material. This buffer is envisaged to be suitable for utilization in field situations where resources are limited.     

Rates and risks of transmission of smallpox and mechanisms of prevention

In 1980, the World Health Organization declared smallpox eradicated from the world; the last known natural case had occurred in Somalia in 1977, and the United States had stopped routinely vaccinating its citizens in 1972. However, with increasing concerns regarding domestic and international terrorism, smallpox has resurfaced as a potential threat to global health. We review the direct and indirect modes of smallpox transmission and how patterns of transmission vary substantially, depending on the severity of circulating disease, vaccination status, environmental and socioeconomic factors, and the setting of an outbreak. We examine mechanisms for controlling outbreaks of disease and preventing further transmission in the event of an outbreak, with an emphasis on smallpox vaccination.     

国内外唇腭裂专科护理发展现状的文献研究及分析

目的了解和分析国内唇腭裂专科护理工作发展的现状。方法检索并分析万方医学网、中国知网、Springer Link及PubMed英文数据库近6年有关唇腭裂手术的围术期护理、患儿的喂养、手术安全管理、围术期疼痛研究以及心理护理的相关文献。结果共检索出国内文献89篇(核心期刊20篇)、国外文献22篇,其中围术期护理38篇、患儿的喂养16篇、手术安全管理10篇、围术期疼痛研究10篇、心理护理15篇。结论与国外文献相比,国内论文总结和回顾性居多,应增加研究探讨性论文,从而促进唇腭裂临床护理工作专科化的发展。     

城乡学童个性行为特征调查

目的探讨农村与城市儿童的个性行为特征。方法将97名农村学龄儿童设为农村组,97名城市学龄儿童设为城市组,采用艾森克个性问卷一儿童版和Achenbach’s 行为量表一儿童版进行评定分析。结果两组学龄儿童艾森克个性问卷各维度评分均无显著性差异（P均〉0．05）,且与全国常模相一致（P均〉0．05）;农村组男学童Achenbach’s行为量表违纪行为、攻击行为及外向型因子分均显著高于城市组,女学童退缩、社交问题因子分均显著高于城市组（P〈0．05或0．01）,其他因子分均无显著性差异（P均〉0．05）。结论农村与城市儿童个性无显著差异,而农村儿童存在较多的行为问题,可能与其所受教养和生活方式有关。     

糖尿病视网膜病变筛查与防治中存在的问题及对策

目的探讨糖尿病视网膜病变(diabetic retinopathy,DR)患者筛查和防治中存在的问题及对策。方法以76例糖尿病DR患者为对象,调查未能早期接受眼科诊治的原因。结果存在问题主要是患者对DR防治知识不了解、血糖控制不理想、内科医生未建议进行专科检查等。结论眼科医护人员应密切与糖尿病专科的联系,尽早对DM患者进行DR健康教育,并开展社区DR防治工作。     

罕见和未知基因型珠蛋白生成障碍性贫血的分析与鉴定

目的对珠蛋白生成障碍性贫血(简称地贫)血液学表型阳性但未检出常见地贫基因型的疑似个体做进一步分子水平检测,以明确诊断。方法收集2015年5月至2018年8月在清远市妇幼保健院就诊的地贫血液学表型阳性但常见地贫基因型检测为阴性的标本96例(包括疑似α-地贫88例和β-地贫8例),分别采用单管多重PCR、DNA测序法、荧光定量PCR和芯片捕获测序法检测罕见和未知缺失型地贫基因。结果从上述疑似α-地贫标本中共检出罕见α-地贫基因型17例,其中泰国缺失型(--^THAI/αα)5例,菲律宾缺失型(--^FIL/αα)2例,α^ΔCD303例,α珠蛋白基因拷贝数增加(ααα^anti3.7或ααα^anti4.2)5例,并且发现2例新的α-地贫突变,即α^ΔCD272-279delAGCTTCGG和CD167-169insT。在8例β-地贫特征个体中检出罕见β-地贫基因型Poly A(A>G)2例,-90(C>T)3例,CD37(TGG>TAG)1例,IVS-I-2(T>A)1例,另外还鉴定出1例新的缺失型β-地贫基因(缺失位置为ch11:5,246,000-5,250,500,缺失长度为4kb左右)。结论对未检出常见地贫突变但血液学表型阳性个体进行深度分析,既可提高地贫基因的检出率,有利于遗传咨询和产前诊断,又可能发现新的地贫突变,丰富了中国人群的地贫基因突变谱。     

Prevalence and severity of nausea and vomiting of pregnancy and effect of vitamin supplementation.

OBJECTIVE: Although nausea and vomiting of pregnancy is the most common medical condition during pregnancy, there are many unanswered questions regarding its cause, epidemiologic features and optimal management. The objectives of this study were to ascertain the prevalence of nausea and vomiting in a sample of Canadian women, to characterize the distribution of their severity and to investigate the role of vitamin B6 deficiency in their etiology. DESIGN: Prospective study. SETTING: Antenatal counselling service for pregnant women. PATIENTS: Three cohorts of women: a prospective, population-based cohort of 193 women, to estimate the rate and severity of nausea and vomiting (cohort A); a cohort of 555 women who sought advice for nausea with or without vomiting, to study the correlation between the maximal daily number of episodes of vomiting and maximal weight loss (cohort B); and a prospective cohort of 301 women who reported vomiting, to correlate vitamin supplementation with vomiting (cohort C). INTERVENTIONS: All 3 cohorts were interviewed during the counselling session, and cohort B was followed up prospectively. OUTCOME MEASURES: Frequency of nausea and vomiting, weight loss, maximal number of daily episodes of vomiting, rate of multivitamin supplementation. RESULTS: Overall, 67% of the women in cohort A reported experiencing nausea or vomiting, or both; 22% reported vomiting, and 9% experienced weight loss. In cohort B there was a significant correlation between the maximal number of daily episodes of vomiting and maximal weight loss, although there was wide variation (r2 = 0.25, p < 0.001). There was a highly significant correlation between the number of daily vomiting episodes and mean weight loss (r2 = 0.99). In cohort C, vomiting was significantly associated with lack of supplementation with multivitamins before 6 weeks' gestation (p = 0.002). CONCLUSIONS: The relation between number of daily vomiting episodes and mean weight loss may serve as a clinical tool to assess the severity of nausea and vomiting in pregnancy and the success of anti-emetics and rehydration regimens. Further study is needed to elucidate the biologic basis of the observed association between vomiting and lack of multivitamin supplementation in early pregnancy.     

History of violence and subjective health of mother and child

Objective: To study the self-reported prevalence of experienced violence among a cohort of women about two years after giving birth, their health during pregnancy, pregnancy outcomes and their experience of their child’s health.

Setting and subjects: In 2011, a total of 657 women participated in phase III of the Childbirth and Health Cohort Study in Icelandic Primary Health Care, 18 to 24 months after delivery. The women had previously participated in phase I around pregnancy week 16 and phase II 5–6 months after delivery. Data were collected by postal questionnaires.

Main outcome measures: Women’s reported history of experienced violence, sociodemographic and obstetric background, self-perceived health, the use of medications and their child’s perceived health.

Results: In phase III, 16% of women reported experiencing violence. These women felt less support from their current partner (p?p?p?p?p?p?=?0.008).

Conclusions: Our study confirms that a history of violence is common among women. A history of violence is associated with various maternal health problems during and after pregnancy, a higher rate of caesarean sections and maternal reports of health problems in their child 18–24 months after birth.

• KEY POINTS

• Violence is a major concern worldwide. Understanding the impact of violence on human health and developing effective preventive measures are important elements of any public health agenda.

• ??The reported prevalence of experiencing violence was 16% among women attending antenatal care in the primary health care setting in Iceland.

• ??Women with a history of violence reported worse health in general during pregnancy and delivered more often by caesarean section, compared to women with no such history.

• ??Mothers with a history of violence also evaluated the general health of their child as worse than women with no such history.

• ??The findings of this study support the importance of recognizing and addressing experienced violence among women in primary care.

     

头面部血管肉瘤3例报告并文献复习

目的:总结我们对头面部血管肉瘤手术联合放射治疗方法的经验认识。方法:报道3例头面部血管肉瘤病例,并复习相关文献。结果和结论:头面部血管肉瘤是一种少见的、多中心的血管肿瘤,预后差。头面部血管肉瘤的手术治疗常常需要切除较广的范围。放射治疗对头面部血管肉瘤是一种合理治疗,既能使受侵犯的真皮组织和周围皮肤得到进一步治疗,又能保护其下的正常组织。