普外科患者手术前后焦虑抑郁症状及其相关性研究

目的探讨手术与焦虑、抑郁之间的联系,以及焦虑和抑郁的关联状况。方法手术前后1d及术后3d应用焦虑自评量表(SAS)和抑郁自评量表(SDS)对患者进行评估。结果手术前后患者的焦虑和抑郁水平均高于常模,手术前后焦虑和抑郁发生率及其程度比较,差异无显著性意义(均P>0.05),而焦虑和抑郁呈中等相关(r=0.66,P<0.01)。结论焦虑和抑郁症状不因手术结束而减弱或消失,应及时提供心理干预,尤其注重焦虑和抑郁两者并存患者的干预。     

外科手术患者的心理护理体会

<正>外科手术患者常伴有紧张、焦虑、恐惧和抑郁等情感障碍,直接影响手术效果。因此,对手术患者的心理护理已引起人们的关注。只有在全面了解手术患者的心理状态的基础上,针对性提出相应的心理护理对策,才能使患者术后顺利康复。2010-12—2011-12,我科对168例手术患者进行心理护理,取得初步效果,现将体会总结如下。     

叙事护理干预对心脏瓣膜置换术患者心理状态的影响

目的 探讨叙事护理在心脏瓣膜置换术患者围术期心理干预中的应用效果。 方法 将100例心脏瓣膜置换术患者随机分为观察组和对照组各50例。对照组实施常规心理护理,观察组在此基础上实施叙事护理干预。比较两组患者的焦虑、抑郁状态,自我效能感、心理弹性和护理满意度。 结果 干预后观察组患者的焦虑、抑郁评分显著低于对照组, 自我效能感、心理弹性得分及护理满意度显著高于对照组（P＜0.05,P＜0.01）。 结论 对心脏瓣膜置换术患者实施叙事护理,可有效缓解其围术期焦虑抑郁情绪,增强心理弹性和自我效能感,提高患者住院满意度。     

围术期患者焦虑反应的相关因素及干预措施

麻醉、手术对于患者是一种严重的心理应激,它通过心理上的疑惧和生理上的创伤直接影响患者的正常心理活动,并由此对手术后的康复产生影响,甚至决定手术的成败.焦虑和抑郁是心理应激引起的情感变化,现着重对围术期患者的焦虑反应、相关因素及干预措施作以下综述.     

择期开颅手术患者围术期抑郁焦虑评价分析

目的 探讨择期开颅手术患者围术期抑郁焦虑状况.方法 于入院时、术前1 d和术后3 d对109例择期开颅手术患者采用SAS和SDS量表评价其自身抑郁焦虑状况,同期由5名经过培训的护士采用HAMA和HAMD量表评价患者抑郁焦虑状况.结果 患者SAS和SDS自评分与HAMA和HAMD他评分时间主效应比较,均P<0.05,且SAS和HAMA、SDS和HAMD评分呈正相关(均P<0.05).结论 开颅手术患者围术期存在抑郁焦虑情绪,应根据不同时期的心理需求采取相应的护理措施.经过培训的护士可以对患者进行心理状况评价.     

综合护理干预对术后下肢深静脉血栓形成患者焦虑抑郁情绪、遵医行为及生活质量的影响

目的探讨综合护理干预对术后下肢深静脉血栓形成(DVT)患者焦虑抑郁情绪、遵医行为及生活质量的影响。方法选取2015-01—2019-01间郑州大学第一附属医院(郑东院区)大血管外科收治的84例术后下肢DVT患者,随机分为2组,各42例。对照组实施常规护理,观察组在常规护理基础上采取心理护理和健康教育等综合护理干预。比较2组患者的焦虑、抑郁(HAD)评分,遵医行为及生活质量。结果综合护理干预后,观察组患者的HAD评分、遵医行为及生活质量均优于对照组,差异有统计学意义(P0.05)。结论在常规护理的基础上,给予心理护理和健康教育等综合护理干预,可显著改善下肢DVT患者的焦虑、抑郁情绪,提升其遵医行为和生活质量。     

心脏手术ICU患者的心理护理干预

目的观察心脏手术ICU患者的负性情绪及护理干预的效果。方法对53例心脏手术ICU患者在采用常规护理的基础上实施心理护理。观察患者转出ICU前及出院前患者的负性情绪变化和术后并发症发生情况。结果本组患者出院前SAS、SDS评分均较转出ICU前显著减小,CD-RISC评分显著增大,差异均有统计学意义(P0.05);患者术后不良反应总发生率1.87%(1/53)。结论心脏手术ICU患者术后常伴有抑郁、焦虑负性情绪,做好早期心理护理干预可改善患者负性情绪,促进手术顺利进行和术后早期康复。     

择期开颅手术患者围术期抑郁焦虑评价分析

目的探讨择期开颅手术患者围术期抑郁焦虑状况。方法于入院时、术前1d和术后3d对109例择期开颅手术患者采用SAS和SDS量表评价其自身抑郁焦虑状况，同期由5名经过培训的护士采用HAMA和HAMD量表评价患者抑郁焦虑状况。结果患者SAS和SDS自评分与HAMA和HAMD他评分时间主效应比较，均P〈0．05，且SAS和HAMA、SDS和HAMD评分呈正相关（均P〈0．05）。结论开颅手术患者围术期存在抑郁焦虑情绪，应根据不同时期的心理需求采取相应的护理措施。经过培训的护士可以对患者进行心理状况评价。     

肠造口患者及家属焦虑抑郁状况及对患者造口自护能力的影响

目的了解造口患者及家属围手术期及术后近期焦虑、抑郁的变化情况,探讨其可能的原因,以及焦虑抑郁对患者造口自我护理能力的影响。方法应用汉密顿焦虑及抑郁量表、造口适应量表和造口自我效能量表,对45组造口患者及家属围手术期(术前、术后3天)及术后1、3、6个月分别进行测量,对所得结果进行统计分析。结果造口患者及家属围手术期及术后近期焦虑与抑郁评分组内比较,差异有统计学意义(均P0.05);术后6个月家属焦虑、抑郁与患者自我效能及造口适应水平呈正相关(均P0.01)。结论造口患者家属的负性情绪影响患者对造口的适应水平及焦虑抑郁水平,医护人员应在术前早期对患者及家属提供支持和帮助,使其较好地控制焦虑、抑郁,并在术后持续关注患者生理、心理需求,提高患者造口适应能力,恢复身心健康。     

肥胖群体心理评估及减重手术的影响

肥胖一直是人们健康的一大威胁,它本身即是一种病态,还能引起各种代谢性疾病。同时,肥胖患者的心理状态和正常人群有显著的差异,肥胖的人会更容易出现焦虑、抑郁等心理问题。研究表明肥胖患者的这些心理问题会影响减重手术的效果。此外,减重手术也可能会对他们的心理状况有所改善。本文就减重手术有关心理研究做一综述。     

70岁以上局部麻醉疝外手术患者的心理干预

目的探讨局部麻醉下70岁以上疝外手术患者心理干预的效果。 方法选取首都医科大学附属北京朝阳医院2015年11月至2016年1月收治的70岁以上疝外手术患者68例作为本次的研究对象,采用随机数字法将其分为常规组与心理组各34例。常规组行常规护理,心理组在常规组基础之上予以心理干预护理。就两组患者护理前后的抑郁、焦虑情绪情况进行测评。 结果干预后,心理组患者的抑郁（35.14±4.27）、焦虑情绪（36.94±2.38）评分均明显低于常规组患者（47.26±5.68、49.86±6.29）,差异有统计学意义（P<0.05）。 结论就70岁以上老年疝外手术患者予以心理干预能够有效减轻患者的术前患者的焦虑和抑郁情绪,促使患者更好地配合治疗。     

Psychological distress in patients undergoing surgery for urological cancer: A single centre cross-sectional study

Purpose

Interest in the disease-specific psychological well-being of patients with cancer has increased, and it has been estimated that less than half of all patients with cancer are properly identified and subsequently treated for anxiety or depression. The aim of this study is to evaluate psychological distress in uro-oncological patients undergoing different surgeries: radical cystectomy, radical prostatectomy, radical nephrectomy, or transurethral resection (TUR) before the surgery.

实景动态教育对心脏手术患者术前心理状况的影响

目的探讨实景动态教育对拟行手术治疗心外科患者术前心理状况的影响。方法将心外科手术患者60例按照时间顺序分为对照组与观察组各30例。对照组按常规健康教育,观察组运用实景动态教育形式进行集中式多媒体授课。结果观察组术前1d焦虑评分显著低于对照组(P<0.05)。观察组对术前教育内容掌握程度及对护理工作的满意率显著高于对照组(均P<0.01)。结论实景动态教育有助于缓解心外科患者术前紧张情绪,提高知识水平及对护理工作的满意度。     

The course of cancer related fatigue up to ten years in early breast cancer patients: What impact in clinical practice?

Little is known about the cancer related fatigue (CRF) along cancer course and risk factors that could predict CRF development and persistence in breast cancer (BC) survivors.This prospective study detected incidence, timing of onset, duration of CRF, impact on QoL and psychological distress.Seventy-eight early BC patients, undergoing chemotherapy (CT) followed or not by hormonal therapy were assessed for QoL and psychological distress by EORTC QLQC30 and HADs questionnaires. Fatigue was investigated with mix methods, structured interview and psychometric measures. A qualitative analysis was added to assess the behavioral pattern of CRF.Low fatigue levels were identified after surgery (9%), increasing during (49%) and at the end of CT (47%), maintaining after 1 year (31%) and declining up to ten years of follow-up. Prevalence of CRF was higher at the end of CT and lower at follow-up. At the end and after 1 and 2 years from CT, persistence of CRF was associated to anxiety in 20%, 11% and 5% and to depression in 15%, 10% and 5% respectively. A relationship between CRF and psychological distress was observed; patients presenting depression and anxiety before CT were at higher risk for fatigue onset at a later period. A relationship between fatigue and QoL was noted at the end of CT.Our study shows the fatigue timely trend in early BC patients from surgery, CT and follow-up. Identification of biological, psychological, social predictor factors related to fatigue could be helpful for early interventions in patients at higher risk of developing fatigue.     

Who is adherent with preoperative psychological treatment recommendations among weight loss surgery candidates?

BACKGROUND: Adherence to treatment regimens is critical for success with weight loss surgery. Weight loss surgery patients commonly undergo a psychological evaluation before surgery. When indicated, patients are provided with preoperative behavioral recommendations; yet, little is known about the adherence to these recommendations. In this study, we evaluated the following: (1) level of adherence to behavioral treatment plans; (2) characteristics that differentiate adherent patients from nonadherent patients; and (3) the weight loss of delayed-adherent patients compared with those whose surgery was not delayed. METHODS: We performed a case review of psychological evaluations, preoperative behavioral treatment plans, and subsequent adherence rates. RESULTS: Of the 837 patients evaluated, 68 (8%) had significant psychosocial issues and were given behavioral treatment recommendations before surgery. Of these 68 patients, 38 (56%) were adherent and subsequently underwent surgery, and 30 (46%) were nonadherent and were not offered surgery in our program. Adherence did not differ relative to body mass index, age, education, race, marital status, depression, anxiety, or rate of eating disorders. Adherence did differ by gender: 31% percent of the men were adherent to recommendations while 62% of the women were adherent. Individuals with complex treatment plans were less likely to be adherent than those with less complex recommendations. Additionally, increased hostility reduced the adherence rates. Patients adherent to the psychological recommendations had weight loss within 2 years, which was similar to that of patients who did not require behavioral treatment recommendations. CONCLUSION: The results of this study have provided information regarding adherence to preoperative psychological treatment recommendations. Although most patients are psychologically suitable for weight loss surgery at the initial evaluation, a better understanding of the factors influencing the adherence with preoperative behavioral programs could improve care for those with major psychosocial issues.     

假体隆乳者围手术期的焦虑症状和抑郁症状调查分析

目的 调查分析假体隆乳者围手术期的焦虑症状和抑郁症状,为制定心理干预措施提供依据.方法 对123例假体隆乳者,应用Hamiltom焦虑量表和Hamiltom抑郁量表,分别于术前和术后测评焦虑和抑郁水平.结果 手术前后焦虑量表评分差异有统计学意义（P＜0.05）,抑郁量表评分手术前后差异无统计学意义（P＞0.05）.同时发现,术后焦虑与术前焦虑和抑郁均呈正相关（r=0.377,0.313,P=0.001）,而术后抑郁与术前焦虑和抑郁也均呈正相相关（r=0.359,0.298,P=0.001）.提示术前有焦虑症状和抑郁症状者,术后1周出现焦虑和抑郁的概率非常大.结论 隆乳者焦虑症状术前明显高于术后,术后逐渐下降;术前有焦虑症状和抑郁症状者,在术后1周出现焦虑和抑郁的概率非常大.     

心理干预对聚丙烯酰胺水凝胶取出术预后效果的影响

目的:探讨心理干预在聚丙烯酰胺水凝胶(polyacrylamide hydrogel,PAHG)取出术患者心理恢复中的作用。方法:通过对94例PAHG取出术患者进行心理干预研究,初步了解PAHG取出术患者心理障碍的状态,并检验心理干预对PAHG患者心理障碍有无效果。结果:PAHG患者存在不同程度的抑郁和焦虑,进行心理干预的实验组患者可以在术后1天即有抑郁和焦虑的状态减轻,并且随心理干预的进行,术后1周可以达到进一步减轻。结论:心理干预可以有效减轻PAHG取出术患者的抑郁和焦虑状态。     

眼部整形美容手术患者心理疏导中配合沟通艺术的效果

目的 分析眼部整形美容手术患者心理疏导中配合沟通艺术的效果。方法 选择单县海吉亚医院 2020年1月-12月收治的80例眼部整形美容手术患者为研究对象，采取随机数字表法将其分为对照组与观 察组，各40例。对照组围术期行心理疏导，观察组在其基础上配合沟通艺术进行干预，比较两组焦虑、抑 郁、希望水平、体象障碍、人格障碍及自尊水平。结果 观察组术后1、7 d焦虑情绪评分优于对照组，差异 有统计学意义（P＜0.05）；观察组术后1、7 d抑郁情绪评分优于对照组，差异有统计学意义（P＜0.05）； 观察组术后1、7 d希望水平评分优于对照组，差异有统计学意义（P＜0.05）；观察组体象障碍、人格障碍 及自尊水平评分优于对照组，差异有统计学意义（P＜0.05）。结论 对进行眼部整形美容手术的患者在心 理疏导的基础上应用沟通艺术能够改善自身焦虑、抑郁的负面情绪，对加强手术治疗效果及情绪的转变有 积极影响，值得临床应用。     

Psychological risk factors for graft rejection among liver transplant recipients

The purpose of this prospective study was to find psychological risk factors predicting acute, chronic, and psychological rejection in patients undergoing liver transplantation using Cognitive Behavioural Assessment (CBA-2.0). The primary scale included an assessment of fears, personality, obsessive-compulsive symptoms, state and trait anxiety, psychological reactions, and depression. We prospectively recruited 44 patients undergoing orthotopic liver transplantation (OLT). Exclusion criteria were: education level below secondary school, unstable clinical situation in an out-patient setting, fulminant hepatitis, psychotic disorders, neurocognitive deficits, dementia, serious mental retardation, current alcohol or drug abuse, recent ideation of or attempted suicide, and non-adherence to therapy. CBA-2.0 primary scale series of questionnaires were handed out to patients immediately after the medical examination, which had been performed to ascertain eligibility for OLT. Rejection (acute and/or chronic) was diagnosed according to clinical and histopathological criteria. Psychological rejection was diagnosed when patients declared, after transplantation, a refusal of the new organ which caused psychiatric symptoms requiring medical treatment and/or psychotherapy. Analysis of variance and logistic regression of psychological variables was performed to detect possible risk factors for each type of rejection. A greater fear of repulsive animals was able a predictor for an acute rejection episode (odds ratio = 1.1; P < .05). No other psychological pretransplant predictor was noted for chronic or psychological rejection. In patients undergoing OLT, preoperative emotions of fear could predict an acute graft rejection episode. These findings imply that pre-OLT screening should include psychological factors in addition to traditional medical criteria with intervention in selected cases.     

The features of psychological problems and their significance in patients on hemodialysis--with reference to social and somatic factors

AIM: For the purpose of identifying the features of psychological problems and their significance in patients on hemodialysis, we analyzed how psychological problems are affected by social and somatic factors. SUBJECTS AND METHODS: The subjects all consisted of patients on hemodialysis at the Kidney Center of Fukuoka Red Cross Hospital between December 1994 and December 1996. We used the Cornell medical index health questionnaire on neurosis and the "easily upset or irritated", State-trait anxiety inventory to determine both state and trait anxiety, the Self rating Depression Scale on depression and divided into the patients who demonstrated each psychological problem and those who did not, and then analyzed the psychological problems between the two groups with reference to somatic and social factors which may have led the patients to develop their respective psychological problems. RESULTS: According to a chi-square analysis, neurosis, clinical trait anxiety and clinical state anxiety were all more closely related to somatic factors than to social factors. In contrast to neurosis and anxiety, more social factors than somatic factors were related with "easily upset or factors were related with" easily upset or irritated". "Easily upset or irritated" was significantly related to living with a spouse or with children. In addition, depression was related to various factors including both somatic and social factors. In a stepwise multiple logistic regression analysis, the presence of restless legs also correlated with all the psychological symptoms investigated in this study. The prevalence of depression was also related to the degree of awareness regarding the cause of renal failure (p < 0.01). CONCLUSION: Our results thus revealed the features of the psychological problems and their significance in patients on hemodialysis.