儿童住院期间其家长应对方式的影响因素分析

目的:研究儿童住院期间患儿家长的应对方式,分析患儿病情和社会因素对应对方式的影响作用。方法:以一般背景问卷、简易应对方式量表、社会支持量表和家庭环境评定量表对陪护住院患儿家长进行评定。结果:患儿家长消极应对分低于常模(P<0·05),常患病患儿家长应对消极(P<0·05),回归分析显示影响积极应对的因素有家长知识性(β=0·219)、年龄(β=0·264),支持利用(β=0·201),影响消极应对的因素有患儿住院频率(β=0·194)。结论:患儿的治疗康复过程中,应关注家长尤其是年轻父母、经常患病的儿童家长的心理、情绪。     

HIE初期患儿家长心理健康及社会支持状况的调查分析

目的:了解新生儿缺氧缺血性脑病(HIE)患儿家长心理健康及社会支持状况,以期探讨家长因素对患儿康复的影响。方法:以方便取样的方法选取69名HIE患儿家长为研究对象。在患儿确诊后的1个月内,用焦虑自评量表、抑郁自评量表及社会支持问卷调查其心理健康及社会支持状况,同时在相同医院选取72名正常新生儿家长为对照。结果:69名HIE患儿家长焦虑、抑郁的得分显著高于正常新生儿家长(P<0.01)。家庭收入是影响患儿家长抑郁情绪的主要因素;患儿家长的主观支持得分与正常新生儿家长无差异,客观支持、对支持利用维度的得分显著高于正常新生儿家长(P<0.05)。结论:医护人员应充分评估HIE初期患儿家长的情绪状态和社会支持状况,以制定缓解其压力、提高对患儿护理效果的措施。     

社会支持对学龄期白血病患儿及其家长的影响

目的 探讨社会支持体系对学龄期白血病患儿的情绪状态及其家长的心理健康和生活质量的影响。方法 采用前瞻性、病例-对照研究方法,通过心理调查问卷分析,分别调查白血病、非恶性血液系统疾病及健康学龄期儿童及其家长,比较社会支持干预前后白血病患儿的情绪及其家长心理状况和生活质量的变化。社会支持干预包括信息支持、经济支持、心理支持等方面。结果 1)白血病患儿较对照组儿童存在较多的负性情绪(P<0.05),经过社会支持干预后,其躯体化/惊恐、广泛性焦虑、学校恐惧和焦虑总分方面与正常对照组相比,差异无统计学意义(P>0.05),且主观心境好转。2)白血病组患儿家长的心理问题突出,表现在各因子得分均高于对照组(P<0.05);经过社会支持干预,人际关系敏感、敌对、恐怖、偏执方面有明显改善(P<0.05)。3)家长的心理问题与患儿的负性情绪存在正相关(P<0.05)。4)社会支持干预下,白血病患儿家长的生活质量总评提高,躯体、社会和心理维度均较无社会支持组家长有所改善(P<0.05)。结论 学龄期白血病患儿存在较多的负性情绪,其家长存在较多的心理问题,积极的社会支持系统有助于减少患儿的负性情绪及改善家长的心理健康,提高家庭的生活质量。     

脑瘫患儿家长焦虑相关因素调查及护理干预

目的:了解脑瘫惠儿住院期间,家长焦虑程度与相关因素的关系,为护士做健康教育时采取有针对性的干预措施提供依据.方法:采用焦虑自评量表,对100例住院的脑瘫患儿家长进行问卷调查.结果:家长焦虑程度与其文化程度、患儿住院时间有关,两者比较差异有显著性(P<0.05).结论:患儿住院期间,家长存在焦虑,程度表现为文化程度越低、惠儿住院时间越长,焦虑程度越重.有针对性的护理干预能缓解家长的焦虑,提高治疗依从性.     

慢性病儿童父母情绪障碍及影响因素分析

目的 探讨慢性病对患儿家长心理和情绪的影响.方法 采用医院焦虑抑郁量表,对72例慢病组和59例正常对照组儿童的父亲和/或母亲的抑郁和焦虑情绪进行调查和比较,并收集患儿及父母基本信息,进行单因素和Logistic多元回归分析.结果 慢病组父母在焦虑(A分值)、抑郁(D分值)得分和总分(T分值)均显著高于正常对照组(P＜0.01);慢性病组儿童父亲和母亲医院焦虑抑郁量表评分比较其3个分值均无显著性差异(P＞0.05);多因素非条件Logistic回归分析显示:与父母医院焦虑抑郁量表得分相关联的变量为:患病年限(OR=1.339)、疾病状况(OR=1.494)和亲友帮助(OR=7.269).结论 慢性病儿童父母有更多的焦虑和抑郁情绪.在治疗患儿躯体疾病的同时,对慢性病患儿及家庭进行针对性的、有效的社会心理干预非常必要.     

白血病患儿家庭坚韧性和影响因素分析

目的分析白血病患儿家庭坚韧性和影响因素。方法选取2017年12月-2020年1月浙江大学医学院附属儿童医院收治的325例白血病患儿为研究对象,采用横断面调查法,使用临床资料调查表、一般自我效能量表、家庭坚韧性量表、简抑郁自评量表及问卷调查进行家庭坚韧性调查,分析白血病患儿家庭坚韧性与自我效能感、简易应对方式及负性情绪等方面的相关性,分析可能影响白血病患儿家庭坚韧性的相关因素和危险因素。结果自我效能、积极应对及正性情绪与白血病患儿家庭坚韧性呈正相关关系(均P0.05),而负性情绪与家庭坚韧性呈负相关关系(P0.05),而消极应对与家庭坚韧性无关(P0.05)。照顾者相关因素(含身份、年龄及文化程度)、一般因素(含性别、年龄、医疗保险方式及化疗阶段)及家庭因素(年收入、居所)是白血病患儿家庭坚韧性的影响因素(均P0.05)。多元线性回归分析结果显示,家庭收入、自我效能、积极应对、正性情绪及负性情绪与家庭坚韧性相关(均P0.05)。结论白血病患儿家庭坚韧性处于中等水平,临床上应积极帮助患儿家庭寻求社会支持,指导患儿家长提升从自我效能、正性情绪及积极应对能力,采取适宜的措施降低负性情绪,以期提升家庭坚韧性,提升患儿家庭的生存质量。     

喘息性疾病患儿家长焦虑与社会支持的调查

目的 了解喘息性疾病患儿家长焦虑、社会支持水平的相关性及其影响因素.方法 采用状态焦虑与社会支持问卷时226名喘息性疾病患儿的家长进行调查.结果 患儿家长焦虑评分为30～68(48.47±9.35)分,焦虑与社会支持呈负相关(r=-0.20,P＜0.01).其性别、年龄、文化程度对状态焦虑水平有影响.文化程度对社会支持有影响.结论 喘息性疾病患儿家长入院时焦虑水平较高.需对其进行相关健康教育和心理疏导,帮助其积极调动社会支持,助于患儿临床恢复.     

肾病综合征患儿家长社会支持、抑郁水平及家庭亲密度适应性的相关研究

目的 通过问卷调查肾病综合征(NS)患儿家长的家庭亲密度及适应性、社会支持和抑郁水平,探索其相关性,并分析NS患儿家长的家庭亲密度与适应性的影响因素,进而探索提高NS患儿家长亲密度及适应性的方法,为提高NS患儿的生活质量,减少因疾病和治疗带来的心理不良影响提供理论依据.方法 采用问卷调查的方法,于2016年8至12月对西安市儿童医院87名NS患儿家长进行调查研究,研究工具包括:一般资料调查表、家庭亲密度与适应性量表、社会支持量表和Beck抑郁量表四部分.结果 家庭月总收入、照顾者文化程度、医疗费主要来源均不同程度影响NS患儿所在家庭的实际亲密度、实际适应性、社会支持及抑郁值,差异均有统计学意义(r=-0.143~0.498,均P<0.05).87名NS患儿家长家庭的实际亲密度、实际适应性得分均低于常模(t值分别为-12.831、-9.365,均P<0.05),家长抑郁发生率为67.8%.NS患儿家长实际亲密度、理想亲密度、实际适应性、理想适应性均与社会支持之间有显著正相关关系(r值分别为0.558、0.391、0.470、0.378,均P<0.05),与抑郁总分呈负相关关系(r值分别为-0.406、-0.270、-0.369、-0.308,均P<0.05),社会支持与抑郁总分呈负相关关系(r=-0.480,P<0.05).结论 NS患儿家长家庭亲密度、适应性和抑郁值与社会支持关系密切,医护人员应当鼓励NS患儿所在家庭寻求良好的社会支持是非常必要的.     

小儿轮状病毒感染的个性化护理方法及对疗效、满意度影响分析

目的:探讨小儿轮状病毒感染的个性化护理方法及对疗效、满意度影响.方法:选取2016年1月-2017年3月88例小儿轮状病毒感染患儿并随机数字表法分组.对照组应用普通护理方法,观察组个性化护理方法.比较两组小儿轮状病毒感染治疗效果;患儿遵医行为、腹泻天数、住院时间、家长满意评分;干预前后患儿焦虑情绪.结果:观察组小儿轮状病毒感染治疗效果高于对照组,P<0.05;观察组患儿遵医行为、腹泻天数、住院时间、家长满意评分优于对照组,P<0.05;干预前两组焦虑情绪相近,P>0.05;干预后观察组焦虑情绪优于对照组,P<0.05.结论:小儿轮状病毒感染的个性化护理方法有助于减轻患儿焦虑感,提升患儿遵医行为,从而改善疗效和提高家长满意度,缩短疗程.     

躯体化障碍患者家属焦虑情绪及影响因素分析

摘要:目的 探讨躯体化障碍患者家属的焦虑状况及其影响因素。方法 采用方便取样的方法,运用自编一般情况问卷、焦虑自评量表(SAS)、D型人格问卷(DS14)及社会支持评定量表(SSRS),对2014年10月-2015年10月就诊于南昌大学第一附属医院心身医学科的117名躯体化障碍患者的家属进行测评。结果 躯体化障碍患者家属的焦虑情绪检出率为66.67%(78/117),焦虑自评量表均分为(55.91±10.74)分;多因素Logistic回归显示,家庭经济条件好、社会支持水平高是焦虑情绪发生的保护因素,D型人格、首次就诊是焦虑情绪出现的危险因素。结论 躯体化障碍患者家属普遍存在焦虑情绪,影响因素是多方面的。对患者进行临床治疗的同时加强对家属的干预,减轻患者家属的负性情绪,为患者的康复提供保障。     

Die sogenannte Vinylchlorid-Krankheit—eine berufsbedingte Systemsklerose?

Zusammenfassung Es wurden 13 Arbeiter untersucht, die zwischen 1 3/4 und 18 Jahren in einem PVC-herstellenden Betrieb beschäftigt waren. 8 von ihnen wiesen sklerodermieartige Hautveränderungen (Abb. 2) auf, die histologisch charakterisiert sind durch Verbreiterung und Homogenisierung der kollagenen Faserbündel (Abb. 3 u. 4) sowie Fragmentation und Rarefizierung der elastischen Fasern (Abb. 5). Bei 7 Patienten bestanden trommelschlegelartige Auftreibungen einzelner Fingerendphalangen (Abb. 1). 11 Patienten zeigten Durchblutungsstörungen der Extremitäten (4 von diesen ein Raynaud-Syndrom) und 6 Patienten Acroosteolysen einzelner Fingerendphalangen (Abb. 6, Tabellen 1–3).Darüber hinaus bestand bei allen Patienten eine Thrombocytopenie, bei 12 Patienten eine Splenomegalie, bei 11 Patienten eine Einschränkung der Leberfunktion (erhöhte BSP-Retention). An der Leber ließ sich histologisch bei den 5 laparoskopierten Patienten eine deutliche Fibrosierung der Portalfelder nachweisen. Bei 4 Patienten bestanden Oesophagusvaricen (Tabellen 4 u. 5). 8 Patienten zeigten eine Partialinsuffizienz mit Hinweisen für vorwiegend restriktive Veränderungen.Die hier beschriebenen Veränderungen gehen weit über das bisher bekannte Acroosteolysesyndrom hinaus. Es wird der dringende Verdacht geäußert, daß langfristige Vinylchlorid-Exposition dieses komplexe Krankheitsbild verursacht. Daher wird für diese systemische Krankheit die Bezeichnung Vinylchlorid-Krankheit vorgeschlagen.Wir danken Frau E. Voigtländer für die Herstellung der klinischen und histologischen Abbildungen.     

Empathic processes: perception by medical students of patients'' anxiety and depression

Perceptions by medical students of patients' affective states were investigated, and the effect of the students' own emotions on such perceptions. One hundred and one fourth-year medical students rated the levels of anxiety and depression of three women patients presented on videotape, rated their own levels of anxiety and depression and completed a questionnaire on aspects of the rating process. Students had widely different and often inappropriate perceptions of patients' levels of anxiety and depression. Students who consistently overrated anxiety or depression in patients, compared to those who consistently underrated, were themselves significantly more anxious or depressed. These data suggest a need in medical education for systematic teaching of empathic skills and for recognition of potential bias in clinical decision-making arising from the clinician's own emotional state.     

The reported incidence of work-related ill-health in Scotland (2002-2003)

BACKGROUND: Although incidence data for work-related ill-health in the UK are available, more detailed information for smaller geographical areas has hitherto been unpublished. AIMS: To estimate the incidence of work-related ill-health reported by clinical specialists in Scotland, 2002-2003. METHODS: THOR (The Health and Occupation Reporting network) is a UK wide reporting scheme for work-related ill-health. In 2002-2003, 241 out of 2162 physicians in THOR were based in Scotland. We have summarized the reported cases and calculated incidence rates for categories of ill-health by age, gender and industry. The UK Labour Force Survey (2002) was used to provide denominator data, with comparisons made between rates for Scotland and the rest of the UK. RESULTS: In 2002-2003, 4043 estimated cases were reported from Scotland. Mental ill-health was most frequently reported (41%); followed by musculoskeletal disorders (31%), skin disorders (16%), respiratory disease (10%), hearing disorders (2%) and infection (1%). The reported average annual incidence rate per 100,000 employees for all work-related ill-health in Scotland was 86.0. The highest reported rate for mental ill-health was found for employees in public administration and defence (76.7 per 100,000), and health and social work (72.3 per 100,000). The construction industry had the highest reported rate of musculoskeletal disorders (41.6 per 100,000), while hairdressers appeared at most risk of developing occupational contact dermatitis (rate=86.4 per 100,000). CONCLUSIONS: Despite its limitations, THOR has indicated types of work-related ill-health and related industries for targeted disease prevention in Scotland.     

Function of the protein RPE65 in the visual cycle

A protein called RPE65 performs a key role in the trans-cis isomerization of retinol in the retinal pigment epithelium of the eye. The palmitoylation of RPE65 serves to switch off the visual cycle in darkness and to switch it on in the light.     

Acute symptoms following work with pesticides

BACKGROUND: Serious accidental poisoning by pesticides is rare in the UK, but more minor pesticide-related illness may be under-reported. Anecdotally, use of sheep dip has been linked with flu-like symptoms. AIM: To explore the frequency, nature and determinants of acute symptoms following work with pesticides. METHODS: A postal survey of men in three rural areas of England and Wales provided data on occupational use of five categories of pesticide, occurrence of 12 specified symptoms within 48 h of using pesticides and tendency to somatize. Risk factors for pesticide-related symptoms were assessed by modified Cox regression. RESULTS: Of 10 765 responders (response rate = 31%), 4108 had at some time used pesticides occupationally, including 935 (23%) who reported symptoms following such work on at least one occasion. In two areas, acute symptoms were most frequent following use of sheep dip (29 and 32% of users), but in the third area the rate was significantly lower (13% of users). The relative frequency of symptoms was similar for all five categories of pesticide, and flu-like symptoms did not cluster unusually among users of sheep dip. Risk of pesticide-related symptoms increased with somatizing tendency (prevalence ratio for highest versus lowest category 2.4, 95% confidence interval 2.0-3.0) and was higher in men who had used pesticides most often or handled concentrate. CONCLUSION: Acute symptoms are common following work with pesticides, but in many cases the illness may arise through psychological rather than toxic mechanisms.     

The Life Events Inventory: re-scaling based on an occupational sample.

The objective of this study was to compare the validity of the original weightings used by the Life Events Inventory (LEI) with those obtained from a contemporary occupational sample. Fifty male and 62 female manufacturing employees (age range 16-55 years) assigned scores to each item on a slightly modified version of the LEI scale. The current sample consistently assigned higher weights to events/items than did the original sample, but there was high agreement in terms of item ranking. Some distinct age and gender differences in scoring were apparent, and are discussed further. It was concluded that when separate weightings are employed for age and gender groups, the LEI remains a useful tool for quantifying background levels of stress in both workplace stress audits and epidemiological studies where statistical control for non-occupational sources of stress is required.     

Maxillofacial injuries related to work accidents: a new concept of a hospital-based full electronic occupational trauma surveillance system

The objective of this study was to investigate the occurrence of occupational maxillofacial injuries using a newly installed relational database. Twenty-six injuries were identified out of 28,624 patients admitted to the emergency unit during a 12 month period. Falls from height or being struck by moving objects were common causes of these injuries. Two-thirds of those identified were construction workers. This paper demonstrates the power of modern databases to identify specific occurrences that may provide the basis for prevention in the future.     

Rôles physiologiques des endocannabinoïdes dans le contrôle de l’homéostasie énergétique

Endocannabinoids are endogenous lipids which modulate the release of neurotransmitters and activate different signaling pathways, through the binding to cannabinoïd receptors, CB1 and CB2. Endocannabinoids are involved in the control of a variety of behavioural and neuroendocrine functions, including feeding behaviour. In the central nervous system, they essentially modulate the expression of orexigen or anorexigen neuropeptides thus resulting in the stimulation of food intake. Their peripheral targets are mainly the liver and the white adipose tissue where they stimulate lipogenesis, through the modulation of several enzymes and proteins expressions. Cannabinoïd receptor agonists are nowadays prescribed to improve appetite of people suffering from cancer or AIDS. In the same way, CB1 antagonist, such as Rimonabant, could provide efficient treatment of obesity.     

Stress in police officers: a study of the origins,prevalence and severity of stress-related symptoms within a county police force

BACKGROUND: High levels of stress-related illness are causing concern across industry. Against a background of impending legislative moves to try to improve this situation, there is a need to identify key work-related stressors. Police work tends to be regarded as inherently stressful because of the personal risk of exposure to confrontation and violence and the day-to-day involvement in a variety of traumatic incidents. As a result, high levels of stress-related symptoms might be expected in this population. OBJECTIVE: To examine the sources of stress-related symptoms within police officers and measure the prevalence of significant associated mental ill-health. METHOD: A cross-sectional questionnaire survey of a population of 1206 police officers was performed to assess levels of strain associated with a series of potential home and work related stressors. Participants were then split into low and high scoring groups on the basis of a General Health Questionnaire (GHQ) threshold score in order to identify those stressors most associated with mental ill-health effects. RESULTS: Occupational stressors ranking most highly within the population were not specific to policing, but to organizational issues such as the demands of work impinging upon home life, lack of consultation and communication, lack of control over workload, inadequate support and excess workload in general. The high scoring group constituted 41% of the population and differed significantly from those with low scores in perception of all stressors, ranking both personal and occupational stressors more highly, and from personality constraints appeared significantly more 'stress-prone'. A significant association between gender and mental ill-health was found, with females more likely to score more highly on the GHQ than males. CONCLUSION: This study confirms previous findings of organizational culture and workload as the key issues in officer stress. Given that the degree of symptomatology appears to be worsening, management action is required. Further research is indicated within the police population into a possible increased susceptibility in female officers.