临床医学生睡眠质量及其影响因素的分析

目的　探讨临床医学生睡眠质量现状及其与心理健康状况、生活事件、应对方式和个性等因素的相互关系。方法　采用匹兹堡睡眠质量指数 (PSQI)、症状自评量表 (SCL 90 )、青少年生活事件量表、应对方式问卷及艾森克个性问卷 ,对中山大学 4 5 0名一、三、五年级的临床医学生进行测查。结果　睡眠问题检出率 17 8% ,三年级睡眠质量较差 ,生活事件应激值、应对方式 ,N、E量表分、SCL 90总均分与睡眠质量呈显著相关 ,各因子间也存在一些显著性相关 ,多元回归分析提示 :学习压力、N分、SCL 90总均分和积极应对分对睡眠质量有显著预测作用。结论　就临床医学生睡眠质量而言 ,生活事件、个性、心理健康状况和应对方式对其既有直接影响又存在交互作用。     

后勤新兵心理健康状况的调查分析

目的　了解后勤系统入伍新兵的心理健康状况。方法　应用症状自评量表 (SCL 90 )、艾森克个性问卷 (EPQ)及心理健康相关问卷对后勤系统 2 0 0 1年 12月入伍的 895名新兵进行心理健康状况调查。结果　后勤新兵SCL 90总分、各因子分、阳性项目数均低于中国军人常模和中国新兵常模 (P <0 .0 0 1) ;EPQ个性问卷中的E分、N分明显高于常模 (P <0 .0 1,P <0 .0 5 )。结论　后勤新兵心理健康状况良好 ,应根据新兵个性特征进行入伍教育、行政管理及军事训练     

上海市浦东新区失地农民心理健康与应付方式的相关性

目的：了解上海市浦东新区失地农民心理健康与应付方式状况，并分析其相关性，为制定有关政策提供依据。方法采用简单随机抽样的方法抽取浦东新区两个镇的居民，其中失地农民和非失地农民各600人，运用症状自评量表（SCL －90）和应付方式问卷（CQS）进行问卷调查。收回有效问卷1109份。结果失地农民 SCL －90各因子得分均高于非失地农民，CSQ 各因子中解决问题因子得分最高。 Pearson 相关分析显示 SCL －90与除退避因子外的 CSQ 各因子有相关性。多元线性逐步回归分析显示，解决问题因子是影响失地农民 SCL －90的主要因素。结论上海市浦东新区失地农民的心理健康与应付方式有关，在遇到问题时善于运用解决问题的应付方式。     

精神科护士应对方式及工作压力状况调查分析

目的 探讨精神科护士应对方式及工作压力状况.方法 将200名精神科护士作为研究组,选取200名非精神科护士作为对照组,问卷评定采用护士工作压力源量表(NJSQ)及应对方式问卷(CMI).结果 研究组NJSQ的各因子得分显著高于对照组(P＜0.05).研究组CMI的积极应对因子评分显著低于对照组(P＜0.05),而消极应对因子评分显著高于对照组(P＜0.05).结论 精神科护士存在应对方式不佳、工作压力较大等心理问题,应予以足够重视.     

精神科护士的心理状态及个性特征

目的探讨精神科护士的心理健康水平及个性结构特征。方法采用临床症状自评量表(SCL-90)和艾森克问卷(EPQ)对84例精神科护士的心理状况及个性结构评估,单纯随机抽出普通护士84例为对照组。结果精神科护士健康水平明显低于对照组,以焦虑、抑郁、强迫、躯体化、恐惧为主,个性特征中神经质、内向性、稳定性、掩饰性均高于对照组。结论精神科护士的心理水平较低,有明显的神经质倾向,情绪不稳定,需要进行有效心理干预。     

吸毒者心理健康与T淋巴细胞亚群及促肾上腺皮质激素的相关性分析

目的　探讨吸毒人员心理健康与T淋巴细胞亚群 (CD3 、CD4/CD8)、促肾上腺皮质激素 (ACTH)的相关性。方法　采用心理评定量表 (SCL 90量表 ) ,对 30名戒毒治疗后 1～ 2个月人员和 2 0名健康对照组进行心理量表评定 ,并用流式细胞分析仪检测血液淋巴细胞亚群CD3 、CD4/CD8,放射免疫法检测血清ACTH。结果　戒毒人员SCL 90症状量表中多项因子评分及总分较对照组显著增高 ;血清ACTH含量两组比较有显著差异 ;(P <0 0 5 ) ;观察组淋巴细胞CD3 、CD4/CD8较对照组下降明显。典型相关分析显示ACTH、CD3 、CD4/CD8与SCL 90症状量表中多项因子评分密切相关 (r=- 0 6 35 5 6 0 ,P =0 0 0 30 )。结论　戒毒人群存在严重的心理健康紊乱 ,ACTH与CD4/CD8含量的改变对这种状态的存在和发展可能有一定联系。     

209名驻岛人员心理应激状态与个性特征的相关研究

目的　研究西沙驻岛人员的心理应激状态与个性特征及相关性。方法　以西沙岛屿 2 0 9人作为调查组 (以下称西沙组 ) ,同一部属的沿海地区人员 2 2 3人为对照组 ,采用症状自评量表 (SCL -90 )、艾森克个性测量问卷 (EPQ)、匹兹堡睡眠质量指数量表 (PSQI)、特质应对方式问卷 (TCSQ)和自行设计一般项目调查表。同时测定血清总甲状腺素 (TT4)及皮质醇 (Cortisal)水平。结果　驻岛人员中较明显的心理健康问题为人际敏感、抑郁、敌对、强迫、偏执和躯体化等 ,西沙组SCL - 90各因子分、阳性项目数、总均分均不同程度高于对照组 (P均 <0 .0 0 1) ;神经质分 (EPQ -N)明显高于对照组 (P <0 .0 0 1) ,而掩饰分 (EPQ -L)低于对照组 (P <0 .0 5 ) ;西沙组 36 .36 %存在睡眠质量问题。结论　心理应激反应影响他们神经、内分泌及免疫系统的变化 ,影响着认知、行为、和情绪 ,应激反应不仅取决于应激源 ,而且取决于个体的个性特征 ,对驻岛人员应予以因人而异的心理调整 ,进行心理应激耐受训练 ,提高他们应激反应的阈值 ,培养健全的个性。     

新兵心理适应不良及心理健康水平研究

目的：了解新兵入伍初期心理适应状况及心理健康水平，为开展心理教育提供科学依据。方法：应用陆军适应不良量表和军人心理健康症状问卷（SCL－90）对1440名新兵进行心理测试。结果：（1）新兵心理适应不良发生率为4．8％，其适应障碍表现按因子分高低依次为情绪障碍、行为问题、社交不良和人际关系不良。（2）新兵SCL－90量表评定中的F1、F2、F4、F5、F7、F8和F9因子分显高于国内常模（P＜0．01），而F3、F4、F5、F6和F9因子分显低于军人常模（P＜0．01）；新兵中度及以上心理痛苦水平（各因子分＞2）的发生率为9．8％－32．4％。（3）新兵心理适应不良量表与SCL－90问卷各因子分间相关系数为0．235－0．554，均呈高度正相关（P＜0．01）。结论：新兵心理健康水平总体上高于军人常模而低于国人常模，少数人员存在适应性障碍。     

对72名中学生的心理状况和个性倾向的分析

作者探讨了中学生的主要心理问题及个性倾向 ,旨在为心理干预提供基础资料。现报道于后。1　对象与方法1 1　对象　来源于 2 0 0 1年元月～ 2 0 0 2年元月来我院心理门诊咨询的中学生共 72人。其中男生 39人 ,女生 33人 ;高中生 4人 ,初中生 2 9人 ;平均年龄 (17 0 1± 1 0 0 )岁。1 2　方法　采用症状自评量表 (SCL - 90 ) [1 ] 、艾森克问卷[[2 ] 作为检测工具。其结果与青年常模相比较。有关数据采用t和 χ2 检验。2　结　　果2 1　中学生SCL - 90评分与青年常模比较 (见附表 )。附表　中学生SCL -90评分与青年常模比较 (x±s)项　…     

待退伍军人心理健康状况及应付方式的调查分析

目的了解待退伍军人的心理健康状况和应付方式,为待退伍军人心理健康教育提供依据。方法采用症状自评量表和应付方式问卷对待退伍军人及现役军人进行调查,分别回收有效问卷100份和105份,并比较待退伍军人、现役军人、中国军人常模的SCL-90及退伍军人与现役军人的应付方式各因子分。结果待退伍军人总体的SCL-90各因子分均低于现役军人及中国军人常模(P<0.05);应付方式问卷中,待退伍军人解决问题、求助因子分高于现役军人(P<0.05),自责、幻想、退避因子分低于现役军人(P<0.05),合理化因子分高于现役军人(P>0.05)。结论待退伍军人心理健康状况优于现役军人及中国军人常模,心理应付方式优于现役军人,多采用成熟应付方式。     

Severe acute respiratory syndrome-related psychiatric and posttraumatic morbidities and coping responses in medical staff within a primary health care setting in Singapore

BACKGROUND: Severe acute respiratory syndrome (SARS) is a major new infectious disease of this century that is unique in its high morbidity and concentration in health care settings. We aimed to determine the level of psychological impact and coping styles among the medical staff in a primary health care setting. METHOD: Using a structured questionnaire, we conducted a cross-sectional survey of the doctors and nurses working within a public, primary health care setting in mid-July 2003. The main outcome measures were rates of psychiatric morbidity, level of posttraumatic stress symptoms, and coping strategies. RESULTS: The response rate was 92.0%. Of the 277 respondents (91 doctors and 186 nurses), psychiatric morbidity and posttraumatic morbidity were found in 20.6% and 9.4%, respectively. Both psychiatric and posttraumatic morbidities were associated with higher scores on coping efforts including self-distraction, behavioral disengagement, social support, venting, planning, and self-blame (all p <.001), but not with direct exposure factors such as contact with suspected SARS patients or working in fever rooms/tentages. Multivariate analysis showed that psychiatric morbidity was associated with post-traumatic morbidity (p =.02) and denial (p =.03), whereas posttraumatic morbidity was associated with younger age (p =.007), being married (p =.02), psychiatric morbidity (p =.02), self-distraction (p =.02), behavioral disengagement (p =.01), religion (p =.003), less venting (p =.04), less humor (p =.04), and less acceptance (p =.02). CONCLUSION: SARS-related psychiatric and posttraumatic morbidities were present in the medical staff within a primary health care setting. Specific coping efforts, age, and marital status, not direct exposure factors, were associated with psychological morbidity. These findings provide possible foci for early identification and psychological support.     

精神科男护士工作压力与应对方式及社会支持的调查研究

目的 了解精神科男护士的主要工作压力、所采取的应对方式及社会支持之间的关系.方法 采用工作压力源量表、简易应对方式问卷、领悟社会支持量表对北京市某三级甲等医院95例精神科男护士进行问卷调查.结果 精神科男护士工作压力平均水平为(2.69±0.57)分,排在首位的压力源是护理专业及工作方面的问题,其中工资及其他的福利待遇低,护理工作的社会地位低为主要的压力源;工作压力源总分及工作环境及资源方面,病人护理方面,管理及人际关系方面与消极应对方式呈正相关(P＜0.01);工作压力源与社会支持呈负相关(P＜0.05).结论 应重视精神科男护士的工作压力,需要社会给予多方面的支持和理解,设法减轻工作压力.精神科男护士应采取积极的应对方式,提高心理素质以最佳的心理状态投入工作.     

Coping and recovery styles in the Vietnam era prisoner of war

Of the nearly 600 Vietnam War American prisoners of war (POWs), 332 were United States Air Force flyers who had suffered maltreatment, confinement, and boredom for months to years. We examined four coping styles of USAF POWs related to successful/unsuccessful coping and resistance stance during captivity and cognitive integration of the prisoner experience after repatriation. Findings indicate that no coping style is clearly associated with an increased risk of postrepatriation psychiatric morbidity. Postrepatriation MMPI scales indicate personality differences between individuals in the various coping groups.     

Suicide and violence risk

Thirty suicidal psychiatric inpatients were compared with 30 nonsuicidal psychiatric inpatients. A battery of self-report tests was administered measuring suicide risk, violence risk and coping styles. The suicidal patients scored higher on both the suicide risk and violence risk. They also used almost all coping styles less frequently than the nonsuicidal patients. Among suicidal patients, suicide risk was negatively correlated with the coping styles of minimization, replacement and blame. Further, suicide risk and violence risk in suicidal patients were shown to be predicted by coping styles. These data indicate that suicidal patients have inadequate mental resources to deal with life problems. Besides their significance for assessing suicide risk, the findings may have possible clinical implications for case detection and early intervention with potential preventive value.     

Coping styles and suicide risk

A total of 30 psychiatric in-patients admitted because of suicidal behaviour were compared with 30 non-suicidal psychiatric in-patients and 32 healthy controls on measures of suicide risk and coping styles. The three groups were similar with regard to demographic variables, but the suicidal group scored higher on the suicide risk scale. Suicidal patients were significantly less likely to use the coping styles of minimization and mapping. They were unable to de-emphasize the importance of a perceived problem or source of stress. They also lacked the ability to obtain new information required to resolve stressful life events. Four coping styles correlated negatively with the suicide risk (minimization, replacement, mapping and reversal), while another three (suppression, blame and substitution) correlated positively. These findings may have important implications for therapists and primary prevention workers, and might pave the way towards recognition of the role played by coping styles in predicting suicide and its use for cognitive intervention in these high-risk patients.     

Coping and subjective wellbeing in women with multiple roles

BACKGROUND: Married, working women experience a considerable amount of strain from their multiple roles. At the same time, studies indicate that they enjoy a high level of wellbeing. While the nature of employment and the level of spousal support have been examined in relation to wellbeing, the role of coping styles has not received much attention. AIM: To examine the role of work-related factors, availability of support and coping styles as predictors of wellbeing. METHOD: Sixty married, working women were individually interviewed with regard to reasons for employment and support availability, and administered the Coping Checklist and Subjective Wellbeing Inventory. RESULTS: On stepwise multiple regression analysis, greater use of social support seeking and less use of denial as coping styles, absence of multiple role strain, working to be financially independent, availability of support and refusal of job promotion were significant predictors of wellbeing. CONCLUSION: In working women with multiple roles, enhancing problem and emotion focused coping by strengthening the use of the support network is important for wellbeing.     

Assaults by patients: the experience and attitudes of psychiatric hospital nurses.

Four hundred and twenty-five nurses working in a 420 bed metropolitan psychiatric hospital were asked to complete a questionnaire about their experience of physical assault by patients and their attitude toward the problem. 61% returned the questionnaire. The overall mean annual rate of assault per nurse was 2.0, with student psychiatric nurses (mean 6.7) significantly more at risk than any other group. Nurses working in the psychogeriatric area reported more than double the rate of assaults reported by nurses working in rehabilitation services. 60% of respondents were female; there were very few sex differences in attitudes to assault. Overall, nurses reported a high tolerance for assault, although they recognised it as an experience that was often very traumatic psychologically. Views about managing assaultiveness differed widely, and this lack of consensus probably hinders the development of optimal strategies to deal with what is a major problem in many psychiatric units.     

应对技能训练应用于抑郁症患者

目的:探讨应对技能训练对抑郁症患者应对方式的影响。方法:将60例抑郁症患者随机分为研究组30例和对照组30例,研究组给予药物治疗加应对技能训练,对照组仅给予药物治疗。观察8周。于训练前及训练8周采用应付方式问卷评价患者的应对水平。结果:应对技能训练后,在应对方式上,研究组自责、幻想、退避评分低于对照组(P<0.05或P<0.01),而解决问题、求助评分高于对照组(P<0.01)。结论:应对技能训练可部分改善抑郁症患者的应对方式。     

三甲医院护士睡眠质量及其影响因素研究

目的了解三甲医院护士的睡眠质量,并分析相关的影响因素。方法采用随机整群抽样法,抽取北京、上海、广州、重庆四座城市8所三甲医院的护士共1508例作为研究对象。采用自编的《一般情况调查表》,以及匹兹堡睡眠质量指数、自测健康评定量表、简易应对方式问巷进行测评。结果三甲医院护士的睡眠质量主要表现在日间功能障碍、入睡时间和主观睡眠质量方面,主要的睡眠问题为入睡困难、夜间易醒或早醒,轮值夜班及聘任制护士的睡眠质量较差;睡眠质量与年龄、文化程度、职称等因素无关;睡眠质量与自测健康、应对方式显著相关。结论三甲医院护士的睡眠质量不容乐观,应采取综合因素进行干预,以提高他们的身心健康水平。     

Coping style and psychological health among adolescent prisoners: a study of young and juvenile offenders

The current study explores the role of coping styles as a predictor of poor psychological health among adolescent offenders. It presents the first study to compare young and juvenile offenders. Two hundred and three male offenders took part: 108 young (18-21 years) and 95 juvenile (15-17 years) offenders. All completed the General Health Questionnaire (GHQ-28) and a revised version of the Coping Styles Questionnaire (CSQ-3). Young offenders reported using emotional, avoidant and detached coping styles more than juveniles. They also reported more overall psychological distress than juveniles, with a trend to report increased depression, anxiety and insomnia. For both young and juvenile offenders, emotional coping predicted increased psychological distress. This was consistent across different symptoms (i.e. somatic, anxiety and insomnia, social dysfunction and severe depression). For young offenders, rational coping predicted a decrease in overall distress and was found across all symptoms. For juveniles, although detached coping predicted a decrease in overall psychological distress, across symptoms it only predicted social dysfunction. Increased rational coping was also found to predict decreased depression for juveniles. The study highlights differences between young and juvenile offenders regarding coping styles and how this relates to psychological distress. It highlights the complexities of trying to understand the coping-health relationship in a prison setting and asks if such settings are increasing the potential for adolescents to over-use coping styles that may not be the most effective.