社交恐怖障碍患者一级亲属执行功能测验初步研究

目的:探讨社交恐怖障碍患者一级亲属的执行功能与正常对照组的差异。方法:采用威斯康星分类卡片测验(Wisconsin CardSorting Test,WSCT)对39名社交恐怖障碍患者的一级亲属和39名健康对照者的执行功能进行评估。结果:在WSCT测验中,社交恐怖障碍患者一级亲属的非持续错误数明显高于对照组,差异具有统计学意义。结论:社交恐怖障碍患者一级亲属可能存在执行功能受损,这是否与遗传或者共同的生活环境有一定关系,尚需进一步更严格的研究证实。     

耳穴压豆法结合放松训练对ICU患者家属焦虑、疲劳的影响

目的:探讨耳穴压豆法结合放松训练对ICU患者家属焦虑、疲劳的干预效果。方法:将符合条件的88例家属随机分为干预组和对照组,各44例。对照组实施两周的放松训练,干预组在此基础上实施4周的耳穴压豆疗法。干预结束后评价两组家属的焦虑、疲劳缓解情况。结果:干预后干预组家属焦虑得分明显低于对照组(t=-6.93,P0.01),干预组疲劳得分明显低于对照组(Z=-7.57,P0.01),差异有统计学意义。结论 :ICU护士在关注患者的同时,也应对家属实施耳穴压豆疗法结合放松训练干预,以缓解家属的焦虑、疲劳。     

Stress response symptoms in relatives of acutely admitted psychotic patients: A pilot study

Objective: The aim of this study is to identify specific stress response symptoms in relatives of acutely admitted psychotic patients, and to compare these responses with those of relatives of chronic inpatients. Method: Twenty-five relatives of acutely hospitalized, psychotic patients and 21 relatives of chronic inpatients were assessed within days of the acute patient's admission and 6 weeks later. The Impact Event Scale assessed intrusion and avoidance; items from the General Health Questionnaire (GHQ) and the Spielberger State Anxiety Inventory (STAI) assessed arousal. Results: At the first assessment, relatives of the acutely admitted psychotic patients reported higher intensity of intrusive symptoms, and more often a high arousal level compared to the relatives of chronic inpatients. Six weeks later, relatives of acutely admitted psychotic patients revealed both higher intensity and higher number of intrusive and avoidance symptoms, and higher level of arousal symptoms. Seven relatives of acutely admitted psychotic patients and no relatives of the chronic inpatients reported moderate to high level of intrusion, avoidance and arousal at both assessments. Conclusion: Relatives of acutely admitted psychotic patients revealed strong acute and persistent stress responses, similar to those described in subjects exposed to severe or life threatening illness. Even relatives of the chronic inpatients revealed stress-specific symptoms, but at a lower level. Specific stress response symptoms may impair the relatives' well-being, care-giving abilities, and their co-operation with the mental health system. Our results suggest that stress response symptoms in relatives should be given more attention.     

慢性精神分裂症患者家属心理健康状况性别差异调查

目的分析慢性精神分裂症患者家属心理健康状况的性别差异及相关原因。方法采用症状自评量表（SCL-90）、简易应对方式问卷及社会支持评定量表,对110名慢性精神分裂症患者家属进行调查分析。结果慢性精神分裂症患者不同性别组家属的SCL-90、社会支持评定量表、简易应对方式问卷评分差异具有统计学显著意义（P〈O．01）,社会支持评分、应对方式评分与SCL-90评分间存在相关,相关具有统计学意义（P〈O．01）。结论慢性精神分裂症患者家属心理健康状况存在性别差异,女性家属的心理问题较男性家属严重,心理健康状况与个体应对方式及社会支持度相关。     

Conditions and strategies to meet the challenges imposed by the COVID-19-related visiting restrictions in the intensive care unit: A Scandinavian cross-sectional study

ObjectivesTo examine conditions and strategies to meet the challenges imposed by the coronavirus disease 2019 (COVID-19)-related visiting restrictions in Scandinavian intensive care units.Research methodology/designA cross-sectional survey.SettingAdult intensive care units in Denmark, Norway and Sweden.Main outcome measuresLikert scale responses and free-text comments within six areas: capacity and staffing, visiting policies and access to the unit, information and conferences with relatives, written information, children as relatives and follow-up initiatives.ResultsThe overall response rate was 53% (74/140 participating units). All intensive care units had planned for capacity extensions; the majority ranging between 11 and 30 extra beds. From March–June 2020, units had a mean maximum of 9.4 COVID-19 patients simultaneously. Allowing restricted visiting was more common in Denmark (52%) and Norway (61%) than in Sweden where visiting was mostly denied except for dying patients (68%), due to a particular increased number of COVID-19 patients. The restrictions forced nurses to compromise on their usual standards of family care. Numerous models for maintaining contact between relatives and patients were described.ConclusionVisitation restrictions compromised the quality of family care and entailed dilemmas for healthcare professionals but also spurred initiatives to developing new ways of providing family care.     

Multimodal voxel-based meta-analysis of structural and functional magnetic resonance imaging studies in those at elevated genetic risk of developing schizophrenia

Computational brain-imaging studies of individuals at familial high risk for psychosis have provided interesting results, but interpreting these findings can be a challenge due to a number of factors. We searched the literature for studies reporting whole brain voxel-based morphometry (VBM) or functional magnetic resonance imaging (fMRI) findings in people at familial high risk for schizophrenia compared with a control group. A voxel-wise meta-analysis with the effect-size version of Signed Differential Mapping (ES-SDM) identified regional abnormalities of functional brain response. Similarly, an ES-SDM meta-analysis was conducted on VBM studies. A multi-modal imaging meta-analysis was used to highlight brain regions with both structural and functional abnormalities. Nineteen studies met the inclusion criteria, in which a total of 815 familial high-risk individuals were compared to 685 controls. Our fMRI results revealed a number of regions of altered activation. VBM findings demonstrated both increases and decreases in grey matter density of relatives in a variety of brain regions. The multimodal analysis revealed relatives had decreased grey matter with hyper-activation in the left inferior frontal gyrus/amygdala, and decreased grey matter with hypo-activation in the thalamus. We found several regions of altered activation or structure in familial high-risk individuals. Reliable fMRI findings in the right posterior superior temporal gyrus further confirm that alteration in this area is a potential marker of risk.     

Disclosing genetic information to family members without consent: Five Australian case studies

Genetic risk information is relevant to individual patients and also their blood relatives. Health practitioners (HPs) routinely advise patients of the importance of sharing genetic information with family members, especially for clinically actionable conditions where prevention is possible. However, some patients refuse to share genetic results with at-risk relatives, and HPs must choose whether to use or disclose genetic information without consent. This requires an understanding of their legal and ethical obligations, which research shows many HPs do not have. A recent UK case held that HPs have a duty to a patient's relatives where there is a proximate relationship, to conduct a balancing exercise of the benefit of disclosure of the genetic risk information to the relative against the interest of the patient in maintaining confidentiality. In Australia, there is currently no legal duty to disclose genetic information to a patient's at-risk relatives, but there are laws and guidelines governing unconsented use/disclosure of genetic information. These laws are inconsistent across different Australian states and health contexts, requiring greater harmonisation.Here we provide an up-to-date and clinically accessible resource summarising the laws applying to HPs across Australia, and outline five Australian case studies which have arisen in clinical genetics services, regarding the disclosure of genetic results to relatives without consent. The issues addressed here are relevant to any Australian HP with access to genetic information, as well as HPs and policy-makers in other jurisdictions considering these issues.     

癫痫患儿亲属不依从治疗的调查分析及护理对策

目的：了解癫痫患儿亲属不依从治疗的原因，纠正患者亲属错误的观念和行为。方法：采用自编问卷调查表，对本院就诊的癫痫惠儿亲属进行问卷调查统计。结果：用药的种类多和时间长，是亲属不依从治疗的主要原因。结论：亲属不依从治疗是导致患儿治疗效果差和病情反复的主要原因之一，加强其健康教育和心理护理，与其建立良好的护患关系，是主要的护理对策。     

农村精神分裂症患者家属情感表达与复发关系的研究

目的　探讨精神分裂症患者家属情感表达方式以及对精神分裂症复发的影响。方法　对 14 6例首次发作且痊愈出院的农村精神分裂症患者家属 ,采用坎伯威尔家庭问卷中文版 (CFI CV)进行调查 ,根据CFI CV评分 ,将被调查对象分为高情感组和低情感组 ,对精神分裂症患者进行 2年随访 ,以比较家属高情感表达组和低情感表达组的复发率。结果　被试对象中高情感表达家属为 5 0 .17%、低情感表达家属为 4 8.83% ,高情感表达家庭 71个 (4 8.6 3% )、低情感表达家庭 75个 (5 1.37% ) ;高情感表达组和低情感表达组精神分裂症的年累计复发率分别为 4 3.6 6 %、14 .6 7% ,两组比较差异有显著性 (P <0 .0 5 )。结论　精神分裂症患者家属的情感表达对患者的病情发展有重要影响 ,有必要对家属进行心理干预 ,降低复发率。