医学院学生焦虑、抑郁、孤独及相关因素探讨

目的了解医学院大学生的生活事件与焦虑、抑郁以及孤独之间的关系,并探求情绪对于应对方式的影响。方法采用《焦虑自评量表》、《自评抑郁量表和抑郁状态问卷》、《孤独量表》以及《青少年生活事件量表》和《应对方式量表》,对浙江省某医学院的210名大学生进行集体问卷调查。结果性别、年级以及专业对于大学生的生活事件、情绪以及应对方式均有影响;大学生的情绪状况与生活事件和应对方式有不同程度的相关;不同的生活事件导致学生不同的情绪水平;不同情绪水平的学生倾向于不同的应对方式;最后,我们还得到了生活事件对于不同情绪的回归方程。结论医学院大学生的不良情绪有其各自的成因和特点,医学院大学生的心理健康教育必须针对这些成因和特点来进行。     

独生子女新兵心理应激及其应对方式、社会支持水平的研究

目的研究独生子女新兵心理应激状况及其应对方式、社会支持水平,为开展心理服务提供依据.方法应用症状自评量表(SCL-90)、简易应对方式量表和领悟社会支持量表,对929名独生新兵和3 686名非独生新兵进行心理测评.结果独生新兵SCL-90总分、阳性均分及4个因子分显著性高于非独生新兵(P<0.05或P<0.01);独生新兵积极应对和消极应对评分均显著性高于非独生新兵(P<0.05或P<0.01),且前者家庭外支持及总社会支持评分前者显著性低于后者(P<0.01);独生和非独生新兵各应对方式类型人数所占比例差异有显著性 (P<0.05或P<0.01).结论入伍初期独生新兵心理应激较非独生新兵强烈,这与其不恰当的应对方式和获取较少家庭外支持有关.     

Experienced Health,Life Satisfaction,Sense of Coherence,and Coping Resources in Individuals Living with Heart Failure

The purpose of this study was to explore relationships between experienced health, sense of coherence, coping resources, and life satisfaction in individuals living with heart failure. Twenty-two patients--12 men and 10 women--were included in the study. All subjects were admitted to a eight-week programme of aerobic training. Four questionnaires were used: the Minnesota Living with Heart Failure Questionnaire (MHLF), the Sense of Coherence scale (SOC), the Coping Resources Inventory (CRI), and the Life Satisfaction Checklist of Fugl-Meyer et al. After the exercise programme the mean score of MLHF was significantly lower as compared with the start of the programme. The majority of the individuals reported that they were satisfied with life as a whole, family life, partnership relation contact with friends, and their psychological state of health. Only one-third were satisfied with their sexual life. A high sense of coherence and coping resources characterized the subjects. There was a slight tendency for those who reported satisfaction with life as whole to report a stronger sense of coherence, a higher degree of coping resources, and a lower degree of symptoms of heart failure. A conclusion was that clinicians should emphasize that patients can continue to remain active and enjoy a reasonable quality of life.     

“Something of the two of us”. The emotionally loaded embryo disposition decision making of patients who view their embryo as a symbol of their relationship

Objectives: This paper describes a recently identified conception of the cryopreserved embryo as a symbol of one’s relationship (SOR). Methods: A questionnaire was sent together with the embryo disposition decision (EDD) form to patients for whom embryos were cryopreserved at the department in Ghent, Belgium. We collected data on patient characteristics, their EDD attitudes and the reasons for their willingness or unwillingness to consider each of the disposition options (donation to others for reproduction, donation for science and discarding). Results: The SOR view was found more often in patients who were less educated and whose last treatment was less than 3 years ago. Viewing the embryo as a SOR was not linked to more difficult decision making, but to more emotionally loaded decision making. In particular, patients with this view more often reported feelings of grief. This view was also linked to the outcome of the decision making process. Conclusion: The conception of the embryo as a SOR is part of an affective attitude towards embryos that has an impact on patients’ disposition decisions. Alongside patients’ values and principles, it is important that counselors acknowledge and clarify patients’ affective conceptualizations.     

Psychometric properties of coping and self-efficacy scales related to substance use in a sample of Iranian adolescents

Abstract

Aim: This study aimed to investigate the cultural adaptation and psychometric properties of the Persian version of self-efficacy and coping skill scales (CSE) which are relevant to substance use in Iranian adolescents. Method: The method included a forward–backward translation with face and content validity in the first step and the psychometric properties were evaluated in the second step. The study used reliability and construct validity in a cross-sectional survey, in three steps, including: item analysis, explanatory and confirmatory factor analyses in 720 adolescents, aged from 14 to 18 years old in Isfahan. Findings: In the first step, three items were excluded because of low CVI and one item was deleted due to low CITC. EFA in the cross-sectional study showed appropriate loading items and revealed an 18-item scale with four factors including: refusal self-efficacy, decision making, assertiveness and communication skills. Results of the confirmatory factor analysis represented an acceptable fitness (CMIN/DF?=?3.6, NFI?=?0.90, TLI?=?0.92, CFI?=?0.93, PNFI?=?0.76, RMSEA?=?0.06). Internal consistency was found from 0.68 to 0.89 for the four subscales. Conclusion: Overall, the results of these studies indicate that the Persian version of coping and self-efficacy appears to be a psychometrically robust instrument and could significantly predict substance use behaviour in Iranian adolescents.     

Older women’s experiences,identities and coping strategies for dealing with a problem-drinking male family member*

Aims: In this study, we highlight the identities and actions of women with a problem-drinking relative by analysing autobiographies of women born between the 1920s and the 1950s. We ask how women describe their relationship and the problems arising because of a significant other’s drinking and how they cope with these problems. Methods: In the analysis, we pay attention to the power dynamics between family members. We, first, trace what kind of positions or identities the protagonists take in relation to the drinker. Second, we examine what kinds of harms and emotional reactions significant other’s drinking causes. Third, we consider how writers identify or take distance from events described in the autobiographies. Findings: Our analysis reveals four main identities and coping strategies: the positions of victim, helper, boundary setter and fighter. The victim and helper positions often entail women’s weakness and oppressed role, while the positions of boundary setter and fighter express women’s own power and reflexivity in action. Conclusions: Knowledge of the identities and coping strategies is important for understanding the power aspects of a relationship and developing appropriate support for women suffering from family member’s drinking.     

知柏地黄丸治疗糖调节受损患者的临床研究

目的观察知柏地黄丸对糖调节受损(IGR)患者的临床疗效及对胰岛素抵抗、胰岛β细胞功能的影响。方法 176例IGR患者,随机分为治疗组与对照组,观察结束共脱落及剔除病例19例,纳入统计病例157例,治疗组77例,对照组80例,两组均给予教育及生活方式干预,治疗组在其基础上给予知柏地黄丸口服,治疗12个月后,观察两组体重指数(BMI)、HOMA胰岛素分泌指数(HOMA-β)、早期胰岛素分泌指数(EISI)及HOMA胰岛素抵抗指数(HOMA-IR)的改变。结果两组患者的BMI及HOMA-IR较治疗前均有下降,HOMA-β明显升高,差异有统计学意义(P0.05,P0.01);与对照组比较,治疗组治疗后HOMA-IR下降,EISI及HOMA-β升高,差异有统计学意义(P0.05,P0.01)。结论知柏地黄丸能减轻胰岛素抵抗,改善胰岛β细胞功能,延缓或预防IGR患者向2型糖尿病(T2DM)发展。     

Evidence of psychosomatic influences in compensated and decompensated tinnitus

The purpose of this study was to evaluate the role and interaction of individual factors on decompensated tinnitus. Subjects consisted of 53 adult patients with chronic tinnitus. They were selected and assigned to two groups, compensated (n?=?28) and decompensated (n?=?25), according to the results of an established tinnitus questionnaire. Both groups were evaluated and compared. The patients with decompensated tinnitus suffered from more pronounced social disabilities, were more prone to depression, and used less effective techniques to cope with their illness. They showed a higher degree of somatic multimorbidity, with particularly strong correlations between tinnitus and the incidence of cardiovascular diseases and hypoacusis. As a consequence, in the psychosomatic tinnitus therapy, greater attention should be given to the treatment of the somatic complaints in addition to psychological and psychosocial aspects.     

儿童青少年1型糖尿病患儿的压力和应对方式对其疾病自我管理的影响

目的 探讨人口学、疾病相关特征、压力、应对方式对儿童青少年1型糖尿病患儿疾病自我管理水平的影响。方法 采用横断面调查研究设计，纳入149名儿童青少年1型糖尿病患儿（8~20岁）。采用一般资料收集表、儿童青少年1型糖尿病自我管理量表、压力知觉量表、青少年应对方式量表进行调查。结果 149例患儿中，37例（24.8%）患儿处于高压力水平。与学龄期患儿相比，青春期患儿压力水平更高，且更多地采用消极应对方式（P < 0.05）。多元线性回归分析结果显示，母亲教育水平为高中及以上患儿以及低压力水平、面对压力采取积极应对的患儿，其糖尿病自我管理水平较高（P < 0.05）。结论 近四分之一的儿童青少年1型糖尿病患儿处于高压力水平。医护人员在对儿童青少年患儿进行糖尿病自我管理教育时，重点人群应放在母亲教育水平为初中及以下水平的家庭；策略方面，应以减压为目标，引导患儿更多地采取积极应对方式缓解压力。     

Relationship between coping,rumination and posttraumatic growth in mothers of children with autism spectrum disorders

This study examined the relationship between coping, rumination and posttraumatic growth in mothers of children with autism spectrum disorders (ASD). One hundred and two mothers of autistic children in China were surveyed using Post-traumatic Growth Inventory, Trait Coping Style Questionnaire, and Event Related Rumination Inventory. Mothers reported mediate level of PTG, mostly on the growth of personal strength. Hierarchal regression analysis indicated that positive coping positively predicted PTG and growth on “relating to others”; deliberate rumination was positively correlated with growth on “appreciation of life”; and intrusive rumination negatively predicted growth on “personal strength”, “new possibilities” and “spiritual change”. No statistically significant relationship between negative coping and PTG was found. The results may be used to provide mothers with a better understanding of the underlying growth process and assist service providers in facilitating this progress.