护理学硕士生心理健康状况及其影响因素分析

目的 探讨护理硕士研究生心理健康状况及其影响因素.方法 采用症状自评量表(SCL-90)、社会支持量表(SSRS)和应对方式量表,对273名护理学硕士研究生进行调查.结果 (1)护理硕士生SCL-90阳性检出率为12.45％.(2) Logistic回归分析显示,学费来源(OR=2.982)、自责(OR=2.731)是护理学硕士研究生心理健康的危险因素,年龄(OR=0.242)、解决问题(OR=0.357)是保护因素,以上4项可预测护理硕士生心理健康变异量的36.9％.结论 护理学硕士研究生心理健康状况较好,但仍存在一些心理问题；教育者应关注年龄较小、自费的学生群体,在护理学硕士研究生教育中,需注重培养其成熟的应对方式.     

Implementation of Robert's Coping with Labor Algorithm© in a large tertiary care facility

Objectiveto implement use of Roberts’ Coping with Labor Algorithm^© (CWLA) with laboring women in a large tertiary care facility.Designthis was a quality improvement project to implement an alternate approach to pain assessment during labor. It included system assessment for change readiness, implementation of the algorithm across a 6-week period, evaluation of usefulness by nursing staff, and determination of sustained change at one month. Stakeholder Theory (Friedman and Miles, 2002) and Deming's (1982) Plan-Do-Check-Act Cycle, as adapted by Roberts et al (2010), provided the framework for project implementation.Settingthe project was undertaken on a labor and delivery (L&D) unit of a large tertiary care facility in a southwestern state in the USA. The unit had 19 suites with close to 6000 laboring patients each year.Participantsfull, part-time, and per diem Registered Nurse (RN) staff (N=80), including a subset (n=18) who served as the pilot group and champions for implementing the change.Findingsa majority of RNs held a positive attitude toward use of the CWLA to assess laboring women's coping with the pain of labor as compared to a Numeric Rating Scale (NRS). RNs reported usefulness in using the CWLA with patients from a wide variety of ethnicities. A pre-existing well-developed team which advocated for evidence-based practice on the unit proved to be a significant strength which promoted rapid change in practice.Implications for practicethis work provides important knowledge supporting use of the CWLA in a large tertiary care facility and an approach for effectively implementing that change. Strengths identified in this project contributed to rapid implementation and could be emulated in other facilities. Participant reports support usefulness of the CWLA with patients of varied ethnicity. Assessment of change sustainability at 1 and 6 months demonstrated widespread use of the algorithm though long-term determination is yet needed.     

灼口综合征患者心理健康状况及相关因素分析

目的:探讨灼口综合征患者心理健康状况及相关因素。方法:采用抑郁自评量表(SDS)、焦虑自评量表(SAS)、艾森克人格问卷简式量表中国版(EPQ-RSC)以及医学应对方式问卷(MCMQ)对60例灼口综合征患者和对照组进行测评。结果:灼口综合征患者抑郁、焦虑情绪明显高于对照组,"回避"和"屈服"应对方式与抑郁情绪呈正相关;精神质、神经质和掩饰性人格与抑郁、焦虑情绪呈正相关。结论:灼口综合征患者并发较高程度的抑郁、焦虑症状,同时不同人格类型与应对方式对其焦虑、抑郁有较大影响。     

The phenomenology of the first panic attack in clinical and community-based samples

The purpose of the study was to contrast first panic attacks (PAs) of patients with panic disorder (PD) with vs. without agoraphobia and to explore differences between first PAs leading to the development of PD and those that remain isolated. Data were drawn from a community survey (N = 2259 including 88 isolated PAs and 75 PD cases). An additional sample of 234 PD patients was recruited in a clinical setting. A standardized interview assessed the symptoms of the first PA, context of its occurrence and subsequent coping attempts. Persons who developed PD reported more severe first PAs, more medical service utilization and exposure-limiting coping attempts than those with isolated PAs. The context of the first PA did not differ between PD and isolated PAs. PD with agoraphobia was specifically associated with greater symptom severity and occurrence of first attacks in public. Future research should validate these findings using a longitudinal approach.     

Implementing Non-violent Resistance,a Method to Cope with Aggression in Child and Adolescent Residential Care: Exploration of Staff Members Experiences

Staff members in residential care for youth are frequently confronted with aggressive behaviour, which has adverse effects on their stress levels and work satisfaction. This paper describes a qualitative evaluation to find out how staff members benefit from Non-violent Resistance (NVR), a method to create an aggression mitigating residential climate. Staff members were positive about NVR and reported feeling more relaxed. Most valued aspects of this method were the focus on being a team, delayed response and giving up the illusion of control. However, training and the intention to use NVR isn't enough, high quality implementation and maintenance are crucial.     

Climate anxiety: Psychological responses to climate change

Climate change will affect psychological wellbeing. Substantial research has documented harmful impacts on physical health, mental health, and social relations from exposure to extreme weather events that are associated with climate change. Recently, attention has turned to the possible effects of climate change on mental health through emotional responses such as increased anxiety. This paper discusses the nature of climate anxiety and some evidence for its existence, and speculates about ways to address it. Although climate anxiety appears to be a real phenomenon that deserves clinical attention, it is important to distinguish between adaptive and maladaptive levels of anxiety. A focus on individual mental health should not distract attention from the societal response that is necessary to address climate change.     

分析外科护理中的潜在风险及应对策略

目的：分析外科护理中的潜在风险及应对策略。方法收集外科的200例患者作为护理组、200例患者作为对照组，总结出外科护理中的潜在风险，并提出相应的安全护理措施。结果实现安全护理措施后，护理组安全意外事件发生率为0.2％，明显低于对照组的0.8%，两组对比差异显著，具有统计意义（P＆lt;0.05）。结论研究外科护理中的潜在风险及应对策略，有利于提高患者及家属对护理的满意度，降低医疗纠纷的发生率。     

门诊西药房退药原因分析与应对策略

目的 通过对本院门诊西药房退药情况进行调查分析,提出应对策略,减少和规范退药。方法 对门诊退药处方进行统计分析,探讨应对策略。结果 退药原因排在前三位的分别是处方错误、患者拒用、不良反应,共110人次,占全部退药的61.7%。结论 退药现象不可避免,应针对原因,完善制度,减少和规范退药。     

Spirituality and Emotional Distress Among Lung Cancer Survivors

BackgroundEmerging research is highlighting the importance of spirituality in cancer survivorship as well as the importance of early distress screening. The purpose of this study was to prospectively examine the relationships among spirituality, emotional distress, and sociodemographic variables during the early period of lung cancer survivorship.Patients and MethodsEight hundred sixty-four lung cancer survivors completed the Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being, and the Short-Form-8 for emotional distress within the first year after lung cancer diagnosis, and 474 of these survivors completed the survey again 1 year later.ResultsAt baseline, spirituality was associated with lower prevalence of emotional distress, being married, fewer years of cigarette smoking, and better Eastern Cooperative Oncology Group performance status. Additionally, high baseline spirituality was associated with lower rates of high emotional distress at 1-year follow-up.ConclusionThese findings suggest that spirituality might serve as a protective factor for emotional distress among lung cancer survivors. Further research is warranted to explore the role of spirituality in promoting distress management among lung cancer survivors.