广州市脑卒中患者病耻感量表的常模构建

目的建立广州市脑卒中患者病耻感量表的常模,为评估脑卒中患者病耻感水平提供参考。方法采用区域分层随机抽样法选取广州市6个行政区域的1464名脑卒中患者为研究对象,采用脑卒中患者病耻感量表对其进行调查。结果广州市脑卒中患者病耻感量表总分为(34.11±19.78)分,各维度得分:躯体障碍得分为(39.11±25.36)分、社会交往得分为(41.99±26.78)分、受歧视经历得分为(18.96±18.37)分、自我感受得分为(37.50±24.09)分;以性别、卒中发生次数、是否需要照顾者、年龄组、卒中类型及病程建立分类常模,并分别以P25,、P 50、P75、P95为界将脑卒中患者病耻感量表总分从高到低依次划为非常高、高、中等、较低和低5种状态。结论针对脑卒中患者病耻感量表建立的常模具有良好的代表性,可以作为广州市脑卒中患者病耻感测评的参考标准。     

同伴支持教育联合思维导图护理对乳腺癌根治术患者病耻感及癌因性疲乏的影响

目的分析同伴支持教育联合思维导图护理对乳腺癌根治术患者病耻感及癌因性疲乏的影响。方法选取2017年5月至2019年5月在本院行手术治疗的乳腺癌患者96例为研究对象,随机将其等分为对照组和观察组,对照组给予常规护理,观察组在对照组基础上给予同伴支持教育联合思维导图护理,比较干预前后两组患者病耻感与癌因性疲乏评分改变情况。结果干预后两组患者癌因性疲乏和病耻感评分低于治疗前且观察组评分低于对照组,差异有统计学意义(P<0.05)。结论同伴支持教育联合思维导图护理可有效改善乳腺癌根治术患者病耻感及癌因性疲乏评分,提高患者心理健康水平,值得推广应用。     

伤残接受度与心理弹性对喉癌永久性气管造瘘患者病耻感影响的路径分析

目的探讨伤残接受度与心理弹性对喉癌永久性气管造瘘患者病耻感影响,并分析其影响路径。方法采用便利抽样法,选取2016年6—2018年8月在广西医科大学附属肿瘤医院住院部及门诊部就诊的喉癌永久性气管造瘘患者264例为研究对象。采用社会影响量表(SIS)、伤残接受度量表(AODS)、心理弹性量表(CD-RISC10)对其进行调查,对三者进行相关性分析并建立结构方程模型进行路径分析。发放264份调查问卷,有效回收256份。结果256例永久性气管造瘘患者病耻感、伤残接受度、心理弹性总分分别为(61.50±9.27)、(76.88±9.34)、(26.49±4.05)分。相关性分析显示,伤残接受度、心理弹性得分与病耻感呈负相关(P<0.01)。结构方程模型分析表明,喉癌气管造瘘患者伤残接受度和心理弹性对病耻感具有直接效应(β值分别为-0.43、-0.28),伤残接受度通过心理弹性间对病耻感的间接效应为-0.06。结论喉癌永久性气管造瘘患者病耻感水平较高,伤残接受度与心理弹性对病耻感有显著预测作用。     

Non-traumatic lower limb older amputees: a database survey from a geriatric centre

Purpose: The purpose of this survey was to examine the characteristic of a geriatric population admitted for amputation of a lower limb and to explore some of the factors that may affect the course of their hospital stay. Method: The study took place in the geriatric division of a tertiary general hospital and included a close geriatric-orthopaedic liaison. Two-hundred and forty-one patients were included in the final analysis. Results: Many above knee amputations were performed, which correlated with advanced age. Rates of in hospital mortality and systemic complications were 16% and 19%, respectively. Thirty-three percent of the patients were discharged back home, and only 6% were supplied with an artificial limb. The general condition of most patients remained poor. Conclusion: We conclude that despite a team approach to the care of the geriatric amputee a poor functional result was obtained. By encouraging earlier referrals from the community it is postulated that a reduction in the costly provision of antibiotics would be beneficial and that perhaps lower levels of amputation could be performed thereby enhancing the possibilities for ambulation.     

Stigma starts early: Gender differences in teen willingness to use mental health services

PurposeTo explore gender differences and the role of stigma in teen willingness to use mental health services.MethodsSelf-administered, written questionnaires were conducted with 274 eighth graders in a suburban community in a mid-Atlantic state. Teens reported on social support for emotional concerns, mental health experience and knowledge, and stigma and barriers associated with mental health service use. Data analysis included chi-square statistics and analysis of variance (ANOVA) to examine associations between gender and independent variables of interest. Logistic regression analyses assessed the relationship of gender, stigma, and willingness to use mental health services, adjusting for race and receipt of mental health services.ResultsMore girls than boys turned to a friend for help for an emotional concern, whereas more boys turned to a family member first. Boys had less mental health knowledge and experience and higher mental health stigma than girls. In adjusted analyses, girls were twice as likely as boys to report willingness to use mental health services (odds ratio [OR] 2.45, 95% confidence interval [CI] 1.20–4.99). Parental disapproval and perceived stigma helped to explain the relationship between gender and willingness to use mental health services (OR 1.65, 95% CI .72–3.77).ConclusionsGender differences in negative mental health attitudes and willingness to use mental health services are present early in adolescence. Enhanced mental health education and services in middle school may reduce gender disparities by incorporating stigma reduction efforts that actively involve parents and address differences in knowledge and exposure to mental health issues.     

Stress, appraisal, and coping: a comparison of HIV-infected women in the pre-HAART and HAART eras

BACKGROUND: It has been widely suggested that highly active antiretroviral therapy (HAART) has improved the psychosocial aspects of living with HIV/AIDS. METHOD: A sample of 79 women living with HIV/AIDS in the pre-HAART era (1994-1996) were compared with a matched sample of 79 women with HIV/AIDS from the HAART era (2000-2003) on measures of stress, illness appraisals, and coping strategies. RESULTS: Contrary to expectations, HIV-infected women in the HAART era were significantly more likely than women in the pre-HAART era to report health-related stress, to report stress from stigma and disclosure, to view HIV as having caused them harm, to report that their health is due to chance, and to report more use of maladaptive forms of coping (e.g., escape-avoidant coping). CONCLUSION: Although HAART may have extended survival for many HIV-infected individuals, they have not resulted in equivalent psychosocial improvements. Thus, efforts are needed to address the psychosocial difficulties that HIV-infected women in the HAART era continue to experience.     

年轻流动人口对艾滋病的歧视及影响因素分析

目的:考察年轻流动人口对艾滋病的歧视及其影响因素。方法:采用问卷调查法,考察2201个年轻流动人口对艾滋病的歧视态度及其影响因素。结果:年轻流动人口对艾滋病及艾滋病人持着一定的歧视态度,表现为对艾滋病和艾滋病人的隔离、疏远和排斥态度;已婚、年龄大于25岁以及初小文化的流动人口对艾滋病的歧视更强;艾滋病知识、高危性行为和抑郁情绪与流动人口对艾滋病的歧视显著相关;在控制了人口学变量和艾滋病知识变量后,抑郁情绪仍可以显著地预测流动人口对艾滋病的歧视(β=0.08)。结论:应关注流动人口对艾滋病的歧视态度,有效的艾滋病歧视消除活动应聚焦在艾滋病知识和抑郁情绪缓解等因素上。     

Health Care Professionals Attitudes Towards Mental Illness: Observational Study Performed at a Public Health Facility in Northern Italy

The United Nations Convention on the Rights of Persons with Disabilities Defines stigma as the process of social oppression barring persons with mental illness from enjoying social interaction through discrimination, exclusion and denial of human and social rights. Modern stereotypes still portray the mentally ill as guilty, unpredictable and violent. Observational studies report how healthcare professionals, including nurses, are often part of the stigma. Such phenomenon belittles the needs of people seeking mental care. The aim of this study is to describe attitudes held by psychiatric nurses and mental care professionals from different care settings of an Italian Healthcare Facility, towards the mentally ill and to identify any associated factors. Mental health care professionals were recruited for this observational study from 10 Italian different psychiatric care units. The Italian version of the Community Attitudes Mentally Ill inventory (CAMI-I) was validated and used for this study. 120 completed questionnaires were deemed valid. Optimal internal consistency (α = 0.856) was measured by calculating Cronbach's Alpha for the CAMI-I. Demographic variables were correlated to items grouped into three factors of the CAMI-I (authoritarian attitudes, benevolence, social restrictiveness). Parametric test (ANOVA) highlight significant differences between CAMI-I results for different demographic variables. Significant data were obtained by comparing responses for each factor of the CAMI-i per professional profile. All healthcare professionals studied show sensitivity and positive attitude towards mental illness. Positive approaches to mental illness contribute towards easing therapeutic care and recovery in patient-centred care. CAMI-I will be a useful tool to identifying discriminatory approaches and sensitize health professionals in Italy.     

双相障碍抑郁患者应对方式及自我和谐对病耻感影响的路径分析

目的探讨双相障碍抑郁患者应对方式、自我和谐和病耻感之间的关系。方法采用便利抽样法,选择2017年6月—2018年12月太原市某三甲医院精神卫生科住院治疗的双相障碍抑郁患者217例,采用一般资料调查表、贬低-歧视感知量表、自我和谐量表、简易应对方式问卷进行调查。采用AMOS 22.0软件进行路径分析。结果217例患者贬低-歧视感知量表得分(30.92±6.41)分,自我和谐量表得分(101.54±16.99)分,积极应对方式得分(21.63±6.46)分,消极应对方式得分(13.36±5.03)分。Pearson相关分析显示,患者积极应对方式与自我和谐和病耻感呈负相关(r值分别为-0.748、-0.655;P<0.01);消极应对方式与自我和谐和病耻感呈正相关(r值分别为0.553、0.742;P<0.01);自我和谐与病耻感呈正相关(r=0.763,P<0.01)。中介效应检验显示,自我和谐仅在消极应对方式和病耻感之间起部分中介作用,中介效应占总效应的40.54%。结论消极应对方式不仅直接影响双相障碍抑郁患者的病耻感,还通过自我和谐间接影响其病耻感。医护人员可以开展以路径为依托的干预措施,降低双相障碍抑郁患者的病耻感。