宫颈癌患者配偶照顾疲劳感及影响因素的研究

目的 探讨宫颈癌患者配偶的照顾疲劳感并分析其影响因素。方法 采用疲劳量表、照顾者压力量表、简易应对方式问卷对240名宫颈癌患者配偶进行调查。结果 宫颈癌患者配偶照顾疲劳总分为（8.92±1.64）分,85.00%的宫颈癌患者配偶处于中度、重度疲劳;与癌症患者配偶相比,躯体疲劳、心理疲劳及疲劳总分均高于癌症患者配偶且有统计学意义。其疲劳感受照顾时间、应对方式、身体心理健康状况及社交经济状况的影响。结论 宫颈癌患者配偶照顾疲劳感发生率高,临床医护人员应针对配偶照顾疲劳感的影响因素,对其实施有针对性的健康教育指导和干预措施,以减轻宫颈癌患者配偶照顾疲劳感,提高其生活质量及身心健康,进而提高对患者的照顾质量,促进患者疾病的康复。     

无精子症患者配偶性生活质量的探讨

目的探讨无精子症患者配偶的性生活质量。方法选择自愿接受性生活质量问卷调查的64例不孕女性,按其男方精液质量进行分组,无精子症组28例为研究组,精液正常因输卵管因素就诊者36例为对照组,调查2组配偶性生活质量及男性性功能状况。结果64例女性性生活质量与职业及文化程度无关,无精子症组配偶性生活总体满意度、同房时间低于对照组,差异有统计学意义（P〈0.05）;同房频率、性冷淡发生率高于对照组,差异有统计学意义（P〈0．05）。结论无精子症患者配偶性生活满意度相对较低,应积极改善不孕不育患者性心理状况。     

心理干预对乳腺癌术后患者及其配偶生活质量的影响

目的探讨心理干预对乳腺癌术后患者及其配偶生活质量的影响,以期提高乳腺癌患者术后生活质量。方法将60例需行手术治疗的乳腺癌患者随机分为干预组和对照组各30例,其配偶按照患者分组同时一一对应分为干预配偶组及对照配偶组,对照组采取常规护理,对照组及其配偶在常规护理基础上进行心理干预,于人院时及术后3个月时分别进行生活质量综合评定问卷调查（GQOLI-74量表）。结果入院时两组患者及其配偶GQOLI-74量表躯体功能、心理功能、社会功能、物质功能维度评分及总分比较差异无统计学意义（P〉0．05）,但术后3个月时两组患者的躯体功能、心理功能、社会功能、物质功能维度评分及总分均高于入院时（P〈0．05）,配偶心理功能、物质功能维度评分及总分也高于入院时（P〈0．05）,干预组患者及其配偶的生活质量改善程度优于对照组及其配偶（尸〈O．05）。结论对乳腺癌手术患者及其配偶进行个性化的心理干预有助于提高患者及其配偶后期的生活质量。     

Knowledge about diabetes in type 1 patients is related to metabolic control

Twenty-five Type 1 diabetic patients and their spouses attending a diabetes clinic completed the recently developed CCQ-1 questionnaire, which assesses knowledge about the disease. Questionnaires were completed in the presence of a clinical psychologist. Glycosylated haemoglobin concentration was inversely correlated with patient scores for general management (r = -0.69, p less than 0.001), insulin (r = -0.66, p less than 0.001), home monitoring (r = -0.53, p less than 0.01), and overall knowledge (r = -0.55, p less than 0.01), but not for diet and footcare. No association was found between patients' metabolic control and scores among spouses, who knew significantly less about the disease than the patients themselves. The strength of the associations found supports the use of well-designed psychological instruments in diabetes research.     

中青年恶性肿瘤生存者配偶家庭适应性现状及影响因素研究

目的：探讨中青年恶性肿瘤生存者配偶家庭适应性现状及其影响因素,为增强其家庭适应能力提供理论依据。方法：采用一般资料调查表、中文版家庭适应性量表、家庭复原力评定量表及ZBI照顾者负担量表对282名中青年恶性肿瘤生存者的配偶进行调查。结果：中青年恶性肿瘤生存者配偶的家庭适应性得分中位数为54(49,58)分;家庭复原力得分为（199.05±21.26）分;照顾负担得分中位数为27(17,41)分。中青年恶性肿瘤生存者配偶的家庭适应性与家庭复原力呈正相关（r=0.584,P<0.001）,与照顾负担呈负相关（r=-0.284,P<0.001)。多元线性回归分析结果显示,家庭复原力的2个二阶维度即家庭信念和家庭力量、肿瘤生存者职业(无固定职业)、肿瘤生存者疾病类型(肺部肿瘤、头颈部肿瘤)及家庭人均月收入可共同解释肿瘤生存者配偶家庭适应性的57.2%的变异量。结论：中青年恶性肿瘤生存者配偶的家庭复原力可影响其家庭适应性,建议医护人员注重提升中青年肿瘤生存者配偶的家庭复原力,帮助其积极寻求解决问题的方法,调动家庭内部沟通、合作协调能力,保持家庭生活秩序及家庭成员间的亲密度,关注配偶的照...     

Partner responses to patient pain and well behaviors and their relationship to patient pain behavior, functioning, and depression

The goals of the current study were to examine the associations between patient-reported spouse responses to pain and well behaviors as assessed by the Spouse Response Inventory (SRI) [22] and (1) patient-reported pain behavior, (2) depression, and (3) physical dysfunction, independent of patient demographics and pain severity. Moreover, we sought to examine the potential moderating influence of marital satisfaction on these relationships. We also evaluated the construct and concurrent validity and internal reliability of the SRI. The findings indicate that encouragement of well behaviors is related to lower levels of patient-reported pain behaviors, while negative responses to well behavior is related to greater patient physical dysfunction. Likewise, higher levels of negative responses to pain behaviors, as well as higher levels of solicitous responses to pain behaviors are generally related to poorer patient functioning. Furthermore, marital satisfaction did not moderate the relationship between any SRI subscales and patient-reported pain behaviors. In summary, our results support the internal reliability and validity of the SRI scales as measures of spousal responses to both pain and well behaviors. The current study also supports the importance of examining the potential impact of responses to both well and pain behaviors. Further research is needed to examine the potential impact of other contextual variables and marital satisfaction on the relationship of spouse responses to both well and pain behaviors.     

围手术期乳腺癌患者配偶生存质量与心理应激的相关性

目的调查围手术期乳腺癌患者配偶的生存质量及心理应激水平,并分析其生存质量与心理应激的相关性。方法采用自制的一般资料问卷、WHO生存质量测定简表（WHOQOL—BREF）和亲属应激量表（RSS）对110名围手术期乳腺癌患者的配偶进行问卷调查,分析其生存质量与心理应激的相关性。结果共发放问卷110份,回收有效问卷102份,有效回收率为92．73％。围手术期乳腺癌患者配偶生存质量生理领域、心理领域、社会关系领域和环境领域的得分分别为（13．34±1．88）,（13．95±2．63）,（13．61±2．45）,（12．22±2．47）分,RSS总分为（11．16±4．69）分;围手术期乳腺癌患者配偶的WHOQOL—BREF各领域得分与RSS总分、与患者关系中所体验的心理痛苦因子及生活被扰乱的程度因子得分呈负相关（P〈0．05）,而仅心理领域和社会关系领域得分与因患者出现负性情感的程度因子得分呈负相关（P〈0．05）。结论围手术期乳腺癌患者配偶的生存质量与其心理应激水平存在负相关。     

恶性肿瘤患者配偶心理体验的质性研究

目的了解恶性肿瘤患者配偶在陪伴照护患者治疗过程中的真实心理感受。方法采用现象学研究法对17例恶性肿瘤患者配偶进行深入访谈,将获得的资料分析整理,提炼出主题。结果恶性肿瘤患者配偶的心理体验主要有三方面,确诊初期有否认、焦虑、不知所措;中期表现适应、接受并有巨大压力;晚期有悲伤、不确定感和丧失感。结论在护理恶性肿瘤患者的同时,需关注其配偶的心身健康,提供心理支持。     

2017 Alzheimer's disease facts and figures

This article describes the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality rates, costs of care, and the overall impact on caregivers and society. The Special Report examines how the use of biomarkers may influence the AD diagnostic process and estimates of prevalence and incidence of the disease. An estimated 5.5 million Americans have Alzheimer's dementia. By mid-century, the number of people living with Alzheimer's dementia in the United States is projected to grow to 13.8 million, fueled in large part by the aging baby boom generation. Today, someone in the country develops Alzheimer's dementia every 66 seconds. By 2050, one new case of Alzheimer's dementia is expected to develop every 33 seconds, resulting in nearly 1 million new cases per year. In 2014, official death certificates recorded 93,541 deaths from AD, making AD the sixth leading cause of death in the United States and the fifth leading cause of death in Americans age ≥65 years. Between 2000 and 2014, deaths resulting from stroke, heart disease, and prostate cancer decreased 21%, 14%, and 9%, respectively, whereas deaths from AD increased 89%. The actual number of deaths to which AD contributes is likely much larger than the number of deaths from AD recorded on death certificates. In 2017, an estimated 700,000 Americans age ≥65 years will have AD when they die, and many of them will die because of the complications caused by AD. In 2016, more than 15 million family members and other unpaid caregivers provided an estimated 18.2 billion hours of care to people with Alzheimer's or other dementias. This care is valued at more than $230 billion. Average per-person Medicare payments for services to beneficiaries age ≥65 years with Alzheimer's or other dementias are more than three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 23 times as great. Total payments in 2017 for health care, long-term care, and hospice services for people age ≥65 years with dementia are estimated to be $259 billion. In recent years, efforts to develop and validate AD biomarkers, including those detectable with brain imaging and in the blood and cerebrospinal fluid, have intensified. Such efforts could transform the practice of diagnosing AD from one that focuses on cognitive and functional symptoms to one that incorporates biomarkers. This new approach could promote diagnosis at an earlier stage of disease and lead to a more accurate understanding of AD prevalence and incidence.     

A broader perspective on education and mortality: Are we influenced by other people's education?

The objective of this study was to find out whether the educational achievements of family members and people in the municipality have an impact on a person's mortality, net of the well-known strong influence of his or her own education. Using register data, discrete-time hazard models for all-cause mortality in 1980-2003 were estimated for all Norwegian men and women born between 1950 and 1973 (i.e. age 30-53). There were 23,692 deaths during the 19.1 million person-years of follow-up. The education of a former or current spouse had the clearest beneficial effect, although own education was more important. Mortality was also negatively associated with the education of the oldest sibling and to a lesser extent with that of the sibling-in-law and father-in-law. The average education in the municipality was not generally related to mortality, but a beneficial effect was seen among men with college education. In contrast to this, parents' education affected mortality adversely, especially among women. The data did not allow causal pathways to be identified, but possible mechanisms were discussed. For example, it was argued that others' education may affect mortality favourably through transmission of knowledge, imitation of behaviour, economic support, and the quality of health services. In some societies, childhood health might also be an issue. On the other hand, having better-educated family members or living in a community with many better-educated people, who typically also have higher incomes, may trigger psychosocial stress. However, one should be careful to interpret the observed relationships as reflecting purely causal effects. Various unobserved factors may influence the person's choice of spouse and place of residence as well as mortality, and having parents with higher (lower) education may signal that the person has had special problems (resources) during childhood or adolescence, which also may have implications for later health.