军事飞行员生活事件量表的编制

目的 根据军事飞行员的职业特点，编制适用于该群体的生活事件量表，建立军事飞行员群体心理负荷的来源及其强度的标准化测量工具。方法 为确定量表结构分别采用三个同质样本(n=152、n2=157和n3=437)进行了项目施测。其中前两个样本作为项目甄选的预测样本，进行二次项目增减，同时采用20人分组讨论的形式对项目进行了反复修订。在项目选择上，采用职业应激事件与一般性生活事件相结合的构念，尽可能涵盖与军事飞行员工作及生活密切相关的特殊生活事件。在质的研究基础上，对正式施测的437名被试的数据进行统计分析。结果 军事飞行员生活事件量表共有六个分量表，包含36个项目。经检验，其信度和效度的各项指标均达到了心理测量学的要求。结论 该量表尚有待进一步扩大样本进行更严格的检验。     

改进原位肛门整形重建术的临床研究

目的探讨采用改进的四联术原位肛门整形重建术的效果。方法38例低位直肠癌行Miles根治术后行一期改进的四联术原位肛门整形重建术,改进包括:①肛门内括约肌改进为双层双套环;②肛门外括约肌改进为肛门外括约肌浅部与深部重建;③直肠角改进为肛提肌切缘牢固地缝合于肛门括约肌外面与结肠前壁;④直肠瓣改进为三个人工直肠瓣。结果38例术后肛门外形、功能及远期生存率均更为优良,术后肛门功能测试的总优良率达94·73%,远期生存率高达76·32%。结论改进的四联术原位肛门重建术的效果良好,改进术式的设计也更符合正常解剖结构与生理功能。     

滥用药物与生命质量退化的伦理思考

本文从生命质量的内涵入手,分析了滥用药物的直接和间接、近期和远期的危害,通过论证得出了滥用药物必将引起人类生命质量退化的结论.以期从一个新的认识度唤起人们对滥用药物问题的重视、并由此引出了一些对医学目的以及滥用药物控制措施的思考.     

西雅图心绞痛调查量表对冠心病患者机体功能及生活质量的评估研究

目的对冠心病患者机体功能状态及生活质量进行评估。方法采用Ｓｐｅｔｕｓ等设计的ＳｅａｔｔｌｅＡｎｇｉｎａＱｕｅｓｔｉｏｎｎａｉｒｅ问卷对１００例冠心病患者躯体活动受限程度、心绞痛稳定状态及发作情况、治疗满意程度和疾病认识程度进行测评研究。结果重复测定显示该量表有良好的重复性，心理疗法配合药物治疗组的评分明显优于单纯药物治疗组（Ｐ＜０．０５）。结论该量表用于我国冠心病患者有较满意的信度，同时也证实了心理疗法在冠心病治疗中的重要地位。     

Life satisfaction in patients with chest pain subsequently diagnosed as coronary heart disease – connection through depressive symptoms?

The aim of this study was to investigate factors associated with life dissatisfaction in symptomatic patients (n = 144) with chest pain subsequently diagnosed as coronary heart disease (CHD) by coronary angiography. Life dissatisfaction was assessed with a four-item life satisfaction scale (LS), depression with the 21-item Beck Depression Inventory (BDI) and other psychiatric symptoms with the symptom check list (SCL). DSM-III-R Axis I and Axis II psychiatric diagnoses were performed by means of the Structured Clinical Interview. All assessments took place one day before angiography. Twenty-four per cent of CHD patients were dissatisfied with their lives. Life dissatisfaction was associated with being unmarried. Dissatisfied patients had Axis I mental disorders and Axis II personality disorders more frequently than others. Psychiatric and depressive symptoms according to the SCL and BDI, respectively, were also higher among dissatisfied patients. In multiple logistic regression analyses, mental disorders were related to life dissatisfaction when age, sex, employment status, New York Heart Association class, duration of chest pain symptoms and work load were controlled in the model. Married subjects had a lower probability of being dissatisfied with their lives than other subjects (Odds Ratio, OR: 0.23). When BDI scores were included in the model, the only factor independently associated with life dissatisfaction was the severity of depressive symptoms (OR: 1.81). To conclude, life dissatisfaction is not primarily determined by the severity of CHD but by the existence of depressive symptoms.     

The Relative Contribution of Domains of Quality of Life to Overall Quality of Life for Different Chronic Diseases

This study examined the contribution of the quality of life (QoL) domains physical, social and psychological functioning to the explanation of overall QoL. Various disorders may differentially affect QoL domains due to disease-specific factors and, consequently, the relationship between QoL domains and overall QoL may vary between diseases. We therefore studied this relationship for several diseases as well as the differential impact of these diseases on QoL. The present study had a cross-sectional design. We selected patients (aged 57 years and older) with one of the following eight chronic medical conditions: lung disorder, heart condition, hypertension, diabetes mellitus, back problems, rheumatoid arthritis, migraine, or dermatological disorders. The total group of respondents included 1457 patients and 1851 healthy subjects. Regression analyses showed that the domain of psychological functioning contributed to overall QoL for all disorders, whereas physical and social functioning contributed to overall QoL for some disorders. Differences were found between most patient groups and healthy subjects with respect to physical functioning; with respect to social and psychological functioning some groups differed from the healthy group. Explanations for the findings and implications for clinical practice are discussed.     

应激相关因素对护士生活质量作用模型的理论构建和结构方程分析

目的应用结构方程分析研究应激相关因素对护士生活质量的影响机制。方法通过随机抽样,采用生活质量综合评定问卷、压力反应问卷、生活事件量表、特质应对方式问卷、领悟社会支持量表、艾森克人格问卷对405名护士进行调查,并应用结构方程分析方法对其作用机制进行探索。结果在5个理论可行的竞争模型中获取了最佳模型(CMINDF2.344;GFI0.928;AGFI0.891;CFI0.945;RMSEA0.060),即应激相关5因素(压力反应、生活事件、社会支持、应对方式和个性特征)中除应对方式外均能直接影响生活质量,而应对方式则以其他应激相关因素为中介对生活质量产生间接影响,这5个因素均可互为中介对护士生活质量产生间接作用。结论结构方程分析方法证实应激对护士生活质量的影响是一个交叉作用系统,在干预应激对护士生活质量的影响时应综合运用直接和间接方法。     

对构建特色医院文化的思考

21世纪的医院是文化的医院,21世纪医院的竞争是文化的竞争,谁能构建出具有特色的医院文化,谁就能赢得竞争主动权。构建特色医院文化,核心是形成共同的理想和精神支柱;关键是打造“学习型”医院组织;根本是树立以人为本、诚信求实的服务理念;目标是树立良好的医院形象;基础是加快医院信息化建设。     

强迫症患者的防御机制、父母教养方式及个性特征的调查分析

目的　探讨强迫症患者的防御机制、父母教养方式及其个性特征。方法　采用防御方式问卷 (DSQ)、父母养育方式评价量表 (EMBU)及艾森克个性问卷 (EPQ)对 36例强迫症患者进行了问卷调查 ,并与 36例正常受试者加以比较。结果　①强迫症组中间型和不成熟防御机制因子分均明显高于正常对照组 (P <0 0 1) ,而成熟防御机制因子分则明显低于正常对照组 (P <0 0 5 ) ;②强迫症组父母的情感温暖因子分低 ,而父母的惩罚、拒绝因子分和母亲的偏爱被试因子分高 ,同正常对照组比较 ,差别均具有显著性或非常显著性意义 (P <0 0 1或P <0 0 5 ) ;③强迫症组EPQ的N因子分明显高于正常对照组 ,而E因子分则明显低于正常对照组 (P <0 0 1)。结论　强迫症患者的防御机制、父母教养方式及个性特征与正常人有着明显的不同 ,它为今后开展分析性心理治疗 ,实施心理干预措施提供了依据。     

口腔医学专业学生认知风格与口腔正畸学学习成绩关系的研究

目的提出对学习策略和教学方式的改进建议。方法测试口腔医学生的场依存/独立认知风格,并用统计学方法分析其与口腔正畸学学习成绩的关系。结果①场独立认知风格是口腔医学专业学生认知风格的主体;②不同性别口腔医学专业学生的场依存/独立认知风格无显著性差异;③学生场依存/独立认知风格与口腔正畸学理论考试成绩有负相关倾向,与口腔正畸学实习操作成绩有正相关倾向。结论学习策略和教学方式因受认知风格的影响而制约学生学习的效果。