首次确诊帕金森病患者情绪和认知功能障碍的关系

目的观察研究首次确诊帕金森痛患者情绪和认知功能障碍之间的关系。方法60例首次确诊帕金森病（PD）患者,采用简易智能状态检查量表（MMSE）和词ir-流畅性测验评定患者的认知功能;采用汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA）评定患者的情绪障碍。采用统一帕金森病评分量表（UPDRS）和改良Hoehn—Yahr分级评定患者的帕金森病严重程度。结果（1）60例首次确诊PD患者改良H0ehn～Yahr分级显示：I级11例,Ⅱ级32例,Ⅲ级16例,Ⅳ级1例。其中具有抑郁障碍患者28例,占46．7％;具有焦虑障碍患者20例,占33．3％,20例焦虑障碍PD患者都具有抑郁障碍。（2）60例首次确诊PD患者中,具有认知功能障碍患者23例,占38．3％;MMSE评分和词汇流畅性测验评分均与病程呈负相关,差异具有统计学意义（r分别为-0．42,-0．46;P〈0．05）。（3）60例首次确诊PD患者HAMD评分和MMSE评分及词汇流畅性测验评分呈负相关,差异具有统计学意义（r分别为-0．69,-0．76;P〈0．01）。PD患者HAMA评分和MMSE评分及词汇流畅性测验评分亦呈负相关,差异具有统计学意义（r分别为～0．60,-0．68;P〈0．01）。结论首次确诊PD患者多为轻、中度患者,早期即表现情绪障碍和认知功能障碍,且两者具有高度相关性。     

Psychosocial Development in South Korean Couples and Its Effects on Marital Relationships

This study explored psychosocial development in South Korean couples and its impact on their marital satisfaction and marital crisis. A sample of 100 cohabiting married Korean couples (n?=?200) and 100 premarital couples (n?=?200) participated in this study. Findings showed that partners in same-couple relationships were more likely to reach the same stages of psychosocial development. Married couples displayed different levels of marital satisfaction and marital crisis depending on which stage of psychosocial development they found themselves in. The results of this study also revealed that partners who successfully resolved psychosocial developmental tasks and conflicts had higher marital satisfaction and lower marital crisis. Implications for practice and future research are discussed.     

Imago Dialogues

Fathers have been excused from involvement with their families because of traditional gender roles, which invite fathers to be more involved with work and somewhat less involved with the emotional well-being of his family. Family therapy is often no exception to fathers' lack of participation in the family. Family therapists, however, are calling for inclusion of fathers in family therapy. This is occurring because most therapists prefer to have as many family members involved in therapy as possible, and because the feminist movement has called for family therapists to reject the "status quo," in this case, lack of fathers involvement in family therapy. Lastly, there is some empirical evidence that fathers inclusion in therapy improves the outcome of family therapy. This paper is written in response to these changes, so that therapists may gain insight into ways they can involve fathers in family therapy.     

A comparison of client and therapist goals for people with aphasia: A qualitative exploratory study

Background: A considerable body of literature attests to the efficacy of client and therapist collaborative goal setting to achieving optimal rehabilitation outcomes. Collaborative goal setting and shared decision making relies on good communication, thus potentially disadvantaging people with aphasia.

Aims: This study aims to identify the similarities and differences between client goals and therapist goals in rehabilitation for people with aphasia and to explore reasons why any differences occur.

Methods & Procedures: Three speech-language pathologists and four people with aphasia participated in in-depth semi-structured interviews to identify rehabilitation goals. All the interviews were transcribed and analysed using qualitative content analysis.

Outcomes & Results: Results indicated both matching and mismatching of goals between the clients and the speech-language pathologists. Matched goals tended to focus on communication outcomes. Mismatched goals were those associated with the client's desire to return to previously valued activities. Reasons for the mismatching included: impaired communication made collaboration on goal setting difficult, the service-delivery approach, the goal was perceived to be outside the speech-language pathologist's scope of practice, and the goal was not considered to be appropriate within the confines of the rehabilitative situation.

Conclusions: This study highlights the need for speech-language pathologists to understand their clients' goals and how these can be incorporated into rehabilitation. A re-examination of some professional beliefs was highlighted. Future research may lead to educational resources that enable better collaborative goal setting between therapist and client so that outcomes of rehabilitation are optimised.     

2006年青岛市35岁以上人群腰围与糖耐量调查及3年后转归情况分析

[目的]了解35岁以上人群腰围与糖耐量情况,探讨影响糖耐量正常人群糖耐量转归的因素,为糖尿病预防提供科学依据。[方法]在青岛市城乡选取2006年糖耐量正常的684名35～74岁人群,测量其腰围值,3年后进行随访。[结果]2006年684名糖耐量正常者中,腹型肥胖罹患率为53.22%。3年后随访上述684人,IGR累积发病率为28.07%,其中腹型肥胖组为34.89%,腰围正常组为20.31%(P<0.01);DM累积发病率为3.51%,其中腹型肥胖者为4.67%,腰围正常组为2.19%(P>0.05)。684人中,2006年腰围为82.38±9.23cm,2009年腰围为85.29±9.45cm(P<0.01)。多因素非条件Logistic回归分析结果,影响糖耐量情况的因素有收缩压(SBP)、腰围(WC)、低密度脂蛋白胆固醇(LDL)、总胆固醇(TC)、尿酸(UA),OR值分别为1.011、1.047、0.643、1.584、1.003。[结论]腹型肥胖者较腰围正常者易发生IGR;收缩压高、腰围值高、低密度脂蛋白胆固醇含量低、总胆固醇含量高、尿酸高的人容易转归为IGR和/或DM。     

同型半胱氨酸和尿酸水平与中老年人冠心病的相关性

目的探讨同型半胱氨酸（HCY）和尿酸（uA）水平与中老年人冠心病的关系。方法将218例患者根据冠脉造影结果分为冠心病组和正常对照组,并根据年龄分为中年冠心病组（61例）和对照组（39例）及老年冠心病组（77例）和对照组（41例）,分别采用免疫荧光偏振法和氧化酶法测定血清HCY和UA的水平。结果中年和老年冠心病组血清HCY、uA水平均高于各自对照组,差异均有统计学意义（P〈0．01或P〈0．05）,且中年冠心病组HCY、UA水平均高于老年冠心病组,差异均有统计学意义（P〈O．01或P〈0．05）。多因素Logistic回归分析显示,HCY、UA是中年冠心病患者的独立危险因素（P〈0．01或P〈0．05）;高血压、糖尿病是老年冠心病患者的独立危险因素（P〈0．05）。结论高HCY、高UA是中年人冠心病发生的独立危险因素。     

胆囊切除术后胆流动力学改变与大肠癌关系探讨

目的探讨胆囊切除术后胆流动力学改变与大肠癌发病关系及机制。方法将130例胆道结石手术患者随机分为对照组65例(胆囊切除术胆总管探查术);观察组65例(胆总管切开取石术),采用胆道测压技术检测两组患者,术中、术后1、5、10、15d胆流压力及胆酸水平变化、随访两组患者5年、对照两组患者结肠癌发病率。结果两组术中胆流压力及胆酸水平比较(t=3.22、2.11,P>0.05,无显著性差异);两组术后1、5、10、15d胆流压力水平比较(t=5.11、5.25、5.36、5.88,P<0.05,具有显著性差异);两组术后1、5、10、15d胆酸水平比较(t=5.01、5.25、5.16、5.38,P<0.05,具有显著性差异);两组患者5年后大肠癌发病率比较(χ2=4.78,P<0.05,具有显著性差异)。结论胆囊切除术后胆流动力学改变后可使胆酸水平升高,可能是诱发大肠癌高危因素之一。     

门诊导医护士人际沟通能力的调查分析

目的:通过调查门诊导医护士对人际沟通的认知及应用情况以提高医疗服务质量,营造和谐的护患关系.方法:随机抽取成都市四家三级甲等医院门诊导医护士30名,采用自制问卷进行调查及面对面访谈.结果:在工作中80.00%的护士会比较注意语言规范及相关礼仪,但仍有50.00%的护士不会主动运用沟通技巧.导医工作中产生误解的情况占到了被调查者的93.33%,其中43.33%的护士归因于咨询者文化水平和理解能力有限,认为是自己表达不清或护患沟通不畅的占36.66%.对于人际沟通大部分护士只有模糊的概念,不能全面地了解沟通的相关内涵.在提高自身人际沟通能力上不主动,原因主要为工作繁忙和资源的缺乏.结论:医院及有关职能部门应从多方面入手提高门诊导医护士的综合素质及人际沟通能力,使其在更好地服务患者的同时营造良好的护患关系,提高护理服务质量.     

高龄老年人睡眠质量与认知功能的相关性分析

目的检查高龄离退休老年人睡眠质量及认知功能,并分析两者相关性。方法利用蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)、简易智能状态量表(mini-mental state examination,MMSE)、匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI),检查325例高龄离退休老年人睡眠质量及认知功能,分析评估其相关关系。结果 325例PSQI平均得分为(5.66±4.27)分,睡眠障碍102例,发生率为31.38%。认知损害95例,发生率29.23%;其中,轻度认知障碍(mild cognitive impairment,MCI)82例,患病率25.23%;阿尔茨海默病13例,患病率4.00%。睡眠障碍组认知损害患病率增加(χ2=12.544,P=0.002)。睡眠质量指数得分与蒙特利尔认知评估量表得分呈负相关(r=-0.194,P<0.05)。部分PSQI子项目与视空间、注意力、语言、延迟回忆、定向力等认知功能呈负相关关系(P<0.05)。结论高龄离退休老年人睡眠质量较差,睡眠质量与认知损害存在相关性。