2型糖尿病患者病耻感调查及其影响因素分析

目的探讨2型糖尿病患者病耻感现状,并分析病耻感的影响因素。方法2018年8月—2020年3月期间,采用便利抽样法,对该院就诊的135例2型糖尿病患者进行问卷调查。调查工具为一般情况调查表、2型糖尿病病耻感评估表。对病耻感的影响因素进行单因素分析和多因素分析。结果所有患者平均病耻感得分为(54.22±10.65)分。不同年龄、文化水平、是否接受胰岛素治疗、是否合并并发症等4个因素的单因素亚组分析显示,组间病耻感得分差异有统计学意义(P<0.05);采用逐步多元线性回归分析显示,只有年龄、是否合并并发症、文化水平是影响病耻感的独立因素。结论该次调查显示2型糖尿病患者普遍存在病耻感,年龄低、具有糖尿病并发症和文化水平较高的患者具有更明显的病耻感,应引起医务人员的重视,并及时给予治疗干预。     

恢复期精神分裂症加用帕罗西汀的社会功能研究

目的探讨利培酮加用小剂量的帕罗西汀对恢复期精神分裂症患者阴性症状、情绪表达、社会功能的影响。方法将71例恢复期精神分裂症患者随机分为干预组(36例)和对照组(35例)。对干预组给予利培酮加用帕罗西汀;对照组单用利陪酮。临床疗效采用阳性与阴性症状量表(PANSS)、个人和社会功能量表(PSP)作为评价指标。结果在加药后12周时,干预组的PANSS总分低于对照组(t=-5.801,P<0.001)。阳性量表分低于对照组(P<0.01);在PSP评分中,干预组的评分大于对照组评分(t=7.08,P<0.001)。组间比较,差异有显著性(P<0.01)。结论利培酮合用帕罗西汀可改善恢复期精神分裂症患者的情绪表达,减轻病耻感、焦虑情绪、增加生活动力,促进患者社会功能的恢复。     

HIV-related stigma experiences: Understanding gender disparities in Thailand

This paper assesses the relationship between gender and HIV-related stigma experiences among people living with HIV (PLHIV) – enacted and anticipated stigma – and PLHIV caregivers – courtesy stigma – in Northern Thailand, along with the underlying reasons for stigmatising attitudes towards PLHIV – instrumental and symbolic stigma – expressed in the general population. We used data from the Living With Antiretrovirals (LIWA) study conducted on all PLHIV receiving antiretroviral treatment in four district hospitals in Northern Thailand (n?=?513) and on a community sample of adults from the general population (n?=?500). Women living with HIV and female caregivers of PLHIV reported higher rates of HIV-related stigma experiences than men. Gender interacted with other predictors – the period of HIV diagnosis and age – to increase the level of stigma experienced. Among the general population, attitudes of contact avoidance were infrequent. However, stereotypes depicting PLHIV as blameworthy were highly pervasive, with women perceived as the “victims” of their spouse's irresponsible sexual behaviours. In this context, women were yet more often subjected to HIV-related stigma than men, in particular women diagnosed in the pre-antiretroviral therapy era and younger female caregivers. The role of gender in shaping disparities in HIV-related stigma experiences is discussed.     

阅读疗法对轻中度抑郁症患者病耻感及主观幸福感的影响

目的 探讨阅读疗法对轻中度抑郁症患者病耻感及主观幸福感的影响.方法 选取2018年10月-2019年6月在我院住院的轻中度抑郁症患者104例,采用随机数字表法将其分为观察组和对照组.对照组给予常规治疗和护理,观察组在对照组基础上实施阅读疗法.在阅读疗法实施前和实施4周、8周后采用Link病耻感量表和纽芬兰纪念大学幸福度...     

结核病相关病耻感量表的研制与评价

目的 研制和评价适用于我国的结核病相关病耻感量表.方法 采用结核病相关病耻感量表对1 342例结核病患者进行测评,利用SAS 9.4和AMOS 17.0对量表的信效度进行分析.结果 结核病相关病耻感量表共有3个维度9个条目,量表的总体Cronbach's α系数为0.88,各维度Cronbach's α系数为0.85、0.60和0.66;结核病相关病耻感量表二阶多因子模型的适配度指标分别为x2/df为4.162,RMSEA为0.049,GFI为0.962,AGFI为0.911,CFI为0.919.结论 结核病相关病耻感量表具有较高的信效度,可以作为我国结核病患者病耻感的测评工具.     

维吾尔药养心达瓦依米西克蜜膏的质量标准

目的:建立养心达瓦依米西克蜜膏的质量标准.方法:采用TLC法对处方中西红花、肉桂进行定性鉴别,并用RP-HPLC法测定西红花中西红花苷Ⅰ的含量;采用Luna C18(4.6 mm×250 mm,5μm)色谱柱,甲醇-水(45∶55)为流动相,流速1.0 mL·min-1,柱温35℃,检测波长440 nm,进样量10μL.结果:薄层鉴别专属性强,分离效果好.西红花苷Ⅰ在0.019 2 ～0.153 6μg呈良好的线性关系(r=0.999 9),平均回收率为98.7％(n=6),RSD 1.51％.结论:方法简便、准确、重复性好,可作为养心达瓦依米西克蜜膏的质量控制方法.     

医疗服务过程中艾滋病相关的耻辱与歧视

人类免疫缺陷病毒/艾滋病(HIV/AIDS)相关的耻辱与歧视已成为目前HIV/AIDS防治工作的最主要问题之一,特别是在医疗卫生服务过程中更引起了研究者和全社会的重视。本文对国内外卫生服务过程中HIV/AIDS相关的耻辱与歧视的现状、造成的影响以及目前的对策进行了概述,并对其原因进行了初步分析。     

精神疾病公众污名的研究进展

公众污名是一种多层次、复杂的现象,是指人们对待被污名化群体的态度及行为,这些被污名化的群体均具有社会不期望或不名誉的特征,如同性恋、艾滋病、性病及精神疾病患者等。精神疾病公众污名则指人们对待精神疾病患者消极的态度及行为,它已经成为精神疾病患者治疗和康复的一大障碍,对患者回归社会造成了直接的影响。为了降低人们对精神疾病的污名,澳大利亚、加拿大及英国等率先发起和实施了反对污名的项目,比如英国在2009年开展的＂Time to Change＂运动等,国内关于此方面的活动或研究少见报道。而我国在集体主义文化的影响下,精神疾病公众污名比西方国家更为严重。     

Breaking worse: The emergence of krokodil and excessive injuries among people who inject drugs in Eurasia

BackgroundKrokodil, a homemade injectable opioid, gained its moniker from the excessive harms associated with its use, such as ulcerations, amputations and discolored scale-like skin. While a relatively new phenomenon, krokodil use is prevalent in Russia and the Ukraine, with at least 100,000 and around 20,000 people respectively estimated to have injected the drug in 2011. In this paper we review the existing information on the production and use of krokodil, within the context of the region's recent social history.MethodsWe searched PubMed, Google Advanced Search, Google Scholar, YouTube and the media search engine www.Mool.com for peer reviewed or media reports, grey literature and video reports. Survey data from HIV prevention and treatment NGOs was consulted, as well as regional experts and NGO representatives.FindingsKrokodil production emerged in an atypical homemade drug production and injecting risk environment that predates the fall of communism. Made from codeine, the active ingredient is reportedly desomorphine, but – given the rudimentary ‘laboratory’ conditions – the solution injected may include various opioid alkaloids as well as high concentrations of processing chemicals, responsible for the localized and systemic injuries reported here. Links between health care and law enforcement, stigma and maltreatment by medical providers are likely to thwart users seeking timely medical help.ConclusionA comprehensive response to the emergence of krokodil and associated harms should focus both on the substance itself and its rudimentary production methods, as well as on its micro and macro risk environments – that of the on-going syndemic of drug injecting, HIV, HCV, TB and STIs in the region and the recent upheaval in local and international heroin supply. The feasibility of harm reduction strategies for people who inject krokodil may depend more on political will than on the practical implementation of interventions. The legal status of opioid substitution treatment in Russia is a point in case.