生物等效性试验受试者招募影响因素的定性访谈研究

目的 通过定性访谈的方法探索影响生物等效性试验受试者招募的可能因素,以期提高招募速度并为保证入组质量提供参考和思路.方法 在天津中医药大学第一附属医院临床试验中心2020年9月—2021年6月开展的生物等效性试验受试者中,随机选择12名受试者作为研究对象,设计半结构式定性访谈提纲,采用个人深度访谈形式,对受试者临床试验整体认知、积极性影响因素两方面进行访谈.结果 无医学背景的受访者对临床试验认知相对不足,角色认同感较消极;受访者总体对临床试验的参与持积极态度,影响参与度的因素包含"补偿费用""药物安全性""周期""采血量""个人时间""行程/研究地点""机构硬件设施"和"护理质量"等关键词,其中以"补偿费用"和"试验药物安全性"为主要影响因素.结论 科学普及临床试验知识,增加受试者对临床试验的认知;丰富重视知情同意内容,注重沟通,做好安全性风险控制;合理设定受试者补偿费用额度,是可能提高受试者对招募回应度的可行方法.     

江苏地区1260名精神科女护士主观幸福感的调查研究

目的 了解江苏地区精神专科医院临床女护士主观幸福感的现状及影响因素,为提高精神专科医院的管理水平提供参考依据。方法 采用中文版的“总体幸福感量表”和自制的“一般情况调查表”对江苏省不同地区的6所精神专科医院1260名女护士进行调查。 结果 被调查对象主观幸福感前18项总分为(67.89±14.09)分,处于中等幸福感49～72分之间,但显著低于全国女性常模(71.00±18.00)分,两者比较,t =-2.768,差异有统计学意义(P<0.01)；经回归分析,其主要影响因素有对职业伤害的担心程度、家庭的支持程度、收入状况、医院支持系统的满意度,差异均有统计学意义(P<0.01或P<0.05)。结论 江苏地区的精神科女护士主观幸福感总体处于中等水平但显著低于全国女性常模,提高其主观幸福感可以从减少精神科护士的职业伤害、关注家庭方面影响、建立合理的薪酬体系和高效的医院支持系统4个方面努力。     

Best Practices for Counseling Adolescents about the Etonogestrel Implant

Among young persons, ease of use, high efficacy, and high acceptability makes the etonogestrel contraceptive implant an important choice for this age group. Adolescent-friendly, patient-centered counseling considers the patient's cognitive development, the influence of friends and family, as well as their own preferences and values. Age-appropriate language, graphics, and models are useful to explain contraceptive options and relevant side effects. Effectiveness, reversibility, safety, noncontraceptive benefits, and side effects are important attributes and should be discussed when teens are choosing a contraceptive method. In this review we describe suggested best practices for counseling adolescents about the etonogestrel implant so they can make informed, prudent decisions about using this contraceptive method.     

Partner Responses to Low Desire: Associations With Sexual,Relational, and Psychological Well-Being Among Couples Coping With Female Sexual Interest/Arousal Disorder

BackgroundThe experience of distressing low sexual interest/arousal—female sexual interest/arousal disorder (FSIAD)—is prevalent in women of all ages and is associated with poorer sexual, relationship, and psychological well-being than women without this difficulty. Women who are partnered are almost 5 times more likely to be distressed by low desire and to receive a diagnosis of FSIAD than unpartnered women, indicating that interpersonal factors are highly relevant, although largely neglected in past research.AimIn a dyadic cross-sectional and longitudinal study, we examined whether partner responses to FSIAD were associated with the sexual, relationship, and psychological well-being of couples, and whether any effects persisted 1 year later.MethodsWomen diagnosed with FSIAD (N = 89) completed a validated measure of perceived partner positive vs negative responses to their low sexual interest/arousal and their partners reported on their own responses, as well as measures of sexual desire, sexual satisfaction, relationship satisfaction, sexual distress, and anxiety. 1 year later, couples (N = 66) completed the outcome measures again. Data were analyzed according to the Actor-Partner Interdependence Model.OutcomesOutcomes included were the Sexual Desire Inventory–Solitary and Partner-Focused Subscales; Global Measure of Sexual Satisfaction; Female Sexual Distress Scale; Couple Satisfaction Index; and State-Trait Anxiety Inventory–Short-Form.ResultsWhen women with FSIAD perceived more positive partner responses (eg, warm, supportive, compassionate) than negative responses (eg, hostile, unsupportive, indifferent), they were more satisfied with the relationship and they and their partners reported lower anxiety. When partners reported more positive than negative responses, they had greater relationship and sexual satisfaction and lower sexual distress and anxiety. Exploratory analyses revealed that women's perceptions of their partners' responses accounted for the link between partners' own responses and women's relationship satisfaction and anxiety. Partner responses did not predict any change in outcomes over time.Clinical ImplicationsFindings support interpersonal conceptualizations of FSIAD and may inform the development of future couple-based interventions.Strengths & LimitationsThis study is one of the few dyadic investigations of FSIAD, as diagnosed via a clinical interview. Significant associations were only observed cross-sectionally, limiting causal conclusions. There was limited power to detect longitudinal effects.ConclusionMore positive responses to women's low sexual interest/arousal by partners is linked to better adjustment among couples affected by FSIAD.Rosen NO, Corsini-Munt S, Dubé JP, et al. Partner Responses to Low Desire: Associations With Sexual, Relational, and Psychological Well-Being Among Couples Coping With Female Sexual Interest/Arousal Disorder. J Sex Med 2020;17:2168–2180.     

从肝脾论治成年女性特应性皮炎

目的:特应性皮炎的发病及治疗存在很大的异质性,在治疗方面特别强调个体化治疗,本文主要总结成年女性特应性皮炎的治疗思路和方法。方法:基于肝脾两脏的生理、病理及成年女性特应性皮炎的临床表现,深入分析其病因病机及治疗方法。结果:女性成年特应性皮炎患者常肝脾同病,肝郁脾虚湿蕴和肝郁脾虚血弱是成年女性特应性皮炎的常见证型,临床可采用疏肝健脾祛湿法和疏肝健脾养血法进行治疗。典型病例中采用肝脾同调法不但可以改善患者的皮疹,也可有效缓解瘙痒和不良情绪。结论:肝脾同调法是治疗成年女性特应性皮炎的有效方法。