正念行为护理对肺癌合并肺结核患者的护理效果观察

目的探讨正念行为护理对肺癌合并肺结核患者的护理效果。方法选取2019年1月至2020年1月间陕西省结核病防治院收治的97例肺癌合并肺结核患者,采用随机数表法分为对照组和观察组。对照组49例患者采用亲情护理,观察组48例患者采用正念行为护理。比较两组患者的屈服、回避和面对评分、自我效能感量表(GSES)、抑郁自评量表(SDS)和焦虑自评量表(SAS)评分及生活质量。结果护理后,两组患者的屈服、回避、SDS和SAS评分均较护理前降低,且观察组均低于对照组,差异均有统计学意义(均P<0.05)。护理后,两组患者的面对、GSES、情绪功能、社会功能、认知功能、躯体功能和角色功能评分均较护理前升高,且观察组均高于对照组,差异均有统计学意义(均P<0.05)。结论正念行为护理能促进肺癌合并肺结核患者养成积极的应对方式,提高自我效能,减轻不良情绪,提高生活质量,值得推广。     

脊髓损伤患者及其配偶二元应对体验的质性研究

目的 探讨脊髓损伤患者及其配偶二元应对体验,为开展针对性的干预对策提供参考依据。 方法 采用目的抽样法,选取2020年4月—2021年3月入住安徽省某三级甲等综合医院脊柱外科的脊髓损伤患者12例及其配偶12名进行半结构化访谈,采用Colaizzi 7步分析法进行资料归纳并提炼主题。 结果 基于二元应对系统交互模型归纳出积极应对（共同面对、一致的疾病信念、转变沟通态度）、消极应对（适应困难、过度的保护行为、回避或冲突）、困难与挑战（亲密感丧失、寻求外部支持、构建新常态）共3个主题和9个亚主题。结论 脊髓损伤患者及其配偶积极应对与消极应对并存。医护人员需重视对患者及其配偶积极二元应对的引导,重点开展以夫妻为中心的应对干预,使其能更好地面对疾病,改善临床结局。     

How can hospitals change practice to better implement smoking cessation interventions? A systematic review

Smoking cessation reduces the risk of death, improves recovery, and reduces the risk of hospital readmission. Evidence and policy support hospital admission as an ideal time to deliver smoking-cessation interventions. However, this is not well implemented in practice. In this systematic review, the authors summarize the literature on smoking-cessation implementation strategies and evaluate their success to guide the implementation of best-practice smoking interventions into hospital settings. The CINAHL Complete, Embase, MEDLINE Complete, and PsycInfo databases were searched using terms associated with the following topics: smoking cessation, hospitals, and implementation. In total, 14,287 original records were identified and screened, resulting in 63 eligible articles from 56 studies. Data were extracted on the study characteristics, implementation strategies, and implementation outcomes. Implementation outcomes were guided by Proctor and colleagues' framework and included acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration, and sustainability. The findings demonstrate that studies predominantly focused on the training of staff to achieve implementation. Brief implementation approaches using a small number of implementation strategies were less successful and poorly sustained compared with well resourced and multicomponent approaches. Although brief implementation approaches may be viewed as advantageous because they are less resource-intensive, their capacity to change practice in a sustained way lacks evidence. Attempts to change clinician behavior or introduce new models of care are challenging in a short time frame, and implementation efforts should be designed for long-term success. There is a need to embrace strategic, well planned implementation approaches to embed smoking-cessation interventions into hospitals and to reap and sustain the benefits for people who smoke.     

Effets de la maltraitance sur la régulation émotionnelle des enfants et des adolescents confiés à l’Aide Sociale à l’Enfance

ObjectivesThis research aims to compare coping strategies (strategies developed to cope with stress) and temperamental dimensions used by children and adolescents have not been maltreated and those who have been. The aim of these analyzes is to identify the effects of age as well as vulnerabilities and resources for children and adolescents who have been maltreated.Materials and methodsA total of 232 children and adolescents aged 7 to 16 years participated in this study including 115 who have never been maltreated (control group) and 117 have been maltreated and are living in foster care (placed group). Each young people responded to a scale measuring the frequency of coping strategies (Kidcope) as well as a questionnaire of temperament (questionnaire d’auto- et d’hétéro-évaluation du tempérament en sept facteurs pour l’enfant d’âge scolaire et l’adolescent).ResultsAn analysis of variance (ANOVA) was performed for each coping strategy and temperamental dimension to evaluate the consequence of maltreatment on the emotional regulation, according to the slice of age. The age-based comparison of control and placed groups reveals major differences in the use of certain coping strategies as well as in the temperamental dimensions of maltreated children and adolescents. This confirms that the child's life experience influences his way of understanding his environment and affects his individual resources.ConclusionsThe results show vulnerabilities of emotional regulation for children and adolescents who have been maltreated. These aspects underline the importance to think about supports in order to promote the development of some coping strategies and to reduce the stressors. These points will be discussed with preventive and therapeutic used to improve coping skills and emotional regulation.     

Leukaemic variants of cutaneous T-cell lymphoma: Erythrodermic mycosis fungoides and Sézary syndrome

Mycosis fungoides (MF) and Sézary syndrome (SS) are the most common types of cutaneous lymphoma, accounting for approximately 60% of cutaneous T-cell lymphomas. Diagnosis requires correlation of clinical, histologic, and molecular features. A multitude of factors have been linked to the aetiopathogenesis, however, none have been definitively proven. Erythrodermic MF (E-MF) and SS share overlapping clinical features, such as erythroderma, but are differentiated on the degree of malignant blood involvement. While related, they are considered to be two distinct entities originating from different memory T cell subsets. Differential expression of PD-1 and KIR3DL2 may represent a tool for distinguishing MF and SS, as well as a means of monitoring treatment response. Treatment of E-MF/SS is guided by disease burden, patients’ ages and comorbidities, and effect on quality of life. Current treatment options include biologic, targeted, immunologic, and investigational therapies that can provide long term response with minimal side effects. Currently, allogeneic stem cell transplantation is the only potential curative treatment.     

Economic Burden of Head and Neck Cancer Treatment in North India

Background: The rising cost of cancer treatment has imposed a huge financial burden on the affected households,leading to catastrophic outcomes and impoverishment. The present study was designed to estimate the economicburden incurred by households for the treatment of head and neck cancer (HNC) in India. Methods: The present studywas undertaken in a large public sector tertiary care hospital of North India. A total of 159 patients were recruitedat time of their first registration in the department of Radiation Oncology, and were followed after completion oftheir treatment. Another 288 were recruited within one month after completion of treatment. Economic burden wasassessed in terms of out of pocket (OOP) expenditure incurred, prevalence of catastrophic health expenditure anddistress financing (borrowing or selling of assets) related to different modalities of cancer treatment. Results: Theaverage OOP expenditure incurred by a patient of HNC patient was INR 37, 845 (USD 563), which varied from INR32,379 (USD 482) when a patient undergoes radiotherapy alone to INR 67,480 (USD 1,004) for surgery along withchemo-radiotherapy. Specifically, patients undergoing 2-DRT and IMRT alone had to spend INR 31,487 (USD 469) andINR 42,405 (USD 631) respectively. The prevalence of catastrophic health expenditure (CHE) and distress financing(DF) was 34% and 45% respectively. The odds of incurring both CHE and DF were found to be higher for patients inthe lowest income quartile and for those in the younger age groups. Conclusion: Cancer imposes significant economicburden on households. The existing public health system should be strengthened to reduce OOP expenditure incurredby patients. In addition, enhanced coverage of risk pooling mechanisms should be ensured.