大小便失禁病人尊严丧失感与社会支持和应对方式的相关性研究

目的:探讨大小便失禁病人尊严丧失感现状及其与社会支持和应对方式的相关性。方法:采用一般资料调查表、病人尊严量表(PDI)、社会支持评定量表(SSRS)、应对方式量表(MCMQ)对山东省3所三级甲等医院119例大小便失禁病人进行调查。结果:病人尊严丧失感程度不一,不同大小便失禁时间病人尊严丧失感得分比较差异有统计学意义(P<0.05)。多元回归分析显示,大小便失禁后不同时间、主观支持、对社会支持的利用度以及屈服的应对方式是导致大小便失禁病人尊严丧失的重要因素。结论:大小便失禁病人尊严丧失感与社会支持和应对方式密切相关,加强社会支持以及积极有效的应对方式能减轻病人的尊严丧失感。     

Style attributionnel et burn-out au travail : une analyse en cluster

In the domain of the workplace, burnout appears as an important consequence of stressful events experienced by an individual. But how to define it, and what reality does this concept represent? The benefits of optimism, and particularly of an optimistic explanatory style, have also been demonstrated on a set of other variables such as health, performance and resilience. If an optimistic explanatory style is an important variable, what are the relationships that can be observed with burnout? The purpose of this study is to explore the links that exist between explanatory styles and burnout assuming that there are different types of profiles according to the styles of the individuals, whether they are actually optimistic or pessimistic, or neither one nor the other. Through a cluster analysis, the results of this study revealed: 1) the existence of three different profiles of explanatory styles, ranging from optimistic to pessimistic; and 2) it was indeed possible to associate levels of burnout with the profiles of these styles.     

不良妊娠患者应对方式的现状及其影响因素

目的了解不良妊娠患者的应对方式并分析其影响因素,为进行针对性的护理干预提供依据。方法方便抽样法选取2013年1月至2014年1月宁波市某三级甲等妇女保健医院收治的不良妊娠患者125例,采用自制的一般情况调查问卷及应对方式问卷(coping style questionnaire,CSQ)对其进行调查,分析调查结果。结果不良妊娠患者最常采用解决问题和求助等成熟型应对方式,不同年龄、文化程度、经济收入、孕龄和生育史的不良妊娠患者在应对方式选择上的差异有统计学意义P0.05或P0.01。结论护理人员应帮助年龄较轻、文化程度和收入较低、孕龄较大及未生育过的不良妊娠患者采用成熟型应对方式,以促进其身心健康。     

以格林模式为指导的健康宣教对尖锐湿疣患者情绪及自我效能的影响

目的探讨以格林模式为指导的健康宣教对尖锐湿疣患者情绪及自我效能的干预作用。方法将220例尖锐湿疣患者按就诊时间分为两组,各110例。对照组予以常规护理干预,观察组在此基础上实施以格林模式为指导的健康宣教,观察6个月,治疗后随访6个月统计复发率。干预前后采用医院自制尖锐湿疣患者健康知识调查问卷调查健康知识掌握情况,采用焦虑自评量表、抑郁自评量表评定焦虑、抑郁情绪,采用医学应对问卷评定应对方式,采用一般自我效能感量表评定自我效能。干预后采用纽卡斯尔护理满意度量表评定护理满意度。结果干预后观察组尖锐湿疣患者健康知识调查问卷总分及尖锐湿疣疾病知识、自我保健知识评分显著高于对照组(P<0.01),焦虑自评量表、抑郁自评量表评分显著低于对照组(P<0.01)。干预后观察组一般自我效能感量表评分及医学应对问卷的面对、自我效能评分显著高于对照组(P<0.01),回避、屈服评分显著低于对照组(P<0.01)。观察组复发率显著低于对照组(P<0.05),总满意率显著高于对照组(P<0.01)。结论以格林模式为指导的健康宣教能提高尖锐湿疣患者健康知识掌握度及自我效能水平,有效缓解其不良情绪,改变其应对方式,降低复发率,提高患者满意度。     

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。     

Clinicians’ accounts of communication with patients in end-of-life care contexts: A systematic review

ObjectiveCommunication between patients and end-of-life care providers requires sensitivity given the context and complexity involved. This systematic review uses a narrative approach to synthesise clinicians’ understandings of communication in end-of-life care.MethodsA systematic, narrative synthesis approach was adopted given the heterogeneity across the 83 included studies. The review was registered prospectively on PROSPERO (ID: CRD42019125155). Medline was searched for all articles catalogued with the MeSH terms “palliative care,” “terminal care” or “end-of-life care,” and “communication”. Articles were assessed for quality using a modified JQI-QARI tool.ResultsThe findings highlight the centrality and complexity of communication in end-of-life care. The challenges identified by clinicians in relation to such communication include the development of skills necessary, complexity of interpersonal interactions, and ways in which organisational factors impact upon communication. Clinicians are also aware of the need to develop strategies for interdisciplinary teams to improve communication.ConclusionTraining needs for effective communication in end-of-life contexts are not currently being met.Practice ImplicationsClinicians need more training to address the lack of skills to overcome interactional difficulties. Attention is also needed to address issues in the organisational contexts in which such communication occurs.     

赋能心理护理对ICU患者家属心理压力及应对方式的影响

目的 探讨赋能心理护理对ICU患者家属心理压力及应对方式的影响。方法 选取2017年1-12月我院收治的120例ICU患者的主要照顾家属为研究对象,采用随机数字表法将其分为观察组及对照组,每组各60例。对照组行常规健康宣教,观察组在对照组基础上行赋能心理干预,比较2组心理压力、自我效能及应对方式。结果 干预后,观察组自我效能评分、积极应对方式评分均明显高于对照组(t=8.477,P<0.001;t=10.845,P<0.001),而消极应对方式评分明显低于对照组(t=8.935,P<0.001)。观察组紧张感、失控感及心理压力总评分均明显低于对照组(P<0.001)。结论 赋能心理干预能有效提高ICU重症患者家属自我效能,使家属能积极面对患者病情,减轻患者家属心理负担。     

伴非自杀性自伤行为青少年抑郁症患者述情和家庭教育方式研究

目的了解青少年抑郁症患者非自杀性自伤行为的现状,并对比分析伴或不伴非自杀性自伤行为患者的述情方式和家庭教育方式差异。方法回顾性连续纳入2018年1月至2019年2月四川大学华西医院心理卫生中心收治的241例青少年抑郁症患者为调查对象,采用多伦多述情障碍量表、家庭教育方式量表、患者健康问卷抑郁量表对其进行调查,并对比伴非自杀性自伤行为(研究组)和不伴非自杀性自伤行为(对照组)患者的差异。结果241例患者中,44.8%(108/241)的青少年抑郁症患者有非自杀性自伤行为。与对照组(133例)比较,研究组家庭教育方式量表中父亲的惩罚/严厉[(24.80±7.36)分比(21.41±6.89)分]、过分干涉[(23.56±5.02)分比(21.74±4.66)分]、拒绝/否认[(13.44±4.39)分比(11.35±3.81)分]、过度保护因子[(12.56±3.28)分比(11.20±2.94)分]得分较高,差异均有统计学意义(均P<0.05),母亲的过分干涉/保护[(42.23±8.06)分比(37.73±7.80)分]、拒绝/否认[(18.65±5.85)分比(15.70±5.72)分]、惩罚/严厉因子[(19.13±6.52)分比(15.97±6.20)分]得分较高,差异均有统计学意义(均P<0.05)。在述情障碍量表中,研究组难以识别自己的情感及难以描述自己的情感因子得分高于对照组[分别为(25.19±6.23)分比(22.12±7.09)分,(18.06±4.19)分比(15.90±4.52)分],差异均有统计学意义(均P<0.05)。结论青少年抑郁症患者中,伴非自杀性自伤行为的发生率较高,其述情方式和家庭教育方式与不伴非自杀性自伤行为患者存在差异。     

Correlation between wing bone microstructure and different flight styles: The case of the griffon vulture (gyps fulvus) and greater flamingo (phoenicopterus roseus)

Flying is the main means of locomotion for most avian species, and it requires a series of adaptations of the skeleton and of feather distribution on the wing. Flight type is directly associated with the mechanical constraints during flight, which condition both the morphology and microscopic structure of the bones. Three primary flight styles are adopted by avian species: flapping, gliding, and soaring, with different loads among the main wing bones. The purpose of this study was to evaluate the cross-sectional microstructure of the most important skeletal wing bones, humerus, radius, ulna, and carpometacarpus, in griffon vultures (Gyps fulvus) and greater flamingos (Phoenicopterus roseus). These two species show a flapping and soaring flight style, respectively. Densitometry, morphology, and laminarity index were assessed from the main bones of the wing of 10 griffon vultures and 10 flamingos. Regarding bone mineral content, griffon vultures generally displayed a higher mineral density than flamingos. Regarding the morphology of the crucial wing bones involved in flight, while a very slightly longer humerus was observed in the radius and ulna of flamingos, the ulna in griffons was clearly longer than other bones. The laminarity index was significantly higher in griffons. The results of the present study highlight how the mechanics of different types of flight may affect the biomechanical properties of the wing bones most engaged during flight.