住院精神疾病患者合并躯体疾病现状调查

目的:研究住院精神疾病患者合并躯体疾病的现状.方法:采用横断面研究的方法进行时点调查.结果:共调查住院精神疾病患者219例,其中合并躯体疾病者70例(32.0%),合并实验室结果异常者69例(31.5%),合并心电图异常者73例(33.3%),合并脑电图异常者88例(40.2%).合并躯体疾病患者的年龄显著大于未合并者(P<0.01);女性患者心电图异常率以及脑电图异常率均显著高于男性(P<0.01);分裂症患者糖尿病的发生率显著高于非分裂症组(P<0.01).结论:精神疾病患者合并躯体疾病有较高的发生率,特别是糖尿病等代谢综合征与心电图异常有其特殊性.     

住院精神疾病患者合并躯体疾病现状调查

目的:研究住院精神疾病患者合并躯体疾病的现状,促进护理安全。方法:采用横断面研究的方法进行时点调查。结果:共调查住院精神疾病患者219例,其中合并躯体疾病者70例(32.0%),合并实验室结果异常者69例(31.5%),合并心电图异常者73例(33.3%),合并脑电图异常者88例(40.2%)。女性患者心电图异常率以及脑电图异常率均显著高于男性(P〈0.01);分裂症患者糖尿病的发生率显著高于非分裂症组(P〈0.01)。结论:精神疾病患者合并躯体疾病有较高的发生率,特别是糖尿病等代谢综合症与心电图异常有其特殊性。     

精神障碍住院患者的流行病学特征及相关危险因素分析

目的:探讨精神障碍住院患者病种构成及精神分裂症、心境障碍和癔症3种主要精神疾病的流行病学特征,并分析其相关危险因素.方法:采用自行设计的调查问卷,以中国精神障碍分类诊断标准第2版修订本为标准,对2008-2010年烟台地区住院精神障碍患者的2 453份病历进行统计分析.结果:住院患者女性多于男性,男女比为0.74∶1,...     

神经内科住院患者心境障碍与对策研究

目的:研究神经内科住院患者的心境障碍,并根据研究结果提出相应的对策。方法:以我院2013年1月~2015年1月收治的300例精神内科住院患者为研究对象,对所有患者进行诊断,以第二版中国精神疾病分类与诊断标准、第十版国际疾病分类诊断标准为判定依据,分析判断患者的心境障碍发生情况。结果:经诊断,300例患者中有很大一部分患者患有不同程度的焦虑和抑郁心境障碍。结论:神经内科住院患者出现焦虑和抑郁心境障碍的概率较大,因此在住院期间应及时采取相关对策,缓解患者的心境障碍。     

长期住院精神疾病患者生存质量及相关因素研究

目的探索长期住院精神疾病患者的生存质量及其影响因素。方法调查2007年2月21日止住院时间超过10年的住院精神疾病患者62例作为对照组,采取干预措施1年后仍在院的59例作为实验组。采用护士用住院病人观察量表（NOSIE）,阴性症状量表（SANS）,对对照组、实验组分别进行效果评定。结果406例住院精神疾病患者中长期住院62例（15.27%）,其中以精神分裂症尤为突出,58例（93.55%）;男性高于女性,经χ2检验（P〈0.05）,有统计学意义;病人的社会支持（亲人、朋友、单位的帮助）均较低;SANS各因子及总分比较有显著性差异（P〈0.01）,实验组阴性症状改善优于对照组;NOSIE总估计、总积极因素和总消极因素有显著性差异（P〈0.01）。结论长期住院精神疾病患者的生存质量全面低下,影响因素是多方面的,医务人员的系统干预可提高其生存质量。     

西部农村地区家庭暴力发生情况及对妇女精神健康的影响

目的:了解西部农村针对妇女的家庭暴力发生情况及对妇女精神健康的影响。方法:使用夫妻冲突量表(the revised Conflict Tactics Scale,CTS2)及自编问卷对宁夏某县1 577名妇女进行调查。结果:24.6%的妇女报告过去1年遭受过精神暴力,轻度和重度精神暴力的发生率分别为23.9%和7.0%;5.5%的妇女过去1年遭受过躯体暴力,轻度和重度躯体暴力的发生率分别为4.4%和4.1%;1.1%的妇女报告过去1年曾受过性暴力。有2.2%的妇女报告在过去1年中曾因家庭暴力受到躯体伤害,轻度和重度躯体伤害的发生率分别为2.1%和1.0%。妇女过去任何时候曾经遭受家庭暴力的比例分别为精神暴力30%,躯体暴力16.3%,性暴力1.8%,躯体伤害6.4%。妇女精神健康分别用过去1个月精神症状出现的种类、过去1年是否有过自杀意念和过去1年心理精神健康状况的自我评价3个指标来描述,多元线性回归和Logistic回归显示,在同时考虑年龄、家庭收入、丈夫是否外出打工这3个因素时,家庭暴力持续显示为影响妇女精神健康的重要因素,遭受精神暴力或躯体暴力的妇女表述过去1个月内出现更多种类的精神症状;过去1年遭受过精神暴力的妇女,其过去1年出现自杀意念的风险是未遭受过精神暴力者的3.98倍,其自我评价过去1年心理精神健康状况差的风险是未遭受过精神暴力者的1.67倍;过去1年遭受过躯体暴力的妇女,其过去1年出现自杀意念的风险是未遭受过躯体暴力者的4.72倍,其自我评价过去1年心理精神健康状况差的风险是未遭受过躯体暴力者的4.57倍。研究还显示,老年妇女和家庭收入极低的妇女为精神健康的危险人群。结论:针对农村妇女的家庭暴力发生情况不容乐观,家庭暴力对妇女的身心健康造成极大威胁,今后应采取有效措施,降低类似农村地区家庭暴力的发生,保护妇女,提高其生活质量。     

住院精神疾病患者伴发低钾血症的防治

目的:探讨住院精神疾病患者伴发低钾血症的防治。方法:对入组73例精神疾病患者伴发低钾血症的临床资料进行登记。采用自制的调查量表,调查分析精神疾病伴发低钾血症的原因、程度、治疗方案与预后转归。结果:住院精神疾病患者伴发低钾血症与性别无明显差异,男性发生率为21.41%、女性为24.69%。伴发低钾血症以饮食不良为主要因素,早期症状不明显,通过积极治疗,预后大多良好。结论:1精神疾病患者容易发生低钾血症。2低钾血症常被精神症状或抗精神病药物不良反应所掩盖。3通过积极治疗,预后大多良好。     

扬州市已婚女性家庭暴力情况调查

目的 了解扬州市已婚女性家庭暴力的发生情况以及影响因素.方法 采用多级分层抽样方法,在扬州市境内的城市、农村和工业区对3122名已婚女性进行家庭暴力问卷调查.结果 扬州地区已婚女性家庭暴力的总发生率为42.8%,其中精神暴力发生率为39.7%,躯体暴力发生率为10.1%,性暴力发生率为13.5%.1种暴力形式的发生率为25.3%,以精神暴力为最多;2种暴力形式的发生率为6.3%;3种暴力形式同时存在的发生率为2.9%.遭受暴力女性的年龄集中在25～45岁之间,其受教育程度显著低于非暴力家庭的女性.结论 扬州市已婚女性家庭中暴力现象较为普遍,以精神暴力为多见,低教育水平的中、青年女性家庭易于发生.     

一日法对住院精神病患者使用抗精神病药物处方调查

目的:比较13年前后住院精神疾病患者抗精神病药物的治疗情况。方法:采用一日法对我院住院精神疾病患者的抗精神病药物处方进行调查,并与1997年进行比较。结果:1.住院精神疾病前三位始终为精神分裂症(69.3%)占据第一位,精神发育迟滞(12.1%)排第二,器质性精神障碍(9.1%)排列第三。但精神分裂症比例有所下降,器质性精神障碍、心境障碍比例有所上升。2.单一用药(68.6%)始终占据首位,联用二种药物的比例有所上升。3.氯氮平(36.7%)的使用上升到首位,氯丙嗪(18.3%)明显下降。4.药物的使用剂量均在推荐的安全使用剂量之下。结论:住院精神疾病患者的抗精神病药物使用情况发生了一些变化,联合用药同时不能忽视治疗安全问题,仍要时刻警惕氯氮平的严重不良反应。     

精神科低年资护士遭受暴力及防攻击学习现况的调查与分析

目的：探讨精神科临床工作6年内护士受患者暴力攻击及应对状况、防攻击学习和应用的现状,以便给构筑精神科临床护理人员安全的工作环境提供理论帮助.方法：采用自行设计问卷,对我院工作6年内的护士54人进行调查.结果：在接受调查的护士中遭受过暴力46人,发生率为85.19%.其中工作2～3年的护士最易受到暴力攻击（P＜0.05）.受调查护士认为防攻击学习有必要占88.80%,认为现行的防攻击学习不够占72.12%.结论：护理人员遭受医院场所暴力的发生率高,现行的防攻击学习远远不能满足临床需要,必须采取有效的防范措施、制定更合理的防攻击学习理论,以确保医护人员的安全.     

The physical, sexual and emotional violence history of middle-aged women: a community-based prevalence study

OBJECTIVES: To determine current and lifetime rates of the experience of partner abuse and sexual violence in a community-based sample of middle-aged women and compare these to figures obtained in a general practice setting. DESIGN AND METHODS: This research was part of the Melbourne Women's Midlife Health Project (MWMHP), an observational, longitudinal, population-based study of 438 Australian-born women conducted over nine years. In 1996, during the sixth year of the study, we asked the MWMHP participants to complete a self-administered "violence questionnaire", incorporating a modified Conflict Tactics Scale and questions on sexual abuse experienced during childhood and adult life. RESULTS: Of the 395 women remaining in the sixth year of follow-up of the MWMHP, 362 (92%) completed the questionnaire. Overall, 28.5% (n = 101) of the women had experienced some form of domestic violence (physical, sexual or emotional) during their lifetime; 5.5% (n = 15) of women had experienced severe physical abuse in the past year at the hands of a partner; and 11.8% (n = 42) of the women had experienced rape or attempted rape between the age of 16 and the time of our survey. Regarding abuse in childhood, 8.9% (n = 32) of women had experienced physical abuse, 42.3% (n = 152) had experienced non-contact sexual abuse, and 35.7% (n = 128) contact sexual abuse. Compared with the general-practice-based study, rates of childhood physical abuse and penetrative sexual abuse were similar, but rates of less intrusive child sexual abuse were significantly higher in our study. CONCLUSIONS: Doctors in all areas of medicine who are dealing with middle-aged women need to be aware of the levels of violence sustained by women throughout their lives. Such experiences may have a substantial impact on women's physical and mental wellbeing.     

Substance abuse and mental illness: unaddressed public health issues for women

Although women have been disproportionately affected by substance abuse and mental illness, these issues have received little attention. Women with substance abuse and mental disorders tend to experience more severe environmental, health, social, and economic consequences and require more costly care. The Substance Abuse and Mental Health Services Administration is responsible for strengthening the nation's health care delivery system for prevention and treatment of substance abuse and mental illness and addresses women's issues through its Women, Children, and Families Team (WCFT). The WCFT is concerned with the public health risks associated with substance abuse and mental disorders in women, including physical and sexual abuse/violence, human immunodeficiency virus and acquired immune deficiency syndrome, criminal justice, welfare reform, and child welfare.     

喹硫平与利培酮治疗老年痴呆精神行为障碍对照研究

目的:探讨喹硫平和利培酮对老年期痴呆患者精神行为症状(BPSD)的疗效和安全性。方法:将60例老年期痴呆伴BPSD患者随机分成两组,分别使用喹硫平和利培酮治疗8周,采用痴呆病理行为评定量表(BEHAVE-AD)、激越行为量表(CMAI)及治疗中出现的药物副反应量表(TESS)评定疗效和不良反应。结果:两组治疗前后BEHAVE-AD和CMAI评分显著下降(P<0.01),两组患者之间治疗前后BE-HAV-AD总减分值差异无统计学意义(P>0.05),但情感障碍和焦虑两因子减分值差异有统计学意义(P<0.05),利培酮组的锥体外系反应、口干、便秘、头昏等较喹硫平组显著(P<0.01)。结论:喹硫平和利培酮对老年痴呆患者精神症状的疗效相当,喹硫平对情感症状和焦虑的疗效更明显、安全性更高。     

乳腺癌病人的心理健康状况及应对对策

目的：测定乳腺癌病人心理健康状况及影响因素.方法：采用症状自评量表（SLC-90）及基础的心理健康状况影响因素调查表,测定50例乳腺癌病人心里健康症状特点及其影响因素,并以50例正常人作为对照.结果：乳腺癌病人SLC-90总分显著高于正常人,P＜0.05,在躯体化、抑郁、焦虑等因子分值明显高于对照组,P＜0.05.结论：乳腺癌病人的总体心理健康状况较差,提示在治疗及护理乳腺癌病人躯体症状的同时,应注意观察病人的心理状况变化,并进行相应的心理治疗和护理,防止其不良情绪的发生,从而使病人以良好的心态接受治疗.     

综合医院精神科联络会诊277例临床分析

目的了解综合医院精神科会诊的临床特点.方法广州医学院第二附属医院8个月的277例精神科会诊病例进行统计分析.结果内科会诊率最高(62.5%),诊断最多的精神障碍是器质性精神障碍(45.8%),随后是神经症(21.3%)和心境障碍(15.2%).结论综合医院精神科联络会诊具有患者的平均年龄较大、与脑功能密切相关的神经科病人最多、以器质性精神障碍为主要病种和新一代精神病药物的使用较多等四大临床特点.     

舒适护理改善心内科住院患者负性情绪和心理障碍的效果研究

目的:探讨心理舒适护理改善心内科住院患者负性情绪和心理障碍的效果,为临床康复护理提供依据。方法:按抛硬币分组法将60例心内科住院患者随机分为研究组和对照组各30例。两组均给予常规药物治疗,对照组按普通护理,研究组在此基础上则给予以健康教育、音乐疗法以及亲情照护为干预措施的心理舒适护理。分别于入院时和出院时,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)和症状自评量表(SCL-90)评价两组的情绪和心理状况。结果:入院时,两组SAS、SDS和SCL-90评分无显著性差异(P>0.05);出院时,研究组SAS、SDS和SCL-90评分明显低于对照组(P<0.01)。结论:心理舒适护理能够改善心内科住院患者负性情绪和心理障碍,有助于促进患者的治疗和康复。     

Survivors of sexual abuse: clinical, lifestyle and reproductive consequences

BACKGROUND: In recent years, an increase in the prevalence of sexual abuse of women has been reported in Canada and elsewhere. However, there are few empirical data on the extent of the problem in Canadian aboriginal populations. The authors investigated the presence of a reported history of sexual abuse and other health determinants in a sample of women attending a community health centre with a substantial aboriginal population. This allowed determination of whether reported sexual abuse and its associated demographic and health-related effects were different for aboriginal and non-aboriginal women. METHODS: A sample of 1696 women was selected from women attending a community health centre in a predominantly low-income inner-city area of Winnipeg for a cross-sectional survey designed to study the association between sexual behavior and cervical infections. The survey was conducted between November 1992 and March 1995 and involved a clinical examination, laboratory tests and an interviewer-administered questionnaire. A substudy was conducted among 1003 women who were asked 2 questions about sexual abuse. RESULTS: The overall response rate for the main study was 87%. Of the 1003 women who were asked the questions about sexual abuse, 843 (84.0%) responded. Among the respondents, 368 (43.6%) were aboriginal. Overall, 308 (36.5%) of the respondents reported having been sexually abused, 74.0% of the incidents having occurred during childhood. The prevalence was higher among aboriginal women than among non-aboriginal women (44.8% v. 30.1%, p < 0.001). Women who had been sexually abused were younger when they first had sexual intercourse, they had multiple partners, and they had a history of sexually transmitted diseases. In addition, non-aboriginal women who had been sexually abused were more likely than those who had not been abused to have been separated or divorced, unemployed and multiparous and to have used an intrauterine device rather than oral contraceptives. Aboriginal women who had been sexually abused were more likely than those who had not been abused to have been separated or divorced, unemployed and multiparous and to have used an intrauterine device rather than oral contraceptives. Aboriginal women who had been sexually abused were more likely than those who had not been abused to have had abnormal Papanicolaou smears. The proportion of smokers was higher among the abused women than among the non-abused women in both ethnic groups. INTERPRETATION: A history of sexual abuse was associated with other clinical, lifestyle and reproductive factors. This suggests that sexual abuse may be associated with subsequent health behaviors, beyond specific physical and psychosocial disorders. Aboriginal and non-aboriginal women who have suffered sexual abuse showed substantial differences in their subsequent health and health-related behaviours.     

Domestic abuse on women in China before, during, and after pregnancy

Background Some researchers found that partner-perpetrated physical violence increased in frequency and severity during the postpartum period compared with the antenatal period, however, limited data exists describing abuse of women in China. The purpose of this study was to examine patterns of abuse in China before, during, and after pregnancy, and explore possible factors related to abuse. Methods A community-based face-to-face survey of a representative group of women who had a child aged 6 to 18 months in 32 communities of Tianjin, Liaoning, Henan, and Shaanxi provinces was carried out between November 1,2001 and February 28, 2002. Results The prevalence of domestic abuse (emotional, sexual, or physical) occurring in any period (before, during, or after pregnancy) was 12.6%. The prevalence of abuse during the approximate 9 months of pregnancy (4.3%) was relatively lower compared with the prevalence of abuse during the 12 months before pregnancy (9. 1%) and after delivery (8.3%) during the mean 11-month postpartum period studied. Abuse before pregnancy was a strong risk factor for abuse during pregnancy and abuse after pregnancy, and abuse during any previous period was a strong risk factor for subsequent abuse. Many women who suffered abuse of any kind generally experienced multiple acts over time and most acts were not severe. The results of logistic regression analysis showed that the factors associated with abuse during pregnancy included women previously witnessing domestic violence, a poor relationship with the panner, socioeconomic level, alcohol consumption, and smoking. Conclusions It is necessary to do in-depth training and to raise awareness of panner abuse among all health professionals. Routine screening of abuse in maternity clinics is advocated to decrease the adverse impact of abuse on women and fetuses.