Conceptualizing and measuring illness self-concept: a comparison with self-esteem and optimism in predicting fibromyalgia adjustment

Illness self-concept (ISC), or the extent to which individuals are consumed by their illness, was theoretically described and evaluated with the Illness Self-Concept Scale (ISCS), a new 23-item scale, to predict adjustment in fibromyalgia. To establish convergent and discriminant validity, illness self-concept was compared to self-esteem and optimism in predicting health status, illness intrusiveness, depression, and life satisfaction. The ISCS demonstrated good reliability (alpha = .94; test-retest r = .80) and was a strong predictor of outcomes, even after controlling for optimism or self-esteem. The ISCS predicted unique variance in health-related outcomes; optimism and self-esteem did not, providing construct validation. Illness self-concept may play a significant role in coping with fibromyalgia and may prove useful in the evaluation of other chronic illnesses.     

神经危重症患者床旁肌电图检查的应用价值

目的探讨神经危重症患者床旁肌电图检查对患者诊断及预后判断的意义。 方法对2016年11月至2017年4月在南方医科大学南方医院神经危重症病房（NCU）住院、且住NCU时间超过3 d的58例神经危重症患者进行床旁肌电图检查。检查项目包括运动神经传导、感觉神经传导、直接肌肉刺激。对超过两个肢体共计3条及以上运动和/或感觉神经传导出现异常定义为多发神经传导异常,并进行分组后病因分析、临床特点和电生理特点的比较。 结果48.3%（28/58）患者呈多发神经传导异常,为多发神经传导异常组,其余30例患者为对照组。与对照组比较,多发神经传导异常组的急性病生理学和长期健康评价（APACHE）Ⅱ评分[（12 ± 5）分vs.（16 ± 6）分]、在院最高脓毒症相关器官衰竭评分（SOFA）分值[4（3,6）分vs. 7（4,11）分]、脓毒症[11/30 vs. 21/28]及多器官功能障碍综合征（MODS）发生率[2/30 vs. 10/28]均更高,预后情况中机械通气时间[0（0,4）d vs. 6（0,16）d]、ICU住院时间[8（5,13）d vs. 14（7,20）d]均更长,出院后30 d [4（3,4）分vs. 5（5,6）分]及90 d [3.0（2.0,4.0）分vs. 6.0（4.2,6.0）分]的改良Rankin评分（mRS）分值、30 d（2/30 vs. 12/28）及90 d（4/30 vs. 15/28）病死情况均更高（P均< 0.05）。多因素Logistic回归分析发现,多发神经传导异常是出院后30 d及90 d病死情况的独立危险因素（P均< 0.05）。多发神经传导异常患者电生理特点显示与其他病因组（14例）比较,危重病性神经肌病（CIPNM）组（14例）运动神经传导未引出复合肌肉动作电位（CMAP）波形的比例更高（6/90 vs. 15/87）,而感觉神经传导异常占比均更低（58/83 vs. 28/81、29/37 vs. 14/37、29/44 vs. 14/44;P均< 0.05）。 结论神经危重症患者常存在周围神经肌肉病变,且病因复杂多样,床旁肌电图检查对神经危重症患者的病因鉴别具有重要意义,且对神经危重症患者预后判断具有重要价值。     

The Relationship of Illness Uncertainty, Illness Intrusiveness, and Asthma Severity to Depression in Young Adults with Long-Standing Asthma

This study examined the potential mediating/moderating influence of both illness intrusiveness and asthma severity on the association between illness uncertainty and depression in a college sample of older adolescents and young adults (N = 40) with histories of childhood asthma. There was a significant association between increased illness uncertainty and increased levels of depression. However, analyses indicated that neither illness intrusiveness nor asthma severity served as mediators in the uncertainty–depression relationship. Examination of moderator effects of intrusiveness and severity on the uncertainty–depression relationship revealed an interaction for severity only; thus, the significant effect of uncertainty on depression was at its maximim under conditions of increased illness severity. Results suggest that cognitive appraisal mechanisms involving decreasing ambiguity about illness may be worthwhile targets for intervention.     

The use of complementary and alternative medicine among california adults with and without cancer

This article examines the extent and correlates of complementary and alternative medicine (CAM) use among a population-based sample of California adults that is highly diverse in terms of sociodemographic characteristics and health status. As a follow-up to a state-wide health survey of 55,428 people, 9187 respondents were interviewed by phone regarding their use of 11 different types of CAM providers, special diets, dietary supplements, mind-body interventions, self-prayer and support groups. The sample included all participants in the initial survey who reported a diagnosis of cancer, all the non-white respondents, as well as a random sample of all the white respondents. The relation of CAM use to the respondents' demographic characteristics and health status is assessed. CAM use among Californians is generally high, and the demographic factors associated with high rates of CAM use are the same in California as have been found in other studies. Those reporting a diagnosis of cancer and those who report other chronic health problems indicate a similar level of visits to CAM providers. However, those with cancer are less likely to report using special diets, and more likely to report using support groups and prayer. Health status, gender, ethnicity and education have an independent impact upon CAM use among those who are healthy as well as those who report suffering from chronic health problems, although the precise relation varies by the type of CAM used.     

Illness perceptions and mood states are associated with injury-related outcomes in athletes

Background.?Athletes have to cope adequately with the consequences of their injury in order to return into sports as soon as possible. Besides the physical characteristics of the injury, illness perceptions and emotional responses impact the behavioural responses to the injury.

Purpose.?To apply Leventhal's Common Sense Model as a theoretical framework in the field of sports medicine, pertaining to injured athletes.

Methods.?In a sample of 95 injured athletes participating in different sports, sociodemographic, injury and sport-related characteristics, the Illness Perception Questionnaire-Revised-Sports (IPQ-R-S) and the Profile Of Mood States were assessed.

Results.?Injured athletes' most experienced symptoms were pain (82%) and loss of strength (50%), associated with a high controllability; they see their injury as not chronic, with minor consequences for daily life and minor emotional consequences. Athletes with an injury of longer duration have minor psychological attributions, 28% suffer from fatigue, which is strongly related to a negative mood state.

Conclusions.?Illness perceptions and mood states are related to injury characteristics. Clinicians ought to incorporate patients' views about their injuries into their treatment in order to increase the concordance between patient's and clinician's perceptions, thereby increasing chances of a quick and uneventful recovery.     

危重病患者血清胃泌素测定的临床意义

报告８个病种３２５例危重病患者血清胃泌素的测定结果并与５８例正常人对比。结果表明：危重病患者不管是否伴有消化道出血，其血清胃泌素均有意义地升高（Ｐ＜０．００１）。说明危重病患者有高胃泌素血症存在。并与消化道出血和ｐＨ值降低可能有一定关系。提示在危重病治疗时，不管是否有消化道出血，及早应用抑制胃泌素分泌的药物对保护胃粘膜，预防消化道出血可能有一定益处。     

Chronic illness -- a disruption in life: identity-transformation among women with chronic fatigue syndrome and fibromyalgia

BACKGROUND: People with chronic illnesses often suffer from identity-loss. Empirical research concerning patients with chronic fatigue syndrome (CFS) or fibromyalgia has not, however, adequately addressed the consequences of these illnesses for identity. AIM: The aim of this article is to describe how women with CFS and fibromyalgia create new concepts of identity after the onset of illness, and how they come to terms with their newly arisen identities. I aim to illuminate the biographical work done by these individuals, which includes a re-evaluation of their former identity and life. This process is illustrated by the following themes: An earlier identity partly lost and Coming to terms with a new identity. METHOD: The study is based on interviews with 25 women in Sweden, 12 with the diagnosis of CFS and 13 diagnosed with fibromyalgia. A grounded theory orientated approach was used when collecting and analysing the data. FINDINGS: The main findings are that: (1) the illnesses can involve a radical disruption in the women's biography that has profound consequences for their identity, particularly in relation to work and social life, (2) biographical disruptions are partial rather than total, calling for different degrees of identity transformation, (3) many of the women also experience illness gains in relation to the new identity. CONCLUSIONS: Thus, the biographical disruption and illness experience comprised both losses and illness gains that had consequences for identity.     

肝移植术后并发神经精神系统疾病原因分析及护理

目的探讨肝移植术后并发神经精神系统疾病分析和护理对策。方法通过术前术后观察分析肝移植术后患者的心理状况改变,找出影响其心理变化的相关因素,针对不同的个体实施有效的心理护理和术后心理辅导。结果解除患者对环境的陌生感,对疾病的恐惧感及自身的孤独失落感,使其主动配合医护人员进行治疗和护理,提高了治愈率。结论肝移植患者术后出现精神状态异常,与患者术前状况、术中情况和术后的监测、治疗有密切的关系。     

癔症性失声患者疾病不确定感与医学应对方式相关性分析

目的调查癔症性失声患者疾病不确定感与医学应对方式现状,探讨二者之间的关系。方法应用Mishel疾病不确定感量表与医学应对方式量表,对106例癔症性失声患者进行调查。结果癔症性失声患者疾病不确定感得分为(120.85±10.14)分,处于偏高水平;面对应对方式与疾病不确定感复杂性呈显著负相关,屈服应对方式与疾病不确定感不可预测性呈显著正相关。结论护士应及时评估癔症性失声患者的疾病不确定感水平,制定有效干预措施,以降低其疾病不确定感水平,提高其应对水平。     

休克指数在失血性危重症患者救护中的应用现状

通过阐述休克指数的含义及临床意义,总结休克指数在危重症患者的病情判断、紧急救护(外伤出血、产后出血、异位妊娠破裂出血、上消化道出血)、失血性危重症患者的预后评估等方面的应用现状,以期为临床护理工作提供理论指导和借鉴。     

热射病并发呼吸衰竭患者的护理

目的总结热射病并发呼吸衰竭患者的护理经验。方法回顾性总结和分析13例热射病并发呼吸衰竭患者的护理方法。结果本组12例患者经治疗与护理治愈出院。l例多脏器功能衰竭患者,抢救无效死亡。结论迅速降温是热射病并发呼吸衰竭抢救成功的关键;保持呼吸道通畅,防止亚低温治疗并发症的发生是护理的重点。     

危重病人血浆甲状腺激素含量变化及其临床意义

目的　探讨危重病人血浆甲状腺激素（ Ｔ Ｈ） 的变化及其临床意义。方法　应用放射免疫分析法测定７３ 例危重病人和６０ 例健康人（ 对照组） 的血浆 Ｔ Ｈ 含量。结果　危重病人血浆 Ｔ３／ Ｆ Ｔ３ 含量〔（１０５ ±０４６）ｎ ｍｏｌ／ Ｌ〕／〔（２８５ ±１４１）ｐｍｏｌ／ Ｌ〕明显低于对照组〔（１９８ ±０５１）ｎｍｏｌ／ Ｌ, Ｐ＜ ００１〕／〔（６３７ ±１３１）ｐｍｏｌ／ Ｌ, Ｐ＜０００１〕;死亡组 Ｔ３／ Ｆ Ｔ３ 水平与非死亡组 Ｔ３／ Ｆ Ｔ３ 水平相比较有显著差异（ Ｐ＜ ００５／ Ｐ＜ ００１） 。结论　 Ｔ Ｈ 参与了危重病人的病理生理过程,监测危重病人血浆 Ｔ Ｈ 水平可作为反映病情程度和评估预后的一项参考指标。