Quality of life for primary caregivers of muscular dystrophy patients in South Korea

Background Although some studies measured the burden of caregivers and the factors that influenced their feelings of burden, few studies have measured the quality of life （QOL） for primary caregivers of patients with muscular dystrophy （MD）. We assessed the QOL for primary caregivers of patients with MD in South Korea and identified factors associated with caregivers＇ QOL. Methods Ninety dyads of patients with MD and their primary caregivers were enrolled in this study. The QOL of caregivers of patients with MD was assessed subjectively using the World Health Organization Quality of Life Assessment, Life Brief Form. Caregivers＇ emotional status was assessed using the Beck Depression Inventory （BDI） and family function level was evaluated using the Family APGAR scale. Patients reported their emotional status using the BDI or the Children＇s Depression Inventory. The functional levels of patients were evaluated by the modified Barthel Index. Results Caregivers＇ QOL was statistically associated with family income, family function, emotional status of patients, level of education, and emotional status of caregivers （P 〈0.05）. Caregivers who were employed had a significantly higher QOL than those who were not （P 〈0.05）. In multiple regression analyses, emotional and employment status of caregivers was strongly associated with caregivers＇ QOL. Conclusion Rehabilitation teams should consider not only the physical factors of patients but also the psychological and demographic factors of primary caregivers of patients with MD.     

Relationships among hope, coping style and social support for Breast cancer patients

Background Breast cancer is one of the most common cancers in women, and its incidence seems to have gradually increased every year. During the treatment of breast cancer, patients suffer psychological morbidity, and hope is one important factor in maintaining psychological health. Therefore, in this study, we investigated the level of hope in Chinese women with breast cancer during chemotherapy and confirmed the relationships among hope, coping style, and social support.Methods One hundred and fifty-nine inpatients with breast cancer who were undergoing chemotherapy in two affiliated hospitals of Harbin Medical University were recruited and investigated. Each patient completed the Herth Hope Index （HHI）, Jalowiec Coping Scale （JCS）, and the social support scale made by XIAO Shui-yuan, and provided general demographic data.Results The mean hope level of the 159 patients with breast cancer was 38.62±4.56. There was a statistical difference between the hope level and monthly income. Analysis of results from the Pearson test showed no relationship between the hope level and coping style; however, there were positive relationships between hope and optimism, hope and self-reliance, and hope and palliative coping styles. In contrast, negative relationships were found between hope and the fatalistic and emotional coping styles. The total score of hope and social support had significantly positive relationship for the three scales.Conclusions Patients with breast cancer achieved high levels of hope, with the level of hope being proportional to increase in the income. During chemotherapy, patients with breast cancer had adopted many coping styles.     

The causes of upper gastrointestinal hemorrhage analysis and nursing observation

Objective To investigate the common causes of upper gastrointestinal hemorrhage and clinical nursing observation. Methods In our hospital from January 2011 to December 2012 medical hospitalized in our hospital clinical data of 46 patients with upper gastrointestinal bleeding were retrospectively analysis. Adopt routine medical care,nursing science system ( including psychological nursing, homeostatic treatment nursing,and diet nursing and health guidance after discharge,etc. ) aspects of the patient and family care,analyze the effect of nursing. Results The physician in 46 patients with upper gastrointestinal bleeding,medical,endoscopic treatment,and science of nursing,28 patients recovered and discharged,11 patients curative effect is distinct,6 cases have a therapeutic effect,1 case of no effect, turn over the superior hospital treatment,no deaths occur during treatment of total effective rate reached 94. 8% . Conclusion In patients with upper gastrointestinal bleeding,gives scientific and effective system of nursing,which can effectively help patients heal as soon as possi- ble,to reduce the recurrence rate and mortality,reduce the economic burden of the patients.     

INTELLIGENT TOOLS FOR PREDICTING ANXIETY OF ALZHEIMER＇S PATIENTS

Objective To predict the incidence of anxiety in Alzheimer＇s disease （AD） patients by using machine-learning models. Methods A large randomized controlled clinical trial was analyzed in this study, which involved AD patients and caregivers from 6 different sites in the United States. The incidence of anxiety in AD patients was predicted by backpropagation artificial neural networks and several machine learning models, including Bayesian Networks, logistic regression, ADTree, J48, and Decision table. Results Among all models for predicting the incidence of anxiety in AD patients, the artificial neural network with respectively 6 and 3 neurons in the first and second hidden layers achieved the highest predictive accuracy of 85.56 %. The decision tree revealed three main risk factors： ＂caregiver experiencing psychological distress＂, ＂caregiver suffering from chronic disease or cancer＂, and ＂lack of professional care service＂. Conclusion The unique ability of artificial neural networks on classifying nonlinearly separable problems may substantially benefit the prediction, prevention and early intervention of anxiety in Alzheimer＇s patients. Decision tree has the double efficacy of predicting the incidence and discovering the risk factors of anxiety in Alzheimer＇s patients. More resources should be provided to caregivers to improve their mental and physical health, and more professional care services should be adopted by Alzheimer＇s families.     

汶川地震后高三学生心理健康状况调查及其影响因素

Objective This article mainly discuss the relationship among coping style,social support,de-pression,stress level and mental health in senior students after the earthquake. Methods 820 sample students were selected randomly from 6 middle schools in temporary inhabitancy of Dujiangyan area. Mental investigational questionnaire of China Ministry of Health, Beck Depression Inventory 2nd edition ( BDI-2), social support ques-tionnaire,simple coping style questionnaire (SCSQ) and other methods were used, and variance, correlation, and hierarchical regression to analyze the relationship of the variable. Results The account for mental investigational questionnaire of China Ministry of Health was (7.49±4.41 ) ,the scoring of B DI (14.66±9.12) was on the high side. Mental problems was positively correlated with depression symptom and stress level (r=0.69,0.15 ), while it was negatively correlated with positive coping and social support (r=-0.33, -0.30). This showed that the interac-tion between positive coping and social support (β=0.14,△R2 =0.02), depression symptom and stress level (β= 0.07, △R2 = 0.01 ) was distinctness respectively. Conclusions Most of senior students have poor scores on mental state examination in the earthquake-stricken area. Depression symptom is a mediator between positive coping and mental health. Social support is a remarkable moderator between positive coping and depression,along with the increasing of social support,the protective effect of positive coping also enhance. Stress level is a moderator between depres-sion and mental problems.     

Study on measuring burden of disease

DALY（Disability Adjusted Life Years) was recommended as a new indicator to measure burden of disease(BOD) .Although BOD combines information from both morbidity and mortality,it only reflects the burden from the patients themselves because of their illness or death.As a common indicator.BOD should not only include the burden from the patients,but also the burden to the society around the patients.such as the input and support from the society to the ill person,and the losses from the related events.The aim of this study is to explore the scope and the magnitude of the burden to the society using stroke as an example.Results show that the burden due to time lost for caring for patients in hospitals accounts for 2.4% of total BOD (in a narrow sense),which indicates that BOD may be underestimated if the burden to the society is ignored.     

Family Status and Dilemma of HIV Positive Subjects

Objective To understand the family status and dilemma of HIV positive subjects and provide some related suggestions. Methods Constructured questionnaire and in-depth interview were used to survey their psychological needs of the 111 HIV positive subjects and AIDS patients from 4 provinces in China. Results HIV positive subjects and AIDS patients had strong mental stress. All of them hope to get support from their families; the most difficulty the subjects faced was economic poor. Conclusion It is a highlight to promote AIDS education to establish a good social environment in which HIV positive subjects and AIDS patients can live quietly and happily. And psychological support from their families and the society is very important to HIV positive subjects and AIDS patients.     

EFFECTS OF ACUPUNCTURE ON IMMUNOGLOBULINS IN PATIENTS WITH ASTHMA AND RHEUMATOID ARTHRITIS

The effects of acupuncture on immunoglobulins in patients with asthma and rheumatoid arthritis were studied. After acupuncture, in 20 patients with asthma, IgG increased (P< 0.01), IgM and IgE decreased (both P< 0.01), while IgA did not change markedly (P> 0.05); in 12 patients with rheumatoid arthritis, after acupuncture IgG, IgA and IgM de-creased (P< 0.05, 0.05, and 0.01, respectively), while IgE did not change evidently. The re-sults observed in these 32 patients indicate that acupuncture exerts modulation action on immunoglobulins of the human body, and that patients with asthma and rheumatoid arthritis responded effectively to acupuncture therapy, the latter might be related to the reinforce-ment of the immunological function by acupuncture.     

阿尔茨海默病患者甲状腺功能与神经精神症状关系的研究

Background Growing evidence links alternation of the thyroid function to the pathogenesis and progression of Alzheimer disease (AD). However, only a few studies evaluate the association between thyroid hormone levels and neuropsychiatric manifestations in patients with AD. Objective To investigate the relationship of thyroid hormone levels and neuropsychiatric symptoms in euthyroid patients with AD. Method Forty patients with AD (26 women and 14 men), with no prior AD treatment within 4 weeks before study entry, were evaluated on their thyroid status (total triiodothyronine [TT3], total thyroxine [TT4] and thyroid-stimulating hormone [TSH]), cognition (Mini-Mental State Examination [MMSE] and Alzheimer’s disease Assessment Scale–Cognitive Subscale [ADAS-cog]), neuropsychiatric symptoms (Neuropsychiatric Inventory [NPI]) and depression (Hamilton Rating Scale for Depression [HAMD17]). Results In euthyroid patients with AD, agitation and irritability of NPI are negative related to the serum level of TSH (t=-2.130, P<0.05; t=-2.657, P<0.05), and core score of HAMD is significant associated with the serum level of TSH (β=0.395, t=2.985, P<0.01). There is no significant association between thyroid hormone levels and cognition (MMSE, ADAS-cog and its subscale score). Conclusions There might be a relationship between thyroid hormone levels and the neuropsychiatric symptoms in euthyroid patients with AD.     

口腔颌面肿瘤病人主要照顾者应激与应对方式现状分析

目的探讨应对方式对口腔颌面肿瘤病人照顾者应激水平的影响。方法以157例口腔颌面-头颈肿瘤科住院治疗病人的主要照顾者作为研究对象,采用自制的一般资料问卷、亲属应激量表、特质应对方式问卷对调查对象的一般资料、应激水平以及应对方式进行调查。结果口腔颌面-头颈肿瘤病人照顾者的亲属应激量表总分为0~30分;照顾者的积极应对分为10~47分;消极应对分为10~50分;照顾者的应激总分及三个因子分与其积极应对分呈明显负相关关系（P < 0.01）,与其消极应对分呈明显正相关关系（P < 0.01）;在照顾者应激总分的回归等式中,病人性别及主要照顾者的消极应对分、积极应对分、觉得自己是否有必要接受相关心理治疗共4个变量进入了回归等式（P < 0.05~P < 0.01）。结论口腔颌面-头颈肿瘤病人主要照顾者的应对方式是其应激水平的影响因素,且其应对方式较消极,因此,应有针对性地改善其应对方式,以促进其自身及口腔颌面-头颈肿瘤病人的身心健康。     

住院脑卒中患者主要照顾者心理状态及其与应对方式和社会支持的相关性

目的：探讨住院脑卒中患者主要照顾者心理状态及其与应对方式和社会支持的相关性。方法：采用便利取样选取住院脑卒中患者主要照顾者160名,利用一般资料问卷,激惹、抑郁和焦虑自评量表（IDA）、医学应对方式问卷（MCMQ）、社会支持评定量表（SSRS）调查其心理状态、应对方式和社会支持的情况。结果：住院脑卒中患者主要照顾者心理状态得分从高到低依次为焦虑、抑郁、外向型激怒和内向型激怒;应对方式中选择积极应对的面对、回避,消极应对的屈服,得分分别为（10.32±2.76）、（18.39±3.24）和（15.08± 2.96）分;社会支持得分从高到低依次为主观支持、客观支持和支持利用度;相关分析显示,住院脑卒中患者主要照顾者心理状态各维度得分与积极的应对方式即面对和回避得分呈显著负相关,而与消极的应对方式屈服得分呈显著正相关（均P＜0.05）;住院脑卒中患者主要照顾者心理状态各维度得分与社会支持各维度得分呈显著负相关（均P＜0.05）。结论：住院脑卒中患者主要照顾者焦虑、抑郁等心理状态较明显,消极的应对方式可能加重其心理问题,而积极的应对方式和更好的社会支持有利于改善不良心理状态,临床可以采取针对性的干预措施。     

注意缺陷多动障碍患儿照顾者照顾负担应对方式对负性情绪的影响

目的 观察注意缺陷多动障碍（ADHD）患儿照顾者照顾负担、应对方式对负性情绪的影响因素。方法 选取2021年6月至2022年12月常州市德安医院心理科确诊的68例ADHD儿童的照顾者为ADHD组,选择同期在医院门诊进行常规体检的83例正常儿童的照顾者作为正常对照组,比较两组抑郁-焦虑-压力自评量表（DASS-21）、照顾者负担量表（ZBI）、简易应对方式问卷（SCSQ）评估结果。结果 ADHD组压力、焦虑、抑郁得分分别为10.0（6.0,16.0）、6.0（2.0,11.5）和5（2.0,11.5）分,照顾者的照顾负担为27.0（20.0,45.0）分,均高于正常对照组,差异均有统计学意义（P<0.05）;ADHD组照顾者的压力与照顾负担和消极应对方式呈正相关（P<0.05）;ADHD照顾者的焦虑与照顾负担呈正相关（P<0.05）,与积极应对方式呈负相关（P<0.05）;ADHD照顾者的抑郁与照顾负担和消极应对方式呈正相关（P<0.05）,与积极应对方式呈负相关（P<0.05）;照顾负担、消极应对方式是ADHD照顾者压力的影响因素（P<0.05）,照顾负担、积极应对方式是ADHD照顾者焦虑的影响因素（P<0.05）,照顾负担、积极应对方式、消极应对方式是ADHD照顾者焦虑的影响因素（P<0.05）。结论 ADHD照顾者的负性情绪较多、照顾负担较重,照顾者的照顾负担和应对方式是影响其负性情绪的主要因素。     

老年人和大学生自我效能感与应付方式的差异

目的 探讨自我效能感和应付方式的年龄差异以及两者之间的特征.方法 以48名老年人和49名在校大学生为被试,进行背景信息问卷、应付方式问卷、一般自我效能感问卷施测.结果 (1)在控制了教育水平差异之后,老年人自我效能感得分[(43.47±11.49)分]高于大学生[(40.82±7.88)分]差异具有显著性( P <0.05);在应付方式上,解决问题和自责2个维度存在显著年龄差异( P <0.05).(2)自我效能感和应付方式部分维度有显著相关( P <0.05),且老年人和大学生的相关模式不同.(3)在应付方式上,大学生的自我效能感高分组和低分组差异有显著性( P <0.05),老年人则没有.结论 老年人和大学生的自我效能感、应付方式以及两者之间的关系模式皆存在显著年龄差异.     

骨肿瘤患者化疗期间焦虑、 抑郁情绪与应对方式的调查研 究简

目的 了解骨肿瘤患者化疗期间焦虑、抑郁情绪与应对方式的现状,探讨其关系.方法 应用一般资料调查问卷、综合性医院焦虑抑郁量表（HAD）和特质应对方式问卷（TCSQ）对109例骨肿瘤化疗患者进行调查,并进行相关性分析.结果 骨肿瘤化疗患者焦虑、抑郁发生率分别是35.78％、31.19％.积极应对得分低于常模,消极应对得分高于常模,差异有高度统计学意义（P＜0.01）.患者的消极应对得分在性别上差异有统计学意义（P＜0.05）.焦虑、抑郁与消极应对呈正相关（r=0.345、0.226,P＜0.05）.结论 骨肿瘤化疗患者焦虑、抑郁情绪反应普遍存在.女性比男性更容易消极面对压力.焦虑、抑郁情绪对患者的应对方式有负性影响,焦虑、抑郁程度越高,应对越消极.护理人员应及时评估患者的焦虑、抑郁情绪及人格特质以发现不良的心理变化,提供个体化的心理指导,促进患者身心健康.     

医学生特质应对与个性心身反应的相关性研究

目的研究医学生特质应对与个性、心身健康水平的关系,进一步探讨应对方式在应激系统中的理论意义。方法对145名三年级医学生进行问卷调查,包括特质应对问卷(TCSQ)、卡特尔16项人格因素问卷(16PF)及心身症状自评量表(SCL-90)。结果单因素相关分析显示:医学生消极应对方式与16PF的L、O和Q4呈正相关,与C、F、G、H和Q3呈负相关(P<0.01);与除F2、F6外的各项SCL-90因子分均具有较大的正相关(P<0.05或P<0.01)。医学生积极应对方式与16PF的C、E、F、H和Q3呈正相关(P<0.01),与L和O呈负相关(P<0.05或P<0.01),与SCL90的F2呈负相关(P<0.05)。多元逐步回归分析提示:影响医学生消极应对方式的主要因素有C、F7、O、G和F8(P<0.05或P<0.01),5个因素总共可解释因变量的35.4%。影响医学生积极应对方式的主要因素有H和O(P<0.05),两个因素总共可解释因变量的12.5%。结论医学生的特质应对方式受个性、心身反应影响,从一个侧面支持了心理应激是多因素相互作用系统的理论假说。     

心肌梗死患者应对方式对创伤后成长的影响分析

目的探讨心肌梗死患者应对方式对创伤后成长的影响,为提高心肌梗死患者创伤后成长提供依据。方法采用特质应对方式问卷、创伤后成长量表及自编患者一般资料问卷,对192例心肌梗死门诊患者进行调查。结果心肌梗死患者创伤后成长总分为（69.63±13.27）分,积极应对方式总分为（33.80±6.12）分,消极应对方式总分为（30.13±6.61）分;积极应对方式得分与创伤后成长及各维度得分均成正相关（P ＜0.05）;分层回归分析结果显示,人均月收入、疾病了解程度、发病次数、是否合并其他疾病、积极应对方式与创伤后成长有关（P ＜0.05）,应对方式可解释创伤后成长变异的4％。结论临床医务人员可以通过指导患者采取恰当的应对策略,帮助患者提高创伤后成长水平。     

基于结构方程模型的社区失能老人主要照顾者焦虑影响因素研究

目的 探讨社区失能老人主要照顾者焦虑的影响因素,分析应对方式、照顾负担、自我效能和社会支持对照顾者焦虑的直接与间接作用,并建立其作用关系模型。 方法 采用自行设计的患者和照顾者一般资料问卷、医学应对方式量表、Zarit照顾者负担量表、一般自我效能感量表、社会支持评定量表和焦虑自评量表于2016年6月-12月对上海市浦东新区金杨社区5个社区440名失能老人及主要照顾者进行调查。建立失能老人照顾者焦虑影响因素模型用AMOS 17.0软件进行分析。 结果 模型数据拟合度良好,结构方程模型分析显示:照顾负担对焦虑有间接正向效应(β=0.384,P<0.01);社会支持对焦虑有直接负向效应(β=-0.053,P<0.01)和间接负向效应(β=-0.590,P<0.01);自我效能对焦虑有直接负向效应(β=-0.070,P<0.01)和间接负向效应(β=-0.374,P<0.01);应对方式对焦虑有直接负向效应(β=-0.706,P<0.01)。 结论 应对方式、自我效能和社会支持均可直接影响照顾者焦虑,照顾负担通过应对方式间接影响照顾者焦虑,自我效能通过照顾负担和应对方式间接影响照顾者焦虑,社会支持通过照顾负担、自我效能和应对方式间接影响照顾者焦虑,因此,社区护士未来应鼓励照顾者应用积极的应对方式,给予针对性的医疗知识和提高照顾技能来增强照顾者的自我效能感,应多角度多方位地给予增强照顾者社会支持系统来最终减轻照顾者焦虑。      

青春期不同性别精神分裂症患者应对方式与应激源及阳性症状关系的研究

目的:探讨不同性别精神分裂症患者应对方式与应激源及阳性症状是否存在关系。方法:采用自编的一般情况问卷、特质应对方式问卷、中学生应激源量表和阳性症状评定量表,对202例青春期首发的精神分裂症患者进行评定。结果:相关分析发现,男性在教师压力与消极应对呈显著负相关,P<0.05,而女性无相关性。女性在家庭压力与消极应对呈显著正相关、在同学朋友压力与积极应对呈显著负相关,P<0.05,而男性无相关性。在怪异行为总评分与消极应对之间,女性呈正相关,而男性则无相关性。男性在阳性思维形式总评分、分量表综合评价总分、阳性症状量表总分与积极应对方式之间呈显著负相关,而女性则无相关性。多因素分析发现性别因素与阳性症状存在明显的关联。结论:不同性别分裂症患者,面对应激的应对方式存在差异;应对方式不同,会影响其症状的表现;性别与阳性症状存在明显的关联。     

154名护理部主任心理健康水平与应对方式的相关性研究

目的 了解护理部主任的心理健康和应对方式状况及其相关性.方法 对湖南省84家医院的154名护理部主任选用症状自评量表(SCL-90)、简易应对方式量表进行调查及分析.结果 ①19.5%的护理部主任存在心理健康问题,护理部主任SCL-90总分为(131.12±39.32)分,与常模进行比较,人际关系敏感和敌对分低于常模(P值分别为0.04,0.02),精神病性分高于常模(P=0.04);②护理部主任积极的应对方式的平均分为(2.04±0.45)分,消极的应对方式的平均分为(0.25±0.06)分,显示积极应对高于常模(P=0.00),消极应对低于常模(P=0.00);③积极应对与敌对呈负相关;消极应对与SCL-90呈显著正相关.结论 护理部主任存在心理问题,消极应对有害于心理健康.