77例帕金森病患者的情绪障碍分析

目的：探讨帕金森病患者的情绪障碍、影响因素及心理干预的效果。方法回顾性分析2012年02月-2013年02月期间在我院治疗的90例原发性帕金森病伴情绪障碍患者的临床资料，随机将90患者分为观察组（45例）和对照组（45例），对照组采用单纯药物治疗；观察组采用药物治疗+心理治疗，观察患者的影响因素并对比治疗效果。结果通过心理治疗干预后，对照组Zung、HAMD较对照组优势明显，差异有统计学意义（P＜0.05），病程、运动障碍、家庭经济情况是与情绪障碍的产生关系密切。结论帕金森病患者长期程、紧张的经济状况以及出现的肢体运动障碍是导致帕金森患者出现情绪障碍的相关因素，在单纯药物治疗的基础上辅以心理治疗能够降低情绪障碍的发病率及严重程度，利于患者生存质量的提高，值得临床推广应用。     

少年儿童情绪障碍120例临床分析

目的:分析少年儿童情绪障碍的临床特点以及发生情绪障碍的相关因素。方法:对住院的120例少年儿童情绪障碍者的临床资料进行回顾性分析。结果:120例少年儿童绪障碍住院患者中,男女比例为1.3∶1,住院人数较高的前3种疾病类型依次为癔症、强迫症、抑郁症,住院期间采用的主要干预方法包括药物治疗和心理治疗等。结论:少年儿童情绪障碍应引起医务人员、家长、学校和社会的重视,通过积极的干预促进少年儿童心理的健康发展。     

连贯性护理健康教育在门诊慢性宫颈炎患者中的应用探讨

目的:分析门诊慢性宫颈炎患者采用连贯性护理健康教育进行干预的效果。方法:随机抽取某门诊2011年3月~2013年12月收治的92例慢性宫颈炎患者,根据患者到门诊治疗时间的区别,分成观察组与对照组,对照组采用常规护理干预,观察组在上述基础上采用连贯性护理健康教育干预,对比两组患者护理效果。结果:观察组护理满意率、遵医行为、疾病知晓率等指标明显优于对照组,组间数据对比差异明显,具有统计学意义(P0.05)。结论:慢性宫颈炎患者采取连贯性护理健康教育措施进行干预,能够有效提高患者满意率、遵医行为、疾病知晓率等,值得临床推广。     

住院网络成瘾患者心理干预的康复效果评价

目的探索改善住院网络成瘾患者负性情绪和社交障碍的措施,为开展临床治疗和护理提供科学依据。方法将60例住院网络成瘾患者随机分为观察组(32例)和对照组(28例),均按常规药物治疗和护理,观察组实施为期8周的以人际心理治疗为主要方式的心理干预,对照组不实施系统的心理治疗。采用抑郁自评量表(SDS)、焦虑自评量表(SAS)、社交回避及苦恼量表(SAD)以及症状自评量表(SCL-90)对2组进行评价。结果治疗后观察组SAS,SDS,SAD及SCL-90等各量表分值的改变均显著优于对照组(P值均<0.01)。结论以人际心理治疗为主要方式的心理干预技术能够改善住院网瘾患者的负性情绪和社交障碍,提高心理健康水平,具有积极的临床治疗作用。     

冠心病患者情绪状态及心理干预

目的了解冠心病患者的情绪状态及对其进行心理干预的结果。方法用焦虑自评量表(SAS)、抑郁自评量表(SDS)和自制的调查表对心血管内科住院的85例冠心病患者心理干预前后进行调查,并与60名健康自愿者进行配比对照分析。结果心理干预前患者有明显的焦虑抑郁情绪,心理干预后患者的焦虑抑郁情绪明显改善。结论冠心病患者的情绪障碍严重,对冠心病患者进行心理干预,改善其负性情绪十分必要。     

注意缺陷多动障碍儿童的综合干预研究

目的 探讨综合治疗方式干预注意缺陷多动障碍儿童效果.方法 31名注意缺陷多动障碍儿童随机分为两组:单纯药物治疗组(n=16),服用"专注达"18mg,每日1次,晨服;药物+父母培训心理治疗组(n=15),除服用药物以外,还进行每次2小时、每周1次,共计8次,历时2个月的父母教养方式培训.采用患儿的学习成绩、母亲满意程度、康纳儿童行为父母问卷来评定干预效果.结果 ①两组治疗后学习成绩均有明显提高(t值分剐为5.78、6.01,均P<0.01);②两组治疗后注意缺陷多动障碍儿童的行为问题明显减少(t值分别为4.95、5.63,P<0.01);③药物+父母培训心理治疗组注意缺陷多动障碍儿童的焦虑情绪减少(t值分别为2.14,P<0.05).结论 综合治疗方式干预对注意缺陷多动障碍儿童干预效果比单纯药物治疗更明显.尤其是针对亲子关系和情绪的改善.     

多形式健康教育干预对老年COPD患者健康行为的影响

目的：探讨多形式健康教育对老年COPD患者健康行为的影响。方法：将76例老年COPD患者分为试验组40例,对照组36例,试验组患者在讲座教育、个体化教育与出院随访中运用多媒体、健康教育手册、口头宣教、技能示范、网络学习、经验介绍等多形式健康教育进行干预,对照组按常规方式进行健康教育。在干预前与干预6个月后,对两组患者进行焦虑情绪、家庭支持、控烟情况及呼吸功能锻炼依从性评价。结果：干预6个月后试验组患者焦虑情绪、家庭支持、控烟情况及呼吸功能锻炼依从性比对照组患者有所缓解,差异有统计学意义（P〈0.05）。结论：多形式健康教育可缓解老年COPD患者的焦虑情绪,提高家庭支持率,降低吸烟率,提高呼吸功能锻炼依从性。运用健康信念模式教育可明显提高老年COPD患者的自我护理能力,提高患者的生存质量。     

同伴支持护理对慢性宫颈炎患者负性情绪及依从性的影响

目的:探讨同伴支持护理对慢性宫颈炎患者负性情绪及依从性的影响。方法:从2017年5月至2018年7月收治的慢性宫颈炎患者中选取86例为研究对象,随机数字表法分为对照组与观察组各43例,对照组接受常规护理,观察组在对照组基础上加用同伴支持护理,对两组患者干预前负性情绪及依从性、应对方式进行观察。结果:两组干预前的HAMA、HAMD评分无明显差异(P0.05),观察组干预后的HAMA、HAMD评分明显低于对照组(P0.05);观察组依从率为97.67%,较对照组83.72%高(P0.05);两组干预前的应对方式评分无明显差异(P0.05),观察组干预后的消极应对评分较对照组低,积极应对评分较对照组高,差异有统计学意义(P0.05)。结论:同伴支持护理能减轻慢性宫颈炎患者负性情绪,也能提高患者治疗依从性,使其积极应对疾病,值得推广。     

健康教育对脑卒中患者焦虑和抑郁的影响

目的 了解脑卒中患者焦虑及抑郁状况,探讨健康教育对其情绪影响.方法 选择96例脑卒中无意识障碍患者,住院第1天采用焦虑自评量表及抑郁自量表方法调查,并进行统计学分析,同时进行随机分组.两组患者均接受责任护士的常规健康教育,在此基础上干预组患者从第2d开始由专业护士进行的针对性个体化健康教育,出院时再次用同样方法调查,并与健康教育前比较.结果 脑卒中无意识障碍患者,存在一定程度的焦虑及抑郁症状.经过健康教育,患者SAS及SDS评分、焦虑及抑郁情绪的发生率均有降低,同健康教育前比较,差异有统计学意义(P＜0.001).结论 针对性健康教育,可减轻或消除脑卒中患者的焦虑及抑郁情绪,降低其发生率,有利于脑卒中恢复.     

高血压病患者生活方式的健康教育及护理干预

目的：研究高血压病患者生活方式的健康教育及护理干预。方法在我院神经内科选取2015年6月～2016年6月收治的60例高血压病患者,对患者的生活方式采用健康教育和护理干预的方式进行干预,观察患者的生活方式。结果实施后所有患者的生活方式明显优于实施前,比较差异P＜0.05,有统计学意义。结论对高血压病患者生活方式采用健康教育及护理干预的方式,能够有效的改善患者生活方式。     

宫颈疾病防治知识的健康教育效果评价及需求调查

目的:了解妇女对宫颈炎和宫颈癌知识的认知、需求情况及健康教育提高宫颈疾病防治知识正确认知的效果。方法:对参加该院妇女病普查的578例妇女,在进行健康教育前后自行填写调查问卷。结果:健康教育前后,研究对象对慢性宫颈炎症状的正确认知率由40.1%提高到72.3%,差异有显著性(χ2=121.6,P<0.001),并且对宫颈炎危险因素、宫颈炎治疗方法、宫颈癌发病因素等的正确认知率亦明显提高,均有统计学意义。调查对象认为开展宫颈疾病防治健康教育的最好3种形式是门诊医生介绍、广播电视、书籍杂志。结论:提高目标人群对宫颈疾病的正确认知对于慢性宫颈炎和宫颈癌的预防和治疗非常重要。健康促进是漫长复杂的过程,各级医疗卫生部门,尤其是妇幼保健机构应开展多种形式的生殖健康教育,加强宫颈疾病的优质便民服务,以满足广大妇女的生殖健康需求,是提高妇女生殖健康的重要手段。     

健康教育对宫颈炎治疗方式选择的影响

目的 对宫颈中、重度糜烂患者开展相关健康教育,评价健康教育的效果,探讨宫颈炎治疗过程中的健康教育模式.方法 对广州地区部分厂矿企业、学校、事业单位等长期在广州市妇婴医院参加妇女病普查并连续两年被诊断为宫颈中、重度糜烂的220例患者进行问卷调查.了解患者接受健康教育前、后对宫颈糜烂的治疗依从性、危害及防治知识的认知程度,次年对患者的治疗依从性、治疗效果、认知水平等进行追踪,以此评价健康教育的效果.结果 健康教育前患者的治疗依从性较差,约90.0%未按医嘱正确治疗,对宫颈炎危害及防治知识认知不足是导致她们没有及时正确治疗的主要原因（占72.3%）,通过健康教育干预,这些患者的治疗依从性和健康意识明显提高,从而获得了满意的治疗效果.结论 开展群体性健康教育和个性化指导、普及妇女常见病防治知识,是提高广大妇女的健康知识水平,明显改善宫颈炎患者的治疗依从性、降低宫颈炎患病率的有效措施.     

Mental Health Disorders Among Caregivers of Preschool Children in the Asenze Study in KwaZulu-Natal, South Africa

Given the existing evidence linking parental depression with infant and early child development, our aim was to describe the burden of mental health disorders among caregivers of young children aged 4–6 years living in an environment of poverty and high HIV seroprevalence. We analyzed baseline data from an epidemiologic study of the health and psychosocial needs of preschool-aged children. Primary caregivers of index children recruited from a household survey were screened for common mental disorders using the Client Diagnostic Questionnaire (CDQ). Sociodemographic, HIV and general health surveys were also conducted. Many caregivers (449/1,434; 31.3 %) screened positive for at least one psychiatric disorder on the CDQ, with post-traumatic-stress-disorder being the most common. Caregivers who screened positive for any disorder were more likely to be older, to have no individual sources of income and to have less formal education. Presence of a disorder was also significantly associated with lower employment levels within the household and death of a young child within the household. Known HIV-infected caregivers were more likely to have any mood disorder than caregivers who previously tested negative. The data support the need for mental health treatment interventions in South Africa, particularly interventions directed at PTSD and depression, and that take into account the high burden of poverty, HIV and childhood mortality. Given the limited formal mental health structure in South Africa to address these highly prevalent disorders; community-based mental health supports, available through decentralized health systems many be critical to delivering accessible interventions.     

An ecological study of the relationship between socioeconomic isolation and mental health in the most deprived areas in Auckland,New Zealand

International debate posits that when groups feel deprived relative to reference groups in society, there may be psychosocial impacts. Deprivation varies geographically and deprived areas may be proximal to advantaged areas. In theory, this leads to chronic stress and poor mental health. This research explored whether socioeconomically isolated deprived areas experience increased levels of anxiety/mental disorder treatment, compared to other deprived areas. We developed a spatial isolation measure to characterise deprived areas surrounded by advantaged areas in Auckland, New Zealand. We found that isolated areas were characterised by fewer Māori and Pacific people, high density and shorter travel time to General Practitioners. We found significantly higher rates of anxiety/mood disorder treatment in highly isolated versus non-isolated areas and a statistically significant relationship with anxiety/mood disorders for each isolation level, both before and after confounder adjustment. This evidence suggests that mental health within small areas may be sensitive to the neighbourhood interactions, through social comparison or discrimination which lead to psychosocial stress.     

The Role of Mental Health Patient Organizations in Disease Management

Mood disorders are serious chronic illnesses that are the leading cause of disability worldwide. Up to two-thirds of all people with a mood disorder are undiagnosed. In the US, there are three suicides for every two homicides, with 70% of these deaths attributed to untreated depression. Mental health advocacy organizations play an important role in the management of these disorders by urging those who are undiagnosed or untreated to seek treatment.Stigma is the number one barrier to mental healthcare, according to the US Surgeon General. Advocacy groups work to eliminate the stigma surrounding mental illness in order to encourage more people to seek treatment. They have a role in disease management as they enhance communication between patients and healthcare providers, an area in which studies have shown a significant gap in perceptions. Advocacy groups educate people so that they can play an active role in their own treatment plans. It has been demonstrated that participation in patient support groups increases patient compliance with treatment plans and decreases incidences of hospitalization for the illnesses.A critical role in disease management is patient advocacy for improved access to care, so that those needing treatment can actually receive it. Finally, mental heath advocacy groups have a role in managing the disease through ‘grassroots’ efforts to promote expanded research for better treatments, and eventually cures, for mental illnesses.     

Mental-physical comorbidity in an ethnically diverse population

The relationship between mental disorders and chronic physical conditions is well established, but the possibility of ethnic group differences in mental-physical associations has seldom been investigated. This study investigated ethnic differences in associations between four physical conditions (chronic pain, cardiovascular disease, diabetes, and respiratory disease) and 12-month mood and anxiety disorders. A nationally representative face-to-face household survey was carried out in New Zealand from 2003 to 2004 with 12,992 participants aged 16 and older, achieving a response rate of 73.3%. The current study is of the subsample of 7,435 participants who were assessed for chronic physical conditions (via a standard checklist), and compares Maori, Pacific and Other New Zealanders. DSM-IV mental disorders were measured with the Composite International Diagnostic Interview (CIDI 3.0). The ethnic groups differed significantly in prevalences of both physical and mental disorders, but almost no ethnic differences in mental-physical associations were found. Independent of ethnicity, associations were observed between chronic pain and mood and anxiety disorders, cardiovascular disease and anxiety disorders, respiratory disease and mood and anxiety disorders. Despite differences in mental and physical health status between ethnic groups in New Zealand, mental-physical disorder associations occur with considerable consistency across the groups. These results suggest that whatever factors are conducive to the development of a mental disorder from a physical disorder (or vice versa), they are either unaffected by the cultural differences manifest in these ethnic groups, or, any cultural factors operating serve to both increase and decrease comorbidity such that they cancel each other out.     

319例女性宫颈分泌物支原体检测及耐药性分析

目的:了解女性宫颈解脲支原体(Uu)和人型支原体(Mh)感染与年龄、宫颈炎、白带清洁度、念珠菌和滴虫感染的关系,并对支原体药敏结果进行分析。方法:取宫颈拭子作支原体培养,取阴道分泌物作清洁度检查及革兰染色镜检,同时记录有无宫颈炎等。结果:支原体阳性率为44.8%,Uu、Uu+Mh、Mh阳性率分别为70.6%、25.2%、4.2%。Uu、Uu+Mh阳性患者好发年龄以21～30岁为主,各年龄段的Uu、Uu+Mh阳性率差异有统计学意义(P<0.01)。Mh阳性患者好发年龄集中在21～50岁,各年龄段的Mh阳性率差异无统计学意义(P>0.05)。宫颈炎、白带清洁度异常者的Uu、Uu+Mh、Mh阳性率明显高于无宫颈炎和白带清洁度正常者(P<0.05)。念珠菌、滴虫感染者的Uu、Uu+Mh阳性率与无念珠菌、滴虫感染者相比,差异无统计学意义(P>0.05)。支原体对美满霉素、强力霉素、交沙霉素较敏感;Uu+Mh感染的耐药率明显高于Uu感染。结论:宫颈炎、白带清洁度异常者为支原体感染的高危人群,诊治时应常规做支原体检测,同时结合药敏试验结果进行治疗。防治支原体感染,应加强卫生知识宣教,提高生殖健康知识水平。     

个案化健康教育对慢性乙肝患者拉米夫定治疗依从性的影响

目的通过对用药全程进行个案化健康教育，提高慢性乙肝患者拉米夫定治疗的依从性。方法将138例住院接受拉米夫定治疗的慢性乙肝患者，随机分为实验组和对照组，每组69例，对实验组进行个案化健康教育，对照组按传统的卫生宣教方法进行教育，于治疗12个月后，对2组患者依从性进行调查分析。结果实验组与对照组遵医嘱用药比较，差异有统计学意义（P〈0．05），在生活方式改善、保持乐观情绪、定期复查3个方面比较，均P〈0．01，2组问差异有统计学意义。结论采取个案化的健康教育方法可提高慢性乙肝患者拉米夫定治疗的依从性。     

奥平栓联合微波治疗慢性宫颈炎疗效观察

目的 观察奥平栓联合微波治疗慢性宫颈炎的临床疗效.方法 将笔者所在医门诊246 例慢性宫颈炎患者,随机分成奥平栓联合微波治疗组126 例和对照组单纯微波辐射治疗120 例.观察两组治疗后的疗效及预后的时间.结果 一次痊愈率治疗组明显高于对照组;治疗后症状明显改善、宫颈恢复时间治疗组明显优于对照组.结论 奥平栓联合微波安全有效,副作用小,术后并发症少,治愈率高,是治疗慢性宫颈疾病的有效方法,值得推广.     

Chronic disease and mental disorder

The aim of this study was to achieve a better understanding of the relationship between chronic medical illness and mental distress. Therefore, the association between chronic medical illness and mental distress was analysed, taking into account the modifying effects of generic disease characteristics (concerning course, control and possible stressful consequences), physical quality of life indicators and social and relationship problems. Panel data from the Dutch national Panel of Patients with a Chronic Disease (PPCZ) were used. Data from 1788 chronically medical ill patients (nine disease categories) concerning their mental and physical health have been used in a cross-sectional, multivariate analysis. Somatic disease, generic disease characteristics and physical quality of life were assessed by medical doctors. Mental distress and social/ relationship problems were assessed by questionnaire (respectively, GHQ-12 and Biopro). Members of the panel had more mental distress than a random community sample. However, there were no differences between specific somatic diseases. Relationship, job-related and financial problems increased the probability of mental disorder considerably. Relationship problems may be considered a generic characteristic of chronically ill patients, causing an increased risk of mental disorder. Poor physical health condition contributed to a higher probability of mental disorder as well. General practitioners, home care providers and medical specialists should be aware that people with chronic diseases are in general more at risk of mental disorder. For many chronically ill people, this risk is further exacerbated by social/relationship problems, and a poor level of perceived health.