汶川地震灾区青少年心理健康及其影响因素纵向分析

目的了解经历地震自然灾害后青少年心理健康水平随时间的变化特点并分析其影响因素。方法选取汶川地震极重灾区和轻灾区2所中学的初中一年级学生为研究对象, 采用纵向设计方案对其进行为期2年共5次追踪调查, 采用重复测量的方差分析以及结构方程模型框架下的潜变量增长曲线模型进行统计分析。结果5次调查均参加的学生共977人, 男生占49%, 女生占51%。重复测量的方差分析分析显示, 极重灾区青少年心理健康、自尊、积极应对始终低于轻灾区(P<0.05), 2个灾区学生消极应对得分差异无统计学意义(P>0.05);心理健康、自尊有下降趋势,消极应对有上升趋势(P<0.05)。潜变量增长曲线模型结果显示, 心理健康的保护因素有自尊、积极的应对方式(P<0.05);消极应对方式阻碍青少年心理的健康发展(P<0.05)。男生心理健康水平均高于女生(P<0.05), 但男女生心理健康变化趋势差异无统计学意义(P>0.05)。结论青少年心理健康具有动态变化的特点;地震对青少年心理健康产生了不利的影响, 但是可以通过内部调节来促进身心健康发展。     

汶川与唐山地震截瘫患者社会支持及身心健康状况

目的 了解汶川地震截瘫患者身心健康及社会支持情况。方法 采用症状自评量表（SCL-90）和社会支持评定量表对汶川地震灾区127例截瘫患者进行调查,并与唐山大地震31例康复村截瘫患者和33例截瘫疗养院患者进行比较。结果 汶川地震截瘫患者中,男、女性SCL-90敌对因子分别为（0.88±0.82）、（0.38±0.33）分,其他因子分别为（1.10±0.67）、（0.60±0.62）分,差异均有统计学意义（P<0.05）;就业与未就业者客观支持维度分别为（8.87±3.11）、（6.17±1.76）分,差异有统计学意义（P<0.01）;唐山康复村、疗养院和汶川地震截瘫患者SCL-90总分分别为（121.48±23.86）、（165.12±57.30）、（68.91±52.35）分;客观支持分别为（17.71±3.99）、（11.00±5.20）、（7.39±2.78）分,主观支持分别为（6.84±1.77）、（5.79±3.66）、（18.36±4.35）分,差异均有统计学意义（P<0.001）;对支持的利用度分别为（6.68±2.24）、（6.12±2.00）、（7.03±1.88）分,差异均有统计学意义（P<0.01）。结论 汶川地震截瘫患者的身心健康状况和社会支持现状好于唐山地震截瘫患者。     

汶川地震灾区中学生焦虑状况调查

目的 了解汶川地震18个月后灾区中学生焦虑情绪发生状况。方法抽取地震灾区3所中学初一、初二、高一、高二年级学生共2 729人,采用青少年焦虑情绪障碍筛查表进行问卷调查。结果 44.6%的中学生存在焦虑情绪;女生焦虑情绪发生比例高于男生,差异有统计学意义(χ²=52.163,P<0.001);灾区中学生总体焦虑水平高于全国常模,差异有统计学意义(t=9.324、14.695,P均<0.001);高中生广泛性焦虑得分高于初中生,高二学生社交恐怖得分高于其他年级学生;具有地震相关经历的学生焦虑情绪发生比例高于对照组(χ²=20.419、5.155、5.994、38.5141、7.302,P<0.05或0.001)。结论 震后18个月,灾区中学生普遍存在焦虑情绪,应重点关注女生、高中年级及具有地震相关经历的学生。     

都江堰市震后安置点卫生状况及居民卫生服务需求

目的分析都江堰市地震灾区不同阶段安置点环境卫生状况及居民卫生服务需求,对现阶段安置点防病工作提供建议,为灾民永久安置点建设提供经验和借鉴。方法分别在2008年6月、8月,2009年3月三次对都江堰市集中安置点进行资料收集、现场观察和问卷调查,采用系统抽样方法对永久安置点居民进行问卷调查,调查内容包括安置点卫生状况、卫生服务需求状况等。结果灾民集中安置经历帐篷聚集点、板房安置点、永久安置点3个阶段,安置点分散式供水人群比例由17.83%降至2.10%;安置点修建排污管网比例由62.38%上升至89.61%,再至100%;垃圾集中收运比例由76.64%上升至94.81%,再至100%;永久安置点居民需求度最高的医疗服务和防病知识分别为疾病诊治和防蚊、蝇、鼠知识和技能,分别为86.36%和65.91%。结论安置点卫生状况逐步好转,但仍存在一定缺陷,应定期对板房安置点进行卫生检查和宣传教育,卫生机构应参与灾后重建规划,并对已建成并入住安置点开展有针对性健康教育活动。     

“5．12”抗震救灾卫生防疫现状与对策

四川汶川大地震后的卫生防疫工作已经取得了阶段性的成果，灾区没有发生重大传染病疫情，卫生防疫网络体系已经初步形成，灾区民众卫生自救意识逐步提高。在局部上还存在需要思考和探讨的问题，重点要解决好合理消杀灭、改善环境卫生和饮食饮水卫生、进一步提高灾区民众保护环境讲究卫生的自觉性、满足灾区救灾部队指战员各种卫生健康的需求、充分利用卫生防病专家队伍的力量，强化卫生防疫工作的决策科学性等问题。     

卫生系统汶川地震灾后心理援助工作调查分析

目的调查和分析卫生系统汶川地震灾后心理援助工作,为将来的突发公共事件灾后心理援助工作提供参考。方法地震灾区各级卫生行政部门负责组织所辖区域内的有关机构收集2008--2011年受灾地区组织开展灾区心理卫生服务网络和队伍建设、大众心理康复宣传和健康教育、重点群体心理疏导和咨询治疗、心理援助信息报告和督查评估等工作相关信息,填写统一的表格,逐级汇总上报。结果在受灾地区的72家精神专科医院和38家综合医院及其他医院设置心理门诊,在有条件的2721个社区卫生服务中心和1771个乡镇卫生院开展心理卫生服务。受灾地区累计培训各级各类心理服务医务人员39131人,接收对口支援精神科医护人员1015人次、心理援助志愿者25464人,组织心理健康宣传教育活动受益人群累计2122496人次,对重点人群进行心理辅导142113人次、心理咨询和治疗55959人次,诊断治疗精神疾病患者42186例。结论汶JiI地震灾区的心理卫生服务网络建设、队伍建设、对口支援、大众心理康复宣传和健康教育、重点群体心理疏导和咨询治疗、心理援助信息、报告和监督评估工作成功开展。     

野外训练时某部队士兵心理健康状况调查

目的　了解野外训练对某部队士兵心理健康水平的影响。方法　应用SCL - 90量表对参加野外训练的士兵进行心理测试分析。结果　士兵组SCL - 90总分为 1 4 8 0 3± 46 92 ,阳性项目数为 34 1 2± 2 0 0 8,阳性项目均分为2 61± 0 56。各因子分均值在 1 37～ 1 80之间。 9项因子分及阳性项目数均高于地方常模 (P <0 0 1 ) ,躯体化、焦虑及敌对这 3项因子分高于军人常模组 (P <0 0 1 )。极重体力劳动士兵的各项因子分高于重体力劳动士兵 (P <0 0 5)。普通作业 1组士兵的偏执因子分高于普通作业 2组 (P <0 0 5)。特殊作业组与普通作业 2组在所比较的 5项因子分中均无显著性差异。特殊作业士兵的躯体化、忧郁、敌对及偏执因子分高于普通作业组士兵 (P <0 0 5)。结论　高强度野外训练可使军人心理健康水平降低 ,极重体力劳动组的心理反应较大。对不同士兵野外训练的心理反应特点 ,应该有针对性地做好心理教育和心理调节工作     

Natural disasters, climate change and mental health considerations for rural Australia

This paper addresses a very salient feature of rural life and landscapes in Australia, natural disasters, and offers a psychological perspective on individual and community perceptions, responses, preparedness and planning. The convergent perspective offered reflects research and practice findings and insights from social and environmental psychology, as well as clinical, health and community psychology. The objective is to briefly characterise how these psychological approaches frame the psychological and social reality of these threats and events, and to canvas what insights and evidence-based best practice psychology have to offer allied professionals and paraprofessionals, and rural communities, as they experience and come to terms with the vagaries and extremes of the Australian environment.     

部队特殊作业人员心理健康评估

目的了解部队特殊作业人员心理健康状况,为制定心理干预措施提供依据。方法采用生物体微弱磁场检测技术对随机抽取的特殊作业人员的37项心理指标进行检测。结果在所检测的37项心理指标中,＂压力稳定性＂、＂情绪稳定性＂、＂睡眠＂、＂意识＂、＂记忆力＂5项心理指标的均值分别为24.41±7.98、69.49±5.65、2.58±3.77、4.78±2.55和16.77±5.11,与正常心理指标标准相比较,其差异有统计学意义（P〈0.01）,5项指标异常率分别为99.8%、99.5%、96.2%、93.2%和85.8%,人均异常项目数为18.8项。结论生物体微弱磁场检测技术能够对特殊作业人员的心理状态指标进行相对量化的评估,能发现特殊作业人员的心理健康状况和心理特点。     

地震灾区高中学生心理健康与个性相关性分析

目的了解四川省汶川地震5个月后都江堰市中学生心理健康状况与个性相关性。方法采用一般状况问卷、症状自评量表(SCL-90)和艾森克个性问卷(EPQ)对都江堰市475名中学生进行调查。结果SCL-90总分阳性率为56.15(,其中抑郁因子阳性率为50.3%,焦虑阳性率为41.3%,SCL-90总分和各因子分均高于全国常模,差异有统计学意义;女生各因子分均高于男生;阳性和阴性心理症状组学生在EPQ量表中内外向、情绪稳定性、精神质和掩饰倾向比较,差异均有统计学意义(P0.05);除内外向维度外,其他3个维度得分与SCL-90各因子得分均相关。结论地震5个月后灾区高中生仍存在不同程度的心理创伤;具有精神质倾向、情绪不稳定及性格内向的学生更易出现心理问题。     

助产士工作压力源、疲溃感及心理健康状况调查

目的探讨助产士的工作压力源、疲溃感、心理健康状况水平及其关系,为改善助产士的身心健康提供依据。方法随机抽取60例助产士和60例产科护士,进行工作压力源、工作疲溃感、应对方式及SCL-90等量表调查,比较2组护士的工作压力源、疲溃感、积极应对、消极应对及心理健康状况得分。结果助产士的总压力源得分(2.66±0.70)高于产科护士(1.99±0.57,P<0.05);助产士的情绪疲溃感(28.28±8.60)、工作冷漠感(12.39±5.04)、工作无成就感(35.74±9.81)、消极应对方式(34.72±4.96)均高于产科护士(23.47±7.35、8.56±3.18、28.62±7.45、30.86±4.50,P<0.05),而助产士的积极应对得分(29.57±3.36)则低于产科护士(33.44±4.71,P<0.05);助产士的心理健康状况总分(1.74±0.61)高于产科护士(1.46±0.50,P<0.05);助产士的工作压力源总分、工作疲溃感总分均与心理健康状况呈正相关性(r=0.687、0.549,P<0.01)。结论助产士与产科护士相比,具有较高的工作压力、工作疲溃感、应对方式差及心理健康等问题,应采取针对性措施来改善助产士的身心健康问题。     

某能源公司粉尘作业人员健康状况调查分析简

目的分析某能源股份有限公司粉尘作业人员健康状况,探讨职业病和工作有关疾病的防治对策。方法回顾性分析16 375名粉尘作业工人的职业健康检查及职业病诊断资料,对职业接触者相关检查内容进行分析。结果职业健康检查异常4 132例（25.23%）,心电图、血压、肺功能检查异常率列前三位,分别为15.69%、14.82%、3.27%。新诊断I期尘肺20人,晋期2人,观察对象53人。结论煤矿用人单位要做好尘肺病防治工作,同时还要预防和控制心血管系统等工作有关疾病的发生。     

Effects of social group work with survivors of the Wenchuan earthquake in a transitional community

This research examined the effects of group work with survivors of the Wenchuan earthquake. The two groups studied were organised by social workers in a transitional community. One group was composed of older people and the other of women. The research adopted qualitative research methods. Data were collected by focus group meetings and in‐depth individual interviews. The 24 research participants were mainly asked to describe their lives before and after joining the groups. The findings indicated that disaster survivors had resilience to loss and trauma and could recover themselves. Group participation facilitated disaster survivors' self recovery and had positive effects on them. Before joining the groups, many members of both groups felt bored and depressed. After joining, they felt better physically and psychologically and enjoyed socialising with each other. Their lives became more meaningful and their social network was broadened and strengthened. The practical and policy implications of the study are noted and further research recommended. It was concluded that group work, in the form of recreational activities, is effective in alleviating disaster survivors' feelings of distress and depression, improving their psychosocial well‐being and fostering their self recovery.     

Physical and mental health shortly after a disaster: first results from the Enschede firework disaster study

OBJECTIVES: Two to three weeks after the explosion of a fireworks storage facility in a residential area (May 2000, Enschede, The Netherlands) we assessed the self-reported physical and mental health among those affected by the disaster. METHODS: A questionnaire survey was conducted among 3792 residents, passers-by, and rescue workers, who were involved in and/or affected by the disaster and were > or =18 years of age. RESULTS: At least 30% of those affected by the disaster reported serious physical and mental health problems 2-3 weeks after the explosion. Compared with reference values in the general Dutch population, high scores were found for somatic symptoms, sleeping problems, and restrictions in daily functioning due to physical and mental problems, such as anxiety, depression, and feelings of insufficiency. The strength of these differences varied between groups, based on the level of involvement and the level of being affected. CONCLUSIONS: Results indicate that the fireworks disaster had a substantial impact on the health of those affected by the disaster. The health impact was most pronounced for residents and passers-by and also for rescue workers living in the affected area, but to a lesser degree. Physical and mental health problems were strongly associated with the shocking experiences during and shortly after the disaster.     

杭州市某区女工心理健康状况调查分析

目的 了解目前工厂企业女工的心理健康状况及其影响因素。方法 应用症状自评量表( SCL-90)对杭州市某区815名女工的心理健康状况进行调查。结果 企业女工SCL-90各因子异常检出率较低,仅为5％,除躯体不适症状明显高于常模外,其余8个项目因子分均明显低于常模,差异有统计学意义(P＜0.01)。从事电子行业的女工各项目因子分均明显高于其他行业。结论 企业女工心理健康状况较好,仅躯体不适症状发生较多。但电子行业的女工心理状况较差,提示不同行业类型对女工的心理健康状况影响不同。     

汶川地震灾区心理干预服务系统反应性评价

目的 了解汶川地震灾区居民对心理干预服务系统反应性的评价. 方法 采用分层、整群、多阶段抽样原则,以心理干预服务系统反应性评价问卷(包括保密性、自主权、服务的及时性等8个指标)为调查工具,对汶川、北川等4个地震极重灾区居民展开入户调查,共调查211人.采用层次分析法确定各指标权重,对心理干预服务系统反应性进行单指标评价与模糊综合评价,并采用Spearman秩相关和Binary logistic回归模型分析心理干预总满意度与反应性各指标的关系. 结果 分析得重要性和评分均较高的指标为尊敬和保密性;及时性和自主权的重要性较高但评分较低;交流的环境和选择性的重要性与评分均较低;重要性较低、评分较高的指标为交流的情况和社会支持网络;居民对心理干预系统反应性的综合评价介于"较好"与"很好"之间.除保密性外,反应性各指标与心理干预服务总满意度的秩相关系数均有统计学意义(rs=0.186～0.362,P＜0.05);1ogistic回归分析表明尊严(调整的OR=3.047,P＜0.001)、交流环境(调整的OR=1.619,P=0.019)和社会支持网络(调整的OR=1.527,P=0.005)是影响总满意度的重要因素. 结论 居民对心理干预服务的反应性综合评价较高,但仍需采取积极有效的措施提高心理干预服务获得的及时性、自主权、可选择性以及服务环境.

Abstract：

Objective To understand the mental intervention service system responsiveness. Methods A stratified,multi-stage random cluster sampling method was used,and a total of 211 residents in the central earthquake area were face to face interviewed by using the evaluating questionnaire of mental intervention service system responsiveness (including confidentiality,autonomy,prompt attention and so on,in sum of eight indicators).Analytic hierarchy process method was used to determine the weight of each index,carrying out a single index evaluation and fuzzy comprehensive evaluation on the mental intervention service system responsiveness,and using Spearman rank correlation and Binary logistic regression model to analyze the relationship of total satisfaction of mental intervention with each index. Results The dignity and confidentiality indicators were higher weight and rating.Prompt attention and the autonomy indicators were higher weight but lower rating,while surroundings and choice of providers indicators were lower weight and rating.It was also found that communication and social support network indicators were lower weight but higher rating.The overall assessment of mental intervention service system responsiveness ranged between "good" and "very good".All rank correlation coefficients of the indicators and the total satisfaction of mental interventions were significant (rs = 0.186-0.362,P ＜ O.05),except for confidentiality.The logistic regression analysis showed that the main factors of the individual variables influencing the total satisfaction were dignity (adjusted OR = 3.047,P ＜ 0.001),surroundings (adjusted OR = 1.619,P = 0.019),and social support network (adjusted OR = 1.527,P = 0.005). Conclusion The overall assessment of mental intervention service system responsiveness was high.Mental interventions should be taken positive and effective measures to improve the prompt attention,autonomy,the choice of providers and service environment.     

Associations of SF-36 mental health functioning and work and family related factors with intentions to retire early among employees

Objective

To examine the associations of mental health functioning (SF‐36) and work and family related psychosocial factors with intentions to retire early.

Methods

Cross sectional survey data (n = 5037) from the Helsinki Health Study occupational cohort in 2001 and 2002 were used. Intentions to retire early were inquired with a question: “Have you considered retiring before normal retirement age?” Mental health functioning was measured by the Short Form 36 (SF‐36) mental component summary (MCS). Work and family related psychosocial factors included job demands and job control, procedural and relational justice, conflicts between work and family, and social network size. Multinomial regression models were used to analyse the data.

Results

Poor mental health functioning, unfavourable psychosocial working conditions, and conflicts between work and family were individually related to intentions to retire early. After adjustments for all work and family related factors the odds ratio for low mental health functioning was halved (from OR = 6.05 to 3.67), but nevertheless the association between poor mental health functioning and strong intentions to retire early remained strong.

Conclusions

These findings highlight not only the importance of low mental health and unfavourable working conditions but also the simultaneous impact of conflicts between work and family to employees'' intentions to retire early.     

汶川地震灾后居民医疗服务需要与利用分析——以甘肃省为例

主要采用问卷调查法,对甘肃两县876户家庭3795名居民的医疗服务需要与利用情况进行调查,为制定灾后紧急医疗救助政策提供依据。结果显示：不同年龄、性别和文化程度居民的两周患病率存在差异;灾区居民对医疗服务利用明显不足,经济困难是主要原因。对此,提出了扩大医疗保障覆盖范围等建议。