团体心理干预对洪灾灾后居民情绪调节的应用研究

目的 探讨团体心理干预对洪灾灾后居民焦虑、抑郁情绪的效果.方法 按随机数字表法将364例江西抚州地区洪灾灾后居民随机分为干预组和对照组,每组182例.干预组进行为期1个月的一般性社会支持和团体心理治疗,对照组则仅给予一般性社会支持.以焦虑自评量表(SAS)和抑郁自评量(SDS)表评估疗效.结果 干预前,干预组和对照组洪灾灾后居民SAS、SDS评分差异均无统计学意义(t=-0.225,P>0.05;t=-1.795,P＞0.05);干预后,干预组灾后居民的SAS、SDS评分低于入组时,差异有统计学意义(t=-14.795,P＜0.01;t=-19.600,P＜0.01);对照组灾后居民的SAS、SDS评分低于入组时,差异有统计学意义(t=-13.347,P＜0.01;t=-11.784,P＜0.01);干预组和对照组SAS、SDS评分差异有统计学意义(t=5.063,P＜0.01;t=2.764,P＜0.01).结论 团体心理干预对洪灾灾后居民焦虑及抑郁情绪的改善有重要作用.     

健康教育在癌痛规范化治疗示范病房患者中的应用

目的 探讨健康教育对癌痛规范化治疗示范病房患者健康信念、自我效能和生活质量的干预效果.方法 选择92例癌痛规范化治疗的患者作为研究对象,随机分为干预组和对照组,各46例.干预组接受健康信念模式教育,对照组接受常规健康教育,4个月后进行评价.结果 干预组癌痛患者在疼痛信念、自我效能、生存质量得分显著高于对照组(P＜0.01,P＜0.05).结论 开展健康信念模式教育可以增强癌痛规范化治疗示范病房患者癌痛的信念和自我效能,提高患者疼痛控制水平,提升患者生活质量.     

护理干预在老年2型糖尿病患者中自我管理的效果研究

目的：探讨护理干预在老年2型糖尿病患者自我管理中的效果。方法：选择138例老年2型糖尿病患者作为研究对象,按随机数字表法分为干预组（69例）和对照组（69例）。干预组患者接受家属参与的糖尿病健康信念教育自我管理干预模式,对照组患者接受常规糖尿病知识健康教育,两组患者干预前后采用糖尿病知识问卷评定。结果：干预组患者干预后6个月糖尿病知识掌握显著高于对照组（t=8.52,P〈0.01）;干预组患者干预后6个月空腹血糖、餐后2 h血糖、糖化血红蛋白指标低于对照组（t=2.13,P〈0.05;t=4.61,P〈0.01;t=4.60,P〈0.01）;干预组患者干预后6个月并发症发生率低于对照组（χ^2=6.82,P〈0.01）。结论：实施系统性、互动性糖尿病健康信念教育模式,减少了并发症,提高了患者自我管理水平和生活质量。     

护理干预对高血压及其并发症的影响

目的通过社区护理干预,提高高血压患者的遵医行为,有效控制高血压,减少并发症的发生.方法对60名高血压患者及其家属进行健康教育及心理、行为、服药等方面的护理干预,并与对照组60例进行比较.结果研究组在坚持规律服药、低盐和低脂饮食、戒烟戒酒、控制体重等方面与对照组差异有统计学意义(P＜0.01);研究组干预前、后血压比较差异有统计学意义(P＜0.01).结论社区护理干预能提高患者的遵医行为,有效控制高血压,减少并发症的发生.     

分阶段控烟手册在长沙市社区吸烟者中的应用

目的 探讨分阶段控烟手册在长沙市社区吸烟者中的应用效果.方法 采取多级整群抽样方法抽取湖南省长沙市岳麓区6个居民社区符合标准的159例吸烟者,按居民所在社区随机分为两组,共分得干预组77例,对照组82例.分别在基线（V0）、干预1个月（V1）、干预3个月（结束,V3）、随访（基线后第6个月,V6）对两组吸烟者进行同样评估,并分析控烟效果.结果 干预后,干预组在干预1个月、3个月、随访时的戒烟率分别为12.5％、23.6％、20.8％,干预组组内吸烟者在不同时点（V0、V1、V3、V6）的每日吸烟量、尝试戒烟24 h及7d以上次数、戒烟率的差异有统计学意义（P＜0.05）.结论 基于跨理论模型的分阶段干预手册,能够使吸烟者每日吸烟量减少,尝试戒烟次数增加,使吸烟者所处变化阶段向积极阶段推进,戒烟率增加,是吸烟者、社区戒烟门诊的恰当戒烟选择之一.     

社区中医综合干预模式对肝肾阴虚型围绝经期患者的疗效分析

目的 通过中医药综合疗法对社区肝肾阴虚型围绝经期综合征患者进行干预,改善患者症状。 方法 从上海市嘉定区6个社区各纳入30例肝肾阴虚型围绝经期综合征患者,共计180例,均于2016年2—8月入组。随机分为对照组和干预组,对照组在常规治疗的基础上为患者建立个人档案,心理疏导,每月为患者进行一次健康宣教。干预组在对照组的基础上采用中医综合疗法,包括口服中药、针刺、耳穴及八段锦。3个月疗程结束后对改良后的Kupperman评分进行比较,并评判临床疗效。 结果 疗程结束后,干预组及对照组干预后与干预前比较,改良的Kupperman评分差异均有统计学意义(P＜0.01),干预后干预组与对照组相比,差异存在统计学意义(P＜0.01)。干预组总有效率为85.71%,对照组为0.00%,差异有统计学意义(P＜0.01)。干预组在潮热出汗、失眠、易激动、抑郁、疲乏、心悸方面较干预前相比,差异有统计学意义(P＜0.01),在眩晕方面与干预前相比,差异有统计学意义(P＜0.05);对照组在易激动、抑郁方面与干预前相比,差异有统计学意义(P＜0.01)。 结论 中医综合干预模式对肝肾阴虚型围绝经期综合征患者有明显疗效,能改善诸多症状,值得在社区卫生服务中心推广。      

阶段性护理干预在妊娠妇女配偶戒烟中的应用研究

目的探讨阶段性护理干预在妊娠妇女配偶戒烟中的应用效果。方法将137例有吸烟史的妊娠妇女配偶随机分为观察组(69例)和对照组(68例),观察组接受基于阶段性护理干预理论指导的戒烟方法,对照组则接受常规戒烟教育。结果干预3个月后观察组所处的行为改变阶段较基线和对照组均有明显提高(P<0.01或P<0.05),对照组干预前后差异无显著性意义(P>0.05)。干预后观察组每日吸烟支数明显少于对照组(P<0.01),较干预前明显下降(P<0.01)。结论阶段性护理干预可帮助吸烟的妊娠妇女配偶提高戒烟意愿及减少每日吸烟支数。     

不同领导者对新兵团体心理干预效果的影响

目的 比较不同领导者对新兵孤独感的改善情况.方法 选取某部2012年入伍的新兵共279人,应用孤独量表,依赖性、宽容性、支配性量表测评,发放问卷279份,回收有效问卷258份,采用整群随机设计法分为心理咨询师团体组(n=88)、班长团体组(n=83)和对照组(n=87).心理咨询师团体组和班长团体组分别在心理咨询师和班长的带领下按方案实施心理干预,对照组不实施任何干预,团体干预结束后对3组进行复测,评估对新兵孤独感的改善情况及差别.结果 ①心理咨询师团体组干预前后宽容性、依赖性、孤独感均有统计学差异(P＜0.01),支配性无统计学差异(P＞0.05);班长团体组干预前后孤独感有统计学差异(P＜0.01),宽容性、依赖性、支配性无统计学差异(P＞0.05);对照组各因子差异无统计学意义(P＞0.05).②心理咨询师团体组和班长团体组的孤独感较对照组低(P ＜0.05,P＜0.01);心理咨询师团体组依赖性较班长团体组和对照组低(P＜0.05,P＜0.01).结论 专业和非专业团体干预均可以在一定程度改善新兵的孤独感,专业的心理咨询师团体干预还可能促进新兵独立性和宽容性,降低依赖感.     

“5R”联合“5A”戒烟干预在社区高血压随访管理中的应用效果

目的：评价“5R”联合“5A”戒烟干预法在社区高血压随访管理中的应用效果。方法：选取2019年6月-2020年6月上海市长宁区新华社区卫生服务中心倪金燕家庭医生工作室在管120例高血压吸烟患者为研究对象,采用随机分组法分为对照组和干预组,各60例。对照组采用自然戒烟法,干预组采用“5R”联合“5A”戒烟干预法,比较两组戒烟情况、控烟知识知晓率。结果：干预后3、6、9个月及1年,干预组的戒烟率高于对照组,差异有统计学意义(P<0.05)。干预前,两组控烟知识知晓率评分比较,差异无统计学意义(P>0.05);干预后3、6、9个月及1年,干预组控烟知识知晓率高于对照组,差异有统计学意义(P<0.05)。干预前,两组CO呼出试验比较,差异均无统计学意义(P>0.05);干预后3、6、9个月及1年,两组CO呼出测试指标均有改善,且干预组CO呼出测试情况均优于对照组,差异有统计学意义(P<0.05)。结论：“5R”联合“5A”戒烟干预在社区高血压随访管理中,可提升患者的戒烟意愿,减少吸烟数量,提高戒烟率,值得在社区慢性病随访管理中应用并予以推广。     

心理卫生进社区对居民心理障碍防治的作用研究

目的探索心理卫生进社区对居民心理障碍防治的作用。方法选择两个基础条件相似的社区,分别设为对照组和干预组,对干预组进行心理干预。使用儿童行为量表(教师用)(RUTTER)、一般健康问卷(GHQ)、简易精神状态量表(MMSE)、上海市普通市民精神卫生知晓率调查问卷、精神卫生基础知识问卷(自编)进行施测。结果干预组居民干预后的知晓率与干预前相比,差异有统计学意义(t=-12.384,P<0.01);干预组居民干预后与对照组比较,在GHQ的分数上差异有统计学意义(t=17.528,P<0.01)。结论心理卫生进社区对居民心理健康的维护有一定的积极作用。     

中国社区控烟10年文献研究

目的研究我国社区控烟的现状和目前存在的问题,探讨社区吸烟人群行为干预措施,为进一步开展社区控烟干预提供科学依据和理论基础。方法应用文献分析法,分析2002—2012年发表在中国知网（CNKI）上的相关文献,根据文献发表年限、地域分布、研究内容等方面进行归纳整理和分析总结。结果共检索文献194篇,最终纳入72篇文献,结果显示2006—2008年是此类文献发表高峰期,东部沿海省市研究明显多于其他地区,农村社区研究相对不足,疾病预防控制中心及高校对社区控烟的研究力度最大,我国社区控烟研究还主要集中于社区吸烟现状调研,有关社区控烟干预策略和控烟效果评价的研究相对较少。结论目前我国社区控烟干预工作仍然主要以传统的健康教育为主,虽然在提高社区居民控烟认知方面起到一定的作用,但是干预前后居民的吸烟率并无明显差异,对于促进人群实际戒烟行为的效果并不明显,因此迫切需要探索一种适合中国社区控烟的有效方法。     

A randomized trial of a family physician intervention for smoking cessation

We assessed the impact of three conditions on one-year smoking cessation rates. Physicians in 70 community general practices were randomly allocated by practice to one of three groups: In the usual care group, smoking patients were to receive the care they normally would receive. In the gum only group, physicians were asked to speak to patients about smoking cessation and offer nicotine gum. In the gum plus group, physicians were trained in the experimental intervention. This intervention involved advice to stop smoking, the setting of a quit date, the offer of nicotine gum, and four follow-up visits. Smoking cessation was measured by self-report after one year and validated using saliva cotinine measures. Using a criterion of at least three months of abstinence, 8.8% of the patients of the trained physicians had stopped smoking at the one-year follow-up compared with 4.4% and 6.1% of the patients in the usual care and gum only groups, respectively.     

经皮冠状动脉介入手术后患者戒烟成功率及影响因素

目的 调查经皮冠状动脉介入(PCI)术后1年及以上的吸烟患者戒烟率及影响因素.方法 横断面调查全国14家三甲或二甲医院心内科门诊或病房符合纳入标准的研究对象1241例,分析戒烟成功率及影响因素.结果 完成调查1226例以男性中老年为主,年龄(59.9±10.7)岁,PCI术后时间为1.5(1.2～2.1)年,尝试戒烟949例(77.4%),戒烟成功679例(55.4%).其中年龄越大,尝试戒烟及戒烟成功的可能越大(OR值分别为1.02,1.03);而吸烟量大者尝试戒烟可能性大(OR=1.03),但戒烟成功的可能性小(OR=0.97).另外烟龄及戒烟动机均对戒烟行为有影响.结论 1年以上吸烟患者在PCI术后成功戒烟,年龄、烟龄、吸烟量、自身所患疾病及医师建议等是影响戒烟的因素.

Abstract：

Objective To investigate the smoking cessation rate and its related factors in cardiovascular patients after percutaneous coronary intervention.Methods A cross-sectional survey of 1241 outpatients or inpatients fulfilling the inclusion criteria was conducted at 14 hospitals across China.Results The survey population mainly consisted of middle-aged male patients with an average age of ( 59.9 ± 10.7 )years old.Their median time after surgery was 1.5 years.Among them,77.4% tried to quit smoking while 55.4% succeed.The elder men were more likely to try to quit smoking and succeed eventually ( OR values:1.02 vs 1.03 ).The higher number of cigarettes smoked daily,the greater possibility of trying to quit smoking ( OR = 1.03 ),but less likely to quit smoking eventually ( OR = 0.97).Furthermore the years of smoking and cessation motivation had impacts on the cessation behaviors as well.Conclusion Smoking cessation was achieved in more than half of the patients at one year after PCI.Age,years of smoking,daily number of cigarettes,concurrent disases and physician recommendations are the influencing factors of smoking cessation.     

Making the sale: communicating the importance of smoking cessation to pregnant patients

The risks that smoking pose to the pregnant patient and her fetus have been well established. Some women quit smoking upon learning they are pregnant, but most do not. Although a direct, succinct intervention by the physician has proven to be a critical initial step in helping the patient to quit smoking, some physicians are not taking advantage of this opportunity. This article provides data obtained from focus groups conducted with pregnant West Virginia smokers. These women spoke very candidly about their experiences with their providers. Chances for succeeding with helping a patient to quit smoking are likely to increase if physicians discuss smoking with their patients at each visit and if it is done in a constructive manner.     

Automated e-mail messaging as a tool for improving quit rates in an internet smoking cessation intervention

ObjectiveThe aim of this study was to determine whether an automated e-mail messaging system that sent individually timed educational messages (ITEMs) increased the effectiveness of an Internet smoking cessation intervention.DesignUsing two consecutive series of participants, the authors compared two Web-based self-help style smoking cessation interventions: a single-point-in-time educational intervention and an enhanced intervention that also sent ITEMs timed to participants' quit efforts. Outcomes were compared in 199 participants receiving the one-time intervention and 286 receiving ITEMs.MeasurementsDemographic factors, number of cigarettes smoked, nicotine addiction, depressive symptoms, and confidence in ability to quit were measured at entry. Twenty-four–hour quit attempts and seven-day point-prevalence of abstinence (nonrespondents assumed to smoke) were measured 30 days after each subject's self-selected quit date.ResultsThe one-time and ITEMs groups differed in some demographics and some relapse risk factors but not in factors associated with 30-day quit rates. ITEMs appeared to increase the rate at which individuals set quit dates (97% vs. 91%, p = 0.005) and, among the respondents to follow-up questionnaires (n = 145), the rate of reported 24-hour quit efforts (83% vs. 54%, p = 0.001). The 30-day intent-to-treat quit rates were higher in the ITEMs group: 7.5% vs. 13.6%, p = 0.035. In multivariate analyses controlling for differences between groups, receiving ITEMs was associated with an increase in the odds ratio for quitting of 2.6 (95% confidence interval = 1.3–5.3).ConclusionITEMs sent on strategic days in smokers' quit efforts enhanced early success with smoking cessation relative to a single-point-in-time Web intervention. The effect appears to be mediated by ITEMs' causing smokers to plan and undertake quit efforts more frequently.     

"Sick of Smoking": evaluation of a targeted minimal smoking cessation intervention in general practice

Several smoking intervention studies have been conducted overseas which use a minimal amount of general practitioners' time and are conducted within the constraints of a normal consultation. However, there are no published reports of minimal interventions in Australian general practice. This study reports on 1238 South Australian smokers who were assigned to a non-intervention control group or a group which received firm general practitioner advice to quit smoking plus literature. At one-year follow-up, 7.5% of smokers in the minimal advice group who had quit for six or more months remained non-smokers compared with 3.2% in the control group. If similar analytical procedures had been used in this study as were used in the benchmark study in England in 1979, the quit rate for this study would have been 11.3% in the intervention group, and 4.8% in the control group--a net gain of 6.5%. These results are discussed with regard to widespread implementation in Australian general practice.     

吉林省长春市新生儿无烟家庭创建项目基线调查

目的:了解新生儿父亲在家中的吸烟行为、戒烟意愿和母亲二手烟暴露水平等情况,为创建无烟家庭、制定控烟措施提供科学依据。方法:采用整群抽样方法,从吉林省长春市2个城区15所社区卫生服务中心登记的新生儿家庭中筛选出父亲在家吸烟的家庭342户,对这些家庭的新生儿母亲和父亲进行一对一入户问卷调查,收回有效的父亲问卷299份,母亲问卷304份。结果: 新生儿父亲每日吸烟者比例为77.6%,平均每天吸卷烟量为(12.4±6.3)支;新生儿母亲每天二手烟暴露率为61.2%;有55.2%的新生儿父亲尝试过戒烟,目前表示会在1个月内戒烟者占5.3%,有43.9%的父亲不打算戒烟;在最近6个月内尝试戒烟的动机中,所占百分比的大小依次是新生儿健康(59.3%)、妻子健康(41.6%)、家人反对(38.1%)和考虑个人健康(28.3%),各动机占比比较差异有统计学意义(χ²=30.072,P<0.01);新生儿父亲和母亲完全同意创建无烟家庭的比例分别为36.8%和 69.4%,父亲和母亲意愿比较差异有统计学意义(χ²=59.207,P<0.001)。结论:新生儿父亲每日吸烟者较多,吸烟量较高,戒烟意愿比例较低,家庭二手烟暴露严重,新生儿健康对父亲戒烟动机影响较大,新生儿母亲对创建无烟家庭意愿较高。     

澳门戒烟门诊戒烟人士吸烟原因及行为分析

以简单随机取样方法对戒烟门诊接受戒烟服务的269名戒烟者采用统一问卷做调查.起初吸烟的原因中以受朋友影响最为常见（53名,占53.0%）,感觉吸烟能减压的88名（占32.7%）,心瘾是阻碍戒烟的最常见原因（221名,占82.2%）,继续吸烟的原因中以心瘾、烦闷、心情不佳及无聊、孤独等心理原因最常见,占79.6%（214名）.提示诱使吸烟与吸烟者的心理因素有关系,现阶段要对戒烟人士加强心理卫生教育,协助戒烟者放松心情、减压和消除负面情绪的技巧.相关部门应针对青少年进行烟害防治的宣传教育,预防青少年成为惯性吸烟者.     

Is telephone counselling a useful addition to physician advice and nicotine replacement therapy in helping patients to stop smoking? A randomized controlled trial

BACKGROUND: The authors evaluated the incremental efficacy of telephone counselling by a nurse in addition to physician advice and nicotine replacement therapy in helping patients to stop smoking. METHODS: The trial was conducted at the University of Ottawa Heart Institute. A total of 396 volunteers who smoked 15 or more cigarettes daily were randomly assigned to either of 2 groups: usual care (control group) and usual care plus telephone counselling (intervention group); the groups were stratified by sex and degree of nicotine dependence. Usual care involved the receipt of physician advice on 3 occasions, self-help materials and 12 weeks of nicotine replacement therapy. Telephone counselling was provided by a nurse at 2, 6 and 13 weeks after the target quit date. Point-prevalent quit rates were determined at 52 weeks after the target quit date. RESULTS: The point-prevalent quit rates at 52 weeks did not differ significantly between the control and intervention groups (24.1% v. 23.4% respectively). The quit rates did not differ significantly at the secondary measurement points of 4, 12 and 26 weeks. INTERPRETATION: Brief physician assistance, along with nicotine replacement therapy, can help well-motivated smokers to quit. Three additional sessions of telephone counselling by a nurse were ineffective in increasing quit rates. This form of assistance may be useful in the absence of physician advice or when self-selected by patients.