正念干预治疗脑卒中患者抑郁效果的Meta分析

目的评价正念干预疗法对脑卒中患者抑郁水平的影响效果。方法检索Cochrane图书馆、PubMed、EMBASE、Web of Science、中国期刊全文数据库(CNKI)、万方数据知识服务平台和中国维普全文数据库中关于正念干预疗法应用于改善脑卒中后患者抑郁的临床研究。采用RevMan 5.3软件进行Meta分析。结果共纳入5篇文献,3篇为随机对照试验,2篇为临床对照试验。Meta分析显示,总体来看,正念干预疗法可以显著降低脑卒中患者的抑郁得分(SMD=-1.05, Z=3.52, P 0.001)。结论正念干预疗法可以降低脑卒中患者的抑郁水平,但具体方法有待进一步研究。     

回忆疗法对养老机构老年人抑郁情绪的影响

摘要：目的 探讨回忆疗法改善养老机构老年人抑郁情绪的效果。方法 用老年抑郁量表（ＧＤＳ）筛选出符合研究要求的老年人７４人，随机分成对照组（３８人）和干预组（３６人）。对照组正常生活，干预组在此基础上进行为期６周的回忆性心理干预，分别在干预前及干预６周后测评老年人抑郁状态，并进行对比分析。结果 干预后干预组ＧＤＳ评分显著低于本组干预前及对照组干预后（均Ｐ＜０．０１）。结论 回忆疗法有助于缓解养老机构老年人的抑郁情绪，提高老年人对环境的适应能力。关键词：老年人；　抑郁；　回忆疗法；　养老机构；　数据收集中图分类号：Ｒ４７；Ｒ７４９　　文献标识码：Ａ　　文章编号：１００１-４１５２（２００７）０９-０００９-０２     

正念干预措施对乳腺癌病人焦虑、抑郁症状影响的Meta分析

[目的]评价正念干预措施(MBIs)对乳腺癌病人焦虑、抑郁症状的影响。[方法]计算机检索Web of Science、PubMed、the Cochrane Library、中国期刊全文数据库、万方数据知识服务平台和维普全文数据库中涉及正念干预措施对乳腺癌病人焦虑、抑郁症状影响的随机对照试验,检索时间为建库至2019年6月15日。2名研究员完成文献筛选、数据提取和质量评价后,使用RevMan 5. 3软件进行分析。[结果]共纳入10篇文献。Meta分析结果显示:干预后正念干预组焦虑评分[SMD=-0. 45,95%CI(-0. 68,-0. 22),P=0. 000 1]和抑郁评分[SMD=-0. 38,95%CI(-0. 60,-0. 17),P=0. 000 4]均低于对照组,差异有统计学意义。[结论]现有证据表明:正念干预措施能有效缓解焦虑、抑郁情绪,但由于纳入研究较少且研究间异质性较高,正念干预对不同种族研究对象抑郁情绪缓解的效果还需进行多人群、大样本的研究,对于正念干预改善抑郁情绪的长期效果(12周)仍需开展更多高质量、多中心的研究。     

不同心理干预方式对围绝经期女性焦虑、抑郁改善效果的Meta分析

目的:探讨不同心理干预方式对围绝经期女性焦虑、抑郁症状的改善效果.方法:计算机检索Pubmed、Embase、Cochrane、Web of Science、中国生物医学文献数据库(CBM)、万方数据库、中国知网数据库(CNKI)、维普数据库(VIP)关于心理干预对围绝经期女性影响的随机对照试验,并筛检纳入研究的参考文献,检索时间为建库至2020年11月.2名研究人员完成文献筛选、数据提取、质量评价后,采用RevMan 5.4软件进行Meta分析.结果:纳入10篇文献,共计1278例病人.Meta分析显示:不同心理干预方式中,认知行为疗法能有效减轻围绝经期女性焦虑[SMD=-0.41,95％CI(-0.75,-0.06),P=0.02]、抑郁[SMD=-0.55,95％CI(-0.82,-0.27),P<0.0001];综合心理干预能减轻围绝经期女性焦虑[SMD=-3.86,95％CI(-4.13,-3.59),P<0.00001]、抑郁[SMD=-2.88,95％CI(-3.41,-2.35),P<0.00001];而正念疗法对围绝经期女性焦虑、抑郁改善效果不明显.结论:认知行为疗法、综合心理干预能够有效缓解围绝经期女性的焦虑和抑郁,正念干预对围绝经期女性焦虑、抑郁的改善效果尚需一些试验支撑.     

西安市养老机构老年人自我评价与抑郁症状发生率的相关性研究

目的探讨西安市养老机构老年人自我评价对抑郁症状发生率的影响。方法采用随机整群抽样的方法,使用老年抑郁量表及自行编制的一般情况调查表对西安市20所养老机构464名老年人进行问卷调查。结果自我评价差的老年人抑郁症状发生率明显高于自我评价好的老年人,差异有统计学意义（P〈0.05）。同时经济条件、社会地位、生活状态、居住环境进入回归方程,提示这4个因素为老年抑郁症状发生的影响因素。结论养老机构老年人抑郁发生率较高,且与老年人自我评价密切相关,护理人员应针对影响因素实施预防性干预,以减少老年人抑郁症状的发生。     

养老机构老年人衰弱、抑郁现状及相关性分析

[目的]了解养老机构老年人衰弱、抑郁现状,探讨衰弱与抑郁的相关性。[方法]于2019年3月采用方便抽样对成都市两所养老机构老年人进行调查,采用一般资料调查表、衰弱筛查量表(The FRAIL Scale)、衰弱筛查量表、简版老年抑郁量表(GDS-15)进行调查。[结果]共纳入262例养老机构老年人,其中117例存在衰弱症状,71例存在抑郁症状,回归分析显示,衰弱是养老机构老年人抑郁症状发生的危险因素[OR=3. 157,95%CI(1. 693,5. 887)],在衰弱的5个指标中,疲劳、耐力减退、自由活动下降、体重下降均是抑郁症状发生的危险因素。[结论]养老机构衰弱老年人抑郁症状发生风险更高,机构应注重发现老年人衰弱症状,早期给予干预,逐渐降低养老机构老年人抑郁发生率。     

社会心理干预对减重手术患者心理功能和生活质量影响的Meta分析

目的评价社会心理干预对减重手术患者心理功能和生活质量的影响。方法系统检索Web of Science,Cochrane Library,PubMed,Embase,CINAHL及中国生物医学文献数据库、中国期刊全文数据库、维普数据库、万方数据库中关于社会心理干预方法对减重手术患者的心理功能和生活质量影响的随机对照试验（randomized controlled trial,RCT）,按照Cochrane 5.1.0质量评价标准对文献进行质量评价,使用Revman 5.3进行Meta分析。结果 共纳入12篇文献,共908例患者。Meta分析结果显示,社会心理干预可降低减重手术患者抑郁[标准化均数差(standardized mean difference,SMD)=-0.26,P<0.05,95%CI(-0.42,-0.10)]、可降低减重手术患者焦虑[SMD=-0.42,P<0.05,95%CI(-2.83,-0.14)]、可改善减重手术患者心理生活质量[SMD=-0.19,P<0.05,95%CI(0.01,0.37)],但在改善总生活质量[SMD=0.04,P=0...     

不同居住环境老年人心理和睡眠的差异

目的 了解不同居住环境老年人心理和睡眠的差异,为相关干预措施的制定提供参考。方法 分别采用患者健康问卷抑郁量表(PHQ-9)、广泛性焦虑障碍量表(GAD-7)、匹兹堡睡眠质量指数(PSQI)评估不同居住环境下老年人的抑郁、焦虑症状和睡眠问题。结果 共收集有效问卷461份。养老机构、社区和乡村老年人抑郁症状的总检出率分别为36.5%、31.5%、48.3%,乡村老年人的抑郁症状总检出率显著高于养老机构和社区老年人,差异具有统计学意义(P<0.05)。养老机构、社区和乡村老年人焦虑症状总检出率分别为30.2%、31.5%、42.1%,乡村老年人的焦虑症状总检出率显著高于养老机构老年人,差异具有统计学意义(P<0.05)。养老机构、社区和乡村老年人睡眠问题的检出率分别为62.9%、52.4%、69.1%,乡村老年人的睡眠问题检出率显著高于社区老年人,差异具有统计学意义(P<0.05)。结论 老年人的心理问题和睡眠问题在不同居住环境均有检出,而乡村老年人的心理问题和睡眠问题更突出,值得家庭和社会广泛关注。     

社会心理干预对老年黄斑变性患者健康状况影响的系统评价

目的系统评价社会心理干预对老年黄斑变性(age-related macular degeneration,AMD)患者健康状况的影响。方法计算机检索Pubmed、EMBASE、Psychinfo、中国生物医学文献数据库、中国期刊全文数据库(Chinese national knowledge infrastructure,CNKI)和万方数据库中社会心理干预对AMD患者健康状况影响的随机对照试验(randomized controlled trial,RCT),并进行质量评价,采用RevMan 5.2软件进行Meta分析。结果共纳入13篇RCT,Meta分析结果显示,社会心理干预较常规干预能提高AMD患者的短期生活质量[SMD=0.18,95%CI(0.04,0.33),P=0.01]以及自我效能[SMD=0.31,95%CI(0.07,0.54),P=0.01],减轻短期[SMD=-0.55,95%CI (-0.85,-0.25),P0.01]和中期抑郁症状[SMD=-0.39,95%CI (-0.58,-0.19),P0.01]。然而,社会心理干预在降低应对方式、日常生活能力方面无明显作用;对于社会心理干预能否降低焦虑症状,促进疾病适应行为和社会支持方面的作用也缺乏有力证据。结论社会心理干预能够提高AMD患者生活质量和自我效能,降低抑郁症状,但对应对方式和日常生活能力方面无显著作用。而对焦虑症状,疾病适应行为和社会支持方面的作用有待进一步验证,同时期待更多临床多中心、大样本量的RCT开展。     

基于“互联网+”的护理干预模式对冠心病患者预后影响的Meta分析

目的 :评价基于"互联网+"的护理干预模式对冠心病患者预后的影响。方法 :检索中国期刊全文数据库(CNKI)、万方数据库(Wanfang Data)、维普数据库(VIP)、中国生物医学文献数据库(CBM)及Cochrane Library、PubMed、Web of Science、CINAHL、EMBASE、JBI数据库中应用于冠心病患者的基于"互联网+"的护理干预模式,研究为随机对照试验。对符合纳入、排除标准的文献进行质量评价,采用RevMan 5.3软件进行Meta分析。结果 :共纳入12篇文献,共计2046例患者。Meta分析结果显示,基于"互联网+"的护理干预模式能有效降低实验组患者的体质指数[MD=-0.43,95%CI(-0.86,-0.01),P=0.04]、改善其焦虑症状[MD=-0.80,95%CI(-1.33,-0.27),P=0.003]和抑郁症状[MD=-0.66,95%CI(-1.14,-0.18),P=0.008]。结论:基于"互联网+"的护理干预模式能有效降低冠心病患者的体质指数,改善其焦虑和抑郁症状。     

Nonpharmacological interventions to improve sleep in nursing home residents: A systematic review

Sleep disturbance is one of the most prevalent symptoms among elderly adults, especially those living in nursing homes. Sleep disturbance adversely affects the healthcare system as well as elderly adults’ quality of life. Nonpharmacological interventions have shown promising results regarding improvements in sleep. This systematic review intended to identify the effects of nonpharmacological interventions on sleep quality and nighttime sleep among nursing home residents. We searched both English and Chinese databases through December 2018 and found 28 eligible studies describing five types of interventions: physical activity (n = 6), light therapy (n = 5), mind-body practices (n = 2), complementary and alternative therapy (n = 8), and multicomponent interventions (n = 7). Although the wide variety of interventions in each category limited the generalizability of the results, physical activity, mind-body practices, acupressure and chamomile extract intake demonstrated positive and promising impacts on sleep quality and nighttime sleep. Due to the small number of included trials, the results should be interpreted cautiously. Further higher-quality studies concerning nonpharmacological treatments are needed.     

护理干预对提高敬老院慢性病患者服药依从性的研究

目的 探讨护理干预对敬老院老年人服务依从性的影响。方法 随机选取35例敬老院慢性病长期服药患者为研究对象给予护理干预,在护理干预前及护理干预后分别对老人进行问卷调查,比较护理干预前后老人的服药依从性情况。结果 护理干预后老人未按时服药、少服药、未服药等情况发生率低于干预前相应指标,差异均有统计学意义(X2=38.85,P﹤0.01)。护理干预前,患者疾病知晓率为32.43%,护理干预后为65.62%,前后比较差异有统计学意义(X2=34.20,P﹤0.01)。结论 根据老年人的特点进行个性化的护理干预,能够有效提高敬老院老人的服药依从性。     

Prevalence of dementia syndromes in persons living in homes for the elderly and in nursing homes in southern Sweden

The prevalence of dementia syndromes was studied in individuals aged 70 and over living in institutions integrated into primary care within a limited area in southern Sweden. The populations studied were all persons living in homes for the elderly in the city of Lund (n = 471) and all persons living in nursing homes in the Lund health service district (n = 384). In the former, 30% were moderately demented and 6% severely demented. The corresponding figures for patients in nursing homes were 33% and 36%. Among the various psychiatric symptoms which are common in dementia, confusion was most prevalent. In the homes for the elderly, 32% of the subjects were moderately or severely confused, while the corresponding figure in the nursing homes was 62%. The consumption of sedatives and hypnotics was greater in homes for the elderly than in nursing homes. The presence of moderate or severe dementia was associated with greater use of sedatives and hypnotics in nursing homes. Prevalence studies of this type might be used to study organizational changes in the care of the elderly within a health service district.     

Evaluation of an educational "toolbox" for improving nursing staff competence and psychosocial work environment in elderly care: results of a prospective, non-randomized controlled intervention

BACKGROUND: Lack of professional development opportunities among nursing staff is a major concern in elderly care and has been associated with work dissatisfaction and staff turnover. There is a lack of prospective, controlled studies evaluating the effects of educational interventions on nursing competence and work satisfaction. OBJECTIVES: The aim of this study was to evaluate the possible effects of an educational "toolbox" intervention on nursing staff ratings of their competence, psychosocial work environment and overall work satisfaction. DESIGN: The study was a prospective, non-randomized, controlled intervention. PARTICIPANTS AND SETTINGS: Nursing staff in two municipal elderly care organizations in western Sweden. METHODS: In an initial questionnaire survey, nursing staff in the intervention municipality described several areas in which they felt a need for competence development. Measurement instruments and educational materials for improving staff knowledge and work practices were then collated by researchers and managers in a "toolbox." Nursing staff ratings of their competence and work were measured pre and post-intervention by questionnaire. Staff ratings in the intervention municipality were compared to staff ratings in the reference municipality, where no toolbox was introduced. RESULTS: Nursing staff ratings of their competence and psychosocial work environment, including overall work satisfaction, improved significantly over time in the intervention municipality, compared to the reference group. Both competence and work environment ratings were largely unchanged among reference municipality staff. Multivariate analysis revealed a significant interaction effect between municipalities over time for nursing staff ratings of participation, leadership, performance feedback and skills' development. Staff ratings for these four scales improved significantly in the intervention municipality as compared to the reference municipality. CONCLUSIONS: Compared to a reference municipality, nursing staff ratings of their competence and the psychosocial work environment improved in the municipality where the toolbox was introduced.     

广州养老机构老年人开展园艺疗法娱乐方式的意愿析因

目的 了解养老机构老年人关于园艺疗法娱乐方式开展的意愿及相关因素,为园艺疗法在养老机构的开展提供理论依据。方法 采用便利抽样法,对广州市番禺区、海珠区、荔湾区、越秀区181名在养老机构养老的老年人进行调查,调查包括一般资料、日常生活能力量表、养老机构老年人开展园艺疗法娱乐方式的尝试意愿及开展建议。数据处理采用单因素分析法、二分类Logistic回归分析法分析了影响广州市养老机构老年人园艺疗法尝试意愿的相关影响因素。结果 43.2%的老年人愿意尝试园艺疗法娱乐方式,56.8%的老年人不愿尝试园艺疗法娱乐方式;单因素分析结果显示,务农经历、种菜经验、自理程度等6个因素是影响养老院老年人尝试意愿的相关因素;Logistic回归分析显示,身体情况不支持、缺乏种菜经验、不能自理、有务农经历4个变量影响养老院老年人尝试园艺疗法的意愿,OR值分别为33.790、4.973、3.538、3.407（P<0.05）;结论 广州市养老机构老年人对园艺疗法较棋牌等常见娱乐方式尝试意愿更积极,愿意尝试的主要因素为满足自身归属和爱、自我实现的需求;不愿意尝试的因素主要受到身体状况、务农经历的影响。     

护理干预对社区老年功能性便秘患者生活质量的影响

目的 探讨自我管理模式的护理干预对社区老年功能性便秘患者生活质量的影响.方法 以某市76例社区老年功能性便秘患者为研究对象,采用随机数字表法分成干预组和对照组,各38例,干预组接受认知行为指导和系统健康教育,对照组只接受社区常规老年人健康管理.干预前后采用便秘患者生活质量评估量表和便秘症状及疗效评估问卷对两组患者进行评...     

Depressive symptoms among older residents at nursing homes in Taiwan

Aims and objectives. To examine the depressive symptoms of older residents at nursing homes and the relationship between their depressive symptoms and certain selected variables. Background. Depression has become a major healthcare concern among the older people, but nursing home‐based studies on risk factors of depression have still hardly been well performed in Taiwan. Design. A cross‐sectional design was developed and implemented. Methods. A research sample of 138 older residents was recruited from eight nursing homes located in southern Taiwan. During face‐to‐face interviews, the Center for Epidemiological Studies Depression Scale, Social Support Scale, Chronic Condition Checklist and Socio‐demographic Inventory were used for data collection. Results. The results showed that 81·8% of those residents were identified as being depressed. It was further discovered that the length of residency, number of chronic conditions, perceived health status and the amount of social support from their family and relatives could explain 38·8% of the total variances in depressive symptoms. Conclusions. Our study suggests that, in Taiwan, older people who live in nursing homes suffer from more depressive symptoms than those in community dwellings. To maintain and improve the health status for the elderly as much as possible, it is suggested that healthcare providers at nursing homes should develop an effective health promotion program for these older peoples. Relevance to clinical practice. There exists a high rate of depressive symptoms among older residents at nursing homes. It is imperative that a proper identification and its correspondent treatment for this health problem on the older residents are required. In late life, to maintain a higher level of quality of life, it is important to suggest that the health providers should regularly screen older people to increase the likelihood of diagnosis and improved treatment of late‐life depressive symptoms.     

Strategies for feeding patients with dementia

OVERVIEW: Despite the high prevalence of dementia among elderly patients in hospitals and nursing homes and the strong association between dementia and feeding difficulty, few sources adequately address effective feeding interventions. Basing their discussion on the conceptual model that grew out of a previously published systematic literature review, the authors address a wide range of assessment and intervention practices specific to various observed behaviors that may aid in feeding patients with dementia.     

不同类型养老机构老年人服药依从性调查

目的:调查并分析不同类型养老机构老年人服药依从性现状。方法:采用分层抽样法,通过问卷调查对重庆市12所养老机构的203例老年人进行横断面调查。结果:不同类型养老机构老年人的服药种类、服药方式、医疗保健费用承受度及药物不良反应发生率不同,不同机构工作人员对老年人服药情况关注度也不同;护养院老年人服药信念显著高于养老院和老年公寓;护养院老年人服药依从性显著高于养老院老年人;老年人的服药信念、服药频率及工作人员关注程度是其服药依从性的影响因素。结论:不同类型养老机构老年人的服药依从性存在较大差异,护养院老年人的口服用药相对较安全,应积极推进养老机构向"互联网+医养结合"方向转型发展。