医学生心理健康状况及其影响因素研究

目的 探讨医学生心理健康状况及其影响因素。方法 应用艾森克人格问卷(EPQ)和症状自评量表(SCP—90)对1652名在校医学生进行调查分析。结果 (1)医学生性格特点与性别、生源及及是否独生子女有关。(2)12．3％的学生存在不同程度的心理问题,新生明显高于老生,主要表现为人际关系敏感、强迫、抑郁、偏执、焦虑等。(3)相关分析表明,家庭因素和个性特征因素与心理健康明显相关。结论 医学生心理卫生问题发病总体水平较低,家庭因素和个性特征因素与心理健康发展有一定关系。     

糖尿病患者的情感障碍

对46例糖尿病患作临床精神医学评定，并与46例正常人作对比分析。结果发现糖尿病13例（28.3%）诊断为器质性情感综合征（抑郁状态），其抑郁发生率明显高于正常对照组。本还对糖尿病患伴发抑郁的原因进行了分析，认为病因可能与生物学及社会心理因素有关。     

偏头痛患儿的心理行为特征研究

【目的】用国内通用的儿童心理量表检测偏头痛是否有其特殊的心理易患基础,有针对性地进行干预和疏导,提高患儿的生活质量。【方法】50例无先兆偏头痛患者于发作间歇期和50名正常健康查体儿童气质类型测定,儿童行为量表,艾森克个性问卷(Eysenck Personality Questionnaire,EPQ)和症状自评量表检测。【结果】偏头痛患儿气质维度因子中活动水平较低,适应性与心境均较高,行为量表显示行为问题发生率较高,行为因子社交退缩、抑郁、躯体诉述分值均较正常对照组高,EPQ的神经质分(N)高于正常对照组,症状自评量表中躯体化、人际关系、焦虑、抑郁、敌对、精神病质因子分值均高于正常对照组。【结论】偏头痛具有特殊心理基础,主要表现为焦虑、抑郁等负性情绪及社交退缩,人际关系紧张可能为发病基础或诱因,应重视偏头痛防治中的心理因素。     

慢性乙型肝炎患者心理状态调查

目的 了解慢性乙肝患者(CHB)患者的心理状态及其与疾病的相关性,评价CHB患者的心理状态及相关因素,以提高CHB人群的生活质量. 方法 采用症状自评量表(SCL-90),焦虑自评量表(SAS),抑郁自评量表(SDS)三项自评量表对74名CHB患者进行问卷调查,资料采用t检验、相关分析. 结果 CHB患者的SCL-90 9项因子中躯体化、强迫、焦虑、敌对性、恐怖、精神病性6项指标均高于国内常模中的相应结果(P＜0.01);人际关系敏感、抑郁低于国内常模中的相应结果(P＜0.01);SAS和SDS 20项冈子的标准分均未超过界分50分,抑郁指数为(0.61±0.04),焦虑评分为(30.47±4.42). 结论不同因子对CHB的影响不同,慢性乙型肝炎患者的心理问题较突出,应有针对性加强对慢性肝炎病人的健康教育,提供心理支持和必要的社会支持,提高CHB患者生存质量.     

个性化护理干预对慢性乙型肝炎患者心理的影响分析

目的：旨对慢性乙型肝炎患者进行个性化护理干预后的心理影响分析。方法：对本科室2012年4月～2013年12月间收治的120例慢性乙型肝炎患者通过自评量表（SCL—90）在个性化护理干预前及护理干预后进行测评;并就测评结果进行对比分析。结果：120例慢性乙型肝炎患者在个性化护理干预之后的评分明显低于护理干预前（P〈0.05）,具统计学意义。结论：通过对慢性乙型肝炎患者予以个性化护理可以明显改善患者的负性心理,促进患者身心健康。     

朝族与汉族待产妇心理健康状况比较

目前有关产妇心理健康的跨文化研究甚少。本研究为了解朝、汉族待产妇心理健康状况及是否有差异,对171名朝、汉族待产妇进行了艾森克个性问卷(EPQ)和症状自评量表(SCL-90)的评定。1对象与方法2003年7月~2004年7月对延边大学医学院附属医院妇产科待产妇171名进行EPQ和SCL-90评定。产妇年龄为23~40岁,平均(29±3)岁;民族:朝鲜族84名、汉族87名;文化程度小学2名,初中40名,高中72名,大专以上57名。用SPSS·10·0软件进行统计分析。2结果2·1朝、汉族待产妇在SCL-90躯体化和焦虑因子有统计学差异。见附表。附表朝、汉族待产妇SCL-90比较…     

文科和医科大学生心理健康及个性的调查分析

目的　了解文科、医科大学生的心理健康状况、个性情况及二者之间的关系。　方法　采用症状自评量表SCL - 90和龚耀先修订的艾森克个性问卷 (EPQ)对福建医科大学二年级临床医学专业学生及福建师范大学二年级外语和教育专业的学生进行测量 ,并运用SPSS软件对所得资料进行统计处理。　结果　①文科和医科大学生的心理健康状况没有差别。②文科生的情绪不稳定性高于医科生。③情绪稳定性和内外倾向性与心理健康密切相关。　结论　专业环境、个性和身心健康三者紧密相关 ,要根据不同的专业、个性特点施以不同的心理卫生教育。     

边防某部新兵心理困忧的调查分析

目的：为探讨部队新兵心理问题及原因,作好新兵心理保健工作。方法：采用症状自评（ＳＣＬ－９０）和艾森克人格测验（ＥＰＱ）两个量表,对南方边防某部入伍１周内的新兵５９３人进行心理调查。结果：新兵在躯体化、强迫、焦虑和抑郁等方面的心理困扰明显高于国内常模。独生子女更为显著。结论：连队创造良好的人际氛围,加强心理辅导,对促使新兵摆脱心理困扰十分重要。     

常州市中学生个性与心理健康调查

目的　了解常州市中学生性格与心理健康状况 ,筛查出可能患有心理障碍或心理疾患的学生。方法　运用症状自评量表 (SCL -90 )和艾森克人格问卷 (EPQ)对常州市 114 0名中学生心理情况进行调查。结果　常州市 16至18周岁中学生心理障碍发生率达 2 3.77%。结论　常州市中学生SCL -90各项因子均分高于全国常模 (青年组 ) ,其中较为突出的心理问题是强迫、人际敏感症状     

腹腔镜手术治疗慢性萎缩性胆囊炎80例的效果分析

目的：探讨用腹腔镜手术方法治疗慢性萎缩性胆囊炎的临床疗效。方法：随机选取2011年11月-2012年11月期间在本院接受腹腔镜手术治疗的80例慢性萎缩性胆囊炎患者和80例同时期在本院接受开腹手术治疗的慢性萎缩性胆囊炎患者。将接受腹腔镜手术治疗的患者作为观察组,而接受开腹手术治疗的患者作为对照组。对两组患者的相关情况进行系统性分析。结果：无论是患者的术中出血量、手术时间和术后胃肠功能的恢复情况还是患者术后止痛药使用率和并发症的发生率等方面,观察组患者的结果均明显优于对照组（P〈0.05）。结论：腹腔镜手术治疗较传统的开腹手术治疗慢性萎缩性胆囊炎有很多优点,诸如创伤小、疗效好、术后止痛药使用少、并发症少等。     

维持性血液透析患者自杀风险及相关心理社会影响因素调查

目的了解维持性血液透析(maintenance hemodialysis,MHD)患者的自杀风险及相关心理社会影响因素。方法采用横断面调查研究方法,自行设计编制一般情况调查表,以抑郁自评量表、焦虑自评量表、疲劳量表(FS-14)、社会支持量表和简明国际神经精神访谈自杀筛选问卷等量表为工具,对医院符合标准的114例MHD患者的自杀风险及相关因素进行调查,同时以多因素Logistic回归方法进行分析。结果单因素分析及Pearson相关分析显示,婚姻状况、并发症、透析时间、经济状况以及抑郁、焦虑、疲劳、社会支持对MHD患者的自杀风险有影响。多因素Logistic回归分析发现,抑郁和焦虑是发生自杀风险的重要危险因素,良好的社会支持是降低自杀风险的保护性因素。结论 MHD患者自杀风险高,应采取综合性预防措施,防止自杀行为的发生。     

非小细胞肺癌与心理社会应激因素的关系

目的探讨生活事件、情绪状态等心理社会应激因素与非小细胞肺癌发病的相关性,为更有效地防治非小细胞肺癌提供科学依据。方法采用病例-对照研究,以经病理确诊为非小细胞肺癌的45例患者为观察组,经病理确诊为非小细胞肺癌的良性疾病45例患者为对照组,采用心理社会应激调查表(PSSG)测试其生活事件、情绪反应;采用焦虑自评量表(SAS)测定其焦虑情况;采用Logistic回归分析非小细胞肺癌与心理社会因素之间的关系。结果多因素Logistic回归分析结果显示,经济困境(OR=3.143)、子女前途问题(OR=7.721)、忧郁(OR=6.122)、绝望(OR=18.215)是非小细胞肺癌的危险因素;而愉快的情绪状态(OR=0.043)是非小细胞肺癌发病的保护性因素。与对照组相比,观察组有严重的焦虑现象,差异有统计学意义(P0.05)。结论某些负性生活事件、消极情绪是非小细胞肺癌发病的危险因素,而保持心情愉快是非小细胞肺癌发病的保护性因素。     

Psychosocial Factors Related to Return to Work Following Rehabilitation of Whiplash Injuries

INTRODUCTION: The present study examined the effects of pain chronicity on the responsiveness of psychosocial variables to intervention for whiplash injuries. METHODS: Participants (N = 75) were work disabled patients with a diagnosis of Whiplash Grade II and were clients in a 10-week community-based, psychosocial intervention aimed at facilitating return to work. Individuals were classified as subacute (4-12 weeks; N = 25), early chronic (3-6 months; N = 25), and chronic (6-18 months; N = 25). Patients in the three groups were matched on sex (13 men, 12 women) and age (+/-2 years). Patients completed measures of pain severity, self-reported disability, pain catastrophizing and fear of movement at pre-treatment, mid-treatment and post-treatment. RESULTS: Return to work rates were 80, 72 and 32% for the subacute, early chronic and chronic groups, respectively. Individuals in the chronic group, compared to individuals in the subacute or early chronic groups, had significantly more elevated pre-treatment scores on measures of pain catastrophizing, F(2, 74) = 9.6, P < .001, and fear of movement, F(2, 74) = 3.4, P < .05. The magnitude of treatment-related reductions in catastrophizing, fear of movement and pain intensity was comparable across groups. However, individuals who were absent from work for more than 6 months showed the least amount of change in self-reported disability through the course of treatment. CONCLUSIONS: The findings suggest that self-reported disability is particularly resistant to change as the period of work disability extends over time. The findings emphasize the importance of early intervention and the need to develop strategies that specifically target disability beliefs in patients with whiplash injuries.     

急性胆囊炎行腹腔镜胆囊切除术引起中转开腹的危险因素分析

目的：探讨急性胆囊炎患者行腹腔镜胆囊切除术后引发中转开腹的临床发病因素。方法：采集本院收治的需进行腹腔镜胆囊切除术的急性胆囊炎患者共120例,按发病时间分为三组。均实施相同手术方法,观察手术后需进行中转开腹的发病率。结果：三组手术时间、并发症等比较差异均无统计学意义（P〉0.05）。患者救治时间对引发中转开腹有着直接的影响（P〈0.05）。同时患者的体温、胆囊壁厚度、胆囊有无肿大,以及白细胞计数等均对中转开腹率有着直接的影响（P〈0.05）。结论：对于急性胆囊炎患者在出现症状后72 h内为进行腹腔镜手术的最好治疗时机,同时体温及白细胞计数等因素与引发中转开腹存在明显的相关性。     

Psychosocial and Psychodynamic Factors Influencing Health Care Utilisation

This paper aims to elucidate some dysfunctional aspects of health care utilisation by combining concepts from modern systems theory and from psychoanalysis. Contemporary health care in industrialised countries can be conceived as a social system in terms of modern systems theory. According to this theory, social systems are operating on the basis of a ‘guiding difference,’ which in the case of health care is the distinction between ‘healthy’ and ‘ill.’ Its rigidity in adhering to the healthy-ill dichotomy exposes health care to being collusively entangled in the interpersonal defence arrangements of patients. In the psychoanalytic view, individual conflicts can be warded off from consciousness not only by intrapsychic defence, but also by interpersonal defence mechanisms. These mechanisms involve the patients’ close social environment, often including doctors and hospitals. The functioning and the motivational structure of health care itself shows features of neurotic defence: Not only its representatives, but health care as a whole act in a rigid, obsessive manner in order to separate the healthy from the ill and to battle against (presumed) diseases. This obsession sometimes results in excessive diagnostic activism and in inconsiderate application of aggressive medical treatments. Both are inappropriate with regard to the salient problem of modern medicine: the increase of chronic nonfatal diseases like depression and chronic pain. The described defence mechanisms are unconscious not only to patients but also to health care professionals (let alone health politicians), and are contributing to dysfunctional health care overuse.     

Urban–Rural Differences in Physical Activity in Belgian Adults and the Importance of Psychosocial Factors

Recent research in urban planning and public health has drawn attention to the associations between urban form and physical activity in adults. Because little is known on the urban–rural differences in physical activity, the main aims of the present study were to examine differences in physical activity between urban and rural adults and to investigate the moderating effects of the physical environment on the relationship between psychosocial factors and physical activity. In Flanders, Belgium, five rural and five urban neighborhoods were selected. A sample of 350 adults (20–65 years of age; 35 adults per neighborhood) participated in the study. Participants wore a pedometer for 7 days, and self-reported physical activity and psychosocial data were also collected. Results showed that urban adults took more steps/day and reported more walking and cycling for transport in the neighborhood, more recreational walking in the neighborhood, and more walking for transportation outside the neighborhood than rural adults. Rural adults reported more recreational cycling in the neighborhoods. The physical environment was a significant moderator of the associations between several psychosocial factors (modeling from family, self-efficacy, and perceived barriers) and physical activity. In rural participants, adults with psychosocial scores above average were more physically active, whereas there were no differences in physical activity according to psychosocial factors in urban participants. These results are promising and plead for the development of multidimensional interventions, targeting specific population subgroups. In rural environments, where changing the environment would be a very challenging task, interventions focusing on modifiable psychosocial constructs could possibly be effective.     

乙型肝炎发病及复发与心理社会因素的关系

为研究乙型肝炎(Hepatitis B,HB)发病及复发与社会心理因素的关系,对85例急性乙肝炎(Acute Hepatitis B,AHB)患者、67例慢性乙型肝炎(Chronic Hepatitis B,CHB)患者采用生活事件量表(LES)、艾森克个性问卷(EPQ)、症状自评量表(Scl-90)进行问卷调查.结果显示HB病人的生活事件单位(LEU)明显高于正常人(P<0.001),并在CHB组和男性患者中明显增高.EPQ测定CHB组在精神质、神经质方面明显异常(P<0.05).Scl-90测定CHB组的多项得分高于AHB组和对照组(P<0.05～P<0.01).提示:社会心理负荷过重是HB发病及复发的诱因之一;CHB患者具有个性异常和心理健康水平低下的特点,是应给予心理学手段干预的高危人群     

Association of Demographic and Socioeconomic Factors With Risk Factors for Chronic Kidney Disease

Objectives:

The goal of this study was to examine the association of various demographic and socioeconomic factors with risk factors for chronic kidney disease (CKD).

Methods:

We used nationally representative pooled data from the Korea National Health and Nutrition Examination Survey (KNHANES), 2007–2013. We estimated the glomerular filtration rate (GFR) using the Modification of Diet in Renal Disease equation. We defined CKD as a GFR <60 mL/min/1.73 m², and 1304 of the 45 208 individuals included in the KNHANES were found to have CKD by this definition. The outcome variable was whether individual subjects adhered to the CKD prevention and management guidelines recommended by the Korea Centers for Disease Control and Prevention. The guidelines suggest that individuals maintain a normal weight, abstain from alcohol consumption and smoking, manage diabetes and hypertension, and engage in regular exercise in order to prevent and manage CKD.

Results:

This study found that individuals with CKD were more likely to be obese and have hypertension or diabetes than individuals without CKD. In particular, male and less-educated CKD patients were less likely to adhere to the guidelines.

Conclusions:

Although the prevalence of CKD, as indicated by the KNHANES data, decreased from 2007 to 2013, the prevalence of most risk factors associated with CKD fluctuated over the same time period. Since a variety of demographic and socioeconomic factors are related to the successful implementation of guidelines for preventing and managing CKD, individually tailored prevention activities should be developed.     

Psychosocial Factors and Functional Capacity Evaluation Among Persons with Chronic Pain

Psychosocial factors have been found to have a significant impact on functional activity, particularly among persons with chronic pain. While various systems have been developed to assess functional limitations through functional capacity evaluation (FCE), assessment of psychosocial factors that may impact function have been largely ignored. This paper examines the existing literature on psychosocial factors and FCE performance. Given that there are few studies that have directly addressed this issue, the paper also examines psychosocial factors that have been found to influence function in persons with pain. The results of the literature review indicate that few psychosocial factors have been found to be directly associated with FCE and functional measures, although many are related to various measures of disability. The strongest evidence that psychosocial factors are related to functional performance is based on the studies examining the association between functional activity and pain-related fear, self-efficacy, and illness behavior. Psychosocial factors have also been shown to influence measures of sincerity of effort often obtained during FCE. Proposals for modifying FCE assessment are given based on the available data, as well as suggestions for future research.