首发脑卒中患者照顾者家庭抗逆力干预方案的构建及应用

目的 构建首发脑卒中患者照顾者家庭抗逆力干预方案,并评价其应用效果。方法 通过文献研究、德尔菲专家函询及预试验构建首发脑卒中患者照顾者家庭抗逆力干预方案。将首发脑卒中患者照顾者按入院时间分为对照组41人和观察组40人;对照组实施常规护理,观察组在此基础上实施首发脑卒中患者照顾者家庭抗逆力干预方案。比较两组干预前、干预后1、3个月家庭抗逆力、脑卒中照顾者综合照顾能力及照顾者负担评分。结果 干预后,观察组照顾者家庭抗逆力、综合照顾能力评分显著高于对照组,照顾者负担评分显著低于对照组(均P<0.05)。结论 首发脑卒中患者照顾者家庭抗逆力干预方案能显著提高照顾者家庭抗逆力和综合照顾能力,降低照顾负担。     

家庭赋权干预对永久性肠造口患者照顾者的影响

目的 探讨家庭赋权干预应用于永久性肠造口患者主要照顾者的效果。 方法 选择永久性肠造口患者及主要照顾者97对作为研究对象,按照患者住院时间分为对照组48对和观察组49对。对照组患者给予常规护理,观察组在对照组基础上实施家庭赋权干预方案。比较两组照顾者干预前后照顾准备程度、照顾负担及心理一致感评分。 结果 干预后,观察组照顾者照顾准备度评分及心理一致感评分显著高于对照组,照顾负担评分显著低于对照组（均P＜0.05）。 结论 家庭赋权干预有利于提高永久性肠造口患者主要照顾者的准备度及心理一致感,对缓解照顾者照顾负担具有积极意义。     

基于二元疾病管理理论的老年肺癌患者出院准备服务方案的实施

目的 探讨基于二元应对理论的老年肺癌患者出院准备服务方案的实施效果。方法 将肿瘤科收治的71例老年肺癌患者随机分为对照组35例和观察组36例。对照组给予常规护理,观察组实施基于二元疾病管理理论的出院准备服务方案。使用出院准备度量表、二元应对量表及癌症照顾者综合需求量表评价干预效果。结果 干预后观察组患者出院准备度、患者及其照顾者支持应对评分显著高于对照组,照顾者综合需求评分显著低于对照组（均P＜0.05）。结论 对老年肺癌患者及照顾者实施基于二元疾病管理理论的出院准备服务方案,有助于提高患者出院准备度及支持应对水平,满足照顾者综合需求。     

以家庭为中心的赋权模式在PICC化疗患者中的应用

目的探究以家庭为中心的赋权模式对PICC化疗患者家庭照顾者照顾能力和照顾准备度的影响。方法将122例行PICC置管化疗的恶性肿瘤患者及其家庭照顾者随机分为对照组与赋权组各61例。对照组给予肿瘤科常规护理,赋权组实施以家庭为中心的赋权模式护理。结果干预后赋权组患者家庭照顾者照顾能力及照顾者准备度显著优于对照组(均P<0.01)。结论以家庭为中心的赋权模式可提高家庭照顾者的照顾能力和照顾准备度。     

积极自我表露干预对中青年脑卒中患者照顾者获益感的影响

目的 探讨积极自我表露干预对中青年脑卒中患者照顾者获益感、照顾负担及生活质量的影响。方法 将78名中青年脑卒中患者的照顾者按照病区分为对照组和干预组各39名。对照组接受常规护理，干预组在对照组的基础上实施为期4周、共8次的积极自我表露干预。比较两组干预前，干预后即刻，干预后1个月、3个月的获益感、照顾负担、生活质量情况。结果 干预组、对照组各有36名照顾者完成研究。干预后即刻及干预后1个月，干预组照顾者获益感评分显著高于对照组（均P＜0.05）；干预后即刻及1个月、3个月干预组照顾负担评分显著低于对照组，生活质量评分显著高于对照组（均P＜0.05）。结论 积极自我表露干预可有效地提高中青年脑卒中患者照顾者获益感，减轻照顾负担，提高生活质量。     

家庭尊严干预对乳腺癌患者照顾者的影响

目的 探讨家庭尊严干预对乳腺癌患者照顾者照顾感受、创伤后成长及照顾能力的影响.方法 将220名乳腺癌患者照顾者随机分为观察组和对照组各110人.对照组给予常规干预,观察组在此基础上实施家庭尊严干预.两组出院时及出院后3个月分别采用照顾者负担量表、创伤后成长评定量表及中文版照顾者能力量表进行调查.结果 观察组照顾负担显著低于对照组,创伤后成长及照顾能力评分显著高于对照组(均P＜0.01).结论 家庭尊严干预能有效降低乳腺癌患者照顾者的照顾负担,提升其创伤后成长水平及照顾能力.     

家庭抗逆力在脑卒中患者日常生活能力与主要照顾者负担间的中介效应

目的 探讨家庭抗逆力在脑卒中患者日常生活能力与主要照顾者负担间的中介作用，为开展护理干预以有效减轻脑卒中患者主要照顾者负担提供参考。 方法 以便利抽样法选取286例脑卒中患者及其主要照顾者，采用一般资料调查表、改良Barthel指数量表中文版、家庭抗逆力评定量表中文简化版、Zarit照顾者负担量表进行调查。 结果 脑卒中患者日常生活能力总分为（40.86±13.14）分，家庭抗逆力总分为（101.85±14.78）分，照顾者负担总分为（40.98±13.68）分。脑卒中患者日常生活能力总分与家庭抗逆力总分呈正相关，二者与主要照顾者负担总分呈负相关（均P＜0.05）；家庭抗逆力在脑卒中患者日常生活能力与主要照顾者负担间起部分中介效应，效应量占比为37.44%。 结论 脑卒中患者日常生活能力可通过家庭抗逆力的中介作用对主要照顾者负担产生影响。医护人员在促进脑卒中患者日常生活能力恢复的同时应以家庭抗逆力作为干预靶点，充分挖掘家庭内部整体力量，促进家庭抗逆力水平的提高，进而减轻脑卒中患者主要照顾者负担。     

维持性血液透析患者家庭照顾者心理一致感现状及影响因素

目的 探讨维持性血液透析患者家庭照顾者心理一致感现状及影响因素,为制订有效的护理干预方案提供指导.方法 便利抽样选取武汉市2所三甲医院维持性血液透析患者家庭照顾者237名,采用一般资料问卷、心理一致感量表、照顾准备度量表及积极感受量表进行调查.结果 维持性血液透析患者家庭照顾者心理一致感得分为(56.37±11.77)分.家庭照顾者心理一致感与照顾准备度、积极感受呈正相关(均P＜0.01).多元线性回归分析显示,照顾准备度及积极感受是家庭照顾者心理一致感的主要影响因素(均P＜0.01),共可解释其38.0％的总变异量.结论 维持性血液透析患者家庭照顾者心理一致感处于较低水平.医护人员需针对影响因素给予指导干预,提高其心理一致感,促进心理健康.     

家庭抗逆力在脑卒中患者日常生活能力与主要照顾者负担间的中介效应

目的 探讨家庭抗逆力在脑卒中患者日常生活能力与主要照顾者负担间的中介作用，为开展护理干预以有效减轻脑卒中患者主要照顾者负担提供参考。方法 以便利抽样法选取286例脑卒中患者及其主要照顾者，采用一般资料调查表、改良Barthel指数量表中文版、家庭抗逆力评定量表中文简化版、Zarit照顾者负担量表进行调查。结果 脑卒中患者日常生活能力总分为(40.86±13.14)分，家庭抗逆力总分为(101.85±14.78)分，照顾者负担总分为(40.98±13.68)分。脑卒中患者日常生活能力总分与家庭抗逆力总分呈正相关，二者与主要照顾者负担总分呈负相关(均P<0.05);家庭抗逆力在脑卒中患者日常生活能力与主要照顾者负担间起部分中介效应，效应量占比为37.44%。结论 脑卒中患者日常生活能力可通过家庭抗逆力的中介作用对主要照顾者负担产生影响。医护人员在促进脑卒中患者日常生活能力恢复的同时应以家庭抗逆力作为干预靶点，充分挖掘家庭内部整体力量，促进家庭抗逆力水平的提高，进而减轻脑卒中患者主要照顾者负担。     

基于跨理论模型的家庭赋权心脏康复管理在中青年PCI术后患者中的应用

目的 探讨基于跨理论模型的家庭赋权心脏康复管理在中青年PCI术后患者中的应用效果,为临床护理干预提供理论依据.方法 选取PCI治疗的86例冠心病患者,按照入住病区分为观察组和对照组.对照组实施常规护理,观察组在常规护理基础上实施基于跨理论模型的家庭赋权心脏康复管理,比较两组患者术后2周,1个月和3个月心脏康复活动行为阶段,心脏康复自主性、过程焦虑及结果焦虑;同时比较两组患者主要照顾者积极照顾感受.结果 两组术后1个月和3个月行为变化阶段差异有统计学意义(均P＜0.01);患者心脏康复自主性、过程焦虑及结果焦虑比较,差异有统计学意义(P＜0.05,P＜0.01);干预后观察组患者主要照顾者积极照顾感受的自我肯定和生活展望得分显著高于对照组(均P＜0.05).结论 基于跨理论模型的家庭赋权心脏康复管理可更好地促进PCI术后患者健康行为形成,提高患者心脏康复的意愿与依从性,提升主要照顾者积极感受程度.     

Relationship of family schema to family adaptation to brain injury

The relationship between family schema and family adaptation to brain injury was investigated. Participants were 87 primary caregivers of persons with brain injuries in Wisconsin who are part of a comprehensive, longitudinal study of family adaptation to having a member with a brain injury. Stepwise multiple regression of variables measuring family schema on family adaptation indicated that manageability and meaningfulness were predictive of family adaptation. Thus the hypothesis that family adaptation can be predicted from variables measuring family schema was supported. Family intervention and research implications are discussed.     

Molecular biology of multispecific organic anion transporter family (OAT family)

It has been predicted that a variety of organic anions of endogenous and exogenous origin are secreted by the renal proximal tubules via the p-aminohippurate (PAH) transport system. Organic anions are taken up from the peritubular plasma by the basolateral PAH transporter, and subsequently excreted into the urine by distinct organic anion transporter(s) in the luminal membrane. In 1997, we isolated the PAH transporter, organic anion transporter 1 (OAT1), from the rat kidney by the expression cloning method. OAT1 is a 551-amino-acid residue protein with 12 putative membrane spanning domains. It is exclusively expressed in the kidney, and is localized to the basolateral membrane of the cells of the middle portion of the proximal tubule, S2. OAT1 is a sodium-independent, organic anion/dicarboxylateexchanger, and mediates the transport of various organic anions. We have also identified two other isoforms of OAT. Rat OAT2 is predominantly expressed in the liver, while rat OAT3 is expressed in the liver, kidney, brain, and eyes. The isoforms exhibit overlapping but distinct substrate specificities. Interestingly, the members of the OAT family are structurally related to the members of the organic cation transporter (OCT) family. In addition, we have identified a membrane protein showing homology to both OATs and OCTs. This clone (CT1) mediated the transport of carnitine, a zwitterion. In this article, we describe the structure and functions of the members of the OAT family in association with these features in members of the OCT family and the zwitterion transporter. Received: September 27, 1999 / Accepted: October 13, 1999     

Psychiatric aspects of family killings

There has been very little research done on family slayings in the RSA. The concept is defined and a short survey of the literature is provided. Five case studies of patients who were referred to Weskoppies Hospital after being involved in family killings are described; a diagnosis of depression was made in all 5 cases. The clinical implications of manslaughter and depression are discussed, and suggestions are offered for future research into psychiatric factors involved in family killings.     

Sexual counselling of the family

The general practitioner's important role as a counsellor on sexual matters is stressed. The psychosexual development of an individual is discussed. Some neglected conditions where family counselling may be required are presented, together with suggestions for the management of the sexual aspects of chronic illnesses and conditions.     

War and the family

Although war can impose powerful stresses on family relationships and functions, and its horros have been described since Euripides wrote The Trojan Women, the subject has received little scientific study. The American Civil War had significant effects on the family and increasing industrialization further disrupted family ties and transformed women's roles. Twentieth-century wars have had both immediate and delayed effects on the family, ranging from anxiety and grief about losses and separations to increased antisocial behavior and juvenile delinquency. Subsequent problems stem from readjustments to civilian life, high divorce rates and women assuming more powerful roles in the family and society. Analysis of a random sample of child guidance clinic records 1923-1983 revealed an increase in children's academic problems and aggressive behaviors during and after World War II. Increases in anxiety and obsessive and aggressive behaviors were evident following the Vietnam conflict along with the adverse effects of post traumatic stress disorder on family life. Although US participation in the Gulf War was limited, disruptive effects were seen in the children of affected military families, and for Iraqi children the consequences were devastating. War generally accelerates dormant changes in family life not yet fully apparent or appreciated.