帕金森病患者家属疾病不确定感与应对方式的相关性研究

目的调查帕金森病患者家属的疾病不确定感与应对方式之间的相关性。方法采用中文版疾病不确定感量表和简易应对方式问卷对92例帕金森患者照顾者进行问卷调查。结果帕金森病患者家属疾病不确定感得分为(136.35±12.52)分,积极应对得分为(18.86±5.00)分,消极应对得分为(14.15±3.66)分,积极应对方式与疾病不确定感呈负相关,消极应对方式与疾病不确定感呈正相关(P0.01)。结论护士应重视评估帕金森患者家属的疾病不确定感,鼓励其采取积极有效的应对方式,以减轻照顾负担,提高患者和家属的生活质量。     

住院精神分裂症患者家属自测健康状况调查研究

目的探讨住院精神分裂症患者家属的自测健康状况,为改善患者的家庭支持系统提供依据。方法采用分层随机取样法,抽取2012年9月-12月在广东省河源市源城区精神卫生防治所住院的精神分裂症患者的家属(家属组)和一般人群(对照组)各100例,进行自测健康评定量表(SRHMS)调查,并采用简易应对方式量表(SCSQ)调查家属组的应对方式特点。结果家属组SRHMS的健康总体自测维度得分和社会健康子量表得分均低于对照组[(28.39±8.95)分vs.(32.51±3.65)分,(75.47±25.52)分vs.(88.66±11.94)分],差异有统计学意义(t=3.015、3.311,P0.01);家属组的积极应对方式和消极应对方式得分与常模比较差异有统计学意义(t=2.056、4.494,P0.05或0.01);家属组SRHMS各维度与积极因子正相关(r=0.728~0.299,P0.05或0.01);除维度1、5、8、9及社会健康子量表分、健康量表总分外,其余各维度与消极因子负相关(r=-0.416~-0.304,P0.05或0.01)。结论精神分裂症患者家属的健康水平偏低,可能与消极应对方式有关。     

抑郁水平与尿毒症非透析患者疾病不确定感的相关性分析

目的 调查尿毒症未接受透析治疗患者疾病不确定感和抑郁水平,并探讨两者之间的关系.方法 以便利抽样的方法,采用Mishel疾病不确定感量表和Zung氏抑郁自评量表（SDS）,对150例终末期肾病患者进行问卷调查.结果 患者疾病不确定感总分为（99.84±8.89）分,处于中等水平,自评抑郁得分为（49.38±5.52）分,抑郁的发生率为47.4%,疾病不确定感及其各维度与抑郁存在正相关.结论 护理人员应该及时评估患者疾病不确定感,同时给予个性化指导,积极应对疾病不确定感,从而减轻抑郁情绪.     

吸烟对精神分裂症男性患者精神病理症状的影响

目的 分析吸烟对精神分裂症临床精神病理症状的影响,探索精神分裂症患者高比例吸烟的原因.方法 收集慢性精神分裂症吸烟患者(332例)和非吸烟患者(95例)共427例,首次发病(以下简称首发)精神分裂症吸烟患者(22例)和非吸烟患者(41例)共63例,均为男性;使用阳性和阴性症状最表(PANSS)评定其临床精神病理症状.结果 (1)在慢性精神分裂症患者巾,吸烟组PANSS阴性症状分量表中的情感交流障碍得分[(3.9±1.5)分]、被动或淡漠得分[(3.6±1.6)分]及其总分[(24.0.±8.2)分]低于非吸烟组[分别为(4.4.±1.7)分、(4.0±1.7)分和(26.3.±9.5)分;P<0.05];PANSS阴性症状分量表7个条目得分及其总分、一般精神病理分量表总分和PANSS总分与患者每天的吸烟量呈负相关(P<0.05～0.01);阴性症状分量表中的情感交流障碍[比值比(OR)=0.832,95%可信区间(95%CI)=0.691～0.980,P=0.029]和一般精神病理分量表中的紧张(OR=0.534,95%CI=0.363～0.786,P=0.001)进入Logistic模型.(2)在首发精神分裂症患者中,吸烟组在阴性症状分量表中的情绪退缩得分[(2.7±1.3)分]、被动或淡漠得分[(2.7 ±1.3)分]低于非吸烟组[分别为(3.5±1.3)分和(3.5±1.4)分;P<0.05];一般精神病理分量表中的动作迟缓与患者每天的吸烟量呈负相关,自知力缺乏与吸烟量呈正相关(均P<0.05);PANSS一般精神病理分量表中的动作迟缓(OR=0.589,95%CI:0.350～0.989,P=0.045)进入Logistic模型.结论 吸烟对阴性症状的正性作用可能是精神分裂症患者高比例吸烟的原因之一.     

脑卒中患者家属疾病不确定感影响因素的分析

目的调查脑卒中患者家属疾病不确定感,并探讨其影响因素。方法采用自行编制的一般资料调查表和疾病不确定感家属量表,对180例符合纳入标准的患者家属进行调查。结果患者家属疾病不确定感得分为(91.12士9.62)分,说明患者家属疾病不确定感处于高水平。患者家属和患者关系、家属收入、家属年龄、患者家属的文化程度、配偶、职业、居住地是其疾病不确定感的最主要影响因素。结论脑卒中患者家属存在较高水平的疾病不确定感,临床护士应帮助其降低疾病不确定感的水平。     

抑郁症患者家属心理健康水平、应对方式及社会支持的现状

目的:探讨抑郁症患者家属的心理健康水平、应对方式及社会支持水平。方法:对与抑郁症患者同住的150名家属进行症状自评量表(SCL-90)、简易应对方式问卷(SCSQ)和社会支持评定量表(SSRS)评估,并与全国常模的数据比较。结果:抑郁症患者家属SCL-90总分及躯体化、抑郁、焦虑、精神病性因子分明显高于全国常模(P均0.05);SCSQ中积极的应对方式得分明显低于全国常模,而消极方式得分明显高于全国常模(P均0.05);SSRS中男性家属客观支持、主观支持、支持利用评分及女性家属客观支持评分明显低于全国常模(P均0.05)。结论:抑郁症患者家属心理健康水平较差,社会支持少,多采取消极的应对方式;他们需要心理干预。     

人工全髋关节置换患者术前疾病不确定感与焦虑水平的关系

目的 探讨人工全髋关节置换患者术前疾病不确定感与其焦虑水平的关系.方法 选定本院2018年11月～2019年11月住院治疗的200例人工全髋关节置换术患者,采用疾病不确定感量表(MUIS)评估患者术前疾病不确定感,采用焦虑自评量表(SAS)评估焦虑水平,通过比较不同疾病MUIS组的SAS评分和不同焦虑水平组的MUIS评分以及Spearman相关性分析来探讨MUIS量表各维度与焦虑情绪的相关性.结果 200例患者MUIS评分71.5～139.4分,平均(105.26±4.64)分.其中21例是高水平不确定感,占10.50％,MUIS评分(60.25±4.14)分;118例是中水平不确定感,占59.00％,MUIS评分(92.52±10.44)分;61例是低水平不确定感,占30.50％,MUIS评分(138.26±6.44)分.200例患者中46例轻度焦虑,占23.00％;101例中度焦虑,占50.50％;53例重度焦虑,占26.50％.重度焦虑组MUIS评分高于中度焦虑组,中度焦虑组MUIS评分高于轻度焦虑组(P＜0.05).MUIS量表不可预测性、信息缺乏、不确定性、复杂性与焦虑水平均为正相关(P＜0.05).结论 人工全髋关节置换术患者的术前不确定感和焦虑水平均处于中等水平,不确定感和患者的焦虑水平呈正相关,临床应及早予以处理,尽可能减轻患者不确定感、焦虑水平.     

精神分裂症后抑郁患者的防御及应对方式

目的探讨精神分裂症后抑郁患者的心理防御及应对方式的特点。方法在精神分裂症患者精神病性症状明显好转,简明精神病量表(BPRS)总分≤35时,将卡尔加里精神分裂症抑郁量表(CDSS)得分≥6分者纳入精神分裂症后抑郁组,CDSS得分<6分者中匹配选择纳入对照组。二组患者均作防御方式问卷(DSQ)和简易应对方式测试。结果精神分裂症后抑郁患者不成熟防御机制因子得分显著高于对照组,成熟型及中间型防御机制因子得分均低于对照组;投射、被动攻击、潜意显现、躯体化等不成熟防御机制及压抑等成熟防御机制得分显著高于对照组,幽默得分显著低于对照组;积极应对方式得分显著低于对照组,而消极应对方式得分显著高于对照组。不成熟防御机制因子分与CDSS得分呈显著正相关(r=0.46,P<0.01);成熟型防御机制因子分与CDSS得分呈负相关(r=0.137),中间型防御机制因子分与CDSS得分呈正相关(r=0.143),但无统计学意义;积极应对方式得分与CDSS得分呈显著负相关(r=0.531,P<0.01),消极应对方式得分与CDSS得分呈显著正相关(r=0.463,P<0.01)。结论过多使用不成熟防御机制和消极应对方式可能是导致精神分裂症患者产生抑郁的因素之一。抑郁症状越严重,越多采用不成熟防御机制,较少采用积极应对方式,反之亦然。     

脑卒中患者的人格特征、应付方式和社会支持状况的调查研究

目的 调查脑卒中患者的人格特征、在不同情况下采用的应付方式和社会支持状况.方法 采用艾森克个性问卷(EPQ)、应付方式问卷(CSQ)和社会支持评定量表(SSS)对68例脑卒中患者和68名正常对照者进行测评.结果 脑卒中组的内外倾向性分(E分)和情绪稳定性分(N分)(11.98±4.79,12.98±4.73)明显高于正常对照组(9.46±4.18,9.60±4.70)(均P＜0.01);脑卒中组自责和退避分量表的得分(3.49±1.29,5.68±1.63)均高于正常对照组(2.17±1.12,4.23±1.27),求助分量表的得分(3.07±2.31)低于正常对照组(5.29±2.03),差异有极显著性(均P＜0.01);脑卒中组社会支持总分(36.68±4.97)、客观支持评分(8.02±2.93)和对社会支持的利用度评分(6.74±2.13)显著低于正常对照组(41.22±3.41,9.88±2.76,8.38±1.82),差异有显著性(均P＜0.05).结论 脑卒中患者的人格具有外倾性和不稳定性;多采用不成熟的应付方式;脑卒中患者缺乏社会支持.     

上海市网络成瘾中学生的应对方式与社会支持

背景应激被认为与青少年网络成瘾存在一定的关联,除了事件本身,应对方式和寻求社会支持则是应激过程中的主观过程。目的评价网络成瘾中学生的社会支持系统和应对机制。方法以Beard的网络成瘾诊断标准结合功能受损程度,通过临床访谈得到网络成瘾中学生205人,以问卷调查形式评估他们的应对方式和社会支持。176人有效完成问卷（问卷有效率85.9%）,并且与352例（按照1∶2的比例年龄、性别配对）不满足网络成瘾诊断标准的学生进行比较。结果与非网络成瘾学生相比,网络成瘾学生在应对方式问卷的＂问题解决＂分量表和＂求助＂分量表上的平均分显著较低,而在＂自责＂和＂幻想＂分量表上的平均分较高。网络成瘾组中,社会支持评定量表中的＂支持总分＂、＂主观支持分＂、＂对支持的利用度＂分量表得分显著较低。Logistic回归分析提示网络成瘾与应对方式中使用＂问题解决＂、＂幻想＂、＂自责＂以及在＂对支持的利用＂能力上独立相关。结论在中学生中,网络成瘾与应对方式、社会支持的利用度相关。需要进一步的研究来确定,是否在学生中鼓励他们使用积极的应对方式或者训练他们发展和使用社会支持资源将预防或者改善网络成瘾的消极影响。     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.     

Sense of coherence as a predictor of subjective state of health: results of 4 years of follow-up of adults

A number of cross-sectional population studies have shown that a strong sense of coherence (SOC) is associated with various aspects of good perceived health. The association does not seem to be entirely attributable to underlying associations of SOC with other variables, such as age or level of education. OBJECTIVE: The aim of the study reported here was to determine whether SOC predicted subjective state of health. METHODS: The study was carried out as a two-way panel mail survey of 1976 individuals with 4 years interval for two collections of data. The statistical method used was multivariate cumulative logistic modeling. Age, initial subjective state of health, initial occupational training level, and initial degree of social integration were included as potential explanatory variables. RESULTS: A strong SOC predicted good health in women and men. CONCLUSIONS: SOC can be interpreted as an autonomous internal resource contributing to a favorable development of subjective state of health. SOC data should, however, be regarded as complementary to and not a substitute for information already known to be associated with increased risk of future ill health.