癌症化疗病人心理健康状况及相关因素调查

[目的]了解癌症化疗病人心理健康状况,并对其相关因素进行分析.[方法]应用抑郁自评量表(SDS)、焦虑自评量表(SAS)和自行设计的心理健康影响因素调查表对住院癌症化疗病人(实验组)161例和放疗病人(对照组)167例进行心理健康状况及其相关因素调查.[结果]两组病人SDS、SAS标准分显著高于常模(P＜0.01);化疗组病人抑郁和焦虑得分明显高于放疗组(P＜0.01);影响化疗病人的心理因素有对医疗费用、治疗效果的担心及治疗副反应的影响.[结论]接受化疗的癌症病人具有较普遍的心理障碍,应及早给予心理干预和必要的社会支持,以提高治疗效果及生存质量.     

食管癌病人心理健康状况的调查研究

[目的 ]了解食管癌病人心理健康状况及其影响因素。 [方法 ]应用抑郁自评量表 (SDS)、焦虑自评量表 (SAS)及相关因素调查表 ,对 15 1例食管癌病人和13 4例普通疾病病人进行对照测评。[结果 ]食管癌病人抑郁、焦虑发生率明显高于国内常模 ,也高于普通疾病病人(P <0 .0 1) ;食管癌病人在经济、家庭、社会、疼痛及疾病相关知识缺乏、治疗副反应等方面与普通疾病组存在差异(P <0 .0 1)。 [结论 ]针对食管癌病人抑郁焦虑等心理障碍进行对症心理治疗和护理干预十分重要。     

癌症放疗与普通内科住院患者焦虑抑郁状况及相关因素分析

目的探讨癌症放疗与普通内科住院患者焦虑抑郁及相关因素状况.方法应用抑郁自评量表(SDS),焦虑自评量表(SAS),汉密顿抑郁量表(HAMD),汉密顿焦虑量表(HAMA)和自行设计相关因素调查表,对180例癌症放疗患者及134例普通内科患者进行问卷调查并对比分析.结果癌症放疗患者焦虑抑郁明显高于普通内科患者(P＜0.01).单因素分析显示:癌症放疗患者在家庭因素、病情因素、经济因素、环境因素等方面与普通内科患者比较有显著性差异(P＜0.01),癌症放疗患者担心治疗费用、治疗效果、对家庭责任感、治疗副作用的影响更大.结论针对不同住院患者作不同心理干预.对癌症放疗患者予减轻放疗反应,给更多的关爱,照顾和支持;对普通内科患者应重视在疾病治疗、康复、预防等健康教育.     

对肿瘤病人放疗心理认同的影响因素分析

[目的]探讨肿瘤病人对放疗的心理认同状况及影响因素.[方法]对42例在我科放疗治疗的恶性肿瘤病人,放疗前采取问卷及面对面交谈法,了解病人对放疗的心理认同状况,应用焦虑自评量表(SAS)、抑郁自评量表(SDS)、艾森克人格测验(EPQ)评定病人的心理状态及个性特征,并对性别、年龄、文化、职业、收入等相关因素进行分析.[结果]不同心理认同状况的病人个性类型不同;SAS、SDS不同的得分病人对放疗的心理认同不同,且焦虑、抑郁程度越重,病人越不能认同放疗;不同性别、年龄、文化程度及职业对放疗病人的心理认同状况有影响.[结论]对恶性肿瘤放疗病人进行护理时,应针对不同心理认同状况实施护理,以提高放疗的心理认同.     

不同疗程鼻咽癌病人的心理状况与生存质量的相关性研究

[目的]探讨不同疗程鼻咽癌病人心理健康及生存质量状况。[方法]采用Zung编制的抑郁自评量表(SDS)、焦虑自评量表(SAS)、陈和年等制定的鼻咽癌生存质量量表(SQOL-NPC)对100例鼻咽癌病人放疗前、放疗中、放疗后进行调查。[结果]鼻咽癌病人放疗前、放疗中、放疗后SDS评分分别为(43.93±9.70)分、(53.29±9.67)分、(45.63±9.40)分,SAS评分分别为(38.43±9.47)分、(48.74±9.08)分、(39.69±8.93)分。放疗中鼻咽癌病人抑郁、焦虑得分最高,治疗中症状与治疗副反应指标(YD)、精神心理指标(YP)在放疗中得分最低。抑郁、焦虑与生存质量呈负相关。[结论]不同疗程的鼻咽癌病人心理健康状况不同,心理健康状况影响其生存质量,临床上应进行相应的、有针对性的心理治疗及护理干预。     

癌症患者抑郁的相关因素调查

目的 探讨癌症患者抑郁的相关因素.方法 应用抑郁自评量表(SDS)、焦虑自评量表(SAS)、相关因素调查表对化疗与放疗各180例癌症患者进行评定.结果 化疗患者抑郁焦虑均值明显高于放疗患者(P＜0.01),影响因素的前7位是经济费用、治疗效果、副作用、处理能力下降、家庭责任未尽、疼痛影响、医学知识缺乏.结论 针对癌症化疗患者存在抑郁、焦虑等影响健康的心理问题及相关因素进行对症护理干预,促进患者生理和心理健康的同期康复.     

癌症放疗病人的心理障碍原因分析及护理对策

[目的]分析癌症放疗病人的心理障碍原因,探讨护理对策。[方法]应用抑郁自评量表(SDS)和焦虑自评量表(SAS)及自行设计原因调查表对202例癌症放疗病人进行问卷调查。[结果]癌症放疗病人存在严重的心理障碍,其原因主要包括担心治疗效果及预后、受家庭因素影响、担心住院费用、受放疗副反应影响、疾病相关知识缺乏等。[结论]提示癌症放疗病人心理障碍的发生是较严重的,临床治疗中配合针对性的心理支持及有效的护理干预,对促进病人身心康复具有重要意义。     

脊髓损伤病人康复期心理健康、自理能力及生活质量的相关性研究

[目的]评估脊髓损伤病人心理健康、自理能力及生活质量状况并分析三者之间的相关性。[方法]采用一般情况问卷、焦虑自评量表(SAS)、抑郁自评量表(SDS)、Barthel指数评定量表及世界卫生组织生活质量简表(WHOQOLBREF)对117例脊髓损伤病人进行调查,分析各变量间的相关性。[结果]脊髓损伤病人焦虑、抑郁得分与生活质量总分及各维度得分呈负相关,Barthel指数得分与生活质量总分及各维度得分呈正相关,焦虑、抑郁及功能障碍对生活质量有影响(P0.05)。[结论]脊髓损伤病人心理健康状况及自理能力均与生活质量显著相关,病人焦虑、抑郁及不同程度自理能力对其生活质量有影响。     

癌症放疗与普通内科住院患者焦虑抑郁状况及相关因素分析

目的探讨癌症放疗与普通内科住院患者焦虑抑郁及相关因素状况。方法应 用抑郁自评量表(SDS),焦虑自评量表(SAS),汉密顿抑郁量表(HAMD),汉密顿焦虑量表 (HAMA)和自行设计相关因素调查表,对180例癌症放疗患者及134例普通内科患者进行问 卷调查并对比分析。结果癌症放疗患者焦虑抑郁明显高于普通内科患者(P<0.01)。单 因素分析显示:癌症放疗患者在家庭因素、病情因素、经济因素、环境因素等方面与普通内科患 者比较有显著性差异(P<0.01),癌症放疗患者担心治疗费用、治疗效果、对家庭责任感、治 疗副作用的影响更大。结论针对不同住院患者作不同心理干预。对癌症放疗患者予减轻放 疗反应,给更多的关爱,照顾和支持;对普通内科患者应重视在疾病治疗、康复、预防等 健康教育。     

急性冠状动脉综合征病人焦虑、抑郁状况及心理危险因素分析

[目的]了解急性冠状动脉综合征(ACS)与急性胰腺炎(AP)住院病人焦虑、抑郁状况及相关心理危险因素。[方法]应用抑郁自评量表(SDS)、焦虑自评量表(SAS)、汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)和自行设计相关心理危险因素调查表,对120例ACS及116例AP住院病人进行问卷调查。[结果]ACS病人焦虑、抑郁发生率明显高于AP病人,家庭因素、经济因素、对病情认知情况、认知干预因素等对心理状态影响更大。[结论]应加强对ACS病人心理干预,给予更多的关爱、照顾和支持,控制焦虑、抑郁症状,改善病人生活质量。     

现代残疾康复理念、政策与社区康复体系研究

本研究分析了当代残疾康复的理念和理论架构,构建了以国际公约、决议和政策、国内法律和政策以及操作性工具3个层次的康复理论体系;运用包容性发展,分析探讨了当代社区康复的体系和特点;就发展康复事业、为残疾人提供全面系统的康复服务提出相关的政策建议。     

国内外唇腭裂专科护理发展现状的文献研究及分析

目的了解和分析国内唇腭裂专科护理工作发展的现状。方法检索并分析万方医学网、中国知网、Springer Link及PubMed英文数据库近6年有关唇腭裂手术的围术期护理、患儿的喂养、手术安全管理、围术期疼痛研究以及心理护理的相关文献。结果共检索出国内文献89篇(核心期刊20篇)、国外文献22篇,其中围术期护理38篇、患儿的喂养16篇、手术安全管理10篇、围术期疼痛研究10篇、心理护理15篇。结论与国外文献相比,国内论文总结和回顾性居多,应增加研究探讨性论文,从而促进唇腭裂临床护理工作专科化的发展。     

城乡学童个性行为特征调查

目的探讨农村与城市儿童的个性行为特征。方法将97名农村学龄儿童设为农村组,97名城市学龄儿童设为城市组,采用艾森克个性问卷一儿童版和Achenbach’s 行为量表一儿童版进行评定分析。结果两组学龄儿童艾森克个性问卷各维度评分均无显著性差异（P均〉0．05）,且与全国常模相一致（P均〉0．05）;农村组男学童Achenbach’s行为量表违纪行为、攻击行为及外向型因子分均显著高于城市组,女学童退缩、社交问题因子分均显著高于城市组（P〈0．05或0．01）,其他因子分均无显著性差异（P均〉0．05）。结论农村与城市儿童个性无显著差异,而农村儿童存在较多的行为问题,可能与其所受教养和生活方式有关。     

我院文职护士管理和培训的实践与体会

目的构建文职护士培训、使用及管理的科学方法。方法通过规范管理、科学施训、作为骨干大胆任用等多种管理方式,使文职护士得到充分的发展。结果文职护士群体成长为医院优秀骨干,首批满3年的文职护士顺利通过续聘考核。结论科学的管理培训是文职护士成长的重要基石,对医院护理管理有着重要作用。     

Comparison of short-term and long-term protocols for stabilization and preservation of RNA and DNA of Leishmania, Trypanosoma, and Plasmodium

Molecular tools continue to be important in the prevention and control of parasitic diseases. However, using these techniques directly in the field remains a major challenge. Therefore, the preservation of clinical samples collected from endemic field areas for later analysis remains an important preanalytical process. This study aimed at identifying a suitable protocol for stabilization and preservation of RNA and DNA in bioclinical specimens for Trypanosoma, Leishmania, and Plasmodium research. Both spiked and unspiked blood samples were preserved in 7 protocols (different media; storage temperatures). Samples were evaluated for possible degradation of DNA and RNA along the storage duration up to the 10th week. Nucleic acid targets were assessed as follows: (i) Trypanosoma and Plasmodium RNA analysis was done using real-time nucleic acid sequence-based amplification (RT-NASBA) for 18S rRNA and for stage-specific Pfs25 mRNA, respectively; (ii) Trypanosoma DNA assessment analysis was conducted by using a conventional PCR for 18S rDNA; (iii) Leishmania RNA analysis was performed with a quantitative NASBA for 18S rRNA and Leishmania DNA assessment with an RT-PCR for 18S rDNA. Findings suggested that a newly developed L3™ buffer proved to be reliable and suitable for both short- and long-term preservation of parasite nucleic acid material. This buffer is envisaged to be suitable for utilization in field situations where resources are limited.     

History of violence and subjective health of mother and child

Objective: To study the self-reported prevalence of experienced violence among a cohort of women about two years after giving birth, their health during pregnancy, pregnancy outcomes and their experience of their child’s health.

Setting and subjects: In 2011, a total of 657 women participated in phase III of the Childbirth and Health Cohort Study in Icelandic Primary Health Care, 18 to 24 months after delivery. The women had previously participated in phase I around pregnancy week 16 and phase II 5–6 months after delivery. Data were collected by postal questionnaires.

Main outcome measures: Women’s reported history of experienced violence, sociodemographic and obstetric background, self-perceived health, the use of medications and their child’s perceived health.

Results: In phase III, 16% of women reported experiencing violence. These women felt less support from their current partner (p?p?p?p?p?p?=?0.008).

Conclusions: Our study confirms that a history of violence is common among women. A history of violence is associated with various maternal health problems during and after pregnancy, a higher rate of caesarean sections and maternal reports of health problems in their child 18–24 months after birth.

• KEY POINTS

• Violence is a major concern worldwide. Understanding the impact of violence on human health and developing effective preventive measures are important elements of any public health agenda.

• ??The reported prevalence of experiencing violence was 16% among women attending antenatal care in the primary health care setting in Iceland.

• ??Women with a history of violence reported worse health in general during pregnancy and delivered more often by caesarean section, compared to women with no such history.

• ??Mothers with a history of violence also evaluated the general health of their child as worse than women with no such history.

• ??The findings of this study support the importance of recognizing and addressing experienced violence among women in primary care.

     

Rates and risks of transmission of smallpox and mechanisms of prevention

In 1980, the World Health Organization declared smallpox eradicated from the world; the last known natural case had occurred in Somalia in 1977, and the United States had stopped routinely vaccinating its citizens in 1972. However, with increasing concerns regarding domestic and international terrorism, smallpox has resurfaced as a potential threat to global health. We review the direct and indirect modes of smallpox transmission and how patterns of transmission vary substantially, depending on the severity of circulating disease, vaccination status, environmental and socioeconomic factors, and the setting of an outbreak. We examine mechanisms for controlling outbreaks of disease and preventing further transmission in the event of an outbreak, with an emphasis on smallpox vaccination.     

通用设计原则与产品研发策略

本文介绍了通用设计的概念和设计原则,并阐述了根据此原则实施通用设计的产品研发策略。通用设计惠及的不仅是残疾人,也惠及了包括普通公众在内的广泛人群,以及企业。应将通用设计的原理应融入政府相关政策和未来发展的规划中,为残疾人以及更多人群提供合理便利的通用设计产品。     

Prevalence and severity of nausea and vomiting of pregnancy and effect of vitamin supplementation.

OBJECTIVE: Although nausea and vomiting of pregnancy is the most common medical condition during pregnancy, there are many unanswered questions regarding its cause, epidemiologic features and optimal management. The objectives of this study were to ascertain the prevalence of nausea and vomiting in a sample of Canadian women, to characterize the distribution of their severity and to investigate the role of vitamin B6 deficiency in their etiology. DESIGN: Prospective study. SETTING: Antenatal counselling service for pregnant women. PATIENTS: Three cohorts of women: a prospective, population-based cohort of 193 women, to estimate the rate and severity of nausea and vomiting (cohort A); a cohort of 555 women who sought advice for nausea with or without vomiting, to study the correlation between the maximal daily number of episodes of vomiting and maximal weight loss (cohort B); and a prospective cohort of 301 women who reported vomiting, to correlate vitamin supplementation with vomiting (cohort C). INTERVENTIONS: All 3 cohorts were interviewed during the counselling session, and cohort B was followed up prospectively. OUTCOME MEASURES: Frequency of nausea and vomiting, weight loss, maximal number of daily episodes of vomiting, rate of multivitamin supplementation. RESULTS: Overall, 67% of the women in cohort A reported experiencing nausea or vomiting, or both; 22% reported vomiting, and 9% experienced weight loss. In cohort B there was a significant correlation between the maximal number of daily episodes of vomiting and maximal weight loss, although there was wide variation (r2 = 0.25, p < 0.001). There was a highly significant correlation between the number of daily vomiting episodes and mean weight loss (r2 = 0.99). In cohort C, vomiting was significantly associated with lack of supplementation with multivitamins before 6 weeks' gestation (p = 0.002). CONCLUSIONS: The relation between number of daily vomiting episodes and mean weight loss may serve as a clinical tool to assess the severity of nausea and vomiting in pregnancy and the success of anti-emetics and rehydration regimens. Further study is needed to elucidate the biologic basis of the observed association between vomiting and lack of multivitamin supplementation in early pregnancy.     

胃癌DNA含量与E-cad、EGFR表达的关系及其意义

目的　探讨胃癌组织DNA含量与E cad、EGFR表达的关系 ,评价其在浸润、转移潜能及预后判断中的作用。方法　应用图像分析仪及SP免疫组化法检测 30例正常胃黏膜上皮、30例不典型增生和 5 0例胃癌组织DNA含量与E cad、EGFR蛋白表达情况。结果　①正常胃黏膜上皮、Ⅰ、Ⅱ、Ⅲ级不典型增生及胃癌组的DI、PI、S %、>5c %逐渐增高 ,与胃癌分期、淋巴结转移显著相关 (P <0 0 1)。②E cad在正常胃黏膜上皮阳性表达率 10 0 % ,EGFR呈阴性表达 ;Ⅰ、Ⅱ、Ⅲ级不典型增生及胃癌E cad阳性表达率逐渐降低 ,EGFR的阳性表达率逐渐升高 ,且差异显著 (P <0 0 5 ) ;E cad表达减弱、EGFR表达升高与胃癌分化差、淋巴结转移显著相关 (P <0 0 1)。③E cad表达阴性的胃癌DNA指数及EGFR表达水平显著高于E cad阳性 (P <0 0 1)。结论　检测DNA含量及E cad、EGFR蛋白表达有助于胃癌的早期诊断及转移潜能和预后的判断。