心理护理对脑卒中焦虑抑郁患者针对性干预的效果观察

目的探讨心理护理针对性干预对脑卒中焦虑抑郁患者的影响。方法采用Zung焦虑自评量表(SAS)及抑郁自评量表(SDS)对100例脑卒中抑郁焦虑患者进行问卷。对照组50例患者行常规护理,干预组在常规护理的同时进行一对一的心理护理,3周后再进行复查。结果经过3周的干预,对照组SAS、SDS评分分别由(50.5±7.98)和(45±5.80)下降为(40.2±6.21)和(26.4±7.10),干预组SAS、SDS评分分别由(55.3±8.26)和(46.3±5.60)下降为(32.2±4.30)和(19.0±6.80),治疗后两组评分比较,差异有统计学意义(P<0.05)。结论对脑卒中焦虑抑郁患者开展心理护理针对性干预,可有效缓解抑郁焦虑程度和症状,可以帮助患者及家属正确面对疾病,提高生活质量,减轻中风后抑郁的不良情绪对其预后的影响,树立了患者的信心,促进患者康复。     

Anxiety and Depression in Older Adolescents With Long-Standing Asthma: The Role of Illness Uncertainty

This study examined the differential contribution of illness uncertainty to self-reported anxiety and depression in a sample of older adolescents with childhood-onset asthma. Fifty-six individuals completed measures of illness uncertainty, anxiety, and depression. In addition, objective assessments of illness severity were obtained via a semistructured interview and pulmonary function test. Results revealed that illness uncertainty contributed significant variance to anxiety after statistically controlling the effects of demographic and disease parameters and depressive symptomatology; illness uncertainty did not contribute significant variance to depression. Findings suggest that interventions should target illness uncertainty and psychosocial education, as well as early identification and treatment of anxiety in this understudied population.     

工作场所空气中二聚环戊二烯气相色谱测量结果不确定度评价

目的建立气相色谱仪测量空气中二聚环戊二烯的测量不确定度评价标准。方法采用《工作场所空气中二聚环戊二烯的溶剂解吸-气相色谱测定方法》,应用于测量不确定度理论,分析气色谱测量不确定度。结果检验方法的扩展不确定度为：Ux=3．78ug/ml。结论该检测方法的研究中进行不确定度的分析,能较为直观了解测试条件,建立分析方法能达到现行的相关标准及其灵敏度的要求,用测量不确定度对该方法进行有效可行性评估。     

Comparison of Men's and Women's Attempts to Dissuade Sexual Partners From the Couple Using Condoms

Undergraduate students were asked about their use of condoms and their attempts to dissuade sexual partners from the couple using condoms during sexual intercourse. Nearly 14% of women and nearly 17% of men who had engaged in sexual intercourse admitted to having actively tried to dissuade a partner from the couple using condoms. Thirty percent of the men and 41% of the women said that a sexual partner had tried to dissuade them. Attempts to dissuade partners from the couple using condoms were most common among students who reported having 10 or more lifetime sexual partners. For both men and women, the most frequently employed categories of verbal strategies were (1) sex feels better without a condom, (2) will not get pregnant, and (3) will not get a sexually transmitted disease. These three categories accounted for about three-fourths of the lines used. Avoidance of condoms because of a perceived decrease in physical pleasure poses a particular problem for sex and health educators.     

Sociodemographic Variables and Depression in Turkish Women From Polygamous Versus Monogamous Families

In this study, we aimed to determine the different sociodemographic variables of polygamous and monogamous wives, and the relationship between depression and polygamous marriage. Seventy-nine polygamous wives and 73 monogamous wives from Kahramanmaras, located in southern Turkey, were interviewed. After reviewing the data, we suggest that there is a statistically significant difference between polygamous wives and monogamous wives in terms of Beck Depression Inventory (BDI) scores. The results highlighted many implications for clinical practice and for future research. Additional research needs to be conducted in order to investigate the effects of polygamy on women's mental health.     

The Relationship Between Multiple Sex Partners and Anxiety, Depression, and Substance Dependence Disorders: A Cohort Study

Changes in sexual behavior have resulted in longer periods of multiple serial or concurrent relationships. This study investigated the effects of multiple heterosexual partners on mental health, specifically, whether higher numbers of partners were linked to later anxiety, depression, and substance dependency. Data from the Dunedin Multidisciplinary Health and Development Study, a prospective, longitudinal study of a birth cohort born in 1972–1973 in Dunedin, New Zealand were used. The relationship between numbers of sex partners over three age periods (18–20, 21–25, and 26–32 years) and diagnoses of anxiety, depression, and substance dependence disorder at 21, 26, and 32 years were examined, using logistic regression. Interaction by gender was examined. Adjustment was made for prior mental health status. There was no significant association between number of sex partners and later anxiety and depression. Increasing numbers of sex partners were associated with increasing risk of substance dependence disorder at all three ages. The association was stronger for women and remained after adjusting for prior disorder. For women reporting 2.5 or more partners per year, compared to 0–1 partners, the adjusted odd ratios (and 95 % CIs) were 9.6 (4.4–20.9), 7.3 (2.5–21.3), and 17.5 (3.5–88.1) at 21, 26, and 32 years, respectively. Analyses using new cases of these disorders showed similar patterns. This study established a strong association between number of sex partners and later substance disorder, especially for women, which persisted beyond prior substance use and mental health problems more generally. The reasons for this association deserve investigation.     

Determinants of Depression in Indonesian Youth: Findings From a Community-based Survey

ObjectivesThis study investigated the determinants of depression in adolescents and young adults.MethodsThe present study analyzed data from the 2018 Indonesia Basic Health Survey (Riset Kesehatan Dasar; RISKESDAS). The study subjects were adolescents (15-17 years old) and young adults (18-24 years old). In total, 64 179 subjects were included. Univariable, bivariable, and multivariable logistic regression analyses were performed to determine associations between youths’ characteristics, risky behavior, chronic disease, parents’ health, and youths’ depression.ResultsThe prevalence of depression was 5.1% in adolescents and 5.6% in young adults. The risk factors for depression in adolescents were being women (adjusted odds ratio [aOR], 3.53; 95% confidence interval [CI], 2.89 to 4.30; p<0.001), an ex-smoker (aOR, 2.99; 95% CI, 2.10 to 4.25; p<0.001), or a current smoker (aOR, 2.60; 95% CI, 1.97 to 3.44; p<0.001); consuming alcohol (aOR, 2.00; 95% CI, 1.33 to 3.01; p=0.001), having a chronic disease (aOR, 2.64; 95% CI, 1.41 to 4.96; p=0.002); maternal depression (aOR, 2.47; 95% CI, 1.97 to 3.09; p<0.001); and paternal depression (aOR, 2.63; 95% CI, 1.98 to 3.50; p<0.001). In young adults, the risk factors were being women (aOR, 2.23; 95% CI, 1.82 to 2.75; p<0.001) or an ex-smoker (aOR, 2.47; 95% CI, 1.67 to 3.67; p<0.001), consuming alcohol (aOR, 2.42; 95% CI, 1.89 to 3.09; p<0.001), maternal depression (aOR, 3.12; 95% CI, 2.54 to 3.84; p<0.001), and paternal depression (aOR, 2.80; 95% CI, 2.17 to 3.63; p<0.001).ConclusionsBeing women, smoking, drinking alcohol, having a chronic disease, and having a parent with depression were crucial factors associated with youth depression. Mental health screening, prevention, and treatment should involve collaboration among primary healthcare, schools, universities, professionals, and families.     

Sexuality and Intimacy in Alzheimer's Patients and Their Partners

Geriatric Sexuality remains one of the more sensitive and controversial issues to be confronted in today's clinical setting. Research indicates that older adults continue to be sexually active well into later life. Older adults with dementing illnesses experience deleterious changes in sexual functioning that can affect their quality of life. However, few health care professionals ask older adults about their sexual functioning. This paper addresses means of fostering acceptance by professionals and families and creating an environment that nurtures sexuality in couples coping with dementia.     

Themes of relational uncertainty and interference from partners in depression

This article draws on the relational turbulence model to illuminate the dynamics of depression in romantic relationships using a thematic analysis of online discourse. Three content areas of relational uncertainty were apparent: (a) depression uncertainty (questions about physical harm, source of depression, and understanding), (b) self and partner uncertainty (questions about helplessness and identity), and (c) relationship uncertainty (questions about physical intimacy, relationship satisfaction, and the future of the relationship). Three content areas of interference from partners also emerged: (a) daily routines (disruptions to household tasks; finances, work, and school; children and parenting; and family and social life), (b) personal well-being (disruptions to health and safety as well as treatment), and (c) the relationship (disruptions to sexual activity, emotional intimacy, and openness). Relational uncertainty and interference from partners coincided in people's experiences in seven ways. The article concludes by discussing the conceptual, empirical, and pragmatic implications of the findings.     

Postpartum Depression Among Rural Women From Developed and Developing Countries: A Systematic Review

Purpose: Postpartum depression (PPD) is a significant public health problem, with significant consequences for the mother, infant, and family. Available research has not adequately examined the potential impact of sociodemographic characteristics, such as place of residence, on risk for PPD. Therefore, this systematic review and meta‐analysis examines the prevalence of and risk factors for PPD in rural communities within developed and developing countries, and where possible, compares rates to those among urban women. Methods: Five databases were searched, from start dates through early May 2010, using key words relevant to PPD and rural residence. Peer‐reviewed articles were eligible if a standardized assessment of depression was administered to rural mothers within the first year postpartum. Data on PPD were extracted from 19 articles, of which 17 provided data for meta‐analyses. Findings: The overall prevalence of PPD among rural women was 27.0% (95% CI, 18.8%‐37.2%). Prevalence was somewhat higher among women in developing countries (31.3%; 95% CI, 21.3%‐43.5%) than among women in developed countries (21.5%; 95% CI, 10.9%‐38.0%), although there was significant heterogeneity among both groups of studies. Comparisons between rural and urban women yielded conflicting results. Although established PPD risk factors were associated with depression in rural women, additional risk factors were reported for rural women from developing countries, such as having 2 or more young children. Conclusions: Longitudinal studies with clearly defined “rural” and “comparison” groups are needed to determine whether rural residence is associated with increased risk for PPD. The results can inform prevention and treatment programs tailored to serve rural women.     

Sexual Attitudes and Number of Partners in Young British Men

The relationship between sexual attitudes and number of heterosexual partners in a survey-based and nationally representative random sample of 551 British men aged 16–25 years was examined. The main predictor of the number of partners in the last 5 years was the time since the first sexual intercourse, whereas age, marital status, education, social class, smoking, and alcohol consumption contributed on a smaller but significant level. Sexual attitudes were summarized in terms of three underlying dimensions which could be described as permissiveness, attitudes toward sexual relations of same-sex partners, and importance of orgasm for sex. None of these was a significant predictor of the number of partners in the last 5 years. Both permissiveness and number of partners were associated with the age of first sexual intercourse and other background variables indicating opportunities for social contact. In conclusion, common factors of sexual attitudes and the number of sexual partners are not directly related but rather jointly predicted by a very similar set of background variables such as age, time since first sexual intercourse, social class, smoking, and alcohol consumption. Given the absence of a significant relationship between sexual attitudes and number of young men's partners, promoting safer sex may be a more sensible strategy than trying to change these attitudes.     

Service Use of Rural and Urban Medicaid Beneficiaries Suffering From Depression: The Role of Supply

Despite the prevalence and consequence of depression in rural areas, the literature on treating depression in rural areas is relatively scarce and inconclusive. The use of mental health services by rural people suffering from depression and the role that supply may play in explaining these differences are not well understood. Understanding these issues for rural Medicaid beneficiaries is important as Medicaid managed carefor physical and behavioral health care is expanded to rural areas. This study compares the mental health service use of rural and urban Medicaid beneficiaries, ages 18 to 64, in Maine suffering from depression and examines what influence mental health and primary care supply have in explaining observed differences. Two models are used to estimate the use of ambulatory mental health services: (1) a logit likelihood estimate of whether a beneficiary uses any outpatient mental health services for depression; (2) an ordinary least squares regression estimating the number of annualized ambulatory mental health care visits among users. Rural beneficiaries suffering from depression have lower utilization than urban beneficiaries. Rural and urban Aid for Families with Dependent Children (AFDC)--and Supplemental Security Income (SSI)--beneficiaries suffering from depression rely more on mental health than on general health care providers to receive ambulatory mental health care. Rural beneficiaries (AFDC and SSI) rely relatively more on general health care providers than urban beneficiaries. Multivariate analysis suggests that mental health supply and patient-level factors, but not primary care supply, account for utilization differences. This article describes the need to better understand factors limiting participation of primary care providers and to study the role of supply across multiple states.     

从五脏角度探析越鞠丸治疗六郁的原理

中医学认为,郁者滞而不通之义,故郁病多由情志不畅阻滞气机所致。朱震亨在前人对郁证论述的基础上,把郁证分为气郁、湿郁、痰郁、热郁、血郁、食郁,首创“六郁”学说,认为郁证不仅为情志因素所致,还与五脏功能失调有关。五脏主五志,是人体精神活动的外在表现,五志变化影响五脏的功能,五脏功能失调发为六郁,故对于六郁的治疗,临床上应从五脏出发,调节七情,从而达到各郁得解的作用。越鞠丸是治疗六郁的经典代表方,其重在解气郁,从“气、火、湿、痰、血、食”6个方面,调节气机,气行则血行,气畅则痰、火、湿、食易解,最终使得五脏功能正常。古今对于越鞠丸的认识缺乏整体与系统的观念,未从脏腑的角度进行认识,文章基于中医整体观念,将六郁从五脏角度重新认识,为越鞠丸的中医临床运用提供新的思路。     

Depression and Health Service Utilization From Age 70 to 85: The Jerusalem Longitudinal Study

BackgroundHealth service utilization rises with age, and yet, its determinants are poorly understood. Our objective was to examine the association between depression and health service utilization from age 70–85.MethodsA representative sample (born 1920–1921) from the Jerusalem Longitudinal Cohort Study (1990–2010) was assessed at age 70, 78, and 85 for depression (using the Brief Symptoms Inventory); emergency room (ER) visits, and hospitalization in the previous year; social, functional, and medical domains.ResultsWe examined 414, 674, and 1118 subjects at ages 70, 78, and 85, among whom prevalence of depression was 16.2%, 21.1%, and 36.7%, respectively. ER visits and hospitalization were higher among depressed subjects. We adjusted for sex as well as financial status (social model); physical activity, going outdoors, functional status (functional model); and diabetes, ischemic heart disease, hypertension, cancer, dementia, chronic pain, and smoking (medical model). Depressed subjects were more likely to report increased ER visits, after adjustment in social, functional or medical models at age 78 (odds ratio [OR], 2.1, 95% confidence interval [CI], 1.3–3.3; OR, 1.8, 95% CI, 1.1–2.9; OR, 2.0, 95% CI, 1.26–3.26), and at age 85 (OR, 1.7, 95% CI, 1.33–2.3; OR, 1.4, 95% CI, 1.04–1.81; and OR, 1.4, 95% CI, 1.1–1.94), respectively. Aside from the social model at age 85 (OR, 1.5, 95% CI, 1.1–2.0), depression was not associated with increased likelihood of hospitalization.ConclusionsDepression at ages 78 and 85 is consistently associated with increased ER visits and should be considered among older people presenting to the ER.