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1.
目的探讨创伤早期意外伤者创伤早期的创伤后成长(posttraumatic growth,PTG)水平,并分析情绪表达和反刍性沉思对其的影响。方法采用一般资料问卷、伯克利情绪表达问卷、事件相关反刍性沉思问卷和中文版创伤后成长问卷对131例创伤后1周内的意外伤者进行调查。结果创伤后1周内意外伤者PTG总分为(38.34±12.78)分,PTG总分与正性情绪表达、负性情绪表达、正性情绪表达强度和侵入性反刍性沉思呈正相关(r=0.197~0.292,均P0.05)。在控制年龄对PTG的影响后,正性情绪表达强度和侵入性反刍性沉思可直接预测PTG,且侵入性反刍性沉思在正性情绪表达与PTG间起完全中介效应。结论创伤早期意外伤者可获得较低水平的PTG,创伤早期医护人员需鼓励伤者主动表达其正性情绪以促其认知加工,进而提升PTG水平。  相似文献   

2.
目的 分析简体中文版事件相关反刍性沉思问卷(C-ERRI)在意外创伤者中的信效度.方法 选取130例意外创伤者作为样本一,使用C-ERRI对其施测以行项目分析和探索性因素分析;另调查320例意外创伤者作为样本二,使用中文版创伤后成长问卷和C-ERRI对其施测,对数据行验证性因素分析、信度分析及效标效度分析.结果 C-ERRI的内在一致性信度:总量表为0.92,侵入性反刍性沉思维度为0.93,目的性反刍性沉思维度为0.85,问卷的两维度共解释56.13%的总方差;验证性因素分析:GFI=0.931,AGFI=0.904,CFI=0.906,NFI=0.915,RMSE=0.046,模型拟合良好.侵入性反刍性沉思反向预测创伤后成长(β=-o.13,P=0.02),目的性反刍性沉思正向预测创伤后成长(β=0.47,P<0.001).结论 C-ERRI的心理测量学特征较好,适合评估意外创伤者的创伤后认知加工并预测其创伤后成长.  相似文献   

3.
目的探讨维持性血液透析(maintenance hemodialysis, MHD)患者注意偏向、反刍性沉思与创伤后成长(posttraumatic growth, PTG)的关系,为促进MHD患者创伤后成长的认知加工,构建创伤护理干预模型提供依据。方法采用现况研究设计方法,采用便利取样法,选择2016年6月—2018年12月本市某三级甲等综合医院门诊复诊的MHD患者220例,应用创伤后成长评定量表(posttraumatic growth inventory, PTGI)、正性负性信息注意偏向量表(attention to positive and negative information scale, APNIS)和事件相关反刍性沉思问卷(event related rumination inventory, ERRI)进行调查。了解患者创伤后成长状况及其与注意偏向、反刍性沉思的路径和关系。结果 210例MHD患者完成调查,MHD患者创伤后成长、注意偏向和反刍性沉思总分分别为(60.72±11.33)分、(69.32±10.31)分和(25.61±10.57)分,处于中等或偏低水平,3个变量间存在相关性(均P0.05)。多重线性逐步回归分析显示:正性信息注意与目的性反刍性沉思是影响MHD患者创伤后成长的因素;并且正性信息注意对创伤后成长有直接正效应,效应值为0.68;目的性反刍性沉思对创伤后成长有直接正效应,效应值为0.96;正性信息注意通过目的性反刍性沉思对创伤后成长有间接影响,总效应值为1.54。结论 MHD患者创伤后成长、注意偏向和反刍性沉思水平有待进一步提升。创伤后成长受到正性信息注意和目的性反刍性沉思的直接或间接影响,护士可从各环节构建心理干预策略或模型,提升MHD患者的创伤后成长水平。  相似文献   

4.
目的 了解意外创伤者的伤后认知加工水平及其影响因素,为临床医护人员针对其伤后认知加工的可调控影响因素实施个性化干预提供依据.方法 便利抽样选取江、浙、沪三地医疗机构收治的320例意外创伤者行问卷调查.结果 意外创伤者的反刍性沉思水平中等偏下,并受其文化程度、家庭经济状况和创伤自评的影响;其中家庭经济状况可解释其侵入性反刍性沉思总变异的10.3%;文化程度、家庭经济状况、创伤自评可解释其目的性反刍性沉思总变异的13.2%.结论 分析意外创伤者反刍性沉思水平及其影响因素,可为临床医护工作者实施个性化干预提供依据.  相似文献   

5.
目的探讨脑卒中患者心理痛苦对创伤后成长(posttraumatic growth, PTG)的影响及反刍性沉思的作用。方法 2019年10月至2020年11月,采取便利抽样法选择华北理工大学附属医院神经内科和康复科收治的203例脑卒中患者为研究对象,使用一般资料调查表、心理痛苦温度计(distress thermometer, DT)、反刍性沉思问卷(event related rumination inventory, ERRI)和中文版创伤后成长问卷(post-traumatic growth inventory, PTGI-C)对其进行调查。结果脑卒中患者心理痛苦与PTG(r=-0.247,P0.01)、目的性反刍性沉思(r=-0.161,P0.05)呈负相关,与侵入性反刍性沉思呈正相关(r=0.292,P0.01);PTG与侵入性反刍性沉思(r=0.209,P0.01)、目的性反刍性沉思(r=0.553,P0.01)呈正相关。心理痛苦对PTG的直接作用显著(β=-0.196,P0.01),目的性反刍性沉思、侵入性反刍性沉思→目的性反刍性沉思的路径在心理痛苦与PTG间的中介效应分别为占总效应的33.0%、14.8%。结论脑卒中患者的心理痛苦不仅可以直接作用于PTG,还可通过目的性反刍性沉思的独立中介作用、侵入性反刍性沉思→目的性反刍性沉思的链式中介作用间接影响PTG。  相似文献   

6.
目的 :分析心理弹性在中青年血液透析患者创伤后成长与反刍性沉思中的中介作用。方法 :对218例中青年血液透析患者采用一般资料调查表、创伤后成长量表、心理弹性量表和事件相关反刍性沉思问卷进行调查。使用回归分析与Bootstrap程序对心理弹性在创伤后成长与反刍性沉思之间的中介作用进行检验。结果 :创伤后成长与心理弹性呈正相关(r=0.76,P0.01);与侵入性反刍性沉思呈负相关(r=-0.14,P0.05),与目的性反刍性沉思呈正相关(r=0.55,P0.01)。目的性反刍性沉思对创伤后成长有正向预测作用(β=0.169,P0.01);心理弹性在目的性反刍性沉思与创伤后成长之间具有部分中介效应,中介效应占总效应的6.1%。结论 :心理弹性在创伤后成长与反刍性沉思具有中介作用。  相似文献   

7.
目的探讨化疗期癌症患者主要照顾者创伤后成长水平与反刍性沉思的现状及其相关性。方法对178例化疗期癌症患者主要照顾者进行问卷调查,了解化疗期癌症患者主要照顾者创伤后成长及反刍性沉思状况及其相关性。结果化疗期癌症患者主要照顾者创伤后成长总分及反刍性沉思总分分别为(71.34±16.96)分与(31.71±13.20)分,均处于中等水平;化疗期癌症患者主要照顾者创伤后成长总分与侵入性反刍性沉思、目的性反刍性沉思呈正相关(r=0.328,P0.01;r=0.567,P0.01)。结论化疗期癌症患者主要照顾者创伤后成长及反刍性沉思呈中等水平,其创伤后成长与反刍性沉思呈正相关关系。临床护理中应鼓励患者主要照顾者采取积极有效的认知方式,鼓励并激发患者主要照顾者创伤后成长,以提高其照顾质量。  相似文献   

8.
目的探讨肝癌患者主要照顾者创伤后成长水平、反刍性沉思的状况及两者的相关性。方法采用创伤后成长评定量表和简体中文版事件相关反刍性沉思问卷对128例肝癌患者主要照顾者进行调查。结果肝癌患者主要照顾者创伤后成长及反刍性沉思总分分别为(60.59±14.36)分与(30.12±13.12)分,均处于中等水平;肝癌患者主要照顾者创伤后成长总分与侵入性反刍性沉思、目的性反刍性沉思呈正相关(P0.01)。结论肝癌患者主要照顾者创伤后成长及反刍性沉思呈中等水平,其创伤后成长与反刍性沉思呈正相关关系。护理人员应鼓励主要照顾者理解事件的意义,寻求解决问题的方法,对事件进行积极建构思考,促进其创伤后成长,以提高肝癌患者术后的康复和生活质量。  相似文献   

9.
目的:调查遭受工作场所暴力的护士反刍性沉思水平,并分析其影响因素。方法:采用中文版事件相关反刍性沉思问卷对354名护士进行问卷调查。结果:护士侵入性反刍性沉思评分为(9.68±3.32)分,目的性反刍性沉思评分为(13.12±4.69)分;暴力类型、暴力次数、年龄为护士侵入性反刍性沉思的影响因素(P0.05);暴力类型、暴力次数、文化程度、年龄为护士目的性反刍性沉思的影响因素(P0.05)。结论:遭受工作场所暴力的护士反刍性沉思水平较低,受暴力类型、暴力次数、年龄、文化程度影响。  相似文献   

10.
目的探讨宫颈癌术后化疗患者家庭关怀度、反刍性沉思和创伤后成长的关系。方法采用创伤后成长评定量表(posttraumatic growth inventory, PTGI)、家庭关怀度指数量表和事件相关反刍性沉思问卷(event related rumination inventory,ERRI)对110例宫颈癌术后化疗患者进行调查。采用Amos17.0软件分析患者家庭关怀度、反刍性沉思和创伤后成长的影响路径和关系效应。结果患者PTGI、家庭关怀度指数量表和ERRI总分分别为(57.87±10.27)分、(8.22±1.45)分和(25.61±10.11)分。家庭关怀度和目的性反刍性沉思与患者创伤后成长呈正相关(P0.05)。结构方程模型表明:家庭关怀度和目的性反刍性沉思均对创伤后成长有直接正效应(P0.05);家庭关怀度通过目的性反刍性沉思对创伤后成长产生间接正效应,间接效应值为0.76。结论宫颈癌术后化疗患者家庭关怀度和目的性反刍性沉思对其创伤后成长存在相关性,并且目的性反刍性沉思在家庭关怀度和创伤后成长之间存在中介作用。可通过在引导患者进行积极的疾病后沉思增强患者家庭关怀度,同时提高患者的创伤后成长水平。  相似文献   

11.
This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.  相似文献   

12.
Ranganath C  Heller AS  Wilding EL 《NeuroImage》2007,35(4):1663-1673
Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.  相似文献   

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目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高<20%视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P<0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P<0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P<0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.  相似文献   

15.
The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.  相似文献   

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Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.  相似文献   

18.
Delineating the Concept of Hope   总被引:2,自引:0,他引:2  
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19.
目的 探讨手转胎头术失败的原因与分娩结局.方法 选择2008年1月至2010年12月于我院住院分娩的持续性枕横位、枕后位产妇198例,根据行手转胎头术后结果分为成功组126例、失败组72例.比较两组分娩结局,对比分析失败原因.结果 失败组胎儿体质量≥3500 g的发生率[76.4%(55/72)]明显高于成功组[31.7%(40/126)],差异有统计学意义(x2=30.177,P=0.001)、失败组宫缩乏力发生率[58.3%(42/72)]高于成功组[38.1% (48/126)],差异有统计学意义(x2=7.569,P=0.006)、失败组骨盆临界或轻度狭窄发生率[38.9% (28/72)]高于成功组[23.8%(30/126)],差异有统计学意义(x2 =5.030,P=0.002)、失败组手转胎头时机不当(宫口开大<6 cm、胎头位于坐骨棘上及宫口开大8~10 cm、胎头位于坐骨棘下≥2 cm)发生率[61.1%(44/72)]高于成功组[38.9%(49/126)],差异有统计学意义(x2=9.084,P=0.003).失败组母儿并发症(产后出血、产褥病率、胎儿窘迫、新生儿窒息)发生率高于成功组(x2 =9.586,P=0.002、x2=9.334,P=0.002、x2=5.910,P=0.015、x2=5.240,P=0.022)、失败组剖宫产发生率[72.2%(52/72)]明显高于成功组[34.1 %(43/126),x2=26.641,P=0.001)].结论 手转胎头术能使难产变顺产,降低剖宫产率,减少母儿并发症,但须积极预防、处理导致手转胎头术失败的原因,对矫正失败后继续矫正及试产应慎重.  相似文献   

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