青少年精神障碍患者非自杀性自伤体验的质性研究

目的 深入了解青少年精神障碍患者住院期间非自杀性自伤的心理感受,为制订针对性护理干预提供参考.方法 采用目的 抽样法选取住院期间发生非自杀性自伤行为的青少年精神障碍患者18例,对其进行半结构式访谈收集资料.采用Colaizzi 7步分析法提炼主题.结果 提炼出4个主题,即难以应对的负性情绪,受症状支配,自我矛盾心理,求...     

青少年抑郁症患者非自杀性自伤心理体验的质性研究

目的 探讨青少年抑郁症患者非自杀性自伤的心理体验,为采取针对性干预提供参考。方法 采用目的抽样法,选取15例经历过非自杀性自伤的青少年抑郁症患者进行半结构深入访谈,采用Colaizzi 7步分析法分析、归纳、提炼资料。结果 经历非自杀性自伤行为的青少年抑郁症患者的心理体验可以归纳为4个主题：来自学校的不良刺激长期蓄积,自我调节能力不足;来自家庭的关爱呵护不足,负性情绪无法释放;自伤前思想封闭拒绝交流,寻求帮助路径不畅;自伤后负性情绪得以释放,享受快感难以自制。结论 青少年抑郁症患者容易发生非自杀性自伤行为,需要学校提供良好的支持教育,家庭营造舒心的氛围,双方共同为青少年提供有效的心理支持,以避免非自杀性自伤的发生,促进青少年的身心健康。     

青少年非自杀性自伤体验质性研究的Meta整合

目的 系统评价有关青少年非自杀性自伤真实体验与感受的质性研究,为制定个性化干预方案提供参考,帮助青少年回归家庭与社会。方法 检索中英文数据库从建库到2023年6月1日有关青少年非自杀性自伤体验的质性研究,采用澳大利亚JBI循证卫生保健中心定性研究质量评价标准对纳入的研究进行评价,运用Meta整合方法进行结果整合。结果 共纳入13项研究,包含226名青少年,提炼42个研究结果,整合成11个新类别,最终归纳为3个整合结果：非自杀性自伤的导火索,非自杀性自伤多维度体验,对治疗与帮助的看法。结论 青少年非自杀性自伤的早期经历各异,身心体验复杂。应加强对青少年非自杀性自伤的重视,建立家庭-学校-医疗机构互助联络网,做到信息共享、早期预防、联合应对,促进青少年心理健康发展。     

青少年非自杀性自伤的护理研究进展

非自杀性自伤是全球性重大公共卫生问题之一,本文对青少年非自杀性自伤流行病学现状、影响因素、评估方法及护理干预措施进行综述,旨在为青少年非自杀性自伤的相关研究及临床干预提供参考,降低青少年再自伤及自杀风险。     

情绪调节策略对抑郁障碍青少年非自杀性自伤行为的影响

目的评价情绪调节策略对抑郁障碍青少年非自杀性自伤行为的干预效果。方法将有非自杀性自伤史的抑郁障碍青少年90例按随机数字表法分为对照组和观察组各45例。对照组按精神科常规护理实施安全性评估与管理,观察组以面对面形式进行以情绪调节策略为主导的短期住院干预,每周2次,每次1 h,共7次。结果观察组干预后3个月自伤频次、对身体最严重的伤害程度显著低于对照组,适应性认知情绪调节策略评分显著高于对照组,非适应性认知情绪调节策略评分显著低于对照组(均P<0.01)。结论以情绪调节策略为主导的短期住院干预有利于提升抑郁障碍青少年的认知情绪调节能力,减少自伤行为。     

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。     

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.     

社区COPD患者家庭疾病管理现状调查

目的了解上海市社区慢性阻塞性肺疾病家庭（患者及照顾者）的疾病管理相关知识和行为的现状,为针对性干预提供参考。方法采用自行设计的患者及照顾者疾病管理相关知识、行为调查表,对上海市COPD患者及其照顾者各84例进行问卷调查。结果COPD疾病管理一般知识和氧疗知识得分率：患者分别为51.09%、19.34%,照顾者分别为38.99%、10.42%;疾病管理行为得分率：患者为39.93%,照顾者为38.51%。患者及照顾者疾病管理知识与其行为的相关系数r为0.575、0.523,均P〈0.01。结论社区COPD家庭疾病管理知识及管理行为处于中低水平,管理知识水平较高者管理行为较好。社区医护人员应寻求有效的干预策略提高COPD家庭疾病管理相关知识和行为,以控制COPD患者疾病进展,提高其生活质量。     

社区COPD患者家庭疾病管理现状调查

目的了解上海市社区慢性阻塞性肺疾病家庭(患者及照顾者)的疾病管理相关知识和行为的现状,为针对性干预提供参考。方法采用自行设计的患者及照顾者疾病管理相关知识、行为调查表,对上海市COPD患者及其照顾者各84例进行问卷调查。结果COPD疾病管理一般知识和氧疗知识得分率:患者分别为51.09%、19.34%,照顾者分别为38.99%、10.42%;疾病管理行为得分率:患者为39.93%,照顾者为38.51%。患者及照顾者疾病管理知识与其行为的相关系数r为0.575、0.523,均P0.01。结论社区COPD家庭疾病管理知识及管理行为处于中低水平,管理知识水平较高者管理行为较好。社区医护人员应寻求有效的干预策略提高COPD家庭疾病管理相关知识和行为,以控制COPD患者疾病进展,提高其生活质量。     

以家庭功能为导向的首发脑卒中患者照顾者支持干预方案实施

目的 评价以家庭功能为导向的首发脑卒中患者照顾者支持干预方案的实施效果。 方法 便利抽取103名首发脑卒中患者照顾者,按时间段分为对照组51名和干预组52名。对照组实施常规护理;干预组在此基础上实施以家庭功能为导向的照顾者支持干预方案,共3个月。比较两组照顾者做好家庭护理的准备、综合照顾能力及家庭功能得分。 结果 干预组出院时照顾者做好家庭护理的准备得分显著高于对照组（P＜0.05）;两组综合照顾能力总分及各维度得分、家庭功能得分比较,组间效应、时间效应和交互效应差异有统计学意义（均P＜0.05）。 结论 以家庭功能为导向的照顾者支持干预方案的实施可提高首发脑卒中照顾者家庭护理准备、综合照顾能力及改善患者家庭功能水平,可帮助患者更好地从医院过渡到家庭。     

精神分裂症患者家庭干预前后家庭支持与生活质量相关性研究

目的探讨家庭干预对精神分裂症患者家庭支持和生活质量改善的可行性和有效性。方法将146例精神分裂症患者随机分为观察组(74例)和对照组(72例),对照组给予常规抗精神病药物治疗,行常规健康教育;观察组在此基础上给予家庭干预1年,干预前后分别采用家庭关怀指数问卷(APGAR)和生活质量评定量表(LQOL)对患者进行评定。结果观察组干预后APGAR、LQOL总分及各因子分(除居住环境、法律安全因子外)显著高于对照组(均P<0.05);观察组患者的家庭支持与工作状况、闲暇活动、家庭关系、社会交往、健康、总体生活状况呈正相关(P<0.05,P<0.01)。结论家庭干预有利于指导家属向患者提供有效的家庭支持,提高患者生活质量。     

家庭干预对女性精神分裂症病人家庭环境及生活质量的影响

目的:探讨系统性家庭干预对女性精神分裂症病人的家庭环境和生活质量的改善作用。方法:对60例存有家庭关系紧张和生活质量明显下降的女性精神分裂症病人进行1年系统的家庭教育和针对性家庭干预,采用家庭环境量表(FES-CV)、生活质量量表(QOL)、简明精神病评定量表(BPRS)及社会功能评定量表(SDSS),进行干预前后评分。结果:1年后,BPRS、SDSS总分,FES-CV、QOL评分,除娱乐性、环境领域及精神信仰因子外,均较干预前有显著改善(Pd0．05或Pd0．01);1年内病人复发率为10．0％(6／60)。结论:本干预方法时具有家庭关系紧张和生活质量下降的女性精神分裂症病人,有改善其家庭处境、提高生活质量、降低复发率的作用．     

Significance of Family History in Breast Cancer Treated with Breast Conservation Therapy

Abstract: The purpose of this study was to evaluate the impact of family history (FH) of breast cancer on the outcome of patients with local-regional breast cancer treated with breast conservation therapy. Of 974 patients treated with breast conservation therapy, a total of 794 consecutive cases were evaluable with adequate FH data and a greater-than-1-year follow-up. All patients had local-regional disease (stages O-IIIA) and underwent lumpectomy, axillary node dissection, and radiation therapy. Seventeen percent of patients had a positive family history of breast cancer, which was defined as a first degree relative (mother, sister, daughter). A significant difference was seen in overall survival in patients with and without an FH of breast cancer (p = 0.027). While FH did not correlate with differences in local failure, distant failure, disease specific survival, or overall survival in patients less than or equal to age 50, a positive FH correlated with a worse disease specific survival (p = 0.045) and a worse overall survival (p = 0.017) in patients over age 50. Multivariate (Cox) analysis confirmed the significance of FH (p = 0.008), tumor size (p = 0.001), and nodal status (p = 0.015). Comparing patients with and without an FH, no differences were seen in age at presentation, age of menarche, age of menopause, parity, tumor size, histologic and nuclear grade, nodal status, or estrogen receptor status. In patients with an FH of breast cancer, the most commonly affected relative was the mother (9.4%). While FH did not impact on outcome of patients age 50 or younger, it was prognostic for a poorer overall survival in older patients, and poorer disease-specific survival. Patients with an FH of breast cancer are similar to patients without a family history in tumor and patient characteristics. An FH of breast cancer does not correlate with an increased local or distant failure in our study population as a whole, but does correlate with a poorer overall survival when compared to patients without an FH of breast cancer.?     

The risk of cancer in relatives of patients with brain neoplasm

Summary The family trees of 142 patients, suffering from histologically proven brain tumour, were compared to those of an equal number of sex and age matched controls. The results showed no statistically significant differences in the occurrence of malignant neoplasm between the two groups. These results indicate that the risk of cancer among relatives of patients with brain tumours does not exceed that of healthy controls.     

应用PDCA对脂肪肝病人实施家庭护理干预研究

目的为脂肪肝病人自我保健、自我康复探讨安全、有效的护理模式.方法按随机数字表抽取健康体检者中度脂肪肝病人240例,单号为观察组(120例),双号为对照组(120例),观察组应用PDCA循环行家庭护理干预,对照组行常规家庭护理干预,于6个月后比较两组干预效果.结果治疗有效率及健康行为,观察组显著优于对照组(均P<0.01).结论应用PDCA循环对病人实施家庭护理干预,能有效促使病人养成良好的行为习惯,从而提高治疗效果.     

信息和情感支持对急性白血病患儿家庭功能的影响

目的探讨信息和情感支持对急性白血病患儿家庭功能的影响。方法将90例住院化疗的急性白血病患儿家属随机分为对照组和干预组各45人,对照组行常规治疗护理,干预组在此基础上增加信息和情感支持,干预前后(16周后)采用家庭功能评定量表进行测评。结果干预后干预组家庭功能中问题解决、沟通、家庭角色分工、行为控制及总的功能得分显著优于对照组(均P<0.05)。结论信息和情感支持能有效改善急性白血病患儿家庭功能。     

Colonoscopy for screening and follow up of patients with a family history of colorectal cancer

Objective To determine the minimum family history of colorectal cancer (CRC), which justifies colonoscopy and to establish whether further colonic assessment is necessary after a negative screening colonoscopy. Method A retrospective review of every colonoscopy undertaken for family screening at the Royal Berkshire and Battle Hospitals, Reading between October 1996 and July 2004. Results Four hundred and thirty‐two patients (261 women) with an average age of 48 years (range 14–84) were screened. Three cancers in patients over the age of 60 years and 49 adenomas were found in 37 patients. Twenty three of 281 (8%) patients with a ‘low‐risk’ family history (one in 12 or less lifetime risk of developing CRC) had either a cancer or an adenoma. Eighteen of 151 (12%) patients with a ‘high‐risk’ family history (one in 10 or greater) had a similar positive colonoscopy. Thirteen of 15 patients who had an adenoma aged under 45 years had a high‐risk family history. Seventy‐three patients subsequently underwent two or more follow‐up colonoscopies. There were 22 adenomatous polyps found in 12 patients (16%) at the first screening, nine adenomas in seven patients in the second colonoscopy and four adenomas found in four patients in all subsequent colonoscopies. Conclusion Patients with a low‐risk family history have a similar adenoma pick‐up to that of the general population. These patients need not be screened below the age of 50 unless symptomatic. Follow up of low‐risk family history (FH) patients with a negative screening colonoscopy is unlikely to be beneficial.     

MiR-183 及 let-7 家族在肝癌患者血清中的表达

目的:检测肝癌及良性肝病患者血清中miR-182、miR-96及let-7a、let-7b、let-7c、let-7e的表达量及其临床意义。方法:收集肝癌、肝硬化、肝炎患者和健康对照组的血清标本各58例、30例、40例、40例,采用荧光定量PCR分析各组间6种miRNA的相对表达量,分析肝癌组的相对表达量与临床病理因素间有无关系。结果:肝癌患者血清中miR-182和miR-96表达量均高于肝硬化血清、肝炎血清以及正常对照组(P0.01);肝硬化组血清miR-182和miR-96水平均大于肝炎组及正常对照组(P0.01)。肝炎组血清miR-96大于正常对照组(P0.01)。肝癌组血清中let-7a的表达量低于肝硬化组、肝炎组及正常对照组(P0.01)。肝癌组血清let-7c表达量大于肝炎组(P0.01)。肝癌血清中let-7e的表达量大于肝硬化组(P0.05)。结论:血清中miR-182及miR-96可能对肝癌有诊断价值,并可能预测肝癌的恶性程度及预后;血清中let-7家族对肝癌的诊断意义不显著。     

Disengagement and social support moderate distress among women with a family history of breast cancer

Using a cross-sectional, exploratory design, this pilot study analyzed the relationships between familial history of breast cancer and psychological distress in order to evaluate who is more distressed and to assess the possible need for intervention. Coping style, social support, and family relations were investigated as potential moderators of these relationships. Participants were 45 women with a familial history of breast cancer recruited from the Family Registry for Breast Cancer (FRBC) at the Northern California Cancer Center (NCCC). Contrary to previous reports of similar cohorts, the overall level of psychological distress in this cohort was comparable to normative samples. The number of relatives with breast cancer was related to distress as measured by the State-Trait Anxiety Inventory (STAI) scale, but there was no significant differentiation in distress associated with the number of first-degree as compared to second- and third-degree relatives with breast cancer. Having more relatives that had died from breast cancer was associated with greater distress on a number of measures. The number of first-degree relative deaths, including maternal death, was also associated with distress. Positive and network support, disengagement coping responses, and family cohesion were each significant moderators of the impact of family history on distress. This association between distress and disengagement is similar to that found in metastatic breast cancer patients themselves, and the findings suggest a subgroup that merits and might respond to more intensive intervention to provide support and facilitate emotional expression.