晚期癌症患者家庭主要照顾者沟通模式现状及影响因素

目的 了解晚期癌症患者家庭主要照顾者沟通模式及影响因素，为制订沟通应对策略提供参考。方法 以方便抽样法选取晚期癌症家庭主要照顾者164人，使用一般资料问卷和家庭照顾者沟通模式问卷对患者照顾者及患者进行调查。结果 晚期癌症患者家庭主要照顾者中孤独型沟通模式103人(62.80%),承担型30人(18.29%),合作型20人(12.20%),主导型11人(6.71%)。无序多分类logistic回归分析显示，照顾者性别、照护时长、文化程度和患者心理痛苦程度是晚期癌症患者家庭照顾者沟通模式的主要影响因素(P<0.05,P<0.01)。结论 晚期癌症患者家庭主要照顾者以孤独型沟通模式为主，医护人员需针对相关影响因素制订晚期癌症患者家庭照顾者沟通应对策略，以改善晚期照护阶段家庭沟通模式。     

晚期结直肠癌患者灵性应对状况及影响因素研究

目的 探讨晚期结直肠癌患者灵性应对现状及影响因素，为临床医护人员指导患者积极应对疾病提供参考。 方法 采用一般资料调查表、灵性应对问卷、个人掌控感量表、慢性疾病治疗功能评估-灵性健康量表、生存痛苦量表对212例晚期结直肠癌患者进行调查。 结果 晚期结直肠癌患者积极灵性应对得分（64.68±4.70）分，消极灵性应对得分（12.07±3.03）分。晚期结直肠癌患者积极灵性应对与个人掌控感、灵性健康呈正相关，与生存痛苦呈负相关；消极灵性应对与个人掌控感、灵性健康呈负相关，与生存痛苦呈正相关（均P＜0.05）。多元线性结果显示，宗教信仰、个人掌控感、灵性健康、生存痛苦是积极灵性应对的影响因素，共解释75.8%的总变异；疾病分期、文化程度、个人掌控感、灵性健康、生存痛苦是消极灵性应对的影响因素，共解释71.0%的总变异。 结论 晚期结直肠癌患者多选择积极灵性应对方式，较少使用消极灵性应对方式。医护人员应注重对患者实施个体化灵性照护，降低患者生存痛苦，提高其个人掌控感与灵性健康，以促使患者产生积极的应对行为。     

基于二元疾病管理理论的老年肺癌患者出院准备服务方案的实施

目的 探讨基于二元应对理论的老年肺癌患者出院准备服务方案的实施效果。方法 将肿瘤科收治的71例老年肺癌患者随机分为对照组35例和观察组36例。对照组给予常规护理,观察组实施基于二元疾病管理理论的出院准备服务方案。使用出院准备度量表、二元应对量表及癌症照顾者综合需求量表评价干预效果。结果 干预后观察组患者出院准备度、患者及其照顾者支持应对评分显著高于对照组,照顾者综合需求评分显著低于对照组（均P＜0.05）。结论 对老年肺癌患者及照顾者实施基于二元疾病管理理论的出院准备服务方案,有助于提高患者出院准备度及支持应对水平,满足照顾者综合需求。     

终末期癌症患者照顾者参与家庭会议体验的质性研究

目的通过收集照顾者参与家庭会议的体验,深入了解家庭会议对癌症患者照顾者照护过程所起的作用。方法采用目的抽样法,选择15名参与过家庭会议的癌症患者照顾者,进行面对面、半结构式深入访谈。结果分析出家庭会议顺利开展的关键要素、家庭会议对照顾者的支持效果、家庭会议促进患者和照顾者之间的情感交流、会议中的负性情感体验4个方面的主题。结论家庭会议有利于促进医患沟通,满足照顾者需求,促进患者与照顾者之间的情感交流。     

中青年乳腺癌患者配偶夫妻疾病沟通现状及影响因素分析

目的 调查乳腺癌患者配偶夫妻疾病沟通现状及其影响因素,为临床开展针对性配偶或夫妻干预提供参考。方法 采用一般资料问卷、夫妻癌症沟通问题量表配偶部分、二元应对量表、洛克-华莱氏婚姻调适量表及癌症自我效能量表-配偶版对278名中青年乳腺癌患者配偶进行调查。结果 中青年乳腺癌患者配偶的夫妻疾病沟通问题总分为15.66±2.27,自我效能、二元应对、婚龄及累计照顾时长是中青年乳腺癌患者配偶夫妻疾病沟通问题的影响因素（均P<0.05）,可解释总变异的40.1%。结论 中青年乳腺癌患者配偶夫妻疾病沟通问题处于中等偏低水平,自我效能低、二元应对水平低、婚龄短及累计照顾时间短的配偶与患者间更易出现沟通问题。医护人员应重视婚龄短、照护时间较短的夫妻,可以自我效能及二元应对为切入点制订配偶及夫妻相关护理措施,改善夫妻疾病沟通问题。     

癌症患者灵性应对的研究进展

灵性对癌症患者的健康结局有着积极影响，灵性应对作为一种独特作用机制受到国外研究者广泛关注。对灵性应对的概念、相关理论框架、研究现状、测量工具及影响因素等进行文献回顾，以促进我国医护人员对灵性应对的理解，为癌症患者开展灵性照护提供借鉴。     

中文版灵性应对问卷的修订及在晚期癌症患者中的信效度检验

目的对灵性应对问卷进行汉化、修订和信效度检验,为晚期癌症患者提供灵性测评工具。方法对英文版灵性应对问卷进行翻译、专家咨询、文化调适等形成中文版灵性应对问卷,调查广州市3所三甲医院442例晚期癌症患者检验中文版问卷的信效度。结果中文版灵性应对问卷共26个条目,7个维度,包括积极灵性应对(个人、社会、环境、超越),消极灵性应对(个人、社会、超越)2个分量表。内容效度为0.933;7个公因子累积方差贡献率为73.251%;验证性因子分析显示χ²/df=1.982,CFI=0.926,IFI=0.927,TLI=0.910,RMSEA=0.067,RMR=0.047;分量表的内部一致性Cronbach′sα系数分别为0.884和0.908,重测信度分别为0.933和0.938。结论中文版灵性应对问卷具有良好的信效度,可用于测量我国晚期癌症患者的灵性应对方式。     

老年慢性病患者家庭照顾者应对方式对虐待老人倾向的影响

目的探讨老年慢性病患者家庭照顾者应对方式现状及对虐待老人倾向的影响。方法便利选取老年慢性病患者家庭照顾者402人,采用简易应对方式问卷和中文版照顾者虐待老年人评估量表进行调查。结果照顾者虐待倾向得分中位数为3分,四分位数间距为4分;分值在2分及以下者有146人(36.32%),3分及以上者有256人(63.68%)。照顾者积极应对维度得分低于国内常模,消极应对维度得分高于常模(均P0.01);照顾者积极应对方式与虐待倾向呈显著负相关(P0.01),消极应对方式与虐待倾向呈显著正相关(P0.01);照顾者应对方式是虐待倾向的影响因素,积极应对方式是虐老倾向的保护因素,消极应对方式是虐老倾向的危险因素,应对方式能解释照顾者虐老倾向总变异的29.0%。结论老年慢性病患者家庭照顾者应对方式趋于消极且其虐老风险较高。护理人员应鼓励照顾者多采取积极应对方式,避免长期采用消极应对方式,以减少虐老风险,提高照顾质量。     

中晚期帕金森病患者家庭照顾者照护能力测评量表的编制及信效度检验

目的 编制中晚期帕金森病患者家庭照顾者照护能力测评量表并检验其信效度,为评估照顾者照护能力提供测评工具。方法 以Farran照顾者技能模型为理论框架,通过文献回顾、半结构式访谈构、专家咨询、预试验,形成初始量表。采用便利抽样法,对218名中晚期帕金森病患者家庭照顾者进行问卷调查,进行项目分析和信效度检验,形成正式量表。结果 正式量表包括疾病认知与应对能力、按需护理技能、基础护理技能、照顾者自身需求管理能力、资源利用能力5个维度28个条目。探索性因子分析5个公因子累计方差贡献率为68.777%;条目水平内容效度指数为0.857～1.000,量表水平的平均内容效度指数为0.980;总量表的Cronbach′s α系数为0.943,折半信度为0.866。结论 中晚期帕金森病患者家庭照顾者照护能力测评量表编制过程合理,量表信效度良好,经验证性分析后可用于中晚期帕金森病患者家庭照顾者照护能力的测评。     

灵性照护在晚期肿瘤患者中的研究进展

辨析灵性与宗教、心理的异同;从意义疗法、宗教疗法、尊严疗法和音乐疗法等方面介绍灵性照护的多样形式;它可以调适晚期癌症患者的心理状况、改善其生活质量、降低其医疗费用;但是还是存在诸多不足,如测量工具单一,灵性照护缺乏专业性、延续性等。有待于进一步完善适合我国国情的灵性照护模式,提升晚期肿瘤患者的生活质量。     

Psychometric Properties of a Hurricane Coping Self-Efficacy Measure

This brief report describes the psychometric properties of an instrument designed to measure Hurricane Coping Self-Efficacy (HCSE). Survivors of Hurricane Andrew (n = 165) and Hurricane Opal (n = 63) completed the HCSE and assessments of optimism, social support, distress, and resource loss. Principal components factor analyses revealed a unidimensional structure for the HCSE. Internal consistency of the HCSE was strong. In both samples, HCSE was positively associated with optimism and social support, but negatively associated with general psychological distress, trauma related distress, and resource loss. Finally, hierarchical regression analyses demonstrated that the HCSE explained a significant amount of experimental variance for intrusive thoughts and avoidance after controlling for social support, lost resources, and optimism.     

Seeing into the future: The role of future-oriented coping and daily stress appraisal in relation to a future stressor

Recent research has identified the value of distinguishing between employee's appraisals of their work-based challenge, hindrance, and threat job demands, and of how employee's future-oriented coping is associated with key occupational outcomes. The current study extends this research by assessing the extent to which employee's proactive and preventive coping techniques each directly and indirectly predicted challenge, hindrance and threat appraisals. Utilizing a daily diary design, 89 undergraduate students completed five daily surveys focused on a common future stressor. Results suggested daily appraisals do not change as much as expected, with only challenge appraisals reducing across the 5-day period. However, both proactive and preventive coping moderated daily stress appraisals, such that when proactive coping was high, challenge appraisals increased and hindrance appraisals decreased. Similarly, preventive coping appeared to reduce both hindrance and threat appraisals. Theoretical and practical implications of the multi-level and dynamic nature of appraisals and future-oriented coping are discussed.     

Coping with Work‐related Traumatic Situations among Crime Scene Technicians

Crime scene technicians collect evidence related to crime and are therefore exposed to many traumatic situations. The coping strategies they use are thus very important in the process of facing the psychological consequences of such work. The available literature shows that crime scene technicians are an understudied subgroup of police workers. Our study is therefore the first unfolding insights into technicians' coping strategies, post‐traumatic symptomatology and somatic health, based on a sample of 64 male crime scene technicians (85% of all Slovene technicians). Crime scene technicians mainly use avoidance coping strategies. Approach strategies that are more effective in the long‐term—i.e. lead to a larger buffering of the effects of traumatic stress—are more frequently used if technicians are familiar with the nature of the task, when they have time to prepare for it, and if they feel that past situations have been positively resolved. Behavioural avoidance strategies were found to be least effective when dealing with traumatic experiences and are also related to more frequent problems of physical health. Results indicate that appropriate trainings for future technicians would facilitate the use of more effective coping strategies and consequently lead to a more effective and satisfied worker. Copyright © 2014 John Wiley & Sons, Ltd.     

The acute psychological impact on survivors following a train accident

Sixty-six passengers surviving a collision of two trains were investigated concerning relevant background data, degree of personal injury, experience of a threat to life, symptoms and problems immediately after the accident, and thoughts about difficulty in coping. The most obvious impact on the survivors was the experience of being close to death. One result of this was that they developed a new coping strategy to minimize emotional pain. Some survivors also suffered problems of re-living the accident. This is important for the coping process. The process includes psychological integration of the accident as an important life event. The findings indicate that re-living of the accident through nightmares and intrusive thoughts is responsible for problems in carrying out ordinary tasks. The observations are in accordance with those made after other types of accidents and disasters.     

Police officers' coping strategies: An Australian police survey

Police officers, in the performance of their duties, face a range of potentially stressful situations and events. These have the capacity to cause significant personal distress, leading to short — and long-term changes in mood, psychological functioning and social activity. In response to the stresses of the job, officers must utilize any number of coping strategies to deal with their occupational stress. The aim of the present study was to examine the stress-coping strategies used by a large sample of Australian police personnel. Responses to the Revised Ways of Coping Checklist showed that most officers utilize problem-focused, direct action coping strategies, with more limited use of social supports, self-blame and wishful thinking. While their coping behaviours may help them moderate problem-focused stress concerns, the data suggest that many officers may not deal effectively with their emotion-focused concerns. These data are examined in the light of the research literature detailing the so-called police personality.     

Vietnamese refugees with PTSD symptomatology: Intervention via a coping skills model

The current study of Vietnamese refugee students revealed that the majority had experienced multiple traumatic events and reported moderate to severe PTSD symptomatology. A stress intervention module (SIT), designed to treat rape victims, was introduced to determine its efficacy for the treatment of Vietnamese refugees with PTSD symptoms. Postintervention PTSD symptomatology was significantly reduced contrasted to virtually no change in symptomatology for the control subjects. Serious methodological concerns, e.g., selection bias, sample size, are highlighted in the paper. The current inquiry is essentially a pilot study. The paper is intended for heuristic value. Clinical literature is extant for culturally sensitive intervention approaches for this vulnerable population.     

Children's selective coping after a bus disaster: Confronting behavior and perceived support

Data were obtained from 675 seventh graders grieving the death of 19 and injury of 14 fellow students in a traffic accident. Frequency of confronting behaviors was inversely related to their intensity. Perceived helpfulness of the various support person categories (oneself, parents, siblings, relatives, friends, classmates, classroom teachers, guidance counselors, psychologists) was related to current stress levels, context of the disaster, and prior helping relationships. Personal loss and situational variables affected confronting behavior and stress reaction levels. Specific helpful support persons affected interest in individual and/or group treatment. Findings were consistent with a model of search and selection of helpful support persons in community-wide stressful situations.     

Work stress and hospital doctors: a comparative study

The findings indicate a direct link between the number of hours worked and stress levels, although the number of hours worked was positively related to the perceived availability of social support. Junior hospital doctors used social support as a coping strategy significantly more often than senior hospital doctors, with both perceiving the hospital environment as a more effective source of social support than the home environment. Despite having access to higher levels of effective social support, junior hospital doctors faced significantly greater sources of stress and poorer mental health than their senior counterparts. Copyright © 1999 John Wiley & Sons, Ltd.     

Coping is not an ‘either’ ‘or’: the interaction of coping strategies in regulating affect,arousal and performance

The purpose of the present studies was to (a) examine the association between coping, affect, and stress during demanding, stressful tasks, and (b) examine the presence of a synergy between coping strategies towards regulating stress, affect and performance. In Study 1 participants were 53 first year undergraduate students at a state university. Student's coping strategies were assessed prior to a job interview. Results indicated that emotion‐focused coping was associated with significantly elevated negative affect compared to problem‐focused coping. Inclusion of an interaction term reflecting different levels of the two coping strategies showed enhanced adaptation compared to the use of either problem‐focused or emotion‐focused coping strategies. Study 2 aimed at replicating the findings of Study 1, and extend them with assessment of behavioral and physiological indices of stress. Participants were 48 undergraduate students and their coping, affect, and behavioral and physiological stress were assessed prior to an in‐class presentation. Results indicated that neither problem nor emotion‐focused coping were associated with stress levels. However, the interaction of problem‐focused and emotion‐focused strategies was associated with significantly lessened stress. It is concluded that the presence of more than one coping strategy at a given time may be more adaptive compared to the adoption of one type of strategy. Copyright © 2006 John Wiley & Sons, Ltd.