The impact of antenatal care on pregnancy performance between adolescent girls and older women

OBJECTIVE: To investigate pregnancy performance and newborn outcome between adolescents and older women receiving adequate and similar antenatal care. METHODS: Four hundred and twenty-five women attending the antenatal clinic at the University Hospital of the West Indies, Kingston, Jamaica, participated in a prospective study. Recruitment included women 19 years and younger (adolescents) and 20 years and older (older women). Anthropometric measurements of the women and their newborn were made. During the pregnancy, all admissions to hospital and the diagnoses were recorded. Neonatal admissions were also recorded. RESULT: Three hundred and sixty-one women each (84.9%) delivered a live infant of which 175 (87.5%) women were less than 20 years old and comprised the adolescent group and 186 (82.7%) of these women were 20 years and older and comprised the women in the older age group. Thirty-nine (9.2%) had early pregnancy losses; twelve among the adolescents (6%) and twenty-seven (12%) among the older women (p = 0.03). There was one intrauterine death and one stillbirth in the adolescent group and two intrauterine deaths and no stillbirth in the older group. The attendance rate at the antenatal clinic for both groups was high throughout the study with each group having greater than 96% attendance. There were 53 (26.5%) admissions among the adolescent girls and 70 (31.1%) admissions among the older women. This was not statistically significant. There was a significant difference in the occurrence of urinary tract infections where 17% of the adolescents had a urinary tract infection compared to 1% of older women (p < 0.0001). There was a lower Caesarean section rate among the adolescent. No significant difference between the number of neonatal admissions for the two groups (p = 0.19) was seen. CONCLUSION: This study showed that with similar and adequate antenatal care there were minimal differences in pregnancy performance between the two groups with only an increased rate of urinary tract infections and a lower rate of Caesarean section in the adolescents.     

孕期保健对孕产妇妊娠结局的影响

目的 观察孕期保健对孕产妇妊娠结局的影响.方法 将2010年10～ 12月于该院就诊的3 044例孕产妇作为研究对象.根据产前检查是否≥7次将所有孕产妇分为孕期保健组(n＝2 664例)和未实施孕期保健组(n＝380例).对比孕期保健组和未实施孕期保健组的妊娠期高血压疾病、妊娠期糖尿病、产后出血率、分娩方式等方面的情况.结果 孕期保健组的妊娠期高血压疾病和妊娠期糖尿病的发生卒明显低于未实施孕期保健组的妊娠期高血压疾病和妊娠期糖尿病的发生率,两组间比较差异有统计学意义(P＜0.05);孕期保健组的产后出血率明显低于未实施孕期保健组的产后出血率,两组间比较差异有统计学意义(P＜0.05);孕期保健组的自然分娩率明显高于未实施孕期保健组的自然分娩率,两组间比较差异有统计学意义(P＜0.05).结论 规范实施孕期保健,可减少妊娠期高血压疾病、妊娠期糖尿病,减少产后出血率,增加自然分娩率,减少不良妊娠结局发生.     

The prevention of adolescent pregnancy

Adolescent pregnancy is best prevented. Prevention, however, is problematic, because adolescents become biologically mature at an earlier age today than in past generations. Most adolescents are still psychologically immature when they initiate sexual activity. Delayed initiation of sexual activity during adolescence, therefore, is the ideal solution. Physicians are an important resource in encouraging responsible sexual behavior and preventing adolescent pregnancy and in guiding the patient and her family when adolescent pregnancy does occur. Physicians can provide age-appropriate contraceptive services and adolescent prenatal and postpartum services. They can also participate actively in community-based sex and family life educational programs as knowledgeable and respected sources of information and guidance.     

The psychosocial impact of prostate cancer on patients and their partners

OBJECTIVE: To assess the psychosocial impact of the diagnosis of either localised or metastatic prostate cancer (PCA) on patients and their female partners. DESIGN: Observational, prospective study at Time 1 and 6 months later at Time 2 of two groups of couples facing PCA. Time 1 was when patients were first diagnosed with histologically confirmed localised (potentially curable) PCA or metastatic (incurable) PCA. MAIN OUTCOME MEASURES: Depression and anxiety disorders according to the Diagnostic and statistical manual of mental disorders 4th edition (DSM-IV); psychological distress; marital satisfaction. RESULTS: At Time 1, partners had rates of DSM-IV major depression and generalised anxiety disorder twice those of women in the Australian community, and considerably higher than the patients' rates. At Time 2, psychological distress in partners had lessened but that in patients had increased. On the other hand, at Time 2, partners' marital satisfaction had deteriorated. CONCLUSIONS: To be fully effective, interventions aimed at reducing the psychosocial morbidity of PCA must involve both patient and partner, rather than the patient alone.     

父母教养方式对青少年抑郁症的影响和作用

目的探讨父母教养方式对青少年抑郁症的影响和作用,为青少年抑郁症的早期预防和治疗提供参考。方法以2011年4月~2013年4月在我院心理科门诊诊治的80例青少年抑郁症患者为研究组,另选来自学校和本院职工子女且汉密尔顿抑郁量表(HAMD)17项测评总分≤7分的80例健康青少年为对照组,采用父母教养方式评价量表(EMBU)、HAMD两个工具来测评两组青少年父母教养方式与青少年抑郁症之间的相关性。结果研究组与对照组父母教养方式各因子比较:男性患者在父亲严厉惩罚因子(FF2)、父亲拒绝否认因子(FF5)、母亲情感温暖因子(MF1)、母亲过度干涉保护因子(MF2)和母亲拒绝否认(MF3)方面的差异有统计学意义(P<0.05,P<0.01或P<0.001);女性患者在父亲情感温暖因子(FF1)、父亲惩罚严厉因子(FF2)、父亲拒绝否认(FF5)、父亲过度保护(FF6)、母亲情感温暖因子(MF1)、母亲过度干涉保护因子(MF2)和母亲拒绝否认(MF3)方面的差异有统计学意义(P<0.05或P<0.001)。结论青少年抑郁症患者的父母存在教养方式不当,改善父母教养方式可能有助于青少年抑郁症的治疗与预防。     

Demoralisation: its impact on informed consent and medical care.

Demoralisation, a mental state characterised by hopelessness and meaninglessness, can be differentiated from depression in that demoralised patients can enjoy the present, their lack of hope being confined to the future. However, like severe depression, demoralisation can interfere with a person's capacity to give informed consent. Doctors and other health professionals are also subject to demoralisation, which influences medical care.     

罗伊-纽曼综合模式护理对前列腺癌去势治疗患者心理的影响

目的:探讨罗伊-纽曼综合模式心理护理对前列腺癌患者术后生活质量和心理状况的影响。方法:将44例前列腺癌围手术期患者随机分为观察组和对照组,观察组应用罗伊-纽曼综合模式进行护理干预,对照组采用常规健康宣教方法进行护理干预。通过生活质量和心理状况问卷调查比较两组患者的生活质量评分值与心理问题发生率。结果:观察组患者生活质量分值明显高于对照组(P<0.05),多项心理问题的发生率明显低于对照组(P<0.05)。结论:应用罗伊-纽曼综合模式可有效改善前列腺癌围手术期患者的心理状况,提高其近期生活质量。     

Development of a regional computerized cancer registry and its impact on medical care

The Brockton Hospital Cancer Registry Program was developed to answer the data needs of the Southeastern Massachusetts region. Expansion of the computer system resulted in a data base that impacts in five areas of medical care. Registry data have been used to determine worthwhile screening sites, help institute new treaments, analyze patient survival, aid in patient follow-up, and upgrade hospital cancer programs. The extent of this impact and the usefulness of the registry in the region is discussed.     

医学新生综合素质调查分析

为了适应医学教育模式的转变,有针对性地做好医学生的教育和培养工作,我们对我院2001级医学新生的思想、心理、学习、生活、人际交往等方面进行了问卷调查,并对结果进行了分析,同时提出了加强医学生综合素质的建议.