心理干预对诱导期透析患者心理健康水平的影响

目的 探讨心理干预对诱导期透析患者心理健康状况的影响.方法 对合肥市第一人民医院血液净化中心诱导期透析患者50例采用症状自评量表（SCL-90）进行心理状况调查,根据调查测评结果实施有针对性的心理与行为方式干预措施,比较干预前后诱导期透析患者心理健康状况.结果 心理干预后SCL-90阳性项目数和躯体化、强迫、人际关系、抑郁、焦虑、敌对、恐怖的因子分均显著低于干预前,差异有统计学意义（P＜0.05）.结论 实施综合的心理干预措施,能明显改善诱导期透析患者的负性情绪,提高其心理健康水平.     

社区重性精神病患者家属心理应激与心理健康的相关分析

目的分析社区重性精神病患者家属心理应激与心理健康状况的关系。方法采用亲属应激量表、一般健康问卷、焦虑自评量表和抑郁自评量表对杭州市部分社区的124名重性精神病患者家属进行调查。结果亲属应激量表测评总分男性(8.71±5.92)分、女性(12.6±6.47)分,一般健康问卷测评有18人≥4分,焦虑自评量表测评20人>50分,抑郁自评量表测评30人>53分,亲属应激量表的3个因子分及总分与一般健康问卷总分、焦虑自评量表评分呈正相关(P<0.01,P<0.05)。结论社区重性精神病患者家属的心理应激与心理健康密切相关。     

Predictors of self-assessed physical and mental health of Icelandic nurses: results from a national survey

Background

Recent health care organizational changes have been associated with stress and musculoskeletal disorders in nurses. However, studies are lacking on what factors are the most important predictors of poor self-assessed health among nurses.

Objectives

To describe and identify the self-assessed predictors of physical and mental health of nurses.

Participants and design

A cross-sectional design was used with a sample of 394 nurses, drawn from the registry of the Icelandic Nurses’ Association, representing 17% of the workforce of Icelandic nurses.

Methods

Data were collected with a self-administered questionnaire, addressing symptoms, illness and treatment, lifestyle and sleep, work and working environment, family and quality of family life. Data were analysed according to nurses’ assessment of their physical and mental health (very good/good; poor/very poor) by use of analysis of variance, chi-square and stepwise multiple linear regression.

Results

21.7% of participants assessed their physical health as poor or very poor and 14.3% assessed their mental health as such. Those who assess their physical or mental health poor/very poor, as compared to the others, reported more symptoms in general, less regular exercise, as well as more use of medication, more visits to physicians, trouble with sleeping, conflicts between work and family life, work absence, and they experience their work as more strenuous. Experiencing symptoms is an important predictor of both physical and mental health of nurses.

Conclusion

Various factors, including work-, family- and socio-cultural environment, play a role in how nurses assesses their health. During our present time of nurse shortage it is imperative that the authorities take special measures in order to improve the work environment of nurses.     

精神障碍患者家属应对方式与心理健康的相关分析

目的:探讨精神障碍患者家属心理健康水平及应对方式对心理健康的影响。方法:采用简易应对方式问卷,症状自评量表(SCL-90)和一般情况调查表对181名患者家属进行调查分析。结果:患者家属的SCL-90总分及躯体化、人际关系、抑郁、焦虑、偏执5个因子与常模比较有明显差异(P0.01),消极应对方式与心理健康水平存在显著正相关,与SCL-90躯体化、人际关系、敌对、精神障碍性4个因子存在正相关(P0.05),与强迫症状、抑郁、焦虑3各因子存在显著正相关(P0.01)。结论:精神障碍患者家属的心理健康水平明显低于常模,并与应对方式存在相关性。     

Emergency department care for patients with mental health problems,a longitudinal registry study and a before and after intervention study

ObjectiveTo describe the numbers and length of stay (LOS) of patients with mental health (MH) problems at a Dutch emergency department (ED) and the effect of a psychiatric intervention team (PIT) on patient flow.MethodsA longitudinal design was used to assess number of MH presentations and LOS during a 3-year period (2014–2016). In 2017, we introduced a PIT during ED peak hours, to reduce LOS for patients with MH problems. We evaluate the effects of the PIT on patients’ LOS with an 18-month before and after intervention study (2017–2018).ResultsTotal number of ED presentations increased with 4%. Total number of MH presentations increased with 23% from 2014 to 2016. LOS increased by 28 min (95 min vs. 123 min) for all presentations, while not changing for MH presentations (2014: 195 min, interquartile range (IQR) 120–293 and 2016: 190 min, IQR 116–296). In the before and after intervention study, number of MH presentations increased with 36% while LOS decreased with 46 min (p < 0.001).ConclusionsThe number of MH presentations increased over the three years while LOS remained similar. In the before and after intervention study, number of presentations increased even more while LOS decreased significantly. Specialist psychiatric input reduces ED LOS.     

新型医疗模式下ICU护士心理健康状况的研究进展

ICU护士是护士中较为特殊的群体,如环境隔离、病人重、工作量大、职业技能要求高等,心理问题在ICU护士中普遍存在,如疲倦、焦虑、抑郁、怀疑等,其原因是多源性的.ICU护士的心理健康问题面临着非常严峻的挑战,应引起护理管理者的关注,采取有效的措施缓解ICU护士的心理压力,保证ICU护士具有健康的心理、身体素质,更好地服务于患者.     

Preparing nurses with enhanced mental health knowledge and skill: A major in mental health

In Australia, since the early 1990s there has been a significant change to the way in which mental illness has been managed. Major government reforms resulted in the ‘mainstreaming’ of mental health care, with a significant reduction in the numbers of psychiatric hospitals. This significant policy change resulted in the demise of direct entry, specialist mental health nurse education that was the main provider of the mental health workforce. In theory, since that time, nurses have been prepared for practice through a comprehensive degree program; however, there is strong evidence to suggest that the mental health content in the comprehensive program is well below what is needed for nurses to have the knowledge and skill to provide effective mental health care. This article reports on the development of an innovative curriculum designed to prepare an appropriately qualified nursing workforce with enhanced mental health knowledge and skill to be responsive to the changing nature of health service delivery.     

Developing confidence in mental health students to recognise and manage physical health problems using a learning intervention

Globally, there is increased recognition of a higher prevalence of physical ill health and mortality in individuals with mental health problems. A review of the literature highlighted the need to address deterioration in physical health of those with mental health problems through better recognition and management on the part of mental health nurses. However, mental health nurses have been found to lack confidence and be unsure of their role within this area. The aim of the project was to develop pre-registration mental health students' confidence to be able to recognise and manage physical health deterioration through the use of high fidelity human patient simulation, the development of contextualised clinical scenarios and additional theory around the A to E mnemonic structured assessment. The project involved 95 third year mental health student nurses, using a self-rating pre and post intervention questionnaire to measure their perceived confidence levels and to evaluate the effectiveness of the learning intervention. Findings demonstrate improved overall confidence levels in recognising and managing physical health deterioration in human patient simulators displaying mental health problems.     

护士长心理健康状况的调查分析与对策

目的调查护士长心理健康状况。方法采用症状自评量表对35名护士长及197名普通护士进行心理测试,并对结果进行统计分析。结果护士长症状自评量表各因子平均分与中国常模比较差异无统计学意义;与普通护士比较,躯体化、强迫状态、人际关系因子分差异有统计学意义;任职≤5年护士长的人际关系因子分明显高于任职5年护士长,差异有统计学意义。结论35名护士长总体心理健康水平处于良好状态,但低于普通护士。医院领导要重视护士长的心理健康维护。     

心理干预对牙颌面畸形患者家长心理健康状况的影响

目的探讨牙颌面畸形患者家长的心理健康状况,提出相应的护理干预对策。方法选择206例牙颌面畸形患者家长为研究对象,使用症状自评量表（SCL-90）分别在干预前后对其进行调查,比较干预前后研究对象SCL-90评分。结果牙颌面畸形患者家长SCL-90评分中躯体化、抑郁、焦虑、敌对、偏执、阳性项目数因子评分及总分均高于全国常模,差异均有统计学意义（t分别为15．01,12．92,10．79,4．55,4．43,16．43,9．79;P〈0．01）;干预后,牙颌面畸形患者家长躯体化、人际关系敏感、抑郁、焦虑、敌对、偏执、阳性项目数评分及总分分别为（1．42±0．65）,（1．61±0．42）,（1．40±0．38）,（1．42±0．51）,（1．45±0．49）,（1．28±0．38）,（26．35±9．27）,（127．56±11．01）分,分别低于对照组的（1．86±0．34）,（1．66±0．49）,（1．97±0．32）,（1．78±0．35）,（1．65±0．41）,（1．56±0．23）,（47．32±11．96）,（155．43±23．68）分,差异均有统计学意义（t分别为6．61,4．41,12．09,5．86,3．27,6．61,46．61,10．31;P〈0．01）。结论牙颌面畸形患者家长存在较多的心理健康问题,护理干预可改善患儿家长的心理状况。     

心理护理对肺尘埃沉着症患者心理状态的影响

目的观察心理护理对肺尘埃沉着症患者心理状态的影响。方法选取160例肺尘埃沉着症患者,随机分为8组,每组20例,观察心理护理前和心理护理后15,30,60d的心理特征,并比较青年、中年和老年组心理护理60d后肺尘埃沉着症患者存在4种或以上心理特征病例数;另选取320例同类患者,随机分为两方面心理护理组和全方面心理护理组各160例,记录2组心理护理前和心理护理60d后的心理特征。统计明显存在4种或以上心理特征的患者数。结果心理护理15d后明显存在4种或者以上肺尘埃沉着症患者心理特征病例数有所减少;心理护理30,60d后病例数进一步减少,与15d后比较差异显著;且60d较30d减少更显著。两方面心理护理组和多方面心理护理组在进行60d心理护理后,病例数明显减少,差异显著;多方面心理护理组减少更显著。经60d心理护理后,青年组病例数减少最显著,与中年组、老年组相比差异显著;而中年组、老年组间比较无显著差异。结论对肺尘埃沉着症患者的心理护理过程是一个长期的、循序渐进的过程,而且全面的心理护理对改善肺尘埃沉着症患者心理状态有极大影响;心理护理对于不同年龄层次患者的影响存在较大差异。     

永久性气管造瘘患者的心理健康状况与应对方式相关性研究

目的：探讨永久性气管造瘘患者心理健康状况与应对方式。方法使用症状自评量表（SCL-90）、简易应对方式问卷和一般情况调查表对17例永久性气管造瘘患者进行测量。结果永久性气管造瘘患者的（SCL-90）阳性因子检出率为51.35%,抑郁、焦虑、人际关系敏感、恐怖等因子分高于常模,差异有统计学意义（P<0.01）;消极应对方式中自责、幻想、退避与心理健康状况呈负相关,差异有统计学意义（P<0.01）。结论永久性气管造瘘患者心理健康状况与应对方式值得关注。     

心理护理对肺尘埃沉着症患者心理状态的影响

目的 观察心理护理对肺尘埃沉着症患者心理状态的影响.方法 选取160例肺尘埃沉着症患者,随机分为8组,每组20例,观察心理护理前和心理护理后15,30,60 d的心理特征,并比较青年、中年和老年组心理护理60 d后肺尘埃沉着症患者存在4种或以上心理特征病例数;另选取320例同类患者,随机分为两方面心理护理组和全方面心理护理组各160例,记录2组心理护理前和心理护理60 d后的心理特征.统计明显存在4种或以上心理特征的患者数.结果 心理护理15d后明显存在4种或者以上肺尘埃沉着症患者心理特征病例数有所减少;心理护理30,60 d后病例数进一步减少,与15 d后比较差异显著;且60 d较30 d减少更显著.两方面心理护理组和多方面心理护理组在进行60 d心理护理后,病例数明显减少,差异显著;多方面心理护理组减少更显著.经60 d心理护理后,青年组病例数减少最显著,与中年组、老年组相比差异显著;而中年组、老年组间比较无显著差异.结论 对肺尘埃沉着症患者的心理护理过程是一个长期的、循序渐进的过程,而且全面的心理护理对改善肺尘埃沉着症患者心理状态有极大影响;心理护理对于不同年龄层次患者的影响存在较大差异.     

护士心理健康及工作压力的相关性

目的 观察某综合性医院护士的心理健康水平,探讨工作压力与心理健康的相关性及其影响因素.方法 采用横断面调查设计,以某三级甲等综合性医院270名护士为研究对象,用一般健康状况量表（GHQ-12）和压力反应量表来评价护士的心理健康水平、工作压力,并对两者的影响因素和相互关系进行统计分析.结果 在270名调查对象中有69名健康状况不良,健康状况不良检出率为25.50％.GHQ-12得分在不同的年龄、性别、科室、职称、学历和婚姻状况之间差异有统计学意义（P＜0.05）.工作压力与心理健康呈正相关,医务人员工作压力越大,心理健康不良的检出率越高.结论 护士的心理健康状况不良检出率较高,高于一般人群的心理健康不良水平.其中专业技术初级职称、大专、年龄＜ 30岁、已婚的护士较为严重.护士的工作压力状况与心理健康高度相关.     

原发性肝癌患者希望水平与心理健康状况的相关性分析

目的：探讨原发性肝癌患者希望水平与其心理健康状况的相关性。方法采用Herth希望量表和症状自评量表(SCL-90)对146例原发性肝癌患者进行问卷调查,采用Pearson相关分析和分层回归分析法探讨希望水平与心理健康状况的相关性。结果146例原发性肝癌患者中,心理不健康者85例,占58.22%。心理健康组现实和未来的积极态度、积极的行动、与他人保持亲密的关系维度得分及总分分别为(12.22±1.38),(12.83±1.58),(13.42±1.71),(38.47±4.43)分,均高于心理不健康组,差异有统计学意义(t值分别为5.977,4.228,4.116,4.779;P<0.01)。 Pearson相关分析显示,心理健康组现实和未来的积极态度、积极的行动、与他人保持亲密的关系维度得分及希望总分与SCL-90均呈负相关(r值分别为-0.586,-0.537,-0.485,-0.528;P<0.01)。分层回归分析显示,希望水平各维度可联合解释原发性肝癌患者心理健康状况总变异的29.1%。结论原发性肝癌患者希望水平越高,其心理越健康。     

住院精神病患者照料者常见心理咨询问题分析

目的：了解住院精神病患者照料者的常见心理咨询问题,为临床干预提供依据。方法对102名住院精神病患者照料者的心理咨询问题进行统计分析。结果本组照料者心理咨询涉及6类问题,分别为生活照顾(27.5%)、妄想幻觉(26.5%)、行为问题(24.5%)、工作婚姻(10.8%)、消极自杀(5.9%)和酒精中毒(4.9%),不同一般资料照料者咨询问题比较差异无显著性(P >0.05)。结论住院精神病照料者心理咨询问题主要涉及生活照顾、妄想幻觉、行为问题方面,照料者精神疾病知识缺乏,应加大心理卫生知识普及力度,以利于全面提高民众的心理健康水平。     

脑血管病人心理状态调查及心理护理效果评价

目的：探讨脑血管病后心理状态及适宜的心理护理措施。方法：对80例脑血管病后病人进行症状自评量表（SCL-90），抑郁自评量表（SDS），焦虑自评量表（SAS）评定，同时用年龄、性别等相匹配的80例健康人为对照，并且对有明显心理行为改变的脑血管病人进行心理护理和必要的药物干预。结果：脑血管病后病人常有抑郁、焦虑、躯体化等心理行为改变。3种量表总分均明显高于对照罂（P〈0.01）。31例有明显抑郁情绪的病人经心理护理及药物治疗后3种量表总分均明显下降（P〈0．01）。结论：脑血管病后心理行为改变较为明显，迫切需要良好的心理护理和心理干预。     

心理疏导对护士身心健康的影响

目的 探讨心理疏导对护士身心健康的影响.方法 将60名护士随机分为实验组和对照组各30名,实验组根据护士情况给予心理疏导,对照组不做任何干预.比较心理疏导前后两组护士身心健康状况.结果 心理疏导前两组护士的身心健康评分比较(P ＞0.05),差异无统计学意义;心理疏导1个月后,两组护士的身心健康评分相比较(P＜0.01),差异有统计学意义.结论 心理疏导能改善护士身心健康状况.