肝移植受者出院疾病不确定感与应对方式的相关性研究

目的 探讨肝移植受者疾病不确定感与应对方式的关系.方法 采用便利抽样方法 抽取80例肝移植出院患者,分别采用Mishel疾病不确定感社区量表(MUISC)和MCMQ应对量表调查疾病不确定感和应对方式.结果 肝移植患者疾病不确定感处于中等水平[(59.91±11.69)分];肝移植患者应对方式中的面对、回避方式得分显著高于常模 (P＜0.05、P＜0.01);疾病不确定感与面对应对方式呈显著负相关(P＜0.01),与屈服呈显著正相关(P＜0.01).结论 肝移植出院受者疾病不确定感与其应对方式呈显著相关,采用面对应对方式可降低其不确定感,屈服应对方式可增加其不确定感.     

消化系统肿瘤化疗患者个人成长结构方程模型的构建

目的依据Mishel疾病不确定感理论构建消化系统肿瘤化疗患者个人成长结构方程模型。方法采用一般资料问卷,疾病不确定感量表,记忆症状评估量表,社会支持评定量表,癌症应对问卷,不确定感成长量表分别对448例消化系统肿瘤化疗期患者进行测评,用结构方程模型分析软件AMOS17.0进行分析。结果患者个人成长均分为153.22±16.05。疾病不确定感对个人成长有间接负向效应(β=-0.117,P0.01);社会支持对个人成长有间接正向效应(β=0.077,P0.01);症状困扰对个人成长有直接负向效应(β=-0.171,P0.01)和间接负向效应(β=-0.045,P0.01)。结论疾病不确定感与社会支持通过间接路径影响个人成长,症状困扰可以通过直接和间接路径两种方式影响个人成长,而应对方式在疾病不确定感与个人成长中发挥中介作用。     

肺癌幸存者社会疏离现状及影响因素调查分析

目的 调查肺癌幸存者社会疏离水平现状,并分析其影响因素.方法 采用一般疏离感量表、自尊量表、领悟社会支持量表对228例肺癌幸存者进行横断面调查.结果 肺癌幸存者社会疏离得分为(42.66±7.96)分;肺癌幸存者社会疏离得分与 自尊得分、领悟社会支持各维度得分及总分呈负相关(均P＜0.01);多元线性回归分析显示,文化程度、治愈后时间、自尊、领悟社会支持是社会疏离的主要影响因素(均P＜0.01),可解释总变异的52.9％.结论 肺癌幸存者存在中等以上水平的社会疏离,医护人员应关注文化程度较低、治愈后时间较短的患者,提高患者自尊水平和领悟社会支持水平,以降低患者的社会疏离水平.     

早产儿母亲出院准备度现状及影响因素分析

目的 探讨早产儿母亲出院准备度现状,并分析影响因素,为提高产妇出院准备水平提供参考.方法 选取青岛市3所三级甲等医院NICU早产儿母亲257名,住院期间实施三阶段干预培训母亲照护技能;采用出院准备度量表、领悟社会支持量表、儿科护士与患儿父母伙伴关系量表进行调查,分析影响因素.结果 257名早产儿母亲出院准备度总分83.31±9.44,社会支持总分48.38±5.42,早产儿母亲与护士的伙伴关系总分146.55±15.65.是否具有育儿经验、不同受教育程度的早产儿母亲出院准备度得分差异有统计学意义(P＜0.05,P＜0.01);出院准备度总分与早产儿母亲和护士的伙伴关系、社会支持总分呈正相关(均P＜0.01);育几经验、社会支持水平、伙伴关系水平是早产儿母亲出院准备的主要影响因素(均P＜0.01).结论 医护人员可从影响早产儿母亲出院准备度的主要因素着手,给予早产儿母亲足够的社会支持同时制定策略加强其与护士的伙伴关系,从而提高其出院准备水平.     

对早产儿父母实施家庭赋权方案的效果研究

目的 探讨家庭赋权方案对早产儿住院期间父母疾病不确定感、出院照顾准备度及出院后1个月应时能力的影响.方法 将2019年6～12月收治的45例早产儿的父母纳入对照组,将2020年1～7月收治的45例早产儿的父母纳入观察组.对照组采用常规护理,观察组在常规护理基础上增加家庭赋权方案进行干预,比较两组早产儿父母疾病不确定感、照顾准备度、出院后1个月应对能力的差异.结果 出院当天观察组父母疾病不确定感评分显著低于对照组,照顾准备度评分显著高于对照组,早产儿出院1个月父母应对能力评分显著高于对照组(P＜0.05,P＜0.01).结论 家庭赋权方案能减轻早产儿父母疾病不确定感,提高家庭照顾准备度及出院后应对能力.     

心理教育支持干预对乳腺癌术后出院患者疾病不确定感的影响

目的探讨心理教育支持干预对乳腺癌术后出院患者疾病不确定感的影响。方法采用便利抽样法抽取乳腺癌术后出院患者80例为研究对象,将患者按随机数字表法分为干预组和对照组各40例,对照组患者出院后接受常规随访,干预组在常规随访的同时给予乳腺癌心理教育支持干预。于干预2、4、6个月后对患者进行疾病不确定感水平的评价。结果两组疾病不确定感总分比较,干预主效应、时间效应、交互效应均P0.01。结论对乳腺癌术后出院患者采取面对面的心理教育支持和电话随访心理教育支持干预,可显著降低其疾病不确定感水平,且干预时间越长效果越好。     

个人中心疗法对首次脑卒中患者康复效果的探讨

目的探讨个人中心疗法对首次脑卒中康复期患者的影响.方法将首次脑卒中的本院住院患者和社区非住院患者共120例随机分为心理治疗(观察组)和一般治疗(对照组)各60例,两组均予常规临床治疗与护理,观察组在此基础上采用个人中心疗法对患者实施治疗,包括主动倾听、无条件积极关注、准确共情、对峙、建立合理认知、满足患者需要及建立良好支持系统等.并采用自我和谐量表及应付方式问卷于治疗前及治疗3个月后评价两组效果.结果观察组自我与经验不和谐、退避、自责分值较治疗前明显降低(均P＜0.01),自我灵活性、求助、解决问题评分较治疗前显著提高(P＜0.05,P＜0.01);自我刻板、幻想、合理化较稳定(均P＞0.05).对照组则仅在自我灵活性及解决问题上分值稍有升高(均P＜0.05),其余变化不大(均P＞0.05).观察组自我不和谐、自责、解决问题评分与对照组比较,差异有显著性意义(均P＜0.01);求助评分与对照组比较,差异有显著性意义(均P＜0.05).结论脑卒中患者普遍伴有抑郁、焦虑,缺乏对社会支持的认识和利用,应付方式易走极端等心理障碍.个人中心疗法在脑卒中后康复期可以很好地帮助患者摆脱负性情绪,形成积极向上的应付方式.     

Impact of intensive interventions on therapeutic compliance of patients with stroke and impaired glucose tolerance

目的 探讨强化护理干预对脑卒中并存糖耐量异常患者依从性的影响.方法 将210例脑卒中并存糖耐量异常患者随机分为观察组和对照组各105例.两组住院期间均接受相同的健康教育,但观察组接受护理人员的监督,确保干预措施的强化和落实.测评两组出院时依从性情况及出院后6个月的血糖.结果 观察组患者出院时治疗依从性显著高于对照组(均P＜0.01),出院后6个月血糖控制情况显著优于对照组(P＜0.01).结论 强化干预可提高脑卒中并存糖耐量异常患者治疗依从性,有利于血糖控制.     

早期实施护理干预对精神分裂症患者社会功能缺陷的影响

目的 探讨早期实施护理干预对精神分裂症患者社会功能缺陷的影响.方法 将106例精神分裂症患者分成三组,分别在出院时,出院后3个月、6个月开始进行同样的护理干预,比较三组患者社会功能缺陷的程度.结果 1年后出院时开始干预组与出院后3个月、6个月组其社会功能缺陷中4项比较,差异有显著性意义(P＜0.05,P＜0.01),而出院后3个月、6个月组差异无显著性意义(均P＞0.05).结论 及早进行护理干预可有效减轻精神分裂症患者的社会功能缺陷,使其治疗效果得到巩固和维持.     

鼻咽癌患者及家属同期健康教育对患者生活质量的影响

目的 探讨对鼻咽癌患者及其家属同时进行健康教育对改善患者生活质量的影响.方法 将110例鼻咽癌患者随机分为两组,对照组(53例)接受常规健康教育,观察组(57例)及其家属同时接受健康教育.在入院时、出院前及出院后6个月,采用生活质量核心量表(E()RTC QLQ-C30)分别对两组患者的生活质量进行评分比较.结果 入院时两组生活质量评分比较,差异无显著性意义(均P＞0.05).出院前及出院后6个月观察组患者的生活质量评分显著高于对照组(均P＜0.01),且出院6个月时观察组放疗不良反应发生率显著低于对照组(均P＜0.01).结论 鼻咽癌患者和家属同时接受健康教育,可以有效地改善患者的生活质量.     

Changes and predictors of psychological stress among elderly stroke survivors 6 months after hospital discharge

The aim of this study was to analyse the changes in psychological stress and identify its basal predictors among elderly stroke survivors after 6 months following discharge from hospital to home directly, rather than to a rehabilitation facility. The sample comprised 50 elderly stroke survivors. Data were collected at 2 weeks (T1), at 3 months (T2), and at 6 months (T3) after hospital discharge. The following instruments were applied: Perceived Stress Scale—10 items (PSS‐10), National Institute of Health Stroke Scale, Functional Independence Measure, and Geriatric Depression Scale—15 items. Study records indicated that the age of the study participants ranged from 60 to 87 years old (mean = 70.3; standard deviation = 7.6). The number of male and female participants was similar. The PSS‐10 score decreased almost 6 points between T1 (mean = 15.1) and T3 (mean = 9.7; p < .001). Both Functional Independence Measure (p = .025) and Geriatric Depression Scale‐15 (p = .017) scores at T1 predicted the PSS‐10 score at T3. The study thus demonstrated that elderly stroke survivors experienced significant stress after hospital discharge, which tended to improve over the next 6 months. Depression and lower functional independence 2 weeks after discharge were predictors of a greater level of psychological stress at 6 months following discharge.     

微课健康教育对脊髓损伤患者出院后生活能力和心理状况的影响

目的 探讨微课健康教育对脊髓损伤患者出院后自我护理能力、日常生活能力及心理状况的影响。方法 将72例脊髓损伤康复治疗后出院患者按随机数字表法分为对照组和干预组,各36例。对照组采用常规健康教育、电话随访,干预组在此基础上采用微课健康教育对患者进行出院后居家康复指导,共6个月。于出院前及出院后1、3、6个月采用自我护理能力量表、Barthel指数量表、焦虑自评量表、抑郁自评量表及自制满意度调查表进行调查。结果 对照组35例、干预组34例患者完成研究。干预组出院后6个月自我护理能力、日常生活能力评分及满意度评分显著优于对照组,焦虑、抑郁评分显著低于对照组（均P＜0.05）。结论 微课健康教育能提高脊髓损伤患者出院后的自我护理能力及日常生活能力,改善患者的心理状况。     

脑卒中患者出院安置现状及预测因子分析

目的 了解脑卒中患者出院安置现状并探索其预测因子,为临床医护人员实施出院准备服务提供参考。方法 采取整群抽样法抽取神经内科收治的脑卒中患者238例,对患者一般资料、疾病相关资料、身体功能资料及出院安置情况展开调查。结果 84例(35.3%)患者出院安置发生改变;居家照护、基层医疗机构与康复机构3种安置类型的患者ADL功能、步行功能、带管情况、合并症指数、经济状况比较,差异有统计学意义(P<0.05,P<0.01)。logistic回归分析结果显示,患者ADL功能、压力性损伤风险与居住状况是出院安置的预测因子(P<0.05,P<0.01)。结论 脑卒中患者出院安置改变发生率较高,入院时ADL功能差、压力性损伤风险高或独居患者更易发生出院安置改变。临床医护人员应结合患者病情严重程度、活动功能、照护支持、经济状况为其出院安置选择提供指导意见,同时出院后医疗卫生服务与转诊制度建设亟需加强。     

急性心肌梗死患者焦虑抑郁状况及预测因素分析

目的了解急性心肌梗死患者急性期的焦虑抑郁状况及其预测因素,以期为护理人员采取预防性的心理护理措施提供依据。方法对136例急性心肌梗死患者在其发病的第5~7天采用综合医院焦虑抑郁量表和SF-12生活质量量表进行问卷调查。结果急性心肌梗死患者中焦虑症状阳性者72例(52.94%),抑郁症状阳性者22例(16.18%)。患者既往的生理职能、锻炼情况和精神健康是患者焦虑水平的影响因素(P<0.05,P<0.01);既往的活力、社会功能和吸烟史是患者抑郁水平的影响因素(P<0.05,P<0.01)。结论急性心肌梗死患者发病前的生活质量和生活方式会影响其急性期焦虑抑郁的发生,护理人员应加强评估并提供针对性的措施,预防和缓解患者的不良心理状况。     

Psychological and Work Stress Assessment of Patients following Angioplasty or Heart Surgery: Results of 1‐year Follow‐up Study

The aim of this study was to explore changes in subjective psychological health and perceived work stress among patients who returned to work (RTW) after a multidisciplinary cardiac rehabilitation (CR) following cardiac interventions. A total of 108 patients were evaluated at the beginning of their CR, at 6 and 12 months after discharge. Self‐report questionnaires were used to assess depression, anxiety, illness perception and work stress at each time stage. Results showed reports of depressive symptoms significantly decreased (p < 0.05) and subjective mental (p = 0.001) and physical health (p < 0.001) improved over time. Patients revealed a decrease in Type A behaviour pattern (p < 0.001) and in job satisfaction levels (p = 0.01), greater internal locus of control (p < 0.01) and increased use of the coping strategy ‘Involvement’ (p < 0.01). Major findings are that cardiac patients had an improvement in subjective psychological health and did not perceive increased work stress after their RTW. Patients' psychological health and work stress need to be assessed during the CR and should be also carefully monitored after the RTW in order to identify patients' psychological and work‐related barriers and facilitate a safe and successful work reintegration. Copyright © 2014 John Wiley & Sons, Ltd.     

急性缺血性脑卒中后吞咽障碍发病率及影响因素分析

目的探讨急性缺血性脑卒中后吞咽障碍发病率、危险因素及预后,为采取干预措施提供参考.方法对急性缺血性脑卒中患者在入院48 h内,采用洼田饮水试验结合容积一黏度吞咽测试完成吞咽功能评估,收集年龄、性别、既往史、卒中部位、肌力、Barthel指数、美国国立卫生研究院脑卒中量表(NIHSS)评分等资料,并随访患者出院后1、3个...     

饮食和运动干预对代谢综合征患者自测健康的影响

目的探讨饮食和运动干预对社区代谢综合征患者自测健康的影响。方法对66例社区代谢综合征患者（干预组）实施为期3个月的饮食和运动干预，并与正常生活的66例患者（对照组）比较干预前后自测健康状况。结果干预后干预组患者在身体症状与器官功能、身体活动功能、正向情绪、角色活动与社会适应、社会资源与社会接触、社会支持等方面得分显著高于干预前和同期对照组（P〈0.05，P〈0.01）。结论饮食和运动干预能有效改善社区代谢综合征患者的自测健康状况。     

The influence of mindfulness and social support on stress reactivity during pregnancy

Exaggerated stress reactivity can lead to negative health outcomes, which can be especially harmful during important periods of development such as pregnancy. Therefore, studies are needed to examine potential protective factors associated with lower perceived stress reactivity and lower cortisol awakening response (CAR) during pregnancy. The current cross‐sectional study examined whether low‐income women (n = 152) with higher mindfulness (attentiveness and awareness of the present moment) and more perceived social support had lower levels of perceived stress reactivity and a lower CAR during pregnancy. Women completed self‐report measures of mindfulness (Mindful Attention Awareness Scale), social support (Medical Outcomes Study‐Social Support Scale), and perceived stress reactivity (Perceived Stress Reactivity Scale) during their first trimester of pregnancy and collected saliva using the passive drool procedure at home (at awakening and at 30 min after awakening). Results showed that women with greater mindfulness and greater perceived social support had significantly lower perceived stress reactivity, but not a lower CAR. These results provide preliminary support for mindfulness and social support as potential protective factors of perceived stress reactivity and have implications for experimental studies aimed at improving pregnant women's mindfulness and social support for reducing their stress reactivity and potentially improving health outcomes.     

妇幼专科医院护理带教老师心理健康状况及与社会支持的相关性

目的 调查妇幼专科医院护理带教老师心理健康状况,并探讨其心理健康与社会支持的关系。 方法 采用整群抽样法抽取1所妇幼专科医院护理带教老师288人,采用一般资料问卷、症状自评量表和社会支持评定量表进行调查。 结果 妇幼专科医院护理带教老师心理健康总均分为1.61±0.50,除躯体化外,其抑郁、强迫症状、人际关系敏感、焦虑、敌对、恐怖、偏执及精神病性因子得分与全国护士常模比较,差异有统计学意义（P＜0.05,P＜0.01）;护理带教老师的社会支持总分为41.50±8.39,其社会支持各维度得分及总分与心理健康各维度及总分呈负相关（均P＜0.01）。 结论 妇幼专科医院护理带教老师的心理健康水平及社会支持均有待提高,医院护理管理者可以通过提高护理带教老师社会支持水平促进其心理健康,使其更好地平衡工作压力和自身需求,保证护理工作质量。     

Quality of life before and after intensive care

Quality of life is often thought to be poor before and after intensive care unit admission. The aim of this study was to investigate changes in quality of life before and after intensive care. A prospective cohort study of 300 consecutive patients admitted to intensive care was performed in a Scottish Teaching Hospital. Quality of life was assessed premorbidly and 3, 6 and 12 months after intensive care admission for surviving patients using SF-36 as well as EQ-5D scores at 12 months. The median value for age was 60.5 years and for APACHE II score, 18. The mean length of stay was 6.7 days. SF-36 physical component scores decreased from premorbid values at 3 months (p = 0.05) and then returned to premorbid values at 12 months (p < 0.001). The mean physical scores were below the population norm at all time points but the mean mental scores were similar or higher than these population norms. Patients who died after intensive care discharge had lower quality of life scores than did survivors (all p < 0.01). Poor premorbid quality of life was demonstrated and appears to reduce after ICU discharge. For survivors there was a slow increase in physical quality of life to premorbid levels by the end of the first year but these remained lower than in the general population. ICU patients experience a considerable longer-term burden of ill health.