某医院精神病住院患者意外死亡及相关因素分析

目的了解某医院精神病住院患者意外死亡情况,探讨预防对策。方法调查该院2014—2017年收治入院的精神病患者意外死亡情况,分析意外死亡危险因素。结果 869例精神病住院患者中,35例发生意外死亡,发生率为4.03%。意外死亡者的BPRS量表各因子评分及总评分均明显高于其他患者(P值均0.05);单因素分析显示,BPRS评分、主要精神症状、住院时间、护理级别、抗精神病治疗不良反应、病区安全设施缺陷及时间段均有一定影响(P值均0.05);logistic多元回归分析显示,BPRS评分、主要精神症状、住院时间、护理级别及时间段是精神病住院患者意外死亡相关危险因素(P值均0.05)。结论精神病住院患者有一定意外死亡风险,应针对相关危险因素积极采取预防对策。     

买地下六合彩诱发精神障碍20例分析

作者对20例因买地下六合彩而诱发精神障碍的病人进行综合分析。结果表明,所有病例起病前均先有睡眠障碍,20例中19例是由输钱所引起。临床症状以幻觉、妄想及思维障碍为主。所有病例对抗精神病药物治疗反应较好,均痊愈出院。认为地下六合彩赌博对彩民是一重大的精神应激性生活事件,不仅可以诱发精神障碍,而且对人民身心健康、社会治安等诸多方面带来严重负面影响。     

精神病患者危机状态护理分析

目的：探讨精神病患者危机状态发生的原因与护理对策。方法将我院2014年10月~2015年10月期间收治的住院精神病患者156例，随机分为两组，对照组患者78例，采用常规的护理方式，观察组患者78例，常规护理的基础上，给予MMPI测试；对两组患者的危机事件发生率进行对比分析。结果精神病患者危机状态发生的危险因素主要与患者、家属、护理人员以及医院环境因素有关，观察组患者危机事件发生率为12%，明显低于对照组的24%，两组比较差异有显著性(P＜0.05)。结论针对MMPI测试结果，对精神病患者危机状态采取早期干预护理，可以有效的降低精神病患者危机事件发生率。     

住院精神病患者攻击行为原因分析及护理对策

本文对42例住院精神病患者出现攻击行为的发生率、攻击对象、常见疾病、诱因等因素进行了统计分析,针对精神病患者攻击行为的诱因及特点,提出相应的护理对策.     

精神病患者拒食现象原因分析及护理对策

目的分析精神病患者出现拒食行为的原因,探讨相应的护理对策。方法从不同角度分析笔者所在医院收治的129例住院精神病患者拒食行为的原因,并采取有针对性的护理措施。结果精神病患者出现拒食主要为精神症状、抵触情绪、药物副作用等原因所致。结论应高度重视精神病患者拒食现象,采用针对性护理对策可明显改善拒食症状。     

防止精神病患者自杀行为的护理措施

目的通过对精神病患者自杀行为的原因、方式和发生时间的分析,研究护理对策,为临床护理提供依据。方法回顾性分析60例有自杀行为的精神病患者,采取防止精神病患者自杀行为的护理对策。结果 60例患者,其中服毒例9例,自缢17例,撞头23例,割腕11例,经洗胃、及时解救、伤口经缝合处理后患者痊愈。结论护理人员应掌握患者自杀行为的发生规律,加强病房管理,提高自身应变能力,采取相应护理可以有效应对自杀事件发生。     

精神科护理风险因素与护理对策分析

目的对精神科护理过程中存在的风险因素进行探究分析,并提出相应的护理对策。方法将我院2012年8月-2013年8月接收治疗的592例精神病患者作为临床研究对象,对其发生的护理风险因素进行探究分析,并针对存在的风险因素制定相应有效的护理对策。结果精神科存在的护理风险因素主要包括护理人员、患者及家属、医院设施以及社会等方面的因素。结论为有效降低精神科护理风险发生率,提高护理质量,保障护理的安全性,需要有效提高护理人员整体素质水平,增强责任心,切实加强护理安全管理。     

防止精神病患者自杀行为的护理措施

目的通过对精神病患者自杀行为的原因、方式和发生时间的分析，研究护理对策，为临床护理提供依据。方法回顾性分析60侧有自杀行为的精神病患者，采取防止精神病患者自杀行为的护理对策。结果60例患者，其中服毒倒9例，自缢17倒，撞头23例，割腕ll倒，经洗胃、及时解救．伤口经缝合处理后患者痊愈。结论护理人员应掌握患者自杀行为的发生规律，加强病房管理，提高自身应变能力，采取相应护理可以有效应对自杀事件发生。     

影响精神病患者服药依从性的因素及对策

目的 总结影响精神病患者服药依从性的因素及相关护理对策.方法 对住院患者有针对性地实施护理对策,井与之前作自身对照.结果 服药依从性明显改善,与对照组相比有明显的差异性(P＜0.01).结论 有针对性的护理对策可提高患者服药依从性.     

老年精神病患者跌倒的危险因素及护理干预对策研究

目的:研究老年精神病患者跌倒的危险因素,并寻求相应的护理干预对策.方法:回顾性分析2015年3月至2016年3月间我院收治的76例老年精神病患者临床资料,对患者的跌倒情况进行统计,并分析原因展开相应护理.结果:入院1周内发生老年精神病患者跌倒事件15例,占比19.74%,患者跌倒原因主要为体位性低血压跌倒,其次是由于环境因素与自身病情,主要跌倒时间集中在凌晨(06:00-08:00)及深夜(22:00-02:00)期间,入院1周后,经过针对性护理,老年精神病患者跌倒事件发生率明显下降,至所有患者出院时,仅再次发生3例老年精神病患者跌倒事件.结论:老年精神病患者跌倒发生率较高,主要由于体位性低血压引发,时间多集中在凌晨与深夜,针对性护理干预能够减少老年精神病患者发生跌倒意外.     

An examination of the food addiction construct in obese patients with binge eating disorder

Objective:

This study examined the psychometric properties of the Yale food addiction scale (YFAS) in obese patients with binge eating disorder (BED) and explored its association with measures of eating disorder and associated psychopathology.

Method:

Eighty‐one obese treatment‐seeking BED patients were given the YFAS, structured interviews to assess psychiatric disorders and eating disorder psychopathology, and other pathology measures.

Results:

Confirmatory factor analysis revealed a one‐factor solution with an excellent fit. Classification of “food addiction” was met by 57% of BED patients. Patients classified as meeting YFAS “food addiction” criteria had significantly higher levels of depression, negative affect, emotion dysregulation, eating disorder psychopathology, and lower self‐esteem. YFAS scores were also significant predictors of binge eating frequency above and beyond other measures.

Discussion:

The subset of BED patients classified as having YFAS “food addiction” appear to represent a more disturbed variant characterized by greater eating disorder psychopathology and associated pathology. © 2011 by Wiley Periodicals, Inc. (Int J Eat Disord 2011)     

Internet gambling: an emerging concern in family practice medicine?

BACKGROUND: Gambling problems are rarely brought to the attention of family practice physicians, but pathological gambling can be associated with poor emotional and physical health. Recent availability and easy accessibility of Internet gambling may be associated with pathological gambling status, and Internet gambling may confer health risks. OBJECTIVE: This study evaluated the prevalence of Internet gambling, its association with pathological gambling, and the relationship between Internet gambling and health status among patients attending medical and dental clinics. METHODS: The South Oaks Gambling Screen and Short Form 12 were administered to 1414 adults in waiting areas of clinics. RESULTS: Only 6.9% of respondents reported ever gambling on the Internet, with 2.8% indicating frequent Internet wagering. Almost two-thirds (65.9%) of regular Internet gamblers were classified as probable pathological gamblers, compared with 29.8% of ever-Internet gamblers and 7.6% of non-Internet gamblers. Internet gambling was associated with poor mental and physical health, and this association remained significant even after controlling for age, gender, site and pathological gambling status. CONCLUSIONS: These data suggest that Internet gambling is linked to pathological gambling and is independently associated with poor health. Family practice physicians should consider referring patients who gamble on the Internet for further treatment.     

Quality of Life of Patients With Korsakoff's Syndrome and Patients With Dementia: A Cross-Sectional Study

ObjectivesKorsakoff's syndrome (KS) is a chronic disorder caused by thiamine (vitamin B1) deficiency and alcoholism. The disorder is characterized by severe amnesia and often compared with dementia. The purpose of this study was to compare the quality of life between patients with KS and patients with dementia from the same nursing homes.DesignCross-sectional study design.SettingThree nursing homes in the Netherlands.ParticipantsParticipants were 72 patients diagnosed with KS and 75 patients diagnosed with dementia through extensive neuropsychological evaluation and multidisciplinary diagnostics.MeasurementsQuality of life (QoL) was scored with the QUALIDEM scale. Multivariate linear regression analysis was used to compare QoL between patients with KS and patients with dementia, applying the covariates “age,” “gender,” and “nursing home.”ResultsOf the 147 included patients, 72 (48.9%) were diagnosed with KS. Overall QoL was higher in KS. Patients with KS scored better than patients with dementia on the QUALIDEM subscales “Restless tense behavior,” “Social relations,” and “Having something to do.” A trend toward a better score was found for the subscale “Positive affect”; a trend toward a lower score was found for “Feeling at home.”ConclusionsKS is associated with profound differences in QoL compared with dementia. Patients with KS tend to have more social relationships and more positive emotions than patients with dementia. Furthermore, patients with dementia show more restless behavior than patients with KS; however, patients with KS tend to feel less at home in a nursing home than patients with dementia. Results suggest that both patients with dementia and patients with KS are in need of specialized nursing homes and care programs to accomplish their specific needs.     

复发性流产患者家庭功能及应对方式与心理状况分析

目的：探讨复发性流产（ RSA）患者家庭功能、个人应对方式及心理健康之间的关系。方法选取复发性流产患者及普通妇女各115例作为病例组及对照组,采用家庭功能评定量表、医学应对方式问卷及症状自评量表（ SCL-90）进行调查,分析三者之间的关系。结果与对照组比较,复发性流产患者SCL-90各因子均分及总分较高（均P＜0．05）,家庭功能中的“问题解决”、“沟通”、“角色”、“行为控制”及“总的功能”得分明显较低（t值分别为3．58、2．81、2．45、2．16、2．81,均P＜0．05）,更倾向于采取“屈服”消极应对方式（t＝3．08,P＜0．01）。复发性流产妇女的SCL-90各因子得分与家庭功能各因子得分呈显著正相关（P＜0．05）,家庭功能各因子与个体的消极应对方式“屈服”均呈显著负相关（r值分别为-0．12、-0．12、-0．12、-0．11、-0．14、-0．13、-0．12,均P＜0．05）。多元回归分析表明,夫妻关系及自然流产次数是影响复发性流产患者心理健康状况的主要因素。结论复发性流产患者心理健康状态差,应帮助其建立正确的认知与积极的应对方式,给予主动、持续、个体化的集关爱与综合干预一体的临床诊治,注重家庭整体系统的干预,以提高复发性流产患者的心理健康水平。     

精神专科医院感染现状分析及对策

目的分析精神疾病患者感染的病原菌分布及易感因素,加强精神专科医院感染的防治。方法对2010年1月-2013年12月入住我院的患者病原菌的分布情况进行分析。使用法国梅里埃公司生产的ATB半自动细菌鉴定仪进行细菌鉴定和药敏试验,数据采用WHONET软件进行统计分析。结果感染部位以呼吸道为主,其次是泌尿系统;病房中革兰阴性杆菌所致的感染要多于革兰阳性球菌;年龄分布以20-60岁的患者为主;精神分裂症感染者232例,占70.9%,心境障碍感染者为43例,占13.2%。结论通过对相关因素的分析,发现精神科医院感染与精神疾病的特殊性有关,应采取针对性的预防和管控措施：1加强医院感染的宣教工作;2每天病房进行通风和严格执行手卫生规范,落实消毒隔离制度;3患者服药期间,定期进行相关检验项目的监测;4落实基础护理及生活护理。     

老年骨折患者反应性精神障碍的护理

探讨老年骨折患者的发生反应性精神障碍情况的护理。方法：回顾性分析52例发生反应性精神障碍的老年骨折患者的骨折特点、心理状态、诱发因素等情况。结果：老年骨折患者反应性精神障碍的发生可能与教育程度、髋部骨折、焦虑型的精神障碍等因素有关。结论：老年骨折患者反应性精神障碍应加强预防及护理干预。     

精神分裂症患者照护负担现状及其影响因素分析

目的:了解缓解期精神分裂症患者照护负担现状及其影响因素,为针对性采取干预措施提供科学依据。方法:采用Zarit负担量表、家庭关怀度量表、社会功能量表对湖北省201名缓解期精神分裂症患者及其主要照顾者进行一对一访谈调查。结果:照顾者中163例(81.1%)存在负担,其中轻、中、重度负担分别66、72、25例,分别占比32.8%、35.9%、12.4%。照顾者家庭关怀和患者社会功能都普遍较差。多重线性回归分析结果显示照顾者年龄、照顾者文化程度、照顾者所受家庭关怀、患者医疗费用、患者社会功能是缓解期精神分裂症患者照护负担的影响因素(P<0.05)。结论:政府、精神卫生中心和家属应了解缓解期精神分裂症患者的照护负担水平及其影响因素,并提供有针对性的措施以减轻照护负担。     

Effects of patients with bipolar, schizophrenic, and major depressive disorders on the mental and other healthcare expenses of family members

Family members who live with patients with serious mental disorders incur increased healthcare expenses. A retrospective study measured these increased expenses using administrative data from a large Blue Cross Blue Shield health plan in the USA. Mental and other healthcare expenses of family members of patients with bipolar disorder, schizophrenia, or major depression were compared to those of control family members. Ordinary least squares and logistic regression were used to estimate differences. In comparison with control (families of two or more members without these psychiatric disorders), mental and other healthcare expenses per family member per month were increased for subject family members as follows: bipolar disorder, $8.85 (213%; P<0.0001) and $10.65 (7.4%; P<0.0001); schizophrenia, $4.03 (81%; P<0.0001) and $5.96 (4.2%; P<0.005); and major depression $8.24 (219%; P<0.0001) and $9.46 (6.5%; P<0.0001). Among other factors, older family members had a greater likelihood of using mental healthcare and higher levels of other healthcare; males were less likely than females to use mental healthcare but had higher levels of other healthcare, and managed forms of coverage were associated with higher levels of both mental and other healthcare. We conclude that living with a person with serious mental illness significantly increases healthcare expenses of family members, especially mental healthcare. Family members of patients with bipolar disorder and major depression experienced larger increases in expenses than family members of patents with schizophrenia, despite the fact that patients with schizophrenia were more seriously ill as reflected in the much higher mental healthcare expenses of these patients.     

植入式心律转复除颤患者的护理及随访

目的总结植入式心律转复除颤器(ICD)安置术的护理。方法2001年7月~2004年6月给予13例ICD患者进行了护理及随访。结果术后有2例患者出现心律失常“风暴”,经处理后未再出现心室颤动。随访患者1~4年,均存活,未发生晕厥等并发症。结论术前重视患者的心理护理,术后密切观察病情,积极预防心律失常“风暴”,并做好ICD健康教育,是ICD手术成功的重要护理措施。     

County level socioeconomic position, work organization and depression disorder: a repeated measures cross-classified multilevel analysis of low-income nursing home workers

This study simultaneously tests the effect of county, organizational, workplace, and individual level variables on depressive disorders among low-income nursing assistants employed in US nursing homes. A total of 482 observations are used from two waves of survey data collection, with an average two-year interval between initial and follow-up surveys. The overall response rate was 62 percent. The hierarchically structured data was analyzed using multilevel modeling to account for cross-classifications across levels of data. Nursing assistants working in nursing homes covered by a single union in three states were asked about aspects of their working conditions, job stress, physical and mental health status, individual and family health-care needs, household economics and household strain. PARTICIPANTS: The 241 nursing assistants who participated in this study were employed in 34 nursing homes and lived in 49 counties of West Virginia, Ohio and Kentucky. MAIN RESULTS: The study finds that emotional strain, related to providing direct care to elderly and disabled clients, is associated with depressive disorder, as is nursing home ownership type (for-profit versus not-for-profit). However, when controlling for county level socioeconomic variables (Gini index and proportion of African Americans living in the county), neither workplace nor organizational level variables were found to be statistically significant associated with depressive disorder. CONCLUSIONS: This study supports previous findings that emotional demand in health-care environments is an important correlate of mental health. It also adds empirical evidence to support a link between financial strain and depression in US women. While this study does not find that lack of a seniority wage benefits--a factor that can conceivably exacerbate financial strain over time--is associated with depressive disorder among low-income health-care workers, it does find county level measures of poverty to be statistically significant predictors of depressive disorder. Longitudinal county level measures of low-income as predictors of depression may even offer a methodological advantage in that they are presumably more stable indicators of cumulative exposure of low income than are more transient workplace indicators. Incorporating measures of cumulative exposure to low income into empirical studies would be particularly timely given the global changes that are currently restructuring the labor force and influencing work organization and labor processes--most notably the growth in low income jobs and the deskilling of labor. Though this study provides evidence that workplace and organizational level variables are associated with depressive disorder among low-wage nursing assistants in US nursing homes, the fact that these relationships do not hold once county level measures of poverty are controlled for, suggests that more distal upstream determinants of workplace mental health problems, such economic inequality, may be at play in determining the mental health of low wage workers.