首次探视对精神病人的心理影响

住院病人,家属往往要探视,给病人以安慰、照顾,然精神科病房不同,家属首次探视时间不当,会给精神病患者的治疗带来不利的影响。为此,我们对一个病区2000年3-9月份148例无陪护住院患者首次接受探视后的反应情况作了观察与归类：     

家属探视情况及对住院患者探视需求的影响

目的：探讨家属探视情况及对住院患者探视需求的影响。方法选取2014年3~11月在本院住院的35例患者作为调查对象,对患者采用一对一访谈法收集其资料,采用患者探视需求问卷、家属探视情况调查表对患者及家属进行调查分析。结果74.3%的患者有探视需求,探视能给88.6%的患者带来情感满足、生活丰富的感受,没有探视给65.7%的患者带来孤独寂寞、生活枯燥的感受。家属的探视频率无法达到或满足住院患者的探视需求,差异有统计学意义(Z=3.125,P<0.05)。家属和住院患者对每次探视时间的意见基本保持一致,差异无统计学意义(Z=0.408,P>0.05)。结论家属探视能满足住院患者被关爱的心理需求,给患者带来安全感;目前家属探视频率并不能完全满足住院患者的探视需求,医护人员需加强对患者家属进行心理指导,转变家属对探视的观念,有利于住院患者配合治疗和早日康复。     

社区重性精神疾病的管理及治疗现状

通过社区摸底调查,建立重性精神病患者健康档案,对重性精神病患者进行追踪随访,对贫困重性精神病患者免费发药等规范管理,观察社区精神病患者康复效果,调查、普及精神病相关知识,提高患者对治疗的依从性,减少病情复发,减少肇事肇祸,促进患者的社会功能康复,从而降低精神病造成的家庭和社会的负担,促进社会和谐。对确诊的所有登记的社区重性精神病患者进行规范化管理及用药、康复指导。加强社区重性精神病规范管理及时合理用药康复指导可有效控制精神病复发     

归因理论在精神病患者康复进程中的应用

根据对临床护理实践依据、探讨有效对策,尝试将归因理论用于精神病患者康复中。其意在识别精神病患者在康复进程中的归因偏差、并掌握其归因倾向。从而进一步运用正确的归因方式为其实施归因治疗,并结合心理护理帮助精神病患者,促使其积极配合治疗。促进精神病患者康复的依从性,实现归因理论在精神病患者康复中的应用。     

浅谈老年精神病患者的护理管理

目的探讨老年精神病患者的管理及护理特点,更好地指导临床护理工作。方法对某院收治的78例老年精神病患者从生活护理、安全护理、心理护理等几个方面,总结经验,阐述护理的方法及重要性。结果78例住院老年精神病患者在住院期间未发生任何意外,在治疗上取得了较好的效果。结论老年精神病患者强化护理管理,对治疗能起到事半功倍的作用。     

对精神病患者健康教育的方法和体会

１ 制定标准健康教育计划１．１ 入院初期：精神病患者入院时，患者处于急性期，多无自知力，自控能力丧失，此时健康教育内容包括：环境、人员（医生、护士）、作息、探视、安全制度和各种检直的目的及注意事项。劝慰患者适应环境，帮助督促患者进行各项检查，指导患者接受治疗和护理。注意不要激惹患者，尽量满足患者告理要求，争取建立良好的护患关系，为下一步的健康教育打好基础。１．２ 疾病治疗期；此期主要针对用药进行指导，解除或濒轻患者治疗过程中的不适反应，使患者主动配合治疗。护理教育指导的内容包括。药物名称、治疗作用…     

精神病合并糖尿病的临床护理策略

目的 探讨精神病合并糖尿病的护理对策。方法 对精神病合并糖尿病患者实施心理护理、服药护理、用药后护理、饮食护理和运动指导。结果 本组精神病合并糖尿病患者62例经过心理护理、服药护理、用药后护理、饮食护理和运动指导,有效56例,无效6例,总有效率90.32%。结论 加强对精神病合并糖尿病的护理,可以减轻患者及家属的痛苦,提高药物的治疗效果,促进患者身体功能的恢复,使患者早日回归到正常生活中,对提高患者的生存质量具有重要意义。     

脑出血住院患者对探视后负性情绪的影响研究

目的为研究住院脑出血患者亲属探视时间,探视人员与患者的关系及所致负性情绪的相关性,探讨有效地护理措施。方法采用随机观察120例患者被探视后的反应。结果29.2%的患者被探视后产生的负面情绪。结论对住院脑出血患者的探视,有利于促进患者的康复.     

延续护理出院康复指导对精神病人生活质量影响

目的:分析延续护理康复指导作用于精神病患者中的有效性。方法:将在某院进行治疗的73例精神病患者展开研究,采用双盲法将患者分为观察组(n=37)实施延续护理出院指导,对照组(n=36)实施常规出院指导。结果:两组患者在康复状态量表评分、生活质量评分以及药物服用依从性对比,观察组均占有显著的优势(P0.05)。结论:对精神病患者实施院外延续护理能够提升患者的服药依从性,进而提升其生活质量,方法值得借鉴。     

对住院精神患者探视的护理干预

目的探讨精神患者住院期间的探视干预方法,探视时机,探视作用和探视需要。方法选择60例住院精神患者,随机分为观察组和对照组各30例进行分析。结果急性期患者不宜探视,缓解期应争取家属适当探视有利于疾病康复。结论掌握适当的探视时机,是促进精神患者疾病康复的重要环节。     

A pilot study into the attribute of patients who use pharmacist's home-visiting and factors related to adherence among patients taking medication for dementia

A survey was conducted among pharmacists providing "home-visit guidance on drug management" to patients taking medication for dementia. Factors related to medication adherence among patients and pharmacists' acquisition of patient information were then verified. The survey items were: (1) patient attributes (degree of care received, bed-ridden, family composition, and living environment); (2) the person controlling medications; (3) drug storage method and location; (4) dispensing method; (5) patient management of visiting nurses; (6) patient management of visiting physician; (7) details of pharmacist's home-visit guidance; (8) medication adherence; (9) five items related to cognitive function (short-term memory, autonomous judgment, fluctuations in level of consciousness, excitation and loss of orientation, understanding); and (10) ten items related of ADL (mobility in bed, transferring, mobility within the home or outdoors, dressing upper/lower body, eating, toilet use, individual hygiene, bathing). The t test was used to verify the number of items of patient information concerning cognitive function and physical function that pharmacists could acquire at a visit. It was suggested that pharmacists were able to acquire more patient information (①cognitive function and ②ADL) when they visited patients cared for at home, compared to facility residents (①p=0.008, ② p=0.006). Thus, it was suggested that there is a latent risk concerning the pharmacist's ability to discover problems with administration of medications among facility residents. These findings demonstrate that it is essential for pharmacists to be more proactive about providing home-visit guidance.     

Referrals made by different health care professionals to community pharmacists for domiciliary visits

Objective — To examine the suitability of referrals made by health professionals to a pharmacist for a domiciliary visiting service. Method — General practitioners (GPs), district nurses and social services carers were contacted to request that they refer patients who they thought might benefit from a home visit by a pharmacist, using a referral form agreed by an expert panel. Information gathered by the visiting pharmacist during the patient interview was compared with the reason for referral by the health care worker. Setting — All GPs, district nurses and social services carers who cared for housebound patients in the Kenton and Stanmore areas of the London Borough of Harrow. Key findings — Ninety patients were visited. Of these, 47 had been referred by GPs, 29 by nurses and 14 by social services. The highest level of incorrectly stated referrals (22 per cent of their referrals) came from nurses. Nurses tended to refer patients for an explanation of the purpose of their medicines, and GPs because patients were taking more than three medications. Six patients, five of whom were referred by GPs, appeared not to have any problems that could be helped by a visit. Conclusion — There may be a need to raise awareness among social services carers about potential medication problems and the role that could be played by community pharmacists in helping these patients. When GPs make referrals, the criterion of patients taking more than three medications may not be sufficiently sensitive; this should be expanded to ensure that the GP has additional clinically related suspicions that there are adherence issues. Generally, little difference was found between the appropriateness of referrals from the three agencies.     

西药不合理用药的探讨

目的：探讨在医院门诊就医的患者中存在的不合理用药原因。方法：采用回访的调查方法对患者临床用药情况进行资料收集;分析方法采用回顾性分析法（时段为2012年至今;研究对象为在我院门诊就医并取药的1000例患者）。结果：接受回访调查的1000例患者当中,有占总数5％的患者不合理用药。结论：为保证患者用药安全,医院门诊药房的药师应对患者用药给予正确指导。     

Attitudes of pharmacy students toward mental illness

Undergraduate pharmacy students' attitudes toward mental illness were measured by a questionnaire that also included questions about students' demographic variables and previous exposure to mental illness. Baccalaureate pharmacy students entering their first week of clinical rotations were asked to voluntarily complete a questionnaire that included Whatley's social distance scale and Morrison's Client Attitude Questionnaire version B (CAQ-B). Information was also sought about demographics, socio-economic factors, and prior exposure to mental illness. Possible total scores for Whatley's social distance scale range from 8 to 24, with lower scores implying more favorable attitudes toward mentally ill patients. Possible total scores for the CAQ-B range from 20 to 60, with scores lower than 40 indicative of a medical-model orientation and scores higher than 46 indicative of a psychosocial-model orientation. A total of 250 students completed the questionnaire. The first 85 students received Morrison's CAQ-B; the other 165 students completed both scales. The mean +/- S.D. score of 13.6 +/- 3.5 on the social distance scale indicates that the pharmacy students generally had favorable attitudes towards patients with mental illness. The mean +/- S.D. score of 32.8 +/- 3.6 on the CAQ-B indicates that the pharmacy students accepted a medical-model orientation. Students reporting a family history of psychiatric diagnoses and hospitalizations, a personal psychiatric diagnosis, or a history of visiting a psychiatric hospital had more favorable attitudes toward mentally ill patients. Female students and students who had a family history of psychiatric hospitalizations and diagnoses were significantly more oriented toward the medical model than students without this history.(ABSTRACT TRUNCATED AT 250 WORDS)     

韶钢社区慢性肾功能不全患者社区干预作用的研究

目的对慢性肾功能不全(氮质血症期)患者进行社区干预以改善患者生活质量,有利于患者的健康。方法 2009年1月～2011年10月,通过对韶钢社区居民慢性肾功能不全(氮质血症期)患者进行社区干预,对干预组59例及对照组39例观察,干预组首先让患者对自己的病情、治疗有正确的认识,通过采取健康教育、饮食控制、药物治疗指导方式进行干预,监测患者血肌酐的变化,调整用药。结果①通过社区干预监测干预组患者血肌酐平均值分布整体趋势下降明显,对照组患者血肌酐平均值下降不明显;②治疗后两组患者的头晕、头痛、乏力、腰部酸痛、失眠等症状不良主诉较治疗前明显减少;干预组与对照组在心理健康、日常精神活动功能、总体健康、活力方面有明显差异,在躯体功能、日常活动功能、身体疼痛、社会活动能力方面相比较,无显著性差异。结论社区干预能够使慢性肾功能患者的肾功能进展减慢,生活质量提高,能够延长患者到达尿毒症期的时间、延长生存时间、减轻患者的经济负担,有利于患者的健康。     

家庭访视对恶性脑瘤化疗患者的意义分析

目的 探讨家庭访视对恶性脑瘤化疗患者的意义.方法 选取2008年6月至2013年6月102例进行化疗的恶性脑瘤患者为研究对象,将其随机分为对照组和干预组每组各51例,对照组进行常规的化疗及护理后出院,干预组除常规化疗外,还对患者进行家庭访视,将两组患者的并发症发生率及护理前后的焦虑抑郁自评量表、世界卫生组织生存质量测定量表评分进行比较.结果 干预组并发症发生率低于对照组,家庭访视后的焦虑抑郁白评量表、世界卫生组织生存质量测定量表评分均优于对照组（P＜0.05）.结论 家庭访视对恶性脑瘤化疗患者有重要意义,使化疗病人掌握化疗相关知识的同时,消除病人思想顾虑,减轻病人痛苦,提高生存质量.     

卵巢早衰的综合治疗

目的评价药物结合心理疏导综合治疗对卵巢早衰的治疗效果。方法采取临床病例对照的方法,对所选取得确诊为卵巢早衰的患者分别进行单纯药物及药物结合心理疏导治疗,经过治疗周期停药后半年复诊,检测临床不适症状缓解患者的血清激素水平,评价两种治疗方案的效果。结果临床认为治疗效果为治愈和有效的患者,血清血检测认为药物结合心理疏导治疗的疗效明显好于单纯药物治疗者（P〈0.05）。结论对卵巢早衰患者进行药物结合心理的综合治疗策略效果明显。     

The changing relationship between health care professionals and the pharmaceutical industry

Although UCLA had established policies and procedures for visiting pharmaceutical representatives, changes in both the pharmaceutical business environment and in UCLA's physical environment mandated an update. To deal with the changes, a multidisciplinary team comprised of various departmental staff members met to develop a new vendor representative visitation policy that included the practice of drug sample distribution. More stringent registration requirements and shared responsibility for policy enforcement are the key elements of the new policy.     

护理干预对精神药物致糖脂代谢异常影响分析

目的：建立适用于服用精神科药物导致糖脂代谢异常全程指导体系,评估护理干预效果。方法将124例精神障碍服用精神药物患者分为研究组（n=62）和对照组（n=62）,两组分别接受系统护理干预和一般常规护理,采用自行设计的调查量表分别进行问卷调查,并记录对比。结果研究组对精神药物引起糖脂代谢异常的认识,患者饮食、运动、改变生活方式配合,康复期社会功能恢复,家庭康复等管理能力方面与对照组对比,差异有统计学意义（P＜0.01）。患者自我管理能力明显高于对照组（P＜0.01）。结论护理干预符合精神障碍患者及照料者获得专科知识的需要,对精神障碍患者康复指导效果明显。