强迫性神经症患者治疗的护理行为干预

随着社会的发展、工作过分紧张、社会心理压力增加 ,强迫症患者有增多的趋势 ,在普通人群中有 2 0 %～ 6 0 %报告曾有过强迫症状 ,在精神科门诊有 70 %～ 94 %报告有强迫症状。成年男女患病率相近 ,终身患病率 6 7%。单纯药物治疗效果不甚满意。我科对收治的强迫症患者采用综合治疗 ,护士积极参与并提供护理行为干预 ,取得了较好的效果 ,现报告如下 :1　对象和方法1 1　对象　 2 0 0 0年 4月～ 2 0 0 1年 4月在我科住院的强迫症病人 10例 ,诊断均符合ＣＣＭＤ - 3诊断标准 ,其中男性 4例 ,女性 6例。年龄最大 5 8岁 ,最小 14岁。文化程度 :…     

强迫性神经症病人的心理护理

强迫性神经症是以反复的持久出现的强迫观念或强迫动作为主要症状的一种神经官能症。1982年我国十二地区精神疾病流行病学调查本病的时点患病率为0.3‰。病人对所患疾病存在自知力。并能意识到强迫症状是异常的不合理的。逐极力抵抗和排斥但又无法摆脱。因而感到焦虑和痛苦。轻者多在门诊治疗。病程迂延,社会功能严重受损,以至影响工作、学习及生活者需住院治疗。本文就9例符合CCMD-2诊断标准的     

运用认知领悟疗法治疗大学生失眠症的个案报告

目的：通过大学生失眠症的认知领悟疗法的个案研究，探讨认知领悟疗法对治疗失眠症的疗效。方法：运用认知领悟疗法，辅以支持疗法和放松训练，对1例罹患失眠症的女大学生进行心理治疗。结果：近2个月的疗程，患者失眠症状明显减轻；治疗结束后1个月电话随访，患者失眠症状已显著消除且疗效稳定。结论：认知领悟疗法治疗失眠症可取得良好的疗效。     

立体定向毁损术治疗强迫性神经症患者的护理

报道了22例行立体定向毁损术治疗强迫性神经症患者的护理。认为充分的术前准备和心理疏导,能解除患者对手术的顾虑,消除其紧张及不安情绪,保证患者积极配合手术治疗。术后密切观察体温、脉搏、呼吸、血压、意识状态、瞳孔变化;防止颅内高压的发生,给予平卧位抬高床头15°￣30°;加强术后并发症的护理,使临床症状得到明显好转;同时认真做好出院指导。22例患者顺利恢复,治疗效果满意,无严重并发症和护理并发症,确保了手术成功率,改善了患者的生活能力,提高了患者的生活质量。     

运用认知领悟疗法治疗大学生失眠症的个案报告

目的:通过大学生失眠症的认知领悟疗法的个案研究,探讨认知领悟疗法对治疗失眠症的疗效。方法:运用认知领悟疗法,辅以支持疗法和放松训练,对1例罹患失眠症的女大学生进行心理治疗。结果:近2个月的疗程,患者失眠症状明显减轻;治疗结束后1个月电话随访,患者失眠症状已显著消除且疗效稳定。结论:认知领悟疗法治疗失眠症可取得良好的疗效。     

认知领悟疗法对强迫症患者治疗依从性的影响

目的 探讨认知领悟疗法对强迫症患者治疗依从性的影响.方法 将87例强迫症患者随机分为研究组(42例)和对照组(45例),在维持常规治疗的基础上,研究组实施认知领悟疗法为主的心理治疗,为期1年;对照组仅进行常规治疗,不作其他特殊干预,为期1年.干预6 w、半年、1年后采用耶鲁布朗强迫症状量表(Y-BOCS)、汉密顿焦虑量表(HAMA)、社会功能评定量表(SDSS)、治疗依从性对病人进行疗效评估,了解其治疗效果.结果 1年后研究组较对照组疗效好、服药依从性高、复发率低,差异有统计学意义(P<0.05,P<0.01).结论 认知领悟疗法能减轻病人的症状,改善社会功能,提高生活质量.     

一例强迫性神经症病人的整体护理体会

强迫症是一种以强迫症状为主的神经症，以反复出现强迫观念和强迫动作为基础特点的一类神经症性障碍。强迫观念是以刻板形式反复进入病人头脑中的观念、表现或冲动：强迫动作是反复出现的刻板行为或仪式动作，这些观念和行为并非自愿且令人反感，没有现实意义或无效的。其特点是有意识的自我强迫和反强迫并存，二者强迫冲突使病人感到焦     

认知领悟疗法对强迫症患者治疗依从性的影响

目的 探讨认知领悟疗法对强迫症患者治疗依从性的影响.方法 将87例强迫症患者随机分为研究组(42例)和对照组(45例),在维持常规治疗的基础上,研究组实施认知领悟疗法为主的心理治疗,为期1年;对照组仅进行常规治疗,不作其他特殊干预,为期1年.干预6 w、半年、1年后采用耶鲁布朗强迫症状量表(Y-BOCS)、汉密顿焦虑量表(HAMA)、社会功能评定量表(SDSS)、治疗依从性对病人进行疗效评估,了解其治疗效果.结果 1年后研究组较对照组疗效好、服药依从性高、复发率低,差异有统计学意义(P<0.05,P<0.01).结论 认知领悟疗法能减轻病人的症状,改善社会功能,提高生活质量.     

抗抑郁剂联合认知领悟疗法治疗强迫症对照研究

目的 探讨抗抑郁剂联合认知领悟疗法治疗强迫症的临床疗效. 方法 将60例强迫症患者随机分为两组,每组30例,两组均口服抗抑郁剂治疗,研究组联合认知领悟疗法治疗,观察6个月.于治疗前及治疗1个月、2个月、4个月、6个月末采用Yale-Brown强迫量表评定临床疗效. 结果 治疗后两组Yale-Brown强迫量表总分及强迫思维因子分均较治疗前有显著下降（P＜0.01）;研究组治疗各时段Yale-Brown强迫量表总分及强迫思维因子分均显著低于对照组（P＜0.05或0.01）.治疗6个月末研究组有效率为73.33%,对照组为43.33%,研究组疗效显著高于对照组（χ2=5.554,P＜0.05）. 结论 抗抑郁剂联合认知领悟疗法治疗强迫症疗效更显著,起效更快,显著优于单纯药物治疗.     

认知领悟疗法在癔症治疗中的作用

癔症的起病与患者的生理、心理素质有关,症状带有明显的情感色彩,具有一定的暗示性。而家属缺乏对疾病的了解,常由于无意的言行产生不良暗示,使病情加重。本次研究对35例癔症患者实施认知领悟疗法。现报道如下。     

园艺疗法对慢性精神分裂症病人的康复效果

为证实园艺疗法对慢性精神分裂症病人的康复效果,对19例慢性精神分裂症病人在药物治疗的同时,给予园艺疗法,并与单纯药物治疗病人进行对比观察,治疗前后应用BPRS,NORS,IPROS量表综合评价病人的康复情况,资料应用SAS统计软件进行分析。结果显示：实验组在生活自理能力和社会适应能力等方面优于对照组（P＜0．001）。提示：园艺疗法对慢性精神分裂症病人的康复是有效的。     

健康指导在治疗老年失眠中的应用研究

目的 :探讨健康指导在治疗老年失眠中的作用 ,从而改善老年人对睡眠的错误认识和态度 ,养成良好的睡眠习惯 ,使失眠症状得到改善。方法 :从住院的 2 0 2例失眠老年病人中随机抽取实验组和对照组病人各 5 0例 ,对其分别施以健康指导和常规治疗 ,进行疗效观察。结果 :实验组其显效率在 80 %以上 ,而对照组的显效率仅为 8%。结论 :健康指导可以提高老年人的睡眠质量 ,使失眠症状得到改善     

糖尿病患者对运动疗法认识及其内心希望的质性研究

目的了解糖尿病患者对运动疗法的认识及其内心希望体验的历程,为开展针对性的护理提供参考。方法 2012年9-12月,应用质性研究中的现象学研究方法,采用半结构式访谈提纲,对解放军第107医院内分泌科收治的10例糖尿病患者进行访谈。结果共提炼出4个主题:"对运动疗法缺乏正确认识","希望对运动疗法有更多了解","对疾病治疗及生活存有希望","坚持及依靠自身力量进行治疗"。结论糖尿病患者对运动疗法认识不足是不能有效实施该疗法的重要因素,但其有强烈的求知意识和个体化、多样化的希望,因而需要加强对糖尿病患者的健康宣教。     

Ability of Early Response to Predict Discharge Outcomes With Physical Therapy for Chronic Low Back Pain

Objective: To determine how well early responses to physical therapy for chronic low back pain predict outcomes at discharge. Methods: A prospective single cohort study of chronic low back pain patients seen at a university spine physical therapy clinic. Self‐reported pain severity on a 100‐mm visual analog scale was measured before each physical therapy visit. The predictive variables were the change in pain score at the second, third, and fourth visits. The first outcome variable was discharge change in pain severity for a correlation analysis. The second outcome variable was a dichotomous variable of whether the subjects had achieved at least a 30% reduction in pain severity at discharge for a discriminant analysis. Results: Spearman’s rank order correlation coefficient showed that early responses at the second (r = 0.324, P = 0.02) third (r = 0.342, P = 0.01), and fourth visits (r = 0.615, P < 0.001) were all significantly correlated with discharge change in pain. The discriminant analysis showed that early responses from the second to fourth visits were able to correctly predict 80.4% of the discharge outcomes (P < 0.001). Conclusions: Early responses with physical therapy help predict discharge outcomes for chronic low back pain.     

农村中老年高血压患者治疗依从性的调查分析

目的了解农村中老年高血压患者治疗依从性的现状,并进行比较分析。方法采用自行设计的调查问卷,调查上海南汇区大团镇车站村中老年高血压患者的一般资料、生活依从性、服药依从性及影响治疗依从性的因素。结果车站村中老年高血压患者的治疗依从性有待提高。影响农村中老年患者治疗依从性的主要因素分别是：对疾病的认识不足、工作忙碌、记忆力下降、行动不便、缺少他人监督、记不清服药规则、缺少同伴支持等。结论针对中年患者应加强相关的知识宣传,使其树立正确的健康信念和加深对疾病的认识,提高治疗依从性;针对老年患者则应采取措施减少其因记忆功能下降、行动不便而导致的治疗依从性下降。     

Effects of a Patient-Centered Graded Exposure Intervention Added to Manual Therapy for Women With Chronic Pelvic Pain: A Randomized Controlled Trial

Objective

To explore the effects of a 6-week patient-centered graded exposure intervention added to manual therapy in women with chronic pelvic pain (CPP) and fear of movement/(re)injury.

中药液冲洗防治鼻咽癌患者放射治疗副作用的疗效观察

目的观察中药液冲洗对鼻咽癌患者进行鼻咽部放疗后所产生毒副作用的疗效。方法将300例鼻咽癌患者随机分为试验组(中药液冲洗)150例,对照组(0.9%氧化钠溶液冲洗)150例。观察两组患者放疗过程中放射性反应及放射性毒副反应情况。结果试验组在放疗期间鼻咽粘膜反应轻、分泌物减少、呼吸情况良好、细菌感染率低。与对照组比较有显著性差异(P<0.05)。结论中药液冲洗是预防鼻咽癌患者放射反应及放射性毒副反应的有效手段。     

Evaluation of Cognitive Behavioral Interventions and Psychoeducation Implemented by Rehabilitation Specialists to Treat Fear-Avoidance Beliefs in Patients With Low Back Pain: A Systematic Review

Objectives

To systematically locate, critically appraise, and synthesize the available evidence regarding the effectiveness of cognitive behavioral therapies (CBTs) and psychoeducation that can be implemented by rehabilitation specialists to treat fear-avoidance beliefs in patients with acute, subacute, and chronic low back pain (LBP).

Assessment of the Effects of Aquatic Therapy on Global Symptomatology in Patients With Fibromyalgia Syndrome: A Randomized Controlled Trial

Munguía-Izquierdo D, Legaz-Arrese A. Assessment of the effects of aquatic therapy on global symptomatology in patients with fibromyalgia syndrome: a randomized controlled trial.

Objectives

To evaluate the effects of a 16-week exercise therapy in a chest-high pool of warm water through applicable tests in the clinical practice on the global symptomatology of women with fibromyalgia (FM) and to determine exercise adherence levels.

Design

A randomized controlled trial.

Setting

Testing and training were completed at the university.

Participants

Middle-aged women with FM (n=60) and healthy women (n=25).

Intervention

A 16-week aquatic training program, including strength training, aerobic training, and relaxation exercises.

Main Outcome Measures

Tender point count (syringe calibrated), health status (Fibromyalgia Impact Questionnaire); sleep quality (Pittsburgh Sleep Quality Index); physical (endurance strength to low loads tests), psychologic (State Anxiety Inventory), and cognitive function (Paced Auditory Serial Addition Task); and adherence 12 months after the completion of the study.

Results

For all the measurements, the patients showed significant deficiencies compared with the healthy subjects. Efficacy analysis (n=29) and intent-to-treat analysis (n=34) of the exercise therapy was effective in decreasing the tender point count and improving sleep quality, cognitive function, and physical function. Anxiety remained unchanged during the follow-up. The exercise group had a significant improvement of health status, not associated exclusively with the exercise intervention. There were no changes in the control group. Twenty-three patients in the exercise group were exercising regularly 12 months after completing the program.

Conclusions

An exercise therapy 3 times a week for 16 weeks in a warm pool could improve most of the symptoms of FM and cause a high adherence to exercise in unfit women with heightened FM symptomatology. The therapeutic intervention's effects can be assessed through applicable tests in the clinical practice.     

The Effects of Music Therapy on Patients With Coronary Artery Disease Before the Invasive Procedure: A Randomized Controlled Study

PurposeThis study was designed to investigate the effects of music therapy provided to patients who would undergo Coronary Angiography before the invasive procedure on pain, anxiety, and vital signs to reduce the administration of sedatives and to ask the views of the patients regarding the music to which they listened.DesignThis study was a randomized controlled study.MethodsThe research sample included 62 patients; 31 in the experimental group and 31 in the control group, who were waiting for having femoral angiography in the waiting room of the invasive procedure and diagnostic laboratory of a training and research hospital in Izmir. Data were collected using “Patient Information Form”, “Vital Signs Inspection Form”, “State-Trait Anxiety Inventory”, and “Visual Analog Scale”. The experimental group listened to nonverbal and instrumental music in the forms of taqsim, saz semai, and peshrev at the speeds of 60 (Adagio) and 100 (Andante). Nihavend mode is the most used mode in music therapy and is suitable for the Turkish Cultural structure. The scale of nihavend mode has the same structure with the g minor scale of classical western music. For both groups, pain and anxiety levels were simultaneously measured before and after the process; vital signs were measured before, during, and after the process.FindingsThe findings obtained in this study showed that there was a statistically significant difference between the means of anxiety (P = .000) and pain (P = .001) of the patients in experimental and control groups after the procedure. A significant difference was determined between the means before and after the procedure for diastolic (P = .002) blood pressure and pulse wave velocity (P = .002) in vital signs. A significant difference was not determined between the mean of patients’ systolic blood pressures (P = .082) and respiration rates (P = .836) before and after the procedure.ConclusionsThe findings suggest that music therapy is effective in reducing blood pressure, respiration rate, anxiety, pain level, and sedative application for the patients. Music therapy within the scope of the nonpharmacological complementary therapies can be administered by the healthcare providers, given that the patients have no adverse effects or additional costs and thanks to ease of implementation.