口服药物自杀未遂者心理状况分析及心理干预

目的:探讨口服药物自杀未遂者的心理状态,为心理评估和心理干预提供依据。方法:采用明尼苏达多相人格调查表、Zang’s抑郁自评量表、焦虑自评量表和症状自评量表评定42例口服药物自杀存活患者心理状态,在常规治疗、健康教育与心理干预3个月后,应用Zang’s抑郁自评量表、焦虑自评量表和症状自评量表再次进行评测,并与国内常模比较。结果:口服药物自杀存活患者Zang’s抑郁自评量表、焦虑自评量表总分和症状自评量表中躯体化、人际关系、抑郁、焦虑、恐惧等因子分值高于国内常模(P<0.05或P<0.01),经过健康教育与综合性心理干预后口服药物自杀存活患者的Zang’s抑郁自评量表、焦虑自评量表总分和症状自评量表中躯体化、人际关系、抑郁、焦虑、恐惧等因子分值显著降低(P<0.05或P<0.01)。结论:口服药物自杀未遂患者存在抑郁、焦虑、躯体化症状等负性情感;健康教育与综合性心理干预能缓解和改善抑郁、焦虑等负性情感。     

产瘫患儿母亲精神焦虑抑郁状况的调查

目的 调查产瘫患儿母亲的焦虑、抑郁水平,为进行护理干预促进患儿母亲身心健康发展提供依据.方法 应用焦虑自评量表(SAS)和抑郁自评量表(SDS),对50例门诊就诊或住院治疗的产瘫患儿母亲进行问卷调查.结果 产瘫患儿母亲的焦虑、抑郁程度,明显高于国内常规模式(48.15±8.24 vs 29.78±0.46,t=15.77,P＜0.01;54.43±9.51 vs 41.88±10.57,t=9.33,P＜0.01).结论 产瘫患儿母亲存在较严重的焦虑和抑郁情绪,在为产瘫患儿进行治疗和护理的同时,还应重视对患儿母亲的心理干预,提供心理健康方面的帮助,从而促进患儿的康复与健康成长.     

极低出生体质量早产儿母亲心理状态与亲职压力的相关性分析

目的探讨极低出生体质量早产儿母亲心理状态、亲职压力状况,并分析二者的相关性。方法采用一般资料调查表、症状自评量表、短式亲职压力量表、0~6岁儿童神经心理发育量表对89例极低及超低出生体质量早产儿母亲进行问卷调查。结果症状自评量表总均分为(1.65±0.21)分,短式亲职压力量表总分为(92.11±8.46)分;症状自评量表总均分与短式亲职压力量表总分呈正相关(P0.01);多元逐步线性回归分析显示出生后窒息、两个月总发育智商和神经运动检查结果可预测症状自评量表总分56.8%的变异量,母亲文化程度、神经运动检查结果和两个月总发育月龄可预测焦虑因子60.4%的变异量;短式亲职压力量表总分、出生后窒息和神经运动检查结果可预测抑郁因子44.8%的变异量。结论关注亲子互动问题,减少早产儿母亲亲职压力,从而改善早产儿母亲的焦虑、抑郁等心理状态。     

心理行为干预对哮喘患儿家长心理障碍的影响

2000年1月~2005年5月,我院对106例哮喘患儿家长的心理状况进行调查,并就心理行为干预对其心理障碍的影响进行了对比研究。现报告如下。1资料与方法1.1临床资料本组男68例,女38例,2~12岁,平均4.5±1.5岁。诊断均符合中华医学会制定的哮喘诊断标准[1],患儿家长文化程度均为初中以上,能自行回答量表问题。1.2方法1.2.1研究方法入院后采用抑郁自评量表(SDS)和焦虑自评量表(SAS)对患儿家长进行心理测试,然后采取护理干预,于第2周再次测评,并对资料进行统计学处理。1.2.2心理行为干预措施①抑郁:抑郁反应的特征性症状有:悲观心理、睡眠障碍、食…     

癫痫患儿家长焦虑、抑郁现状调查及其影响因素分析

目的:了解癫痫患儿家长的焦虑、抑郁现状并分析其影响因素。方法:采用一般情况问卷、焦虑自评量表(SAS)、抑郁自评量表(SDS)对2011年5-10月在某儿童医院神经内科就诊或住院的癫痫患儿父亲或母亲共104名进行问卷调查。结果:癫痫患儿家长SAS总得分为(49.41±6.99)分;SDS总得分为(59.68±8.47)分;家长学历和服药疗程知识是家长焦虑的影响因素,家长学历是家长抑郁的影响因素。结论:癫痫患儿家长存在焦虑和抑郁的心理问题,家长学历和服药疗程知识是其焦虑或抑郁的影响因素,可以通过加强对家长进行健康教育、改善患儿治疗效果来改善癫痫患儿家长的心理状况。     

精神发育迟滞患儿母亲焦虑、抑郁状况与社会支持的相关性

目的 探讨精神发育迟滞患儿母亲焦虑、抑郁状况及其与社会支持的关系及影响因素.方法 采用焦虑自评量表(SAS)、抑郁自评量表(SDS)和社会支持评定量表(SSRS),对64例精神发育迟滞患儿母亲的焦虑、抑郁及社会支持水平进行调查,并对结果进行分析.结果 精神发育迟滞患儿母亲焦虑发生率为23.4％,抑郁发生率为40.7％,焦虑、抑郁得分均显著高于国内常模水平.本组患儿母亲社会支持总分为(32.19±5.02)分,显著低于国内常模水平;本组患儿母亲的焦虑、抑郁状况与社会支持呈负相关;影响患儿母亲焦虑、抑郁的因素为家庭经济收入.结论 精神发育迟滞患儿母亲的焦虑、抑郁状况较突出,社会支持缺乏,有效的社会支持可以减轻其焦虑、抑郁状况,提高患儿及其母亲的生活质量.     

癌症患儿父母心理健康状况及需求的调查研究

[目的]探讨癌症患儿父母的心理健康状况及心理需求,为临床医疗护理工作提供参考依据.[方法]采用随机抽样方法对246例癌症患儿的父母进行心理健康状况评定及心理需求调查.[结果]症状自评量表(SCL-90)评分显示癌症患儿父母躯体化、强迫、人际关系敏感、抑郁、焦虑、恐怖、偏执因子分均显著高于全国常模(P<0.01);患儿母亲抑郁、恐怖因子分均显著高于患儿父亲(P<0.05);患儿父母心理需求包括希望患儿得到最佳的救治、希望能缓解和消除患儿不适症状、医生多查房、有固定医护人员为患儿治疗和护理.[结论]治疗癌症患儿的同时要注重患儿父母的心理健康状况以及心理需求,特别是母亲的心理支持,积极控制患儿疾病症状,给予父母早期心理干预,开展多形式的健康知识教育,使患儿父母了解癌症疾病相关知识,消除紧张、焦虑甚至抑郁等负性心理,营造积极乐观的氛围.     

帕金森病伴抑郁64例心理特点及护理对策

目的 探讨帕金森病(PD)伴抑郁患者的心理护理及家庭支持.方法 对64例患者采用抑郁自评量表(SDS)进行评定分析.结果 住院的64例PD患者都伴有抑郁症状.结论 加强PD伴抑郁患者的心理护理和家庭支持措施,很大程度改善了患者的生活质量和预后.     

心理干预对减轻冠心病患者焦虑、抑郁情绪的效果评价

目的 探讨心理干预对冠心病伴焦虑、抑郁患者的作用。方法 选取冠心病伴焦虑抑郁患者62例,随机分为观察组和对照组各31例。对照组只给予常规冠心病的治疗及护理,观察组在对照组的基础上给予有针对性的心理干预,于患者入院时及出院前一天用焦虑自评量表(SAS)和抑郁自评量表(SDS)综合评分,并进行对比分析。 结果 观察组焦虑自评量表和抑郁自评量表评分在干预后均低于对照组。结论 系统的、有针对性的实施心理干预能明显改善或控制冠心病患者的焦虑、抑郁心理,提高治疗效果。     

独生与非独生护生积极心理品质及其影响因素的比较

目的 分析独生与非独生护生积极心理品质及其影响因素的异同,为各高等护理院校采取切实有效的心理干预措施提供理论依据。方法 采用方便抽样,对长沙市5所护理院校745名护生应用自制一般资料问卷、中国大学生积极心理品质量表、焦虑自评量表(self-rating anxiety scale,SAS)、抑郁自评量表(self-rating depression scale,SDS)、自我效能感量表(general self-efficacy scale,GSES)进行调查。结果 独生护生的创造力、好奇心、热情、社交智慧、领导能力、幽默风趣等6项积极心理品质及认知、人际、超越等3大维度的得分均高于非独生护生(均P0.05);焦虑、抑郁、自我效能感得分与非独生护生差别无统计学意义(均P0.05)。多元线性回归结果显示:自我效能、对积极心理品质了解程度、与同学关系、老师的关注、母亲的文化水平及关心是独生与非独生护生积极心理品质的共同影响因素(均P0.05);学习成绩、家庭所在地、家庭人均月收入、父母的教育方式(尊重理解、表扬鼓励)对独生护生积极心理品质形成存在影响(均P0.05);体育参与度、抑郁、是否学生干部、父母的期待是非独生护生积极心理品质的影响因素(均P0.05)。结论 独生与非独生护生的积极心理品质及其影响因素存在差异,应依据其异同点采取个性化的心理干预措施,以促进护生身心健康发展。     

On investigation of markers that may influence alloantibody responses to HPA-1a

In > 99% of cases, HPA-1a antibody production during pregnancy is associated with maternal DRB3*0101 positivity. However, only 35% of HPA-1a neg/DRB3*0101 women produce antibodies (Ab). This study attempted to identify additional genetic marker(s) that may better predict anti-HPA-1a production in these women.
Seventy-eight DRB3*0101 pos HPA-1a neg, women (40 HPA-1a Ab pos, 38 Ab neg) with HPA-1a pos infants, were typed for HLA-DRB1*, -B3*, -B4*, -B5*. Results were compared with those from 83 DRB3*0101 pos normal donors. SNaPshot™ was used to test for a polymorphism of the TNF-α locus.
The frequency of DRB1*15 was significantly lower in Ab pos mothers (1/40) compared to controls (16/83; P  = 0·03), but not compared to Ab neg mothers (6/38; P  = 0·07). DRB1*12 was found only in Ab neg mothers (5/38) (controls 0/83; P  = 0·02). A study of TNF-α genotype ( n  = 30, Ab pos; Ab neg; controls) found no difference between the mothers' groups, or mothers and controls.
Presence of DRB1*15 or DRB1*12 may lower the likelihood of HPA-1a Ab production. Raised frequency of DRB4* was seen in mothers with affected neonates (13/22) (unaffected, Ab pos 3/11; P  = 0·02). DRB4* may increase the odds of HPA-1a alloimmunization. Three NAITP cases due to anti-HPA-1a have been reported (2 local, 1 published), involving mothers DRB3*0101 neg, but DRB4* pos. TNF-α genotype may not predict anti-HPA-1a production in these women. Studies with larger groups would establish the value of these markers in defining women at high risk of HPA-1a alloimmunization.     

妊娠期糖尿病治疗时机与母婴预后的关系

目的 探讨不同时机治疗妊娠期糖尿病对母婴预后的影响.方法 回顾性分析我院2006年1月至2009年1月住院分娩的86例妊娠期糖尿病患者的临床资料,其中48例在孕中期(34周前)确诊为妊娠期糖尿病并给予治疗(A组),38例未行孕期保健或孕中期血糖筛查,于孕34周后住院确诊妊娠期糖尿病(B组),比较2组的妊娠结局.结果 A组中妊娠期高血压疾病、羊水过多、产后感染、早产儿分别为10.42%(5/48)、12.50%(6/48)、8.33%(4/48)、6.25%(3/48),均低于B组[分别为36.84%(14/38)、42.11%(16/38)、26.32%(10/38)、34.21%(13/38),P均<0.05].结论 妊娠期糖尿病对母婴危害大,及早诊断和治疗,可减少母婴并发症.     

Perceptions of stress,worry, and support in Black and White mothers of hospitalized,medically fragile infants

The purpose of this article is to describe maternal perceptions about hospital-related stressors, worry about the infant's health, and support from the health care team in mothers of medically fragile infants. A second purpose was to explore possible differences between Black and White mothers on these same variables. Participants were 31 Black and 38 White mothers of infants who were hospitalized in a tertiary hospital for a serious life-threatening illness. Data were collected using five self-report questionnaires. All mothers reported high levels of stress associated with the appearance of their infants and moderately high stress associated with their altered parental role, moderately high levels of worry about their infants' health problems, and high support from nursing and the health care team. Black mothers were more stressed by the sights and sounds of the hospital environment; however, the levels of their stress were only moderate. On the other hand, mothers with less education expressed more worry about their infants than did mothers with more education. Findings have implications for helping mothers during the hospitalization of a critically ill infant.     

Psychosocial functioning of mothers with chronic pain: a comparison to pain-free controls

This study compared the functioning of mothers experiencing chronic pain and control mothers on a range of psychosocial variables. Participants included 39 mothers with chronic pain conditions ranging from migraine and arthritis to chronic neck and back pain and 35 control mothers with out chronic pain. Analyses indicated that mothers with chronic pain experienced more physical, psychological and social difficulties when compared to controls. More difficulties were reported in completing day-to-day parenting tasks in mothers with chronic pain. Consistent with the biopsychosocial model of chronic pain, psychosocial variables accounted for approximately half of the variance in chronic pain mothers' physical functioning scores. The importance of psychological variables in the experience of chronic pain, the potential reduction in parenting efficacy and the risk that these influences hold for children are discussed.     

Polycythaemia in infants of diabetic mothers: β-hydroxybutyrate stimulates erythropoietic activity

This study tested whether elevated maternal β-hydroxybutyrate (β-OHB) levels contribute to polycythaemia in infants of diabetic mothers. Pregnant diabetic women (n = 27) and non-diabetic controls (n = 20) and their singleton infants were included. Maternal glycosylated haemoglobin and β-OHB levels were studied at 34-36 weeks' gestation; levels were significantly higher in mothers with diabetes than in controls. Birth weights and cord blood levels of insulin and fetal haemoglobin were significantly higher in infants from diabetic mothers compared with control infants, as were haematocrit levels in venous blood samples taken from each infant at 4 h following delivery. Cord blood erythropoietin levels were similar in both groups. There was a positive strong correlation between maternal β-OHB levels and polycythaemia in newborn infants, indicating that β-OHB could activate erythropoiesis independently from intrauterine hyperinsulinaemia and/or erythropoietin levels, and may be important in the pathogenesis of polycythaemia in infants born to diabetic mothers.     

Behavioral responses of newborns of insulin-dependent and nondiabetic, healthy mothers

The purpose of this study was to compare the behavioral responses of term newborns of insulin-dependent diabetic mothers (NDMs) with newborns of nondiabetic, healthy mothers. The research design involved matched controls with repeated measures. Participants included 40 NDMs matched with 40 newborns of nondiabetic, healthy mothers. The main outcome measures were the seven dimensions of the Neonatal Behavioral Assessment Scale (NBAS) and the modal response score. The results showed that NDMs performed significantly poorer than their matched controls on motor processes and reflex functioning. For all newborns, motor processes, autonomic stability, reflex functioning, and the modal performance score were better on Day 2 than Day 1. It was concluded that although NDMs' behavioral responses improved by Day 2, their overall pattern of responses could be described as listless or sluggish. Due to their poorer motor and reflex responses, NDMs may require increased efforts to facilitate sensitive maternal responding during their first days of life.     

Belated diagnosis of congenital myotonic dystrophy in a boy with cerebral palsy

We report a boy affected by both congenital myotonic dystrophy (CDM) and cerebral palsy (CP). He was born preterm and suffered from recurrent respiratory distress and respiratory tract infections. He was diagnosed with spastic diplegic CP. During the follow-up, long faces that lacked expression with a drooping mouth, of him and his mother, led to a detailed diagnostic evaluation. His electrodiagnostic testing demonstrated myotonic discharges. Molecular genetic tests revealed that the boy had 1240 CTG repeats and that his mother had 220 repeats, which confirmed the diagnosis of maternally transmitted CDM. Considering the increased obstetric risk of myotonic dystrophy (DM1), children of mothers with DM1 are susceptible to develop disorders such as CP. Clinical suspicion of comorbid CDM should be raised in children with CP who show features suggestive of DM1.     

Adenylate cyclase and ATPase activities in red cell membranes of patients and genetic carriers of Duchenne muscular dystrophy.

Basal adenylate cyclase activity was increased in red cell ghosts from both patients with Duchenne muscular dystrophy and their mothers when the activities were compared to proper age-matched controls. The activity of ATPase measured in the presence of Na+, K+, and Mg2+ was not found to be different in erythrocyte ghosts from Duchenne dystrophic patients, age-matched controls, or the mothers of Duchenne patients, and ouabain inhibited ATPase in ghosts to the same extent in all membrane preparations.     

Maternal zinc and intrauterine growth retardation

The levels of zinc in plasma, erythrocytes, polymorphonuclear (PMN) and mononuclear (MN) white cells were measured after delivery in women giving birth to appropriate-for-gestational-age (AGA) babies (group I mothers), or small-for-gestational-age (SGA) babies (group II mothers) and in non-pregnant controls. Mean maternal plasma zinc and albumin levels 24-48 h after delivery were lower than in controls, but PMN and MN zinc levels were unchanged. PMN zinc levels were lower than those of MN cells. PMN and MN zinc levels were significantly lower in group II mothers than in group I, irrespective of smoking habits. There were no racial differences in peripheral white cell zinc levels. PMN, and to a lesser degree MN, zinc levels were lower in smoking than in non-smoking mothers. Erythrocyte zinc did not correlate with other zinc measurements nor with the size of the babies. Fetal erythrocyte zinc levels were one-third of maternal levels. A combination of smoking and/or low PMN zinc levels selects 85% of mothers having small-for-gestational-age babies.     

Differences between exclusive breastfeeders, formula-feeders, and controls: a study of stress, mood, and endocrine variables

The purpose of this study was to examine relationships among lactational status, naturalistic stress, mood, and levels of serum cortisol and prolactin and plasma adrenocorticotropic hormone (ACTH). Eighty-four exclusively breastfeeding, 99 exclusively formula-feeding, and 33 nonpostpartum healthy control women were studied. The postpartum mothers were studied cross-sectionally once between 4 and 6 weeks after the birth. Stress was measured using the Perceived Stress Scale, the Tennessee Postpartum Stress Scale, and the Inventory of Small Life Events. Mood was measured using the Profile of Mood States. Serum prolactin, plasma ACTH, and serum cortisol levels were measured by commercial ELISA (enzyme-linked immunosorbent assay) kits. Results indicate that breastfeeding mothers had more positive moods, reported more positive events, and perceived less stress than formula-feeders. Reports of stressful life events were generally equivalent in the two groups. Serum prolactin was inversely related to stress and mood in formula-feeders. When breast and formula-feeders were compared to controls, they had higher serum cortisol, lower stress, and lower anxiety. Breastfeeders had lower perceived stress than controls. Breastfeeders had lower depression and anger and more positive life events reported than formula-feeders. However, there were few correlations among stress, mood, and the hormones in postpartum mothers, and those only in formula-feeders, whereas strong relationships were found between serum ACTH and a number of stress and mood variables in controls. Postpartum mothers reported a range of stress and negative moods at 4 to 6 weeks, and in formula-feeders, serum prolactin was related to some of the stress and mood variables. Breastfeeding appears to be somewhat protective of negative moods and stress.