颈髓损伤患者的早期综合康复护理

目的探讨颈髓损伤患者的早期康复护理,预防并发症及功能康复锻炼,以提高患者生活质量。方法选择颈髓损伤患者60例,随机分为2组,对照组给予常规护理措施,康复组在常规护理基础上进行康复护理干预。治疗前后对比2组患者并发症发生率和Barthel指数。结果康复组并发症发生率明显低于对照组,同时治疗后Barthel指数也明显高于对照组,康复组日常生活能力明显优于对照组,差异有统计学意义(P0.05)。结论颈髓损伤康复过程中加强早期综合康复护理干预,有助于提高患者生活质量。     

农村精神分裂症患者照料者的社会支持和生活质量研究

目的探讨农村精神分裂症患者照料者的社会支持和生活质量的相关因素.方法用社会支持量表(SSRS)、世界卫生组织生活质量评定量表中文版(WHOQOL-100)的26条目版本,对108名精神分裂症患者照料者及108名对照者(11匹配)进行评定分析.结果照料者的社会支持(除客观支持)和生活质量各领域均差于对照组(P＜0.05);逐步回归分析表明,照料者生活质量主要受其主观社会支持(偏回归系数β=0.296,P＜0.01)和病人SDSS总分(偏回归系数β=-0.286,P＜0.01)影响.结论社会对精神病患者照料者的理解、支持和精神卫生知识的普及非常重要.     

精神分裂症患者配偶生活质量及其与社会支持调查

精神分裂症的发病对每个家庭成员都是一个强烈的精神刺激。精神分裂症患者不但自身生活质量受到影响,其病情、治疗、费用、护理及转归等因素对其家庭成员的生活质量也有不良影响。我们对精神分裂症患者配偶进行生活质量及社会支持问卷调查,旨在了解精神分裂症患者配偶的生活质量及与社会支持的关系,报告如下。     

颈髓损伤术后急性呼吸衰竭患者ICU监护

创伤性颈髓损伤患者伤情严重而复杂,病程长,并发症多,预后不佳,往往给患者造成致命的身心创伤.手术治疗是脊髓损伤综合治疗的方法之一,而急性呼吸衰竭是颈髓损伤术后最严重的并发症,也是最常见的死亡原因[1-5].因此,术后严密的病情观察和切实有效的呼吸管理,对提高患者手术的成功率和存活率起至关重要的作用.现总结报告如下.     

精神分裂症患者残疾水平、生活质量及社会支持状况分析

目的探讨精神分裂症患者的精神残疾现状以及生活质量与社会支持状况。方法采用世界卫生组织残疾评定量表第二版(WHO-DASⅡ)、生活质量综合评定问卷(GQOLI-74)对河北省衡水市精神病院门诊就诊的符合《国际疾病分类(第10版)》(ICD-10)精神分裂症诊断标准的119例患者进行精神残疾、生活质量测评,采用社会支持评定量表(SSRS)对患者的客观支持、主观支持及对支持的利用度进行测评。结果 119例精神分裂症患者重度残疾32人(26.9%)、中度残疾24人(20.2%),轻度残疾63人(52.9%)。不同残疾程度患者GQOLI-74总分及物质生活维度评分差异有统计学意义(F=5.570,P=0.005;F=3.734,P=0.027),多重比较发现生活质量总分轻度残疾组较中、重度残疾组高(P0.05),中、重度组比较差异无统计学意义(P0.05)。物质生活因子分轻度残疾组较重度残疾组高,差异有统计学意义(P0.05)。结论精神分裂症患者的精神残疾较普遍,生活质量尤其是物质生活水平低,精神残疾程度就高。     

个性化心理护理干预对老年冠心病患者心理状态和生活质量的影响

目的观察老年冠心病(CHD)患者接受个性化心理护理干预对其心理状态和生活质量的影响。方法招募2019年3月~2021年1月就诊于我院的164例老年CHD患者,随机分为:观察组(纳入82例,提供个性化心理护理干预)和对照组(纳入82例,提供常规护理干预),评价患者健康调查简易量表(SF-36)评分、心理状态评分、匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index,PSQI)、治疗依从性。结果(1)干预后,观察组SF-36评分、心理状态评分、PSQI评分更佳,差异有统计学意义(P<0.05);(2)在治疗依从性方面,观察组(93.90%)优于对照组(81.71%),差异有统计学意义(P<0.05)。结论对老年CHD患者实施个性化心理护理干预,可有效改善其心理状态,提高生活质量,值得推广。     

心理护理干预对ICU重症患者生活质量及心理状态的影响

目的 观察心理护理干预对重症监护病房（ICU）重症患者的效果及对其生活质量、心理状态的影响。方法 选择2019年7月～2021年7月接诊的86例ICU重症患者,按照随机数字表法分为：观察组（纳入43例,在对照组基础上加用心理护理干预）、对照组（纳入43例,提供常规护理干预）,评价组间健康调查简表（SF-36）、心理状态[抑郁自评量表（SDS）、焦虑自评量表（SAS）]、急性生理和慢性健康评分Ⅱ(APACHE Ⅱ)、心理弹性问卷（CD-RISC）、匹兹堡睡眠质量指数（PSQI）。结果 干预前,组间SF-36、SDS、SAS、APACHE Ⅱ、CD-RISC、PSQI无明显差异,P>0.05;干预后,观察组SF-36、CD-RISC评分更高,SDS、SAS、APACHE Ⅱ、PSQI评分更低,P<0.05。结论对ICU重症患者提供心理护理干预,能够改善其负性情绪及心理弹性水平,减轻睡眠障碍,提高生活质量,促进病情转归。     

天津市社区居民社会支持与生活质量调查

目的了解城市居民社会支持与生活质量状况及相关因素。方法选择天津市作为调查地点,分层随机抽取调查样本居民,利用社会支持评定量表、生活质量评定量表及自制调查表对564名居民进行一对一的入户调查。结果生活质量评分男性高于女性（t=3．321,P=0．001）,社会支持总分（t=5．222,P=0．002）、主观社会支持分（t=5．751,P=0．000）及社会支持利用度评分（t=1．984,P=0．048）年轻组高于老年组,客观社会支持分男性高于女性（t=1．975,P=0．049）;各项评定与受教育程度呈正相关,社会支持利用度与年龄成负相关,生活质量评分与家庭年收入呈负相关,各项评定与心理疾病及躯体疾病受限呈负相关。结论心理健康教育的关注点应该落在老年、女性、受教育程度相对较低的群体。     

急性颈髓损伤对心血管系统影响的临床分析

目的探讨急性颈髓损伤(CSCI)后出现的心血管系统异常情况及其发病机制。方法回顾性对比分析30例CSCI患者与30例非CSCI患者的血压、心率。结果CSCI患者血压、心率明显降低(P均<0.05);颈4以上比颈4以下损伤患者的血压、心率下降更为明显(P均<0.05)。结论急性颈髓损伤后出现心血管系统功能明显异常,血压、心率下降,且其严重度与损伤平面有关。其机制可能为急性颈髓损伤时抑制了体内交感神经系统。     

社会心理干预对慢性精神分裂症患者生活质量的影响

目的探讨社会心理干预对慢性精神分裂症患者生活质量的影响。方法将80例慢性精神分裂症患者随机分为干预组和对照组,各40例,对照组单用药物治疗,干预组合并社会心理干预。在人组时及第6、12个月分别对两组采用PANSS评定患者病情,社会功能缺陷筛选量表（SDSS）和生活质量综合评定问卷（GQOLI-74）评定患者社会功能及生活质量。结果干预组SDSS总分在6个月及12个月时均显著低于对照组,干预组GQOLI-74评分在6个月和12个月时除物质生活维度外,其他三个维度均显著高于对照组。两组PANSS评分则无显著性差异。结论社会心理干预可改善患者社会功能,提高患者生活质量。     

Community reintegration and quality of life following spinal cord injury.

This report contains a brief overview of issues related to community reintegration and quality of life for persons with spinal cord injuries. Current data from the National Spinal Cord Injury Statistical Center are provided on place of residence, employment, education and marital status after rehabilitation discharge. The health policy implications of these data are discussed along with prospects for continued improvement of long term social outcomes and directions for future research.     

The quality of life of three functional spinal cord injury subgroups in a Swedish community

Vast community provisions in Sweden are intended to offer spinal cord injury (SCI) subjects equal opportunities and the same living standards as the able-bodied. This study on all 56 subjects representing 3 distinct functional subgroups, out of a consecutive series treated at a Spinal Unit, explored the skills used in a wide range of community living activities and the details of these subjects' quality of life (QL). C6-tetraplegics with complete lesions (n = 15), wheelchair-bound paraplegics (n = 23) and ambulant paraplegics (n = 18) varied in physical independence in proportion to their disabilities but disturbances of mood states and QL perception did not differ between groups or from a control population sample. Eighty per cent of the subjects were engaged in gainful employment or education. Work/education, home management and mobility in the neighbourhood were clearly restricted by more severe disability but social and recreational activities were not. Degree of social activity and ability to drive a car were closely associated with levels of mental well-being and of perceived QL. Access to transport and home-help services, appropriate housing and technical aids included few unmet subjective needs, possibly explaining why these environmental factors did not inhibit the activity levels of the study population. Extensive society support and stimulation can satisfy important needs and expectations of well-functioning SCI subjects.     

Path analysis of relationship among personality,perceived stress,coping, social support,and psychological outcomes

AIM: To provide a structural model of the relationship between personality traits, perceived stress, coping strategies, social support, and psychological outcomes in the general population. METHODS: This is a cross sectional study in which the study group was selected using multistage cluster and convenience sampling among a population of 4 million. For data collection, a total of 4763 individuals were asked to complete a questionnaire on demographics, personality traits, life events, coping with stress, social support, and psychological outcomes such as anxiety and depression. To evaluate the comprehensive relationship between the variables, a path model was fitted. RESULTS: The standard electronic modules showed that personality traits and perceived stress are important determinants of psychological outcomes. Social support and coping strategies were demonstrated to reduce the increasing cumulative positive effects of neuroticism and perceived stress on the psychological outcomes and enhance the protective effect of extraversion through decreasing the positive effect of perceived stress on the psychological outcomes. CONCLUSION: Personal resources play an important role in reduction and prevention of anxiety and depression. In order to improve the psychological health, it is necessary to train and reinforce the adaptive coping strategies and social support, and thus, to moderate negative personality traits.     

癌症患者的生存质量、社会支持及相关性研究

目的　研究癌症患者的生存质量、社会支持及其相关性。方法　采用世界卫生组织生存质量量表简表 (WHOQOL BREF)、社会支持评定量表评定癌症组、肝炎对照组及健康对照组的生存质量及社会支持状况。结果　癌症组生存质量的生理领域、心理领域、社会关系评分低于肝炎组和健康组 (P <0 0 1) ,社会支持的利用度评分低于肝炎组和健康组 (P <0 0 1) ;癌症组生存质量的社会关系评分与客观支持呈正相关 (P <0 0 5 ) ,生理领域评分与支持的利用度呈负相关 (P <0 0 5 )。结论　癌症患者的生存质量较差 ,对支持的利用度低 ,应加强对癌症患者的客观社会支持 ,以提高其生存质量。     

强迫症患者生活质量和社会支持情况调查

目的:了解强迫症患者生活质量与社会支持情况,并分析二者的相关性. 方法:对91例符合DSM-Ⅳ诊断标准的强迫症患者及92名健康对照者实施健康状况问卷(SF-36)与社会支持评定量表(SSRS)评估. 结果:强迫症患者SF-36各维度评分、SSRS总分及各维度评分均低于正常对照人群(P ＜0.05或P＜0.01);社会支持量表总分与躯体疼痛(r=0.276,P=0.009)、情感职能(r=0.234,P=0.028)存在相关;客观支持与情感职能(r=0.242,P=0.021)、躯体疼痛(r=0.257,P=0.015)存在相关;主观支持与躯体疼痛(r =0.220,P=0.037)存在相关. 结论:强迫症患者生活质量和社会支持低于正常人群,其生活质量与社会支持有关联.     

The social and vocational outcome of spinal cord injury patients.

Functional status, perception of adjustment, occupational outcome and social functioning were investigated in a group of spinal cord injury (SCI) patients (mean age 34, range 10-74 years) seen at a specialised spinal unit over the period January 1984-December 1988. Functional status was assessed using a standardised scale measuring patients' performance of specific tasks, and other measures of outcome were investigated by a structured interview. Almost two thirds (68%) of the patients were independent according to the standardised scale (33% quadriplegic and 84% paraplegic). Patients' autonomy appeared to be threatened by architectural barriers in and about the house: approximately one third (34%) of those classified as 'independent' on the standardised rehabilitation scale used needed some help in their everyday life. A negative occupational outcome emerged: compared to the pre-morbid situation, 43 patients (44%) were worse off; 48 (49%) did not experience substantial changes--though it must be noted that 68% of these (33/48) were virtually unemployed (ie student, home maker, retired, unemployed) before the injury; and for 6 (7%) some improvement took place. With a multivariate analysis age was the only statistically significant predictor of poor occupational outcome, with older patients being worse off irrespective of the extent of disease and functional autonomy. The paper discusses these results and stresses the need for integrating results based on the use of standardised rehabilitation scales with the analysis of potential barriers influencing a patient's ability to exploit his/her autonomy.     

The relationship of life adversity, social support, and coping to hospitalization with major depression.

We evaluated the relationship between life events, social support, coping, and depression in 27 male inpatients meeting the requirements for Research Diagnostic Criteria major depressive disorder and in 35 age- and sex-matched nonpatients. Overall, the hospitalized depressed patients reported significantly more events and difficulties than did the controls, but this difference in statistical significance disappeared after excluding from analysis "non-independent" happenings which could have been brought on by depression. More hospitalized depressed patients (23 of 27, or 85%) than controls (8 of 35, or 22.9%) experienced markedly threatening events and difficulties ("marked adversities") in the 6 months before their interview. The depressed group also reported having significantly fewer social supports, being less satisfied with the emotional component of this support, and using more emotion-focused coping than the controls. A discriminant analysis predicted depressive status from a combination of marked adversities, reduced number of social supports, and greater use of emotion-focused coping. The results indicate that the relationship of life events to depression is complex. The excess number of events might be partly a product of dysfunctional behavior that "produces" depression-related events which might, in turn, exacerbate depression; simultaneously, patients are more likely to experience highly adverse events which might precipitate the depression in the first place. Reduced social supports and the use of emotion-focused coping appear to also be associated with hospitalization for major depression.     

The relationships among the severity of spinal cord injury, motor and somatosensory evoked potentials and spinal cord blood flow

To characterize the changes in axonal function in the motor and somatosensory tracts of the cord after spinal cord injury (SCI) and to correlate these changes with spinal cord blood flow (SCBF), the relationships among the severity of SCI, motor and somatosensory evoked potentials (MEPs and SSEPs) and SCBF were examined. Fifteen rats received a 1.5 g (n = 5), 20 g (n = 5) or 56 g (n = 5) clip compression injury of the cord at C8. SCBF at the injury site was measured by the hydrogen clearance technique 35 min before and 30 min after SCI. Concomitantly MEPs from the cord at T10 (MEP-C) and from the sciatic nerve (MEP-N) and SSEPs were recorded. A linear relationship (r = -0.89, P less than 0.002) was found between the severity of SCI and the reduction in SCBF at the injury site. Linear discriminant analysis revealed that both the MEP (P less than 0.0001) and SSEP (P less than 0.003) were significantly related to the severity of SCI. Furthermore, the amplitude of the MEP (r = 0.65, P less than 0.0001) and SSEP (r = 0.58, P less than 0.001) was significantly correlated with the posttraumatic SCBF. Multiple regression revealed that both the severity of cord injury and the degree of posttraumatic ischemia were significantly related to axonal dysfunction after SCI. While the MEP was more sensitive to injury than the SSEP, the SSEP more accurately distinguished between mild and moderate severities of cord injury. Axonal conduction in the motor and somatosensory tracts of the cord was significantly correlated with the reduction in posttraumatic SCBF and, therefore, these data provide quantitative evidence linking posttraumatic ischemia to axonal dysfunction following acute cord injury. Furthermore, this study validates the hypothesis that the combined recording of MEPs and SSEPs is an accurate technique to assess the physiological integrity of the cord after injury.