精神分裂症患者缓解期孤独感与病耻感现状及相关性

目的探讨精神分裂症患者缓解期孤独感与病耻感现状及相关性。方法选择2016年6月至2019年3月我院收治的110例精神分裂症缓解期患者为研究对象,采用情绪-社交孤独问卷(ESLI)调查其孤独感情况,采用精神疾病病耻感调查表(ISMI)调查其病耻感情况,并分析两者的相关性。结果精神分裂症患者ESLI总分(30.23±4.81)分,其中情绪孤立评分最高,为(8.82±1.81)分,其次为社交孤立、情绪孤独与社交孤独;ISMI总分(10.54±2.01)分,其中社交回避评分最高,为(2.82±0.33)分,其次为歧视经历、刻板印象认可、对抗病耻感及疏远;ESLI总分与ISMI总分呈正相关。结论精神分裂症患者存在孤独感,主要表现为情绪孤立和被孤立方面,孤独感与病耻感呈正相关关系,患者的精神分裂症到达缓解期后应关注其心理健康,辅助其建立良好人际关系,以降低孤独感与病耻感。     

住院精神分裂症患者孤独感与自我效能感的相关性分析

目的：探讨住院精神分裂症患者的孤独感与自我效能的相关性。方法：采用自制的一般资料问卷、UCLA孤独量表、自我效能感量表对130例住院精神分裂症患者进行调查分析。结果：130例精神分裂症患者的孤独感得分为（47.87±4.46）分,轻度孤独感以上的患者95例;自我效能感得分（24.25±6.92）分低于国内常模（28.67±5.21）分,差异具有统计学意义（P<0.001）;患者的孤独感与自我效能呈负相关（r=-0.464 P=0.038）。结论：住院精神分裂症患者多数具有轻度以上的孤独感;自我效能感越低,孤独感程度越高。     

希望水平在精神分裂症患者病耻感及社会功能缺陷间的中介作用

目的 探讨希望水平在精神分裂症稳定期住院患者病耻感及社会功能缺陷间的中介作用。方法 采用便利抽样法选取湖南省某三级医院2021年1月至6月的精神分裂症住院患者为调查对象,采用精神分裂症患者希望量表、贬低-歧视感知量表、社会功能缺陷筛查量表进行问卷调查。结果 217例精神分裂症患者病耻感得分为（29.25±3.40）分,希望得分为（9.41±1.85）分,社会功能缺陷得分为（6.64±3.37）分。希望水平在精神分裂症患者病耻感及社会功能缺陷间存在部分中介作用,效应值为0.243,占总效应38.4%。结论 病耻感可通过希望水平间接影响精神分裂症患者社会功能缺陷。在治疗康复中,医务人员和患者家属都应重点关注患者的病耻感及希望水平,加强患者自我肯定训练,促进社会功能恢复,帮助患者回归社会。     

综合护理干预对康复期精神分裂症患者病耻感及社会功能的影响

目的 探讨综合护理干预对康复期精神分裂症患者病耻感及社会功能的作用.方法 选取60例康复期精神分裂症患者按随机数字表法随机分为干预组和对照组各30例,对照组予精神科常规护理,干预组予12周的综合护理干预,两组在治疗前后分别予病耻感评估量表及护士用住院病人观察量表（NOSIE）评定,并比较两组结果.结果 干预前两组患者病耻感得分及NOSIE量表各因子评分比较差异均无统计学意义（P＞0.05）;经过12周的综合护理干预,干预组病耻感得分（25.52±10.33）分,NOSIE量表中社会功能（21.85±4.46）分、社会兴趣（11.02±3.06）分、个人整洁（15.35±2.29）分、抑郁（3.03±1.44）分,与干预前[（38.10±15.50）,（18.46 ±5.65）,（7.78±3.14）,（12.15±3.30）,（3.76±1.37）分]及对照组[（32.26±12.15）,（18.89±3.36）,（9.34±1.98）,（11.57±3.02）,（4.20±1.53）分]比较差异均有统计学意义（P＜0.05）;对照组病耻感得分与干预前比较差异无统计学意义（P＞0.05）.结论 综合护理干预能降低精神分裂症患者的病耻感,改善患者的社会功能,提高其生活质量.     

正念认知治疗对精神分裂症伴代谢综合征患者病耻感和自尊水平的影响

目的 正念认知治疗对精神分裂症伴代谢综合征患者病耻感和自尊水平的影响。方法 将2021年1月—2022年7月广西壮族自治区脑科医院收治的80例精神分裂症伴代谢综合征患者应用随机数表法分为研究组与对照组,每组40例。对照组用抗精神病药等进行常规治疗,研究组在对照组的基础上加用正念认知治疗。入组前和治疗6周后,比较治疗前后两组自我怜悯量表、病耻感量表、自尊心量表评分。结果 干预后,研究组的自我怜悯评分（98.52±3.77）分和病耻感评分（1.17±0.11）分优于对照组,差异有统计学意义（t=11.689、5.328,P<0.05）。干预后,研究组患者的阳性症状评分（11.17±3.01）分与阴性症状评分（6.14±1.01）分均低于对照组,差异有统计学意义（t=2.137、15.822,P<0.05）。干预后,研究组的自尊量表评分与对照组比较,差异有统计学意义（P<0.05）。结论 正念认知治疗对精神分裂症伴代谢综合征患者的负面情绪具有明显改善作用,使患者的病耻感得以降低,明显提高自我心理健康水平。     

知觉压力在维持性血液透析患者病耻感与应对方式间的中介作用探讨

目的 了解维持性血液透析患者知觉压力、病耻感及应对方式现状,并探讨知觉压力在病耻感与应对方式间的中介效应。方法 采用便利抽样方法,选取2020年6—12月至大连医科大学附属第一医院进行维持性血液透析的患者179例作为研究对象。采用一般资料调查表、社会影响量表、中文版知觉压力量表和医学应对方式问卷对其进行调查。结果 被调查的179例患者维持性血液透析患者病耻感、知觉压力得分分别为（60.20±14.57）分、（47.51±12.27）分,应对方式面对、回避、屈服3个维度条目均分分别为（2.18±0.64）分、（2.24±0.67）分、（2.40±0.67）分。维持性血液透析患者知觉压力在病耻感与应对方式面对、回避和屈服3个维度间均起部分中介作用,分别占总效应的19.88%、17.10%、35.28%。结论 维持性血液透析患者的病耻感、知觉压力均处于中等水平,医护人员可通过帮助患者降低病耻感水平、改善知觉压力,以促进患者选择积极有效的应对方式。     

425例住院缓解期精神分裂症患者病耻感现状及影响因素分析

目的调查住院缓解期精神分裂症患者的病耻感,并分析其影响因素。方法采用便利抽样法,选取2017年12月—2018年5月在江苏省某三级甲等医院住院缓解期精神分裂症患者425例为研究对象。采用一般资料问卷、Link贬低-歧视感知量表、Herth希望量表对425例住院精神分裂症患者进行调查,采用多元线性回归分析病耻感的影响因素。结果 425例住院缓解期精神分裂症患者贬低-歧视感量表总分为(28.59±4.01)分,病耻感检出率为86.4%;多元线性回归结果显示,文化程度、住院次数、未婚、离异及丧偶、希望水平进入回归方程(P0.05),共解释了住院缓解期精神分裂症患者病耻感总变异的44.2%。结论住院缓解期精神分裂症患者病耻感检出率较高,希望水平低、未婚、离异及丧偶、住院次数多、文化程度低是患者病耻感影响因素。建议护理人员通过自我肯定训练等干预措施来提高患者的希望水平,增加对精神疾病知识的教育,鼓励其坚持服药减少复发,帮助其建立起良好的人际关系,从而减轻其病耻感。     

精神分裂症家属病耻感现况及与心理困扰、自尊水平的关系

目的:调查精神分裂症患者家属病耻感,并探讨与心理困扰、自尊水平的关系。方法:随机抽取2018年5月至2019年5月在山东省精神卫生中心就诊的精神分裂症患者的家属150名,展开问卷调查。整理患者家属的基本信息和一般资料,分析其人口社会学特征;采用Link病耻感量表、Kessler10量表及自尊量表分别评估患者家属病耻感、心理困扰和自尊水平。发放问卷共计150份,回收134份,有效回收率89.33%。应用软件SPSS 21.0对各量表数据进行统计学分析。结果:134名患者家属年龄以31~50岁居多,职业以农民或职员为主,已婚者占81.34%(109/134),经济状况一般占61.94%(83/134),与患者关系大多为父母、配偶。患者家属Link量表平均(2.68±0.45)分,其中<2.5分占58.21%(78/134);Kessler10量表平均(19.57±6.23)分,其中>16分占70.90%(95/134);自尊量表平均(30.12±3.86)分。经Pearson相关分析,精神分裂症患者家属病耻感与心理困扰呈正相关(r=0.364,P<0.05);病耻感与自尊水平呈负相关(r=-0.220,P<0.05);心理困扰与自尊水平呈负相关(r=-0.421,P<0.05)。结论:精神分裂症患者家属往往因病耻感产生极大的心理困扰,而自尊是病耻感与心理困扰的保护因素;医护人员应对高病耻感、低自尊水平患者家属加强关注,采取干预措施以解除或减轻其心理困扰。     

未透析慢性肾脏病患者病耻感发生率及影响因素分析

目的 了解未透析慢性肾脏病（chronic kidney disease,CKD）患者病耻感的发生率,探讨其影响因素,为未透析CKD患者的科学管理提供依据。方法 采用便利抽样法,选取2019年12月-2020年12月四川大学华西医院肾脏内科住院的未透析CKD患者作为研究对象。采用一般资料调查表、社会影响量表、社会支持量表进行调查,采用logistic回归分析探讨未透析CKD患者病耻感的影响因素。结果 本研究共发放问卷300例,回收有效问卷272例,有效回收率90.67%。患者年龄为15～83岁,平均（38.34±13.64）岁。患者病程在1个月～18年之间,中位数为3年。患者病耻感得分为23～86分,平均分为（40.14±1.67）分,其中≥48分（有病耻感）101例,占37.13%。Logistic回归分析显示,性别[比值比（odds ratio,OR）=1.871,95%置信区间（confidence interval,CI）(1.018,3.347),P=0.042]、居住地[OR=2.991,95%CI(1.645,5.824),P=0.001]、个人月收入[OR=0.575,...     

心理弹性在稳定期精神分裂症患者病耻感与生存质量间的中介作用

目的探讨稳定期精神分裂症患者病耻感、心理弹性与生存质量之间的关系。方法本研究为横断面研究。采用便利抽样法, 于2021年1—12月选取在南京医科大学附属脑科医院门诊就诊的305例稳定期精神分裂症患者为研究对象, 采用一般资料调查表、世界卫生组织生存质量简表、心理弹性量表、贬低-歧视感知量表进行调查。采用Pearson相关分析法分析精神分裂症患者生存质量、病耻感和心理弹性的关系, 采用AMOS 25.0建立结构方程模型并进行中介效应验证。本研究共发放问卷305份, 回收有效问卷286份, 有效回收率为93.8%(286/305)。结果 286例稳定期精神分裂症患者的心理弹性得分为(56.49±14.28)分, 病耻感总分为(29.62±5.70)分, 生存质量总分为(63.15±11.67)分;稳定期精神分裂症患者的心理弹性与生存质量得分呈正相关(r=0.461, P<0.01), 病耻感与生存质量得分呈负相关(r=-0.328, P<0.01), 病耻感与心理弹性得分呈负相关(r=-0.309, P<0.01)。中介效应分析结果显示, 心理弹性在病耻感与生存质量之间起...     

Loneliness in elderly people: an important area for nursing research

The phenomenon of loneliness occurs in people of all ages but may be a particular problem in the elderly It is acknowledged that loneliness is not a necessary accompaniment to ageing and that ageing is not solely responsible for the development of loneliness in elderly people However, there is a relationship between ageing and loneliness Four major theories of loneliness are reviewed and their utility for application to research in the elderly is examined along with a consideration of the ways in which loneliness can be measured While causal relationships are difficult to determine, there is evidence that loneliness is associated with a number of physical and psychological pathologies and the relevance of these to nursing is discussed There is a growing awareness of the phenomenon of loneliness in elderly people in the nursing literature and some evidence that nursing intervention can be beneficial in this regard both at alleviating loneliness and reducing some of the adverse effects of loneliness Finally some directions for nursing research are presented which are aimed at improving the assessment and nursing intervention for loneliness in elderly people     

Loneliness among elderly people living in Stockholm: a population study

The purpose was to investigate experienced loneliness among the elderly. The material included 1725 people, aged 75 and over. The study describes relationships between loneliness, social network, cognitive function and health. Thirty-five per cent experienced loneliness, and a higher percentage was found among women. A gradual increase in loneliness was found up to the age of 90, after which a levelling was found. Elderly persons living together with a partner experienced less loneliness. There were no significant differences between those with and without children. Ten per cent reported not having any friends and, of these, one out of two experienced loneliness. A high frequency of experienced loneliness was found among elderly people with reduced cognitive function. Subjectively experienced bad health and loneliness were strongly related to each other, i.e. a person who experienced loneliness did usually not feel completely healthy.     

Relationships of leisure social support and flow with loneliness among nursing home residents during the COVID-19 pandemic: An age-based moderating model

Identifying predictors of loneliness is important to develop interventions that help older adults residing in nursing homes reduce their loneliness, particularly during the COVID-19 pandemic. Therefore, we examined whether leisure social support and flow (also identified as optimal experience) were predictive of loneliness, and whether age moderated the relationship between flow and loneliness. In total, 235 nursing home residents, aged 65 years or older, participated in our study. We conducted in-person surveys to measure their age, leisure social support, flow, and loneliness as well as used multiple linear regression analysis to analyze data. Results indicated that high levels of leisure social support and flow predicted low levels of loneliness. However, age decreased the negative relationship between flow and loneliness. We discuss implications of these results in terms of reducing loneliness, without depending highly on the presence of others, during times of social isolation associated with responses to the COVID-19 pandemic.     

妊娠期糖尿病患者功能失调性态度对孤独感的影响

目的:探讨妊娠期糖尿病患者功能失调性态度对孤独感的影响,为妇产科护士对患者进行针对性的健康教育提供参考意见。方法:对239例妊娠期糖尿病患者运用"中文版功能失调性态度问卷"和"感情与社会孤独量表"进行测试。结果:功能失调性态度和孤独感的分数分别为(3.24±0.79)分和(3.28±0.41)分;功能失调性态度和孤独感均处于中等水平,功能失调性态度与孤独感呈显著性相关关系;功能失调性态度3个维度能联合预测孤独感28.8%的变异量。结论:功能失调性态度能有效地预测妊娠期糖尿病患者的孤独感,妇产科护士应针对患者功能失调性态度进行相应的健康教育以减轻其孤独感。     

Loneliness and Psychotic Symptoms: The Mediating Role of Depression

Psychotic symptoms have been shown to be associated with numerous social factors, such as migration and urban upbringing, of which one plausible common component is loneliness. This suggests a relationship between loneliness and positive psychotic symptoms. According to current cognitive models of psychosis, the relationship between loneliness and positive symptoms is likely to be explained by affective states. The current study examined the cross-sectional relationship between loneliness, depression, and positive symptoms in four separate community samples (combined N = 766) with regression based mediation analysis and network analysis. The results showed that depression completely mediated the relationship between loneliness and positive symptoms in three out of four samples. Partial mediation was found in one sample. Network analysis revealed that loneliness, depression, and positive symptoms clustered separately and that there was a unique connection between loneliness and items that assess paranoid beliefs, in the sense that loneliness was not found to be connected to other psychotic symptoms, such as hallucinations. As expected, loneliness is related to positive symptoms and depression played a strong role in explaining the association. Thus, early interventions of psychosis that target loneliness are likely to be beneficial, especially if these interventions additionally target depression. Furthermore, the specific connection of loneliness and paranoid beliefs supports the theory that specific adversity leads to specific psychotic symptoms.     

Risk factors for loneliness in patients with cancer: A systematic literature review and meta-analysis

ObjectiveTo systematically review the literature on the severity and risk factors for loneliness in adult cancer patients.MethodsWe systematically reviewed quantitative studies addressing loneliness in cancer patients. Exclusion criteria were absence of a validated loneliness questionnaire, and studies that focused on loneliness determined by specific circumstances, and not cancer in general (e.g. appearance concerns, cultural and language barriers, requiring palliative care). We searched PsycINFO, CINAHL, Embase, Cochrane Library, and Pubmed in compliance with the predefined in- and exclusion criteria. The search, quality appraisal, and data extraction were performed by two independent reviewers. Weighted mean scores were calculated by using random effects adjusted inverse variance weighting.ResultsWe included 15 studies. In 13 studies the UCLA loneliness scale was used (range 20–80; higher scores indicate higher loneliness). The weighted mean loneliness score was 38.26 (95% CI: 35.51–41.00), which corresponds to moderate loneliness. Time since diagnosis was positively associated with degree of loneliness. Other cancer-related factors, such as cancer site, treatment type, or stage of disease were not associated with loneliness. The non-cancer related determinants of loneliness in cancer patients that emerged from our review were being unmarried (people who have never been married, are widowed or divorced), and lack of psychological or social support.ConclusionOur findings suggest that the level of loneliness rises with increasing time after cancer diagnosis. Furthermore, social functioning emerged as a consistent theme, for which it was shown that lack of social support was associated with increasing levels of loneliness.     

吸毒人群孤独感及相关分析

目的探讨吸毒人群的孤独感水平。方法采用感情与社会孤独量表、幸福感指数量表和自尊量表,对109名吸毒人员和119名正常人员进行调查。结果⑴吸毒人群的情感孤独、社会孤独和孤独指数均显著性高于正常人群;⑵在女性水平、24岁及以下水平、未婚水平、农民水平、城镇水平以及文化因素、父母文化因素和父母婚姻因素的所有水平上,吸毒人群的孤独感显著性高于正常人群;⑶吸毒人群的孤独感与情感指数、生活满意度和幸福指数倾向于零相关,与自尊呈显著性负相关。结论吸毒人群的孤独感显著高于正常人群,降低吸毒人群的孤独感有助于提高心理健康水平。     

A Review of: “The Past in the Present”

Older women report more loneliness than male peers. Loneliness is an area of concern related to the well being of older women because it is a cause of emotional distress and is linked to a variety of health problems in older individuals. Life changes, including widowhood and relocation, are associated with increased vulnerability to loneliness. Gender, social, and cultural factors influence the experience of loneliness in older women. Cognitive and interactionist theoretical approaches to loneliness have utility for nursing practice and research with older women who experience loneliness.     

The relationship between companion animals and loneliness among rural adolescents

The relationship between loneliness and companion animal bonding was explored among 293 rural adolescents. Participants from two ethnically diverse southwestern high schools completed self-report measures of loneliness, pet ownership, companion animal attachment, and social support. Pet owners reported significantly lower loneliness scores than non-pet owners. Furthermore, companion animal bonding scores were inversely related to loneliness scores. Companion animal attachment was positively related to the number of humans in the social support network. The results of this study indicate that interventions promoting a pet relationship may be valuable in reducing loneliness among adolescents.