强化社会支持对癌症患者及其家属疾病不确定感的影响研究

目的：了解癌症患者及其家属社会支持状况以及强化社会支持对改善疾病不确定感的影响,从而提高患者生命质量（QOL）。方法：采用疾病不确定感量表（MUIS）和社会支持量表对2006年1～6月住院的200名癌症患者及其家属的社会支持状况和QOL进行调查、评分,并对评分结果进行统计分析。结果：疾病不确定感与强化社会支持之间存在负相关（r=（0.369,P〈0.05）,社会支持得分高低对其总的QOL满意度有影响（P〈0.05）。结论：社会支持可降低癌症患者及其家属疾病不确定感并提高其社会支持程度。     

冠心病病人家属应对方式相关因素的调查研究

[目的]探讨冠心病病人家属疾病应对方式的相关因素并提出干预措施,以帮助其建立积极的应对方式,提高对病人的照护能力,最终改善冠心病病人的生存质量.[方法]采用简易应对方式量表(SCSQ)和疾病不确定感家属量表-中文版(PPUS-FM-CV)、社会支持评定量表(SSRS)对62名冠心病病人家属进行问卷调查.[结果]冠心病病人家属积极应对方式得分显著低于常模;不同年龄、文化程度、家庭月收入的冠心病病人家属应对方式得分差异有统计学意义(P＜0.05);疾病不确定感、社会支持系统与应对方式存在相关关系,其中病人家属对支持的利用度、主观支持及疾病不确定性有较强的预测作用.[结论]冠心病病人家属尚未建立积极的应对方式,病人家属人口学特征如年龄、文化程度,家庭月收入影响家属的应对方式;降低其疾病不确定感、提高社会支持水平是建立积极应对方式的重要内容.     

严重烧伤患者家属疾病不确定感与其生活质量相关性研究

目的探讨严重烧伤患者家属疾病不确定感与其生活质量相关性。方法收集我院2016年1月至2019年1月收治的126名严重烧伤患者家属的资料,采用家属疾病不确定感量表(MUIS-FM)和家属生活质量量表(QOL-C)调查其疾病不确定感和生活质量并分析其相关性。结果严重烧伤患者家属疾病不确定感总平均分为(97.98±9.25)分,处于较高的不确定水平,其中不明确性总均分最高为(39.45±5.61)分。患者家属生活质量在健康状况、躯体疼痛、生理机能、生理职能、社会功能、精力、情感职能和精神健康各维度得分均处于中低等水平。采用Pearson相关性分析得出,疾病不确定感与生活质量中的健康状态、生理机能、社会功能以及精力状况均呈现负相关。结论严重烧伤患者家属存在一定不同程度的疾病不确定感,且随着不确定感增强,生活质量降低,因此医护人员应采取适当鼓励措施,以降低家属不确定感,提高其生活质量,进而提高对患者的照护效果。     

冠心病病人家属应对方式相关因素的调查研究

[目的]探讨冠心病病人家属疾病应对方式的相关因素并提出干预措施,以帮助其建立积极的应对方式,提高对病人的照护能力,最终改善冠心病病人的生存质量。[方法]采用简易应对方式量表（SCSQ）和疾病不确定感家属量表-中文版（PPUS-FM-CV）、社会支持评定量表（SSRS）对62名冠心病病人家属进行问卷调查。[结果]冠心病病人家属积极应对方式得分显著低于常模;不同年龄、文化程度、家庭月收入的冠·心病病人家属应对方式得分差异有统计学意义（P〈0．05）;疾病不确定感、社会支持系统与应对方式存在相关关系,其中病人家属对支持的利用度、主观支持及疾病不确定性有较强的预测作用。[结论]冠心病病人家属尚未建立积极的应对方式,病人家属人口学特征如年龄、文化程度、家庭月收入影响家属的应对方式;降低其疾病不确定感、提高社会支持水平是建立积极应对方式的重要内容。     

青年乳腺癌病人家属疾病不确定感及影响因素分析

[目的]了解青年乳腺癌病人家属疾病不确定感状况,探讨其影响因素。[方法]采用一般资料调查问卷、Mishel疾病不确定感家属量表(MUIS-FM)、状态焦虑量表(S-AI)、社会支持量表(SSRS),对159名18岁~45岁乳腺癌病人家属进行调查。[结果]青年乳腺癌病人家属疾病不确定感总分为71.47分±8.345分,85.5%家属存在较高水平的疾病不确定感,多元回归分析显示,疾病不确定感与状态焦虑、社会支持、化疗副反应种类及文化程度相关。[结论]青年乳腺癌病人家属疾病不确定感处于较高水平,且受多种因素影响。医护人员可适时为家属提供病人疾病的相关信息,以降低家属疾病不确定感,减轻其心理压力,提高照顾质量。     

HIV感染者/AIDS病人及其家属的生活质量调查及相关因素分析

目的调查分析HIV感染者/AIDS病人及其家属的生活质量及其相关因素,为建立HIV感染者/AIDS病人社区综合关怀支持模式、改善HIV感染者/AIDS病人及其家属的生活质量提供依据.方法选择四川省HIV感染率和AIDS患病率较高的两个县(资中县和凉山州昭觉县)作为目标社区,共计调查71名HIV感染者/AIDS病人及其162名家属和97名健康者,采用生活质量综合评定问卷(GQOLI-74)、社会支持评定量表(SSS)及自制的一般情况记录表收集相关资料,用SPSS统计软件进行统计分析.结果HIV感染者/AIDS病人及其家属的GQOLI-74总分及躯体功能、心理功能、社会功能和物质生活状态4个维度分均低于正常对照(分别为F=36.512、F=11.046、F=31.616、F=34.235、F=2.386,P值均＜0.01),HIV感染者/AIDS病人及其家属生活质量总分与疾病状况、社会支持存在明显相关性.结论HIV感染者/AIDS病人及其家属的生活质量均较低,这与疾病状况、社会支持等因素有关.     

宫颈癌患者生活质量与家属焦虑、抑郁的关系

目的探讨宫颈癌患者生活质量与家属焦虑、抑郁情绪的关系。方法采用便利抽样法随机抽取100例宫颈癌的患者及家属进行调查,采用患者一般资料问卷、宫颈癌患者生活质量评价量表(the quality of life assessment scale for cervical cancer patients,QLS-CCP)对患者进行调查,采用焦虑自评量表(the self-rating anxiety scale,SAS)、抑郁自评量表(the self-rating depression scale,SDS)对患者家属进行评估。结果宫颈癌患者QLS-CCP总得分为(103.30±14.10)分,低于国内常模。有抑郁情绪的宫颈癌患者家属,其照顾的患者生活质量中的社会功能和疾病本身维度得分更低(t=1.054,P=0.033;t=2.041,P=0.041),且宫颈癌患者家属SAS、SDS得分与患者QLS-CCP中的心理功能、社会功能维度得分和总分呈负相关。结论宫颈癌患者的生活质量较低,患者生活质量与家属的焦虑、抑郁情绪呈负相关。     

The relationship between meaning of illness, social support, coping strategies, and quality of life for lung cancer patients and their family members

This article explores the relationship between meaning of illness, perceived social support resources, coping strategies used, and quality of life (QOL) by patients with lung cancer and their family members. The study was cross-sectional using interview data from 85 patients and associated family members. Regression results showed that total QOL in patients with lung cancer is predicted most by meaning of illness, specifically, the illness being perceived as manageable. QOL in family members is predicted most by meaning of illness, specifically, less adverse impact. Interestingly, the overall meaning of illness, coping strategies used, and social support were similar in the 2 groups. The results of the study emphasize the importance of acknowledging the circumstances of people's lives, both patients surviving lung cancer and their family members, which contribute to QOL.     

家庭功能和社会支持对慢性阻塞性肺疾病患者生存质量的影响

目的了解COPD患者家庭功能、社会支持及生存质量现状及三者之间的关系。方法采用方便抽样的方法,选择2017年6月—2018年9月某三级医院收治的225例COPD患者作为研究对象,应用一般资料调查表、APGAR家庭关怀度指数问卷、社会支持评定量表和WHO生存质量测定量表简表进行调查。采用单因素分析、Pearson相关、多元线性回归分析患者生存质量与社会支持、家庭功能的关系。结果COPD患者的家庭功能评分为(7.03±2.15)分,社会支持评分为(39.43±8.46)分,生存质量评分为(51.91±11.48)分;患者的家庭功能评分、社会支持各维度得分及总分均与生存质量评分呈正相关(P<0.05);家庭功能、社会支持、疾病严重程度是COPD患者生存质量的影响因素(P<0.01)。结论良好的家庭功能和社会支持有利于改善COPD患者的生存质量,建议护理人员鼓励家庭成员给予患者更多的关注,改善患者的社会支持水平,提高患者的生存质量。     

ICU重危患者家属需求的研究进展

目的了解ICU重危患者家属的需求,实施有针对性的护理。方法采用文献回顾,包括定量和定性研究。结果家属需求分为认知、情感、社会和工具四类。信息是共性的需求。情感需求中感到有希望、病情保证和待在患者身边极为重要。家属将患者放在首位,因而极少关注自己。医护人员常低估了家属的需求。结论ICU患者家属的需求满足状况有待进一步改善。准确评估家属的需求,提供确切易懂的信息,给予个性化的探视时间,有利于家属需求的满足。     

ICU重危患者家属需求的研究进展

目的了解ICU重危患者家属的需求，实施有针对性的护理。方法采用文献回顾，包括定量和定性研究。结果家属需求分为认知、情感、社会和工具四类。信息是共性的需求。情感需求中感到有希望、病情保证和待在患者身边极为重要。家属将患者放在首位，因而极少关注自己。医护人员常低估了家属的需求。结论ICU患者家属的需求满足状况有待进一步改善。准确评估家属的需求，提供确切易懂的信息，给予个性化的探视时间，有利于家属需求的满足。     

In-hospital social support for families of heart patients

Chronic illness in one family member influences all aspects of family life. Research has documented the positive contributions of social support in an unexpected and stressful event such as a family member's heart disease. The aim of the study was to describe in-hospital social support provided by nurses to families of heart patients and to identify factors related to social support. Data were collected using a mailed questionnaire to family members of heart patients (n = 161) receiving treatment on two medical wards of a university hospital in southern Finland. The results show that the family members were not very satisfied with the social support from nurses, because about 40% were dissatisfied with the concrete aid and affirmation they received and about 30% with emotional support. According to regression analysis the most important predictors of social support were family structure, patient's age, gender of family member and whether the patient had been hospitalized for cardiac symptoms. This report shows that supporting families of cardiac patients need development according to the family nursing practice.     

住院肺结核患者家属心理健康状况调查分析

目的探讨住院肺结核患者家属的心理健康状况。方法对80名肺结核患者的家属采用一般情况调查表和症状自评量表进行调查。结果 80名患者家属症状自评量表中的躯体化、抑郁、焦虑、敌对、恐怖和阳性项目数高于国内常模(P<0.01);家属年龄、与患者关系、户籍、性别和患者发病情况是主要影响因素。结论肺结核患者的家属心理健康水平较低,而且受家属社会人口学资料和患者疾病状况的影响。临床护理工作中要关注这些影响因素,采取切实有效的干预措施,以改善家属心理状况。     

ICU病人家属对限制陪护的心理反应及护理对策

目的 探讨病人在ICU接受监护期间，其家属对ICU限制陪护的心理反应及相关原因。方法 参考国外危急重病人家属需要量表，对本市两家三级甲等医院100名ICU病人家属进行调查。结果 病人家属对探视制度的看法与健康教育，病情转归，医护质量有关。结论 ICU护士必须重视健康教育，充分认识病人家属的需要，及时提供各种反馈信息，帮助家属应对其危机状态，同时，要求医院设定相关配套服务措施，维护病人家属的身心健康。     

Disability, home care and the care-taking role in family life

This exploratory study examines the dynamics of keeping a disabled adult in the home. In interviews with 30 families, major foci emerged which spanned the interaction between family members and one member, the disabled adult. These foci were: the initial weighing process in the decision to keep the disabled at home, the therapeutic process which evolved among members, the interactional system which served the social unit, and the social context and adaptation that the family made to perceived misfortune.     

Applying the family adjustment and adaptation response model to care of an AIDS patient's family

Discrimination against AIDS patients occurs in our society, not only influencing the patients but also restricting their usage of social resources. We report on a 31-year-old AIDS patient facing a family crisis because of an imbalance between the meanings, demands, and capabilities of his family. In this paper, we have applied the family adjustment and adaptation response (FAAR) model to assess this family, and identified three health problems, including (1) poor communication among family members, (2) deficiency in disease-related knowledge and skill, and (3) dysfunctional processing among the family. Throughout the care, we adopted a family-centered belief to communicate with the family to resolve their misunderstandings. We provided the family with information related to the disease to reduce their stress arising from caring for the patient. We also helped the family to utilize social resources by coordinating multi-disciplinary care. The family successfully restored a balance between meanings, demands, and capabilities. If we can apply this model clinically to understand the capabilities, demands and meanings of family existence as well as to help family members to develop their capabilities, reduce demands and recognize the positive meanings of family, we can help AIDS patients and their families to achieve positive adaptation.     

川崎病患儿家属感知脆弱现状及影响因素分析

目的 对川崎病患儿家属感知脆弱现状进行调查,并研究其感知脆弱的影响因素.方法 选择2019年1月-2020年5月在我院治疗的148名川崎病患儿的家属作为调查对象,调查量表包括一般资料、感知脆弱程度量表、社会支持评定量表以及简易应对方式量表.结果 川崎病患儿家属感知脆弱程度量表得分为(6.25±0.86)分,感知脆弱高水...     

重性精神疾病患者的家庭负担调查

目的探讨重性精神疾病患者的疾病家庭负担。方法采用疾病家庭负担量表(FBS),对148 例符合ICD-10 诊断标准的精神分裂症和双相障碍患者的照顾者进行评定。结果精神分裂症和双相障碍患者的疾病家庭负担普遍存在,涉及多个维度。各维度影响达中度以上的分别为家庭关系(51%)、家庭娱乐活动(50%)、家庭日常活动(45%)、经济负担(43%)、家庭成员心理健康(36%)、家庭成员身体健康(32%)。年轻、自费及无个人收入患者的疾病家庭负担更重。结论提示需制定综合的心理社会干预措施,有效减轻照顾者的家庭负担。     

The perspectives of patients,family members and healthcare professionals on readmissions: preventable or inevitable?

Abstract

An understanding of what complex medical patients with chronic conditions, family members and healthcare professionals perceive to be the key reasons for the readmission is important to preventing their occurrence. In this context, we undertook a study to understand the perceptions of patients, family members and healthcare professionals regarding the reasons for, and preventability of, readmissions. An exploratory case design with semi-structured interviews was conducted with 49 participants, including patients, family members, nurses, case managers, physicians, discharge planners from a general internal medicine unit at a large and academic hospital. Data were analyzed using a directed content analysis approach that involved three investigators. Two contrasting themes emerged from the analysis of interview data set. The first theme was readmissions as preventable occurrences. Our analyses elucidated contributing factors to readmissions during the patients’ hospital stay and after the patients were discharged. The second theme was readmissions as inevitable, occurring due to the progression of disease. Our study findings indicate that some readmissions are perceived to be inevitable due to the burden of disease while others are perceived to be preventable and associated with factors both in hospital and post-discharge. Continued interprofessional efforts are required to identify patients at risk for readmission and to organize and deliver care to improve health outcomes after hospitalization.