心理干预在关节炎病痛治疗中的应用

本文主要介绍了对关节炎躯体疼痛的心理干预问题。关节炎的躯体疼痛常常会导致患者精神紧张,引起焦虑、抑郁等不良情绪反应,影响家庭和生活。因此,对关节炎病痛进行心理干预十分必要。国内外研究发现,对患者进行心理干预有助于缓解病情,改善患者生活质量。但是国内目前还没有对病痛干预进行专门和系统的研究,这正是未来我们可以进行的方向。最后,本文提出了未来研究必须注意到心理干预研究的科学性和系统性,也必须从患者角度考虑心理干预的价值和实际问题。     

心理干预对胃癌术后吻合口瘘患者生活质量的影响

目的探讨心理护理干预方法对胃癌术后吻合口瘘患者生活质量的影响，为提高其生活质量提供参考。方法通过对确诊的胃癌术后吻合口瘘患者26例术前进行SF-36生存质量调查，从人院、术后及恢复期对其实施心理护理干预，于出院前再次进行生活质量调查，分析患者术前及康复期生活质量的变化。结果总体健康、生理功能、生理职能、躯体疼痛、活力、社会功能、情感职能及精神健康八个角度的评分显著高于术前。结论对胃癌患者进行系统的心理护理干预，能显著改善其生活质量。     

神灯治疗仪联合个性化护理在类风湿关节炎患者中的应用效果

目的 探讨神灯治疗仪联合个性化护理在类风湿关节炎患者中的应用效果。方法 选取2021年1月至2022年6月医院收治的68例类风湿关节炎患者，采用随机数字表法分为两组，各34例。对照组采用个性化护理，观察组在对照组基础上加用神灯治疗仪干预，对比两组临床效果、疼痛、生活自理能力、生活质量、心理状态和不良反应。结果 相较于对照组，观察组干预后心理状态、疼痛评分均较低，临床效果、生活自理能力、生活质量评分均较高，差异有统计学意义（P<0.05）；干预后，两组不良反应发生率差异无统计学意义（P>0.05）。结论 神灯治疗仪联合个性化护理在类风湿性关节炎患者中应用效果确切，有利于减轻关节疼痛，改善患者心理状态与临床症状，提高生活自理能力并提升生活质量，且安全性好。     

社区心理综合干预治疗晚期癌痛效果观察

探讨对社区中的晚期癌痛患者实施心理综合治疗后与患者疼痛、精神心理状态和生活质量的相关性。本文将83例晚期癌痛患者随机分为干预组和对照组，两组病人均给予常规镇痛治疗，干预组附加精神、心理康复治疗。结果干预组患者的疼痛缓解度、精神状态和生活质量明显好于对照组病人。实践证明对社区晚期癌痛患者实施心理综合干预治疗是十分必要的。     

护理干预对类风湿性关节炎患者疼痛的影响研究

目的:本研究旨在探讨实施护理干预对类风湿性关节炎患者疼痛的影响.方法:选取我院2010年1月-2011年6月风湿免疫科收治的300例类风湿性关节炎患者为研究对象,将300例患者随机分为两组,对照组与干预组,每组150例患者.对照组实施常规护理措施;干预组在常规护理的基础上,侧重对患者的心理护理及康复指导等.分别于入院时及入院15d对两组患者使用11点疼痛数字等级量表(PI-NRS)对患者的疼痛程度进行评估.结果:患者入院15d后,对两组使用11点疼痛数字等级量表(PI-NRS)对患者的疼痛程度进行评估.统计结果显示,对照组与干预组间存在差异,P＜0.05,有统计学意义,即干预组好于对照组.结论:实施护理干预对类风湿性关节炎患者的疼痛治疗有积极明显的作用,有效的心理护理及康复指导可以促进患者的康复.     

延续性护理对类风湿关节炎患者生活质量的影响

目的探讨延续性护理对类风湿关节炎患者生活质量的影响。方法选取2013年3月至2015年7月我科收治的类风湿关节炎患者65例,随机分为两组。对照组32例采用常规护理,观察组33例在常规护理的基础上施加延续性护理干预。采用视觉模拟评分法(VAS)评估患者疼痛感,采用SF-36生活质量量表评估患者生活质量,比较两组的VAS评分、生活质量评分。结果干预后,观察组的VAS评分显著低于对照组,观察组在总体健康、精神健康、社会功能、躯体疼痛、生理功能、情感职能及生理职能方面的评分均显著高于对照组,差异有统计学意义(P<0.05)。结论延续性护理能有效改善类风湿关节炎患者的躯体症状和疼痛,提高患者的自我管理能力和生活质量。     

浅析外科疼痛患者的心理护理

影响外科疼痛病人的心理因素有许多，通过药物等控制外科疼痛患者的痛苦是控制痛苦的有效办法之一，但考虑到药物的不良反应以及潜在的毒副作用，良好的心理护理称为协助病人缓解痛苦的主要办法。为了更有效地展开疼痛护理，本文对外科疼痛患者的心理护理进行浅谈，期望协助更多的外科病痛患者。     

认知护理干预对卵巢囊肿患者术后疼痛及生活质量的影响

目的:探究认知护理干预对卵巢囊肿患者术后疼痛及生活质量的影响。方法选取我院2014年4月~2016年2月收治的98例卵巢囊肿患者,经随机平行的方式,分成观察组和对照组,各49例。观察组采取认知护理干预,对照组实行常规护理干预,对比两组术后疼痛情况、生活质量评分。结果两组术后疼痛评分、物质生活和躯体功能、心理功能、社会功能等生活质量评分比较,差异具有统计学意义,P0.05。结论对卵巢囊肿患者实行认知护理干预,能减轻患者术后疼痛,提高生活质量,具有重要的临床价值。     

类风湿关节炎住院妇女心理健康状况及相关因素分析

[目的]探索女性类风湿关节炎住院病人心理健康状况以及相关因素,为临床干预提供依据.[方法]应用个人深入访谈的方法,对20例符合诊断标准的女性类风湿关节炎住院病人按照统一的访谈提纲进行访谈.[结果]多数病人在发病初期并未给予足够的重视及治疗,情绪也比较稳定,随着病情的进展,大部分病人出现情绪波动,焦虑和抑郁情绪比较明显;病人在住院期间社会支持水平低,对不良情绪的应对能力差;医疗服务的内容主要是以疾病治疗为中心,无任何心理健康干预.[结论]类风湿关节炎病情的发展,对患者的生理、心理及社会各方面均产生负性影响,在医疗活动中医护人员不仅要关注患者躯体症状的消除和改善,也要关注患者的心理问题,应将心理干预作与临床治疗相结合,从而提高类风湿关节炎患者的生活质量.     

心理干预对改善妇科恶性肿瘤患者生活质量的观察

目的探讨对妇科恶性肿瘤患者进行心理干预后生活质量改善的效果。方法将83例妇科恶性肿瘤患者分为2组。干预组（n=43）采用PTSD的方法进行心理干预治疗。对照组（n=40）仅随访，不予心理干预。分别进行生活质量5项指标的评分分析。结果随访前两组生理状态、心理状态量、躯体性焦虑度、自身满意度、社会生活状态评分接近（P〉0．05）。随访后干预组生活质量指标、免疫学明显优于对照组（P〈0．05），且肿瘤类别与患者生活质量改变无关，临床分期与患者生活质量的改变有关。结论患者生活质量的改变与患病的种类无关，与肿瘤分期有关。心理干预可明显改善妇科恶性肿瘤患者的生理、心理及自身满意度及社会生活状态，从而明显改善患者的生活质量。     

中国部分地区关节炎患者生活质量调查

目的　初步评价中国部分地区关节炎患者的生活质量。方法　采用分层随机抽样方法获得关节炎患者 1344例 ,生活质量调查采用关节炎患者生活质量量表 ,填答方式为自填法。结果调查的关节炎患者中 ,各年龄组不同性别患者的生活质量得分差异均无显著性 (P >0 .0 5 ) ;但其中 6 5岁以上女性、受教育年数较少者、月均收入较低者的生活质量得分均相对较差 ;丧偶或离婚者得分也较未婚和已婚者差 (t=9.310 ,P =0 .0 0 1) ;无业者、农民的得分较其他所有职业者低 (P <0 .0 5 ) ;在生理指标方面显示生理指标得分差者 ,生活质量得分也差 ,但对于压痛指数 2、3级者之间生活质量得分差异并无显著性 (平均差数为 4 .910 ,P =0 .76 5 ) ,对于关节肿胀指数 0、1级者之间 (平均差数为16 .30 8,P =0 .0 79)以及 2、3级者之间 (平均差数为 6 .6 4 3,P =0 .5 33)差异也无显著性。结论　关节炎患者整体生活质量的提高不仅有赖于医学水平的提高 ,还有赖于有关部门予以重视 ,并采取完善社会保障制度和农村医疗保障制度 ,提高农村教育水平 ,关注老年生活等有效措施。     

Entering the loop: assessing the contribution of pain clinics in northern Britain

A survey of patients attending ten outpatient pain clinics throughout northern Britain was undertaken to identify opportunities for improving the treatment of pain patients. A short data collection form was designed to obtain information at every patient consultation. The patients were found to be a diverse group, many with complex pain problems. For many patients meaningful diagnoses could not be obtained. The focus of the study was altered to address a selected group of patients: those with neurogenic pain. This group was selected because it was comparatively easy to define, and previous studies suggested that nerve damage pain might not always be well managed. Many patients were found not to have had adequate trials of potentially effective therapies prior to attendance at the pain clinics. Some of these therapies, such as antidepressants and anticonvulsants, could have been prescribed by general practitioners. However, there were also substantial differences between the clinics in the proportion of patients receiving particular therapies. Finally, although many patients had psychological morbidity few were offered psychological assessment and management. These studies have shown that the pain clinics provide a range of therapies which patients are unlikely to receive elsewhere. But there is scope for improvement in the management of patients in pain clinics and efforts are currently being directed towards this.     

矽肺患者生存质量及其影响因素的调查分析

目的了解矽肺患者生存质量及其影响因素。方法采用世界卫生组织生存质量表对某铜矿150例矽肺患者及150名未患矽肺工人进行调查,并采用SPSS11.5统计软件对调查资料进行相应的分析。结果矽肺患者对生存质量及其生理功能、心理状态、独立性领域的主观满意度均较未患矽肺工人低,特别是在躯体疼痛、精力、睡眠、信心、负性情感、行动能力、日常生活能力、依赖性、获取信息、休闲活动、信仰,总体健康等方面与未患矽肺工人比较,差异有显著性(P<0.01或P<0.05)。矽肺患者并发症的多少、期别的高低、年龄、婚姻状况、参与休闲娱乐的机会及参与程度、人际关系的满意程度等对生存质量均有影响。结论在对矽肺及并发症进行治疗的同时,重视健康教育,提供心理治疗,鼓励参加休闲活动和社会交往,有利于提高矽肺患者的生存质量。     

Rheumatoid Arthritis

Rheumatoid arthritis is a common inflammatory joint disorder, with a prevalence of about 1% in the general population. It shows high variability with respect to its course and prognosis. In typical cases an insidious onset of symmetrical synovitis of the small joints of the hands and feet occurs, accompanied by symptoms such as morning stiffness, weakness and fatigue. Besides clinical findings, laboratory tests and imaging techniques are other cornerstones for diagnosis of rheumatoid arthritis.Rheumatoid arthritis is anything but a benign disease, potentially leading to disability, chronic pain, morbidity and even early death. Recent studies provide strong evidence that early diagnosis and treatment are crucial for the prognosis of the disease. In recent years, great efforts have been made to detect and establish diagnostic, as well as prognostic, parameters for rheumatoid arthritis. Whereas the reliability of new diagnostic parameters has not been proven conclusively, reliable prognostic factors have been established that may help in identifying patients at high risk for progressive, disabling disease. These risk factors include: high number of joints involved at onset, marked disability, elevated acute phase reactants, a positive finding for rheumatoid factor, female gender, advanced age, presence of certain HLA class II antigens, early x-ray changes, low bone mineral density and job-related physical requirements.As the established classification criteria cover longstanding disease, but not the early stages, it appears necessary to establish a new set of diagnostic criteria for early rheumatoid arthritis. In the case of newly diagnosed rheumatoid arthritis, more attention should be paid to well-known risk factors. This allows a risk profile to be established for individual patients, which may facilitate decisions regarding therapy. A better outcome of rheumatoid arthritis would not only be advantageous for individual patients, but would also result in reduced costs for healthcare systems.     

Chronic pain—the end of the welfare state?

The problem of low back pain has reached epidemic proportions in the industrialized nations. The predicament of back pain is common, 30–40% of our populations from 10–65 years old report such trouble to occur on a monthly basis. In 1–8% this results in work-disabling back pain. Only in very few of these patients can physicians diagnose a definite pathoanatomical cause for the pain. It can be deduced that psychosocial factors, including insurance benefits are of importance for this variation. Sweden, with 100% sickness benefits, has the highest disability rate.Few non-surgical methods have proven effective in rendering the patient better for him to return to work. Even fewer studies demonstrate any benefit from surgery, simple open removal of a proven disc hernia being the only exception. For patients with unproven diagnostic labels such as facet arthritis, degenerative disc disease, internal disc resorption and instability, no evidence exists that any type of surgery is cost-effective.More attention must be paid to illness behaviour by anyone treating chronic low back pain syndromes (> 3 months). Such psychological reactions to an originally nociceptive pain stimulus somewhere in the motion segment, must be elucidated and addressed, before embarking on risky and expensive treatment modalities including surgery.It is time for all of us, politicians as well as physicians, to distinguish what types of support will contribute to our nations' future and which ones will undermine it. Our welfare systems are at stake.     

The stability of health status in rheumatoid arthritis: a five-year study of patients with established disease.

We employed a health status measure to describe the outcomes of rheumatoid arthritis patients over five years. Of the 410 rheumatoid arthritis patients who were originally administered the Arthritis Impact Measurement Scales (AIMS), 299 completed a follow-up five years later. Data were analyzed using nine health status scales, three components of health status, and an overall arthritis impact item. Results for survivors indicated that there were no clinically important deteriorations in any of these measures. In fact, small improvements on most measures were found. The health status changes were similar for patients originally in a clinical trial and for those receiving routine specialty care. Age was found to positively relate to improvements in psychological status and overall arthritis impact, but we were unable to demonstrate any consistent effects of sex, marital status, education, or disease duration. Our results contrast with other studies that have noted major declines over time in the health status of patients with rheumatoid arthritis. Furthermore, level of education was not a major determinant of morbidity in this group. These results suggest that health status in certain patients with rheumatoid arthritis is more stable than previously thought. This has implications for both clinical practice and clinical research in rheumatology.     

心理干预对耳鼻喉局麻手术患者的影响

目的观察心理干预对耳鼻喉局麻手术患者的心理影响。方法将在耳鼻喉科局麻下行手术治疗的76例患者随机分为观察组和对照组,各38例,对照组按常规健康教育,围手术期不进行心理干预;观察组在常规健康教育基础上,围手术期进行心理干预。采用Zung焦虑自评量表测量患者心理状态,用多功能监护仪监测围手术期患者呼吸、脉搏、心率、血压及氧饱和度,用视觉模拟镇痛评分法（VAS）评估患者的镇痛效果。结果两组患者术前心理焦虑均高于正常,但观察组低于对照组（P〈0．01）,手术过程患者疼痛程度与心率、收缩压、舒张压均明显低于对照组（P〈0．01）。结论正确的心理干预可使患者有安全感,消除其紧张、恐惧与忧虑,提高疼痛阈值,增强患者对手术的信心,有利于患者围手术期生命体征的稳定和术后健康恢复。     

Musculoskeletal Pain and Psychological Distress in Hospital Patient Care Workers

Purpose The aim of the study was to assess the association of psychological distress and musculoskeletal pain, how it is related to pain interference with work and multiple pain areas, and potential differences between the different pain areas in hospital patient care workers. Methods Data were collected from a cross-sectional survey of patient care workers (n?=?1,572) from two large hospitals. Results Patient care workers with musculoskeletal pain reported significantly more psychological distress than those without pain. Psychological distress was significantly related to pain interference with work, even after adjusting for pain and demographics (OR?=?1.05; CI?=?1.01?C1.09). The association was strongest for those with both upper- and lower body pain (OR?=?1.12; CI?=?1.06?C1.18). Psychological distress was also independently associated with multiple pain areas. Conclusions Psychological distress was found to be higher in workers with musculoskeletal pain, and highest among workers with both upper and lower body pain. Distress was further significantly associated with pain interference with work as well as number of pain areas. The findings may be followed up with a longitudinal design to better determine the direction of the associations, and to investigate if psychological distress increases the risk of work disability and injuries.