综合护理在女性抑郁症康复中的应用

[目的]探讨综合性护理对规范药物治疗的女性抑郁症病人转归的影响。[方法]2010年5月—2014年2月我院收治住院的女性重型抑郁症病人90例,随机分为干预组和对照组。均使用帕罗西汀进行基础药物治疗,对照组采用常规护理,干预组采用综合性护理干预。采用抑郁自评量表(SDS)、汉密尔顿抑郁量表(HAMD)评定抑郁症状,观察两组病人治疗依从性情况。[结果]护理干预后干预组SDS评分(36.4分±2.6分)低于对照组(46.2分±2.8分);干预组HAMD评分(9.4分±1.8分)低于对照组(19.2分±2.3分);干预组治疗总依从率(95.83%)高于对照组(85.71%),两组比较差异均有统计学意义(P0.05)。[结论]综合性护理干预用于女性重型抑郁症病人的治疗能提高疗效、增加病人治疗依从性。     

认知行为干预对围生期心肌病合并心力衰竭病人预后的影响

[目的]探讨认知行为干预对围生期心肌病合并心力衰竭病人预后的影响。[方法]将2006年1月—2014年12月北京安贞医院急诊抢救室救治的29例围生期心肌病合并心力衰竭病人随机分成观察组15例和对照组14例,两组均给予常规药物治疗,观察组给予认知行为干预,对照组给予常规护理,随访(24.0±0.2)个月,观察两组病人短期和长期临床症状及心理状态改善情况。[结果]观察组病人出院前焦虑自评量表(SAS)评分为(39.33±6.57)分,抑郁自评量表(SDS)评分为(45.88±5.47)分;对照组病人出院前SAS评分为(44.17±6.86)分,SDS评分为(50.02±6.55)分,两组比较差异均有统计学意义(P0.05),且观察组病人依从性较好,症状改善情况优于对照组。[结论]及时的药物治疗联合认知行为干预可以改善病人的心理状况和心功能情况。     

护理干预在原发性骨质疏松症合并椎体骨折病人护理中的应用

[目的]探讨护理干预在原发性骨质疏松症合并椎体骨折病人护理中的应用。[方法]将61例骨质疏松症合并椎体单纯压缩性骨折病人随机分为对照组28例和观察组33例,对照组病人采取常规护理,观察组病人在常规护理基础上给予护理干预。监测病人治疗前后骨密度,比较两组的治疗效果。[结果]观察组治疗效果、骨密度改善优于对照组（P〈0．05）。[结论]对骨质疏松症合并椎体单纯压缩性骨折病人进行早期护理干预,可提高骨量、恢复骨质结构,具有明显的治疗效果。     

综合护理干预对反复种植失败冻融胚胎移植病人心理和妊娠结局的影响

[目的]探讨综合护理干预对体外受精-胚胎移植(IVF-ET)反复种植失败冻融胚胎移植(FET)病人治疗结局的影响。[方法]选择2015年1月—2015年5月在我院反复种植失败2次及以上,有冻融胚胎进行FET移植治疗周期的134例病人为研究对象,将单日入移植治疗周期的66例病人设为对照组,给予常规护理干预;双日入移植治疗周期的68例病人设为观察组,给予常规护理联合音乐疗法、耳穴按摩、药膳进行综合护理干预。在FET周期治疗启动日发放焦虑自评量表(SAS)和抑郁自评量表(SDS)评估其心理状态,并在FET移植日再次进行问卷调查。比较干预后两组病人心理状况、临床妊娠率、流产率、活产率。[结果]FET移植日对照组SAS得分为(48.62±5.04)分,SDS得分为(50.77±6.56)分,观察组SAS得分为(44.27±4.85)分,SDS得分为(46.26±7.41)分,两组比较差异有统计学意义(P0.01);观察组临床妊娠率(60.82%)高于对照组(53.03%),流产率(5.88%)低于对照组(16.67%),两组比较差异均有统计学意义(P0.05)。[结论]综合护理干预能有效降低反复种植失败病人的焦虑状态,缓解病人的心理压力,从而获得更好的临床治疗结局。     

护理干预对骨折术后病人焦虑与抑郁心理的影响

[目的]观察护理干预对骨折术后病人焦虑与抑郁心理的影响。[方法]将150例骨折病人随机均分为观察组与对照组,对照组予手术治疗及基础护理措施,观察组病人在此基础上给予护理干预。采用焦虑自评量表(SAS)以及抑郁自评量表(SDS)对病人护理前后焦虑及抑郁进行评分。[结果]观察组病人护理后SAS及SDS评分较护理前降低,且低于对照组护理后(P<0.05)。[结论]对骨折术后病人实施综合护理干预可改善病人的焦虑及抑郁情绪。     

综合护理干预对乳腺增生病人心理状态的影响

[目的]了解综合护理干预对乳腺增生病人心理的影响。[方法]将200例首次药物治疗的乳腺增生病人随机分为观察组和对照组,对照组药物治疗的同时给常规护理,观察组在此基础上给予综合护理干预措施。采用焦虑自评量表(SAS)和抑郁自评量表(SDS)分别测量首诊时和治疗3个月后的焦虑和抑郁状况。[结果]综合护理干预3个月后观察组SDSSAS评分与对照比较差异有统计学意义。[结论]对乳腺增生病人给予综合护理干预可减轻或缓解负性情绪。     

肠易激综合征病人心理评估及护理干预

[目的]调查肠易激综合征病人的心理状况,探讨相应的护理干预措施。[方法]将68例肠易激综合征病人随机分为观察组和对照组各34例,两组病人药物治疗相同,观察组同时采用心理治疗与护理干预,疗程为12周,分别于治疗前1周及治疗后12周采用症状自评量表(SCL-90)、焦虑、抑郁自评量表对两组病人进行测评。[结果]治疗后观察组SCL-90总分及各因子分以及焦虑、抑郁量表评分均下降,与对照组比较差异有统计学意义(P0.05)。[结论]肠易激综合征病人心理健康状态普遍较差,采用心理治疗与护理干预对肠易激综合征病人的康复有一定效果。     

理性情绪调节结合希望理论对癫痫病人心理状况及应对方式的影响

[目的]探讨理性情绪调节结合希望理论在癫痫病人护理中的应用价值。[方法]选取收治的癫痫病人102例为研究对象,经随机数字表法分为对照组51例,观察组51例,对照组给予常规护理,观察组在对照组基础上应用理性情绪调节结合希望理论,观察两组病人心理状态、应对方式变化及治疗依从性。[结果]护理干预前两组病人心理状况比较差异无统计学意义(P0.05),经干预后均有改善,观察组焦虑自评量表(SAS)与抑郁自评量表(SDS)评分低于对照组,差异有统计学意义(P0.05);护理干预前两组病人应对方式比较差异无统计学意义(P0.05),经干预后均有好转,观察组合理化、解决问题、求助评分高于对照组,自责、退避、幻想评分低于对照组,差异有统计学意义(P0.05);观察组病人治疗依从率为96.08%高于对照组(84.31%),差异有统计学意义(P0.05)。[结论]理性情绪调节结合希望理论可有效减少癫痫病人负性情绪,改善其心理状况及应对方式,提高治疗依从性。     

护理干预对骨折术后病人焦虑与抑郁心理的影响

[目的]研究护理干预对骨折术后病人焦虑、抑郁情绪的影响。[方法]将74例骨折病人随机分为对照组和观察组,全部病人均给予手术治疗和基础护理,观察组病人在此基础上给予系统的护理干预。采用Zung焦虑自评量表（SAS）和抑郁自评量表（SDS）评价病人的心理,并比较两组病人干预前后焦虑、抑郁程度的差异。[结果]与治疗前比较,两组病人治疗后SAS评分、SDS评分均有不同程度的下降,差异均有统计学意义（P〈0.05）。观察组病人焦虑、抑郁改善程度明显优于对照组,差异有统计学意义（P〈0.05）。[结论]系统的护理干预可有效改善骨折术后病人的焦虑、抑郁情绪。     

数字化虚拟技术对老年髋骨骨折病人健康教育效果的影响

[目的]探讨数字化虚拟技术对老年髋骨骨折病人健康教育效果的影响.[方法]选择135例老年髋骨骨折病人随机分为观察组67例和对照组68例,观察组在常规护理基础上应用数字化虚拟技术进行健康教育;对照组进行常规护理和健康教育.观察并比较两组病人干预后的治疗配合度、治疗效果、症状自评量表(SCL-90)评分.[结果]观察组治疗配合率为94.03%,对照组为83.82%,观察组明显优于对照组(P<0.05);观察组治愈率为73.13%,对照组为51.47%,观察组明显优于对照组(P<0.05);观察组干预后SCL-90评分5个因子均低于对照组(P<0.05).[结论]在老年髋部骨折病人健康教育中应用数字化虚拟技术效果明显.     

现代残疾康复理念、政策与社区康复体系研究

本研究分析了当代残疾康复的理念和理论架构,构建了以国际公约、决议和政策、国内法律和政策以及操作性工具3个层次的康复理论体系;运用包容性发展,分析探讨了当代社区康复的体系和特点;就发展康复事业、为残疾人提供全面系统的康复服务提出相关的政策建议。     

我院文职护士管理和培训的实践与体会

目的构建文职护士培训、使用及管理的科学方法。方法通过规范管理、科学施训、作为骨干大胆任用等多种管理方式,使文职护士得到充分的发展。结果文职护士群体成长为医院优秀骨干,首批满3年的文职护士顺利通过续聘考核。结论科学的管理培训是文职护士成长的重要基石,对医院护理管理有着重要作用。     

国内外唇腭裂专科护理发展现状的文献研究及分析

目的了解和分析国内唇腭裂专科护理工作发展的现状。方法检索并分析万方医学网、中国知网、Springer Link及PubMed英文数据库近6年有关唇腭裂手术的围术期护理、患儿的喂养、手术安全管理、围术期疼痛研究以及心理护理的相关文献。结果共检索出国内文献89篇(核心期刊20篇)、国外文献22篇,其中围术期护理38篇、患儿的喂养16篇、手术安全管理10篇、围术期疼痛研究10篇、心理护理15篇。结论与国外文献相比,国内论文总结和回顾性居多,应增加研究探讨性论文,从而促进唇腭裂临床护理工作专科化的发展。     

城乡学童个性行为特征调查

目的探讨农村与城市儿童的个性行为特征。方法将97名农村学龄儿童设为农村组,97名城市学龄儿童设为城市组,采用艾森克个性问卷一儿童版和Achenbach’s 行为量表一儿童版进行评定分析。结果两组学龄儿童艾森克个性问卷各维度评分均无显著性差异（P均〉0．05）,且与全国常模相一致（P均〉0．05）;农村组男学童Achenbach’s行为量表违纪行为、攻击行为及外向型因子分均显著高于城市组,女学童退缩、社交问题因子分均显著高于城市组（P〈0．05或0．01）,其他因子分均无显著性差异（P均〉0．05）。结论农村与城市儿童个性无显著差异,而农村儿童存在较多的行为问题,可能与其所受教养和生活方式有关。     

Comparison of short-term and long-term protocols for stabilization and preservation of RNA and DNA of Leishmania, Trypanosoma, and Plasmodium

Molecular tools continue to be important in the prevention and control of parasitic diseases. However, using these techniques directly in the field remains a major challenge. Therefore, the preservation of clinical samples collected from endemic field areas for later analysis remains an important preanalytical process. This study aimed at identifying a suitable protocol for stabilization and preservation of RNA and DNA in bioclinical specimens for Trypanosoma, Leishmania, and Plasmodium research. Both spiked and unspiked blood samples were preserved in 7 protocols (different media; storage temperatures). Samples were evaluated for possible degradation of DNA and RNA along the storage duration up to the 10th week. Nucleic acid targets were assessed as follows: (i) Trypanosoma and Plasmodium RNA analysis was done using real-time nucleic acid sequence-based amplification (RT-NASBA) for 18S rRNA and for stage-specific Pfs25 mRNA, respectively; (ii) Trypanosoma DNA assessment analysis was conducted by using a conventional PCR for 18S rDNA; (iii) Leishmania RNA analysis was performed with a quantitative NASBA for 18S rRNA and Leishmania DNA assessment with an RT-PCR for 18S rDNA. Findings suggested that a newly developed L3™ buffer proved to be reliable and suitable for both short- and long-term preservation of parasite nucleic acid material. This buffer is envisaged to be suitable for utilization in field situations where resources are limited.     

History of violence and subjective health of mother and child

Objective: To study the self-reported prevalence of experienced violence among a cohort of women about two years after giving birth, their health during pregnancy, pregnancy outcomes and their experience of their child’s health.

Setting and subjects: In 2011, a total of 657 women participated in phase III of the Childbirth and Health Cohort Study in Icelandic Primary Health Care, 18 to 24 months after delivery. The women had previously participated in phase I around pregnancy week 16 and phase II 5–6 months after delivery. Data were collected by postal questionnaires.

Main outcome measures: Women’s reported history of experienced violence, sociodemographic and obstetric background, self-perceived health, the use of medications and their child’s perceived health.

Results: In phase III, 16% of women reported experiencing violence. These women felt less support from their current partner (p?p?p?p?p?p?=?0.008).

Conclusions: Our study confirms that a history of violence is common among women. A history of violence is associated with various maternal health problems during and after pregnancy, a higher rate of caesarean sections and maternal reports of health problems in their child 18–24 months after birth.

• KEY POINTS

• Violence is a major concern worldwide. Understanding the impact of violence on human health and developing effective preventive measures are important elements of any public health agenda.

• ??The reported prevalence of experiencing violence was 16% among women attending antenatal care in the primary health care setting in Iceland.

• ??Women with a history of violence reported worse health in general during pregnancy and delivered more often by caesarean section, compared to women with no such history.

• ??Mothers with a history of violence also evaluated the general health of their child as worse than women with no such history.

• ??The findings of this study support the importance of recognizing and addressing experienced violence among women in primary care.

     

Rates and risks of transmission of smallpox and mechanisms of prevention

In 1980, the World Health Organization declared smallpox eradicated from the world; the last known natural case had occurred in Somalia in 1977, and the United States had stopped routinely vaccinating its citizens in 1972. However, with increasing concerns regarding domestic and international terrorism, smallpox has resurfaced as a potential threat to global health. We review the direct and indirect modes of smallpox transmission and how patterns of transmission vary substantially, depending on the severity of circulating disease, vaccination status, environmental and socioeconomic factors, and the setting of an outbreak. We examine mechanisms for controlling outbreaks of disease and preventing further transmission in the event of an outbreak, with an emphasis on smallpox vaccination.     

通用设计原则与产品研发策略

本文介绍了通用设计的概念和设计原则,并阐述了根据此原则实施通用设计的产品研发策略。通用设计惠及的不仅是残疾人,也惠及了包括普通公众在内的广泛人群,以及企业。应将通用设计的原理应融入政府相关政策和未来发展的规划中,为残疾人以及更多人群提供合理便利的通用设计产品。     

胃癌DNA含量与E-cad、EGFR表达的关系及其意义

目的　探讨胃癌组织DNA含量与E cad、EGFR表达的关系 ,评价其在浸润、转移潜能及预后判断中的作用。方法　应用图像分析仪及SP免疫组化法检测 30例正常胃黏膜上皮、30例不典型增生和 5 0例胃癌组织DNA含量与E cad、EGFR蛋白表达情况。结果　①正常胃黏膜上皮、Ⅰ、Ⅱ、Ⅲ级不典型增生及胃癌组的DI、PI、S %、>5c %逐渐增高 ,与胃癌分期、淋巴结转移显著相关 (P <0 0 1)。②E cad在正常胃黏膜上皮阳性表达率 10 0 % ,EGFR呈阴性表达 ;Ⅰ、Ⅱ、Ⅲ级不典型增生及胃癌E cad阳性表达率逐渐降低 ,EGFR的阳性表达率逐渐升高 ,且差异显著 (P <0 0 5 ) ;E cad表达减弱、EGFR表达升高与胃癌分化差、淋巴结转移显著相关 (P <0 0 1)。③E cad表达阴性的胃癌DNA指数及EGFR表达水平显著高于E cad阳性 (P <0 0 1)。结论　检测DNA含量及E cad、EGFR蛋白表达有助于胃癌的早期诊断及转移潜能和预后的判断。     

Prevalence and severity of nausea and vomiting of pregnancy and effect of vitamin supplementation.

OBJECTIVE: Although nausea and vomiting of pregnancy is the most common medical condition during pregnancy, there are many unanswered questions regarding its cause, epidemiologic features and optimal management. The objectives of this study were to ascertain the prevalence of nausea and vomiting in a sample of Canadian women, to characterize the distribution of their severity and to investigate the role of vitamin B6 deficiency in their etiology. DESIGN: Prospective study. SETTING: Antenatal counselling service for pregnant women. PATIENTS: Three cohorts of women: a prospective, population-based cohort of 193 women, to estimate the rate and severity of nausea and vomiting (cohort A); a cohort of 555 women who sought advice for nausea with or without vomiting, to study the correlation between the maximal daily number of episodes of vomiting and maximal weight loss (cohort B); and a prospective cohort of 301 women who reported vomiting, to correlate vitamin supplementation with vomiting (cohort C). INTERVENTIONS: All 3 cohorts were interviewed during the counselling session, and cohort B was followed up prospectively. OUTCOME MEASURES: Frequency of nausea and vomiting, weight loss, maximal number of daily episodes of vomiting, rate of multivitamin supplementation. RESULTS: Overall, 67% of the women in cohort A reported experiencing nausea or vomiting, or both; 22% reported vomiting, and 9% experienced weight loss. In cohort B there was a significant correlation between the maximal number of daily episodes of vomiting and maximal weight loss, although there was wide variation (r2 = 0.25, p < 0.001). There was a highly significant correlation between the number of daily vomiting episodes and mean weight loss (r2 = 0.99). In cohort C, vomiting was significantly associated with lack of supplementation with multivitamins before 6 weeks' gestation (p = 0.002). CONCLUSIONS: The relation between number of daily vomiting episodes and mean weight loss may serve as a clinical tool to assess the severity of nausea and vomiting in pregnancy and the success of anti-emetics and rehydration regimens. Further study is needed to elucidate the biologic basis of the observed association between vomiting and lack of multivitamin supplementation in early pregnancy.