接纳承诺疗法对口腔癌复发患者癌症复发恐惧的影响

目的探讨接纳承诺疗法降低口腔癌复发患者癌症复发恐惧情绪的效果。方法将63例口腔癌复发患者按照住院时间分为对照组32例和干预组31例。对照组接受常规护理,干预组在对照组的基础上以接纳承诺疗法为理论基础,构建并给予口腔癌复发患者癌症复发恐惧的接纳承诺疗法干预方案。结果干预后,干预组恐惧疾病进展简化量表、接纳与行动问卷、焦虑自评量表得分显著低于对照组(均P0.01)。结论应用接纳承诺疗法干预方案有利于降低口腔癌复发患者癌症复发恐惧情绪。     

脑瘫患儿父母心理弹性现状及影响因素调查

目的 调查脑瘫患儿父母的心理弹性现状及影响因素,为实施针对性心理干预提供参考。方法 便利选取256例脑瘫患儿的父母,采用心理弹性量表、简易应对量表、一般自我效能量表和大五人格问卷进行问卷调查。结果 脑瘫患儿父母的心理弹性得分为58.34±13.35,得分率58.34%。应对方式、自我效能、人格特质与心理弹性呈正相关（均P＜0.01）。父母脑瘫知识水平、坚持康复治疗情况、应对方式、自我效能是影响脑瘫患儿父母心理弹性的因素,可以解释心理弹性变异的46.20%。结论 脑瘫患儿父母心理弹性处于较低水平,受脑瘫知识、康复治疗、应对方式、自我效能等多种因素影响。在临床工作中应开展积极心理干预和康复知识宣教,给予患儿父母社会支持,提升其心理弹性。     

情景游戏对患儿心理行为及其家属情绪状态的影响

目的探讨情景游戏对住院患儿心理行为、患儿家属焦虑与抑郁程度及住院满意度的影响。方法将101例住院患儿按入院时间分为对照组（50例）和观察组（51例）。对照组给予儿内科常规护理;观察组在此基础上融入情景游戏,分别在入院首日、有创操作前及首次检查前,由研究者将患儿及其家属带至情景游戏室,让患儿在模拟情景与游戏中熟悉并理解相关检查与操作,所有过程鼓励患儿家属参与。采用Achenbach儿童行为量表（CBCL）评价两组患儿的行为问题,采用焦虑自评量表（SAS）、抑郁自评量表（SDS）及自行设计的满意度调查表测评患儿家属的焦虑、抑郁程度及对护理工作的满意度。结果两组患儿入院时与出院前CBCL评分比较,差异有显著性意义（均P〈0.01）。观察组出院前CBCL评分低于对照组,但差异无显著性意义（P〉0.05）;其家属出院前SAS、SDS评分及对护理工作的满意度与对照组家属比较,差异有显著性意义（P〈0.05,P〈0.01）。结论情景游戏可减缓患儿住院期间的行为退化;可有效降低患儿家属的焦虑、抑郁程度,提高家属满意度。     

基于接纳与承诺疗法的延续干预对乳腺癌改良根治术患者心理灵活性、病耻感及自护能力的影响

目的 探讨基于接纳与承诺疗法(ACT)的延续干预对乳腺癌改良根治术(Auchincloss术)患者的临床应用价值。方法 回顾性分析2020-01—2021-09在濮阳市3所医院行Auchincloss术的174例乳腺癌患者的临床资料。按出院后的干预方法分为2组,各87例。对照组行常规延续干预,ACT组行基于ACT的延续干预。比较2组患者的基线资料,干预前后的自护能力、心理灵活性、病耻感、自我感受负担和生活质量。结果 2组患者的基线资料差异无统计学意义(P>0.05)。干预后ACT组患者的自我护理技能、自我概念、健康知识、自我护理责任感评分均高于对照组,接纳与行动问卷(AAQ-Ⅱ)评分高于对照组,慢性病病耻感量表(SSCI)评分、自我感受负担和癌症患者生活质量测定量表(QOL-C30)评分均低于对照组。以上差异均有统计学意义(P<0.05)。结论 基于ACT的延续干预能提升Auchincloss术后患者的自护能力、心理灵活性和生活质量,并能减轻患者的病耻感和自我感受负担。     

脑瘫患儿家长心理调适及其影响因素研究

目的探讨脑瘫患儿家长积极与消极心理调适现状及其影响因素。方法采用一般资料问卷、心理健康调查表(MHI 38)、中文版创伤后成长问卷(PTGI-C)对122名脑瘫患儿家长进行调查。结果脑瘫患儿家长心理痛苦得分70.75±19.36,心理幸福感得分44.15±13.66,创伤后成长得分68.98±18.72;相关分析显示,创伤后成长与心理痛苦呈负相关,与心理幸福感呈正相关(均P0.01);多元线性回归结果显示,患儿的瘫痪程度是家长心理痛苦的影响因素,解释22.2%的变异量;患儿的瘫痪程度、家长文化程度、创伤后成长是家长心理幸福感的影响因素,共解释42.7%的总变异。结论脑瘫患儿家长心理痛苦与创伤后成长并存,且积极与消极心理调适具有不同的影响因素,医护人员需全面了解脑瘫患儿家长的心理状态以制定针对性的干预措施。     

118例脑瘫患儿家长的心态调查及护理

脑瘫患儿的智力发育,心理、性格与人格的形成与脑瘫的障碍程度有关,更与其父母的心理状态、治疗的环境、指导教育的效果有密切关系。脑瘫的康复治疗必须与日常生活活动相结合。因此,脑瘫患儿家长的心理状态是决定其能否及时治疗的关键。为了解家长不良心理对患儿的影响,探讨护理对策,笔者于2000年10月至2001年6月对收治的66例脑瘫患儿家长实施心理干预,效果显著。     

团体接纳承诺疗法在炎症性肠病患者心理干预中的应用

目的 探讨团体接纳承诺疗法对炎症性肠病患者的心理干预效果。方法 将93例炎症性肠病患者按住院时间分为对照组46例、干预组47例。两组均行常规治疗与护理,在此基础上干预组制定和实施团体接纳承诺疗法,连续干预8周。评价两组干预前及干预后（干预8周时及干预后1个月）各项指标。结果 两组完成全程研究均为43例;干预后干预组疾病接受度、焦虑、自我管理能力及克罗恩病疾病活动度评分显著优于对照组（均P＜0.05）。结论 针对炎症性肠病患者制定和实施团体接纳承诺疗法,可有效改善患者负性心态,提高自护能力,促进疾病缓解。     

情景游戏对患儿心理行为及其家属情绪状态的影响

目的 探讨情景游戏对住院患儿心理行为、患儿家属焦虑与抑郁程度及住院满意度的影响.方法 将101例住院患儿按入院时间分为对照组(50例)和观察组(51例).对照组给予儿内科常规护理;观察组在此基础上融入情景游戏,分别在入院首日、有创操作前及首次检查前,由研究者将患儿及其家属带至情景游戏室,让患儿在模拟情景与游戏中熟悉并理解相关检查与操作,所有过程鼓励患儿家属参与.采用Achenbach儿童行为量表(CBCL)评价两组患儿的行为问题,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)及自行设计的满意度调查表测评患儿家属的焦虑、抑郁程度及对护理工作的满意度.结果 两组患儿入院时与出院前CBCL评分比较,差异有显著性意义(均P＜0.01).观察组出院前CBCL评分低于对照组,但差异无显著性意义(P＞0.05);其家属出院前SAS、SDS评分及对护理工作的满意度与对照组家属比较,差异有显著性意义(P＜0.05,P＜0.01).结论 情景游戏可减缓患儿住院期间的行为退化;可有效降低患儿家属的焦虑、抑郁程度,提高家属满意度.     

接纳与承诺疗法在国内护理领域应用的文献计量学分析

目的 探讨接纳与承诺疗法在国内护理领域的研究现状及发展趋势,为进一步开展相关研究提供参考.方法 采用文献计量学分析法,对中国期刊全文数据库(CNKI)、维普(VIP)、万方数据库建库至2020年3月的接纳与承诺疗法相关文献进行分析.结果 纳入98篇文献,其中学位论文8篇,期刊论文90篇;从2016年开始文献数量呈逐年上...     

接纳与承诺疗法对尿流改道腹壁造口术患者创伤后成长的影响

目的探讨接纳与承诺疗法对膀胱癌尿流改道腹壁造口术患者创伤后成长的影响。方法根据住院时间将膀胱癌尿流改道腹壁造口术患者分为对照组42例和观察组44例。对照组住院期间行接纳与承诺疗法干预3次,同时行常规健康教育和出院随访;观察组在对照组基础上,于出院后2～3个月对患者行接纳与承诺疗法干预3～4次。采用简体中文版创伤后成长评定量表测评患者干预前、出院时、出院2个月、出院3个月、出院6个月的创伤后成长状况。结果出院时、出院后2个月两组创伤后成长评分比较,差异无统计学意义(均P0.05),出院后3、6个月时两组创伤后成长评分比较,差异有统计学意义(均P0.01)。结论对膀胱癌尿流改道腹壁造口术患者出院后行接纳与承诺疗法干预,为患者提供院外延续性护理方案,可有效提升其创伤后成长水平,利于其身心康复。     

Fractures in children with cerebral palsy

INTRODUCTION: We studied the fracture history in a large population of patients with cerebral palsy to determine which children were at the highest risk for fracture. METHODS: The International Classification of Diseases (Ninth Revision) coding identified 763 children with cerebral palsy. Patients and caregivers were contacted for information about fracture history and risk factors for low bone density. Of the 763 children identified, 418 children (54.8%) were available for this study; 243 (58%) had quadriplegia, 120 (29%) diplegia, and 55 (13%) hemiplegia. Three hundred sixty-six children were spastic, 23 mixed tone, 13 athetoid, and 16 classified as others. We identified 50 children (12%) who fractured; 15 of these same children had, over time, multiple fractures. RESULTS: The number of fractures showed a normal distribution by age, with a mean of 8.6 (SD, 4.0). Children with cerebral palsy with mixed tone had a higher rate of fracture (chi = 14.7, P < 0.01); chi analysis indicated that the children who fractured were, as a group, more likely to use a feeding tube, have a seizure disorder, take valproic acid (VPA), and use standing equipment in therapy. Multiple regression analysis demonstrated older age and VPA use as predictive of fracture and gave the following equation: fracture = -0.01 + (VPA x 0.17) + (age x 0.15).The subgroup that sustained multiple fractures were older at the time of first fracture than the children who had only one reported fracture (t = -2.3, P < 0.05). CONCLUSIONS: The main finding of our article is that older age at first fracture and use of VPA are predictive of fractures and define a group of children with cerebral palsy who may benefit from treatment interventions to increase bone density.     

Uptime in children with cerebral palsy

Quantitative evaluation of function, in children with physical disabilities, has to date been mainly focused on laboratory-based measures. However, the measurement of activity in the community may have a more direct relationship with physical function, health, and well-being. We assessed the utility of a remote activity monitor, the Uptimer (National Aging Research Institute of Melbourne, Melbourne, Australia), to measure one aspect of physical function, time spent in the upright position, in a consecutive cohort of 300 children with cerebral palsy who attended an orthopedic outpatient department. The Uptimer was found to be a valid and reliable tool to measure the amount of time children spent on their feet each day. Uptime was closely related to the severity of cerebral palsy and had excellent correlations with validated instruments including the Pediatric Orthopaedic Data Collection Instrument (PODCI), the Child Health Questionnaire (CHQ), and the Functional Mobility Scale (FMS). Uptime complements any quantitative functional assessment of impairments in children with cerebral palsy.     

The 'true' acetabular index in children with cerebral palsy

INTRODUCTION: The acetabular index is a measurement used to determine whether or not an acetabular osteotomy may be required at the time of hip reconstruction in children. METHODS: A retrospective analysis of pre- and postoperative values of the acetabular index was carried out on two groups of children. One group of children had an acetabuloplasty and the other did not during hip reconstruction, the decision being made at the time of open reduction, based on lack of hip congruity. RESULTS: When the pre-operative acetabular index measurements were reviewed, the mean difference between the two groups was only 7 degrees. Range of measurements was similar between the two groups. CONCLUSIONS: The acetabular index is difficult to measure in some children with cerebral palsy. The bony landmarks are difficult to standardise. This may explain the similar pre-operative values between the two groups of children in this study. We, therefore, recommend that before hip reconstruction in children with cerebral palsy, the measurement of the acetabular index should be abandoned. Decisions as to whether to undertake an acetabuloplasty or not should be made at the time of open reduction.