改进原位肛门整形重建术的临床研究

目的探讨采用改进的四联术原位肛门整形重建术的效果。方法38例低位直肠癌行Miles根治术后行一期改进的四联术原位肛门整形重建术,改进包括:①肛门内括约肌改进为双层双套环;②肛门外括约肌改进为肛门外括约肌浅部与深部重建;③直肠角改进为肛提肌切缘牢固地缝合于肛门括约肌外面与结肠前壁;④直肠瓣改进为三个人工直肠瓣。结果38例术后肛门外形、功能及远期生存率均更为优良,术后肛门功能测试的总优良率达94·73%,远期生存率高达76·32%。结论改进的四联术原位肛门重建术的效果良好,改进术式的设计也更符合正常解剖结构与生理功能。     

Preterm Birth: Implications for Family Stress and Coping

The event of preterm birth represents a significant risk to the equilibrium of the family, often placing the family under significant stress. This paper is intended to assist neonatal nurses in understanding factors related to a family's appraisal of stress and strategies used for coping. Such factors are an important consideration in planning the most effective interventions to support optimal family adaptation to their preterm infant's birth. In identifying the best clinical approaches to supporting a family coping with the event of a preterm birth, nurses need to consider levels of the evidence that supports adoption of clinical intervention strategies. Working to reduce family stress and improve family coping ensures the most optimal home environment for the preterm infant to grow and thrive in after discharge.     

对构建特色医院文化的思考

21世纪的医院是文化的医院,21世纪医院的竞争是文化的竞争,谁能构建出具有特色的医院文化,谁就能赢得竞争主动权。构建特色医院文化,核心是形成共同的理想和精神支柱;关键是打造“学习型”医院组织;根本是树立以人为本、诚信求实的服务理念;目标是树立良好的医院形象;基础是加快医院信息化建设。     

强迫症患者的防御机制、父母教养方式及个性特征的调查分析

目的　探讨强迫症患者的防御机制、父母教养方式及其个性特征。方法　采用防御方式问卷 (DSQ)、父母养育方式评价量表 (EMBU)及艾森克个性问卷 (EPQ)对 36例强迫症患者进行了问卷调查 ,并与 36例正常受试者加以比较。结果　①强迫症组中间型和不成熟防御机制因子分均明显高于正常对照组 (P <0 0 1) ,而成熟防御机制因子分则明显低于正常对照组 (P <0 0 5 ) ;②强迫症组父母的情感温暖因子分低 ,而父母的惩罚、拒绝因子分和母亲的偏爱被试因子分高 ,同正常对照组比较 ,差别均具有显著性或非常显著性意义 (P <0 0 1或P <0 0 5 ) ;③强迫症组EPQ的N因子分明显高于正常对照组 ,而E因子分则明显低于正常对照组 (P <0 0 1)。结论　强迫症患者的防御机制、父母教养方式及个性特征与正常人有着明显的不同 ,它为今后开展分析性心理治疗 ,实施心理干预措施提供了依据。     

口腔医学专业学生认知风格与口腔正畸学学习成绩关系的研究

目的提出对学习策略和教学方式的改进建议。方法测试口腔医学生的场依存/独立认知风格,并用统计学方法分析其与口腔正畸学学习成绩的关系。结果①场独立认知风格是口腔医学专业学生认知风格的主体;②不同性别口腔医学专业学生的场依存/独立认知风格无显著性差异;③学生场依存/独立认知风格与口腔正畸学理论考试成绩有负相关倾向,与口腔正畸学实习操作成绩有正相关倾向。结论学习策略和教学方式因受认知风格的影响而制约学生学习的效果。     

腹膜透析患者应对压力的方式与焦虑抑郁情绪的关系

目的：探讨应对压力的方式与腹膜透析患者的焦虑抑郁情绪的关系。方法：采用自填式结构问卷，对81例腹膜透析患者进行调查，了解患者的一般情况和患者应对措施，同时用综合性医院焦虑和抑郁情绪量表测量他们的焦虑与抑郁情绪。结果：控制年龄等因素后的等级回归分析表明：使用“面对”和“自我缓解”应对方式显著降低患者的焦虑情绪，采用“屈从”应对方式增加焦虑的发生；文化程度高的患者采用逃避应对方式则大大增加焦虑情绪的程度，女性和经济收入高者采用面对应对方式可以大大降低焦虑情绪的发生；“自我缓解”应对方式显著降低患者抑郁情绪发生的可能性。结论：不同的应对方式对腹膜透析患者的焦虑抑郁情绪存在差异。     

影响出国维和待命士兵应付方式的相关因素

目的 了解参加维和部队士兵在出国前的心理应付方式，探讨应激性心理障碍与应付方式的关系。方法 采用应付方式问卷量表（CSQ），艾森克（EPQ）个性问卷量表和生活事件量表，Zung焦虑自评量表（SAS）、抑郁自评量表（SDS），对维和待命士兵进行测评，分组进行对照分析。结果 年龄与“自责”、“幻想”因子呈负相关，文化程度与“求助”因子呈负相关，军龄与“解决问题”呈正相关，与“自责”呈负相关；正性事件分值与“求助”、“合理化”因子呈正相关，负性事件分值与“自责”、“退避”呈正相关，生活事件总值与“自责”、“退避”呈正相关。结论 士兵应付方式与年龄、军龄、文化程度、性格具有相关性，焦虑抑郁组应付方式和对照组有较大差异。在士兵中进行应付方式的教育和训练，有益于平战时的心理健康。     

实习期医学生心理健康状况、应对方式及压力状况的调查

目的探讨实习期医学生心理健康状况、应对方式及压力状况。方法将进入临床实习期的364名临床医学生作为研究组,而选取379名非实习期的临床医学生作为对照组,问卷评定采用症状自评量表(SCL-90)、应对方式问卷及心理身体紧张松弛测试表。结果研究组SCL-90的人际关系敏感、强迫、抑郁、焦虑、敌对因子得分显著高于对照组(t=2.25~5.17,P<0.05);与对照组相比,研究组的应对方式中解决问题因子分有显著性降低,自责、退避因子分则有显著性增高(t=-1.97~2.89,P<0.05);研究组的心理压力状况明显差于对照组,且差异具有显著性意义(χ2=56.03,P<0.05)。结论实习期的临床医学生存在不同程度的心理问题,应予以足够重视。     

The relationship between activity and pain in patients 6 months after lumbar disc surgery: Do pain-related coping modes act as moderator variables?

BACKGROUND: In LBP patients, the relationship between pain and physical activity remains unclear. Whereas a negative relationship between pain and self-reported physical activity was found, this relation disappeared in the case of overt behavioral data (e.g., accelerometer). Cognitive-behavioral models of the development of chronic pain suggest subgroups with signs of physical underuse and overuse. AIMS: To examine if patients with pain-related adaptive, endurance and fear-avoidance coping differ in pain, self-reported physical function and overt physical activity 6 months after disc surgery. METHODS: 24 patients completed questionnaires (Von Korff chronic pain grade (CPG), Kiel pain inventory (KPI), Funktionsfragebogen Hannover-Rücken FFbH-R) and underwent an 8-h accelerometer assessment in their daily life (physical activity level (PAL), number of constant postures (CP)). The KPI differed between adaptive coping (AC) (N=9), fear avoidance coping (FAC) (N=1) and endurance coping (EC) (N=14). RESULTS: In the whole group, pain intensity was negative related to self-reported physical activity whereas PAL and CP displayed no correlation with pain. EC patients showed significantly higher pain scores and lower self-reported physical functioning compared to AC but the same level of PAL and furthermore, a significantly higher number of CPs in daily life. The visual inspection of the FAC patient revealed also high pain, low physical functioning and low overt physical activity. CONCLUSIONS: The assessment of pain-related coping modes yielded an important differentiation between subgroups of LBP patients 6 months after surgery. Endurance copers displayed signs of overuse in their daily behavior in spite of pain than adaptive copers. The one fear avoidance coper tends to do less physical activity in the sense of underuse.