1396名小学3～6年级儿童适应行为的评价研究

目的通过对儿童适应行为的评价，探讨儿童适应技能发展的现状及规律。方法采用美国精神迟滞学会编制的适应行为量表（AAMD—ABS），对1396名（男性709人，女性687人）3～6年级小学生进行评价。结果儿童的正常适应行为的评价得分随年龄的增长而增加；同年级女生的得分要高于男生。与1994年资料相比，第一、二因子的得分显著增加，而第三因子的得分有所降低。结论儿童的适应能力随年龄的增长而提高，并且在男、女生之间存在着一定的差异；与10年前相比，也有明显的提高，但是不良适应行为有增加的趋势。     

耶鲁抽动症整体严重度量表对抽动障碍患儿的临床评估

目的引进耶鲁抽动症整体严重度量表(YGTSS)并评估其与临床症状轻重的关系，以及以量表积分在观察者间的一致性。 方法2001年7月至2002年6月成都市儿童医院全文翻译YGTSS，未予修改，观察72例抽动患儿YGTSS总积分与临床抽动症状严重度分型的关系和该量表积分进步率与治疗后症状改善程度的关系(临床效度检验)，观察24例患儿该量表运动和发声抽动数量、频度、强度、复杂性、干扰性5个维度积分及总积分在观察者间一致性。 结果抽动患儿该量表总积分与临床抽动症状严重度分型之间和该量表积分进步率与治疗后症状改善程度之间有较好的效度(F值分别为59.31和124.44，P均<0.01)，运动和发声抽动数量、频度、强度、复杂性、干扰性5个维度积分及总积分的组内相关系数(ICC)值均大于0.7，显示较好的观察者间一致性。 结论耶鲁抽动症整体严重度量表中译本具有较好的信度和效度，是衡量抽动症状严重程度的工具之一。     

Symptom dimensions in recent-onset schizophrenia and mania: a principal components analysis of the 24-item Brief Psychiatric Rating Scale

Previous four- and five-factor solutions of the 18-item Brief Psychiatric Rating Scale (BPRS) suggested the possibility of an affective dimension in psychosis. A principal components analysis was used to analyze psychiatric symptom data rated on an expanded 24-item version of the BPRS. BPRS data were collected during a period of acute psychotic and affective illness with 114 young adult, recent-onset schizophrenia and schizoaffective patients and 27 bipolar manic patients. Principal components analyses of the 18-item and 24-item BPRS indicated a four-factor solution was the most interpretable. Principal components analysis of the 24-item BPRS produced a clear mania factor characterized by high loadings from items added to the 18-item BPRS, which included elevated mood, motor hyperactivity, and distractibility. This factor solution suggests that the 24-item BPRS allows for an expanded assessment of affective symptoms relating to a manic dimension. Potentially important symptoms that were added to the traditional 18-item version, namely suicidality, bizarre behavior, and self-neglect, also make clear contributions to other factors.     

Adolescent hyperactivity and general psychopathology

The aim of this study was to explore the relationship between activity and psychopathology in adolescents. A total of 289 high school students completed the Symptom Check List-90-R (SCL-90-R) and Wender Utah Rating Scale (WURS) in December 1998. The WURS was used to measure the students' activity level and the SCL-90-R was used as a measure of general psychopathology. Forty-one students (14.18%) scored higher than 46, the cut-off point for differentiation of attention deficit hyperactivity disorder (ADHD) from the general population according to Ward's report, in the WURS (WURS(+)). The WURS(+) students scored significantly higher than the WURS(-) students in all the subscales of SCL-90-R. The prevalence rate of adolescent WURS(+) in this study is 14.18%. This result shows that ADHD adolescents have overlapping symptoms with depression.     

Measuring the expressed emotion in Chinese family caregivers of persons with dementia: Validation of a Chinese version of the Family Attitude Scale

BackgroundExpressed emotion (EE) captures the affective quality of the relationship between family caregivers and their care recipients and is known to increase the risk of poor health outcomes for caregiving dyads. Little is known about expressed emotion in the context of caregiving for persons with dementia, especially in non-Western cultures. The Family Attitude Scale (FAS) is a psychometrically sound self-reporting measure for EE. Its use in the examination of caregiving for patients with dementia has not yet been explored.ObjectivesThis study was performed to examine the psychometric properties of the Chinese version of the FAS (FAS-C) in Chinese caregivers of relatives with dementia, and its validity in predicting severe depressive symptoms among the caregivers.MethodsThe FAS was translated into Chinese using Brislin's model. Two expert panels evaluated the semantic equivalence and content validity of this Chinese version (FAS-C), respectively. A total of 123 Chinese primary caregivers of relatives with dementia were recruited from three elderly community care centers in Hong Kong. The FAS-C was administered with the Chinese versions of the 5-item Mental Health Inventory (MHI-5), the Zarit Burden Interview (ZBI) and the Revised Memory and Behavioral Problem Checklist (RMBPC).ResultsThe FAS-C had excellent semantic equivalence with the original version and a content validity index of 0.92. Exploratory factor analysis identified a three-factor structure for the FAS-C (hostile acts, criticism and distancing). Cronbach's alpha of the FAS-C was 0.92. Pearson's correlation indicated that there were significant associations between a higher score on the FAS-C and greater caregiver burden (r = 0.66, p < 0.001), poorer mental health of the caregivers (r = −0.65, p < 0.001) and a higher level of dementia-related symptoms (frequency of symptoms: r = 0.45, p < 0.001; symptom disturbance: r = 0.51, p < 0.001), which serves to suggest its construct validity. For detecting severe depressive symptoms of the family caregivers, the receiving operating characteristics (ROC) curve had an area under curve of 0.78 (95% confidence interval (CI) = 0.69–0.87, p < 0.0001). The optimal cut-off score was >47 with a sensitivity of 0.720 (95% CI = 0.506–0.879) and specificity of 0.742 (95% CI = 0.643–0.826).ConclusionsThe FAS-C is a reliable and valid measure to assess the affective quality of the relationship between Chinese caregivers and their relatives with dementia. It also has acceptable predictability in identifying family caregivers with severe depressive symptoms.     

Risk factors for complications and in-hospital mortality: An analysis of 19,834 open pelvic ring fractures

BackgroundOpen pelvic fractures are rare injuries, associated with high patient morbidity and mortality. Few studies have investigated the impact of patient demographics, comorbidities, and injury related factors on complication and mortality rates. The purpose of this study was to: (1) identify the overall incidence of complications and mortality after open pelvic fractures, (2) compare patient factors between those who did and did not develop complications, (3) identify perioperative independent risk factors for complications and mortality.MethodsA query was performed for patients with open pelvic fractures between 2007 and 2017 using the American College of Surgeons National Trauma Data Bank. Patient and injury specific variables were collected and complications were identified using International Classification of Disease Ninth and Tenth edition Codes. Patient demographic and perioperative data was compared using Fisher’s exact test and chi-square test for categorical variables, and Welch’s t-test for continuous variables. Using pooled data from multiple imputations, logistic regressions were used to calculate odds ratios and confidence intervals of independent risk factors for complications.ResultsA total of 19,834 open pelvic fracture cases were identified, with 9622 patients (48.5%) developing at least one complication. Patients who developed complications were older (35.0 vs 38.1 years), and had higher Injury Severity Scores (17.7 vs 26.5), lower Glasgow Coma Scores (14.2 vs 11.7), and a larger proportion presenting with hypotension (21% vs 6.9%). After pooled regression involving 19 factors, these were the strongest independent predictors of inpatient complication and mortality.ConclusionWe report a mortality rate of 14%, with an inclusive complication rate of 48.5%. Evaluating risk factors for morbidity and mortality for this devastating orthopaedic injury provides knowledge of an inherently sparse population.Level of EvidenceLevel II, Retrospective study.     

肺癌患者生活质量的评估及意义

随着现代医学的发展,医学模式已经从生物医学模式进入生物-心理-社会医学模式。世界卫生组织指出:"健康不仅是没有疾病或身体虚弱,而且要有健全的身心状态和社会适应能力"。消除患者病痛和心理障碍、提高生活质量成为治疗癌症患者的重要问题。可应用规范化的量表对肺癌患者生活质量予以评估,应用评估结果指导,以提高肺癌患者的生活质量。在未来的发展过程中,肺癌治疗面临的新挑战是提高患者生活质量。