心理护理对肿瘤患者化疗期间心理状态的影响

目的通过了解肿瘤患者化疗期间的抑郁、焦虑等不良心理状态,并给予系统心理护理干预,减轻化疗副作用,提高生活质量。方法选择40例化疗患者,采用汉密顿抑郁量表(HAMD)和汉密顿焦虑量表(HAMA)评价心理护理前1周及心理护理后4～6周心理状态。结果心理护理干预后抑郁和焦虑评分明显优于干预前,差异有统计学意义(P<0.01)。结论心理护理干预可明显减轻患者化疗期间不良心理状态,提高生活质量。     

全程导乐助产护理联合心理护理干预应用于分娩产妇的临床效果评价

目的 探究全程导乐助产护理联合心理护理干预对分娩产妇焦虑抑郁评分、自然分娩率及新生儿窒息发生率的影响。 方法 以南京医科大学附属无锡妇幼保健院于2018年1月至2019年1月收治的96例产妇为研究对象，随机分为两组各48例。对照组应用常规护理方法助产，观察组采用全程导乐助产护理联合心理护理，分析并比较两组产妇的疼痛程度、焦虑抑郁情绪以及产后母婴结局，如自然分娩率、新生儿窒息、胎儿窘迫以及出血率等。 结果 两组产妇的SAS和SDS评分在生产后都有明显降低（P<0.05），其中观察组产妇两项评分低于对照组（P<0.05）；观察组产妇的疼痛程度多分布于1级（64.58%），而对照组多分布于2和3级（47.90%、27.10%），两组相比，观察组疼痛程度明显轻于对照组（P<0.05）；另外，对照组患者的自然分娩、胎儿窘迫、新生儿窒息、产后出血的发生病例数分别为24（70.8%）、6（12.5%）、5（10.4%）、4（8.3%）例，观察组分别为42（87.5%）、1（2.1%）、0例，观察组各项发生率均明显低于对照组（P<0.05）。 结论 将全程导乐助产护理联合心理护理应用于自然分娩过程，可显著改善产妇负面情绪，降低疼痛程度，促进母婴良好结局，具有临床应用价值。     

Desire for Control, Sense of Control and Obsessive-Compulsive Symptoms

While control-related cognitions have often been implicated in discussions of Obsessive Compulsive Disorder (OCD), empirical investigations of the relationship between control-constructs and OCD symptoms have been relatively limited. In this article it was hypothesized that OCD symptoms may be linked with a higher desire to control (DC), but a lower sense of control (SC) over the self and environment, leading to motivation for compulsive symptoms. This hypothesis was investigated in an analogue population, using regression analyses controlling for depression and anxiety. Consistent with predictions, it was found that higher levels of DC and lower levels of SC were associated with higher levels of OCD-related beliefs and symptoms. While control cognitions were linked with the OCD-related beliefs of perfectionism and the over-estimation of threat, they did not relate to cognitions concerning the importance of/need to control thoughts. With respect to specific OCD-symptoms, control cognitions were most strongly related to contamination obsessions/washing compulsions. Implications for theory and treatment are discussed.

对鼻咽癌放疗患者全程实施心理干预的调查与分析

目的探讨心理干预对鼻咽癌放疗患者治疗的影响。方法123例鼻咽癌放疗患者随机分为两组:观察组63人,进行常规护理、心理护理和心理治疗;对照组60人,接受常规护理,不做心理干预。对两组患者均应用SCL-90症状自评量表测试。结果观察组患者抑郁、焦虑和敌对情绪显著低于对照组(P<0.05);心理护理组患者皮肤、口腔粘膜反应及上消化道反应均低于对照组(P<0.05)。结论正确的心理护理有助于缓解患者心理障碍,减轻放疗副反应,提高生活质量。     

Psychological impact of comprehensive tumor genomic profiling results for advanced cancer patients

ObjectiveComprehensive tumor genomic profiling (CTGP) is increasingly used to personalize treatments, providing hope, but potentially disappointment, for patients. We explored psychological outcomes in patients with advanced, incurable cancer, after receiving CTGP results.MethodsParticipants with advanced, incurable cancer (n = 560, mean age 56, 43% university educated) in this longitudinal substudy of the Molecular Screening and Therapeutics Program (MoST), completed questionnaires before and after receiving CGP results. MoST participants, recruited from Australian oncology clinics, undergo CTGP, and if there are actionable findings, are offered treatment in a related therapeutic trial if available.ResultsPatients who received actionable results, (n = 356, 64%) had lower gene-related distress (MICRA) (p < 0.001) and Impact of Events scores (p = 0.039) than patients with non-actionable results. Those with actionable results offered ensured access to tailored treatment (n = 151) reported lower anxiety (p = 0.002) and depressive symptoms (p = 0.01) and greater hope (p = 0.002) than those not offered. Positive attitudes towards uncertainty and higher self-efficacy for coping with results were associated with lower psychological distress and uncertainty, and higher hope and satisfaction with the decision to have CTGP (ps=0.001–0.047). Those with higher knowledge reported greater anxiety (p = 0.034).ConclusionReceiving a non-actionable CTGP result, or an actionable result without ensured access to treatment, may cause increased distress in advanced cancer patients. Coping style was also associated with distress.Practice implicationsPre-testing assessment and counseling addressing attitudes toward uncertainty and self-efficacy, and post-CTGP result support for patients receiving a non-actionable result or who receive an actionable results without ensured access to treatment, may benefit patients.     

Assessment of peri-operative quality of life in patients undergoing surgery for gastrointestinal cancer

The purpose of this study was to assess the pre- and postoperative quality of life (QOL) of patients with gastrointestinal cancer and to investigate the relationship between QOL and various psychological and clinical factors. Eighty-five patients who underwent surgery for gastrointestinal cancer and 26 control patients undergoing surgery for digestive diseases other than cancer were interviewed. Two tests were administered to assess QOL and psychological status respectively: the Japanese-language version of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and the Japanese-language version of the Hospital Anxiety and Depression Scale (HADS). Each test was administered before surgery, before discharge, and 6 months after discharge. Gastrointestinal tumors were localized to the stomach, colon, or rectum in 88% of cases and classified as advanced stage or early stage according to staging protocols. Changes in EORTC QLQ-C30 subscale scores over time were compared among advanced stage, early stage, and control patients. All groups showed significant changes in subscale scores of QOL; the scores of the advanced-stage group indicated worse QOL than the early-stage and control groups in a lot of areas. The physical function (PF2) QOL subscore was influenced by diagnosis, postoperative complications, medical equipment at discharge, and the length of admission and negatively correlated with depression and anxiety. These results suggest that QOL in gastrointestinal cancer patients is variable over time and is influenced by various clinical factors. Therefore, consideration of these clinical factors is paramount to the optimal care of gastrointestinal cancer patients.     

心理危机干预技术在急诊意外伤害患者中的应用研究

目的：研究心理危机干预技术在急诊意外伤害患者中的应用。方法：将122例急诊意外伤害患者随机分成两组，在负性心理干预方面，对照组给予一般的心理护理。实验组应用心理危机干预技术进行心理干预。测评两组患者的负性心理干预效果及对急诊护理工作的评价。结果：实验组优于对照组，更能缓解患者的焦虑、抑郁及恐惧情绪，同时，提高了患者对急诊护理工作的满意度，差异均具有统计学意义（P〈0.01）。结论：心理危机干预技术适合在急诊意外伤害患者中应用，是一项有利于意外伤害患者的心理护理新技术。     

英国4所大学护理本科成人护理课程的研究及思考

对4所英国大学护理本科注册前护士教育项目的教学计划、护理本科课程设置、课程教学大纲等19份资料进行文献研究,描述成人护理课程群的主要课程要素,归纳出英国护理本科成人护理课程主要优点为按照专业方向设置护理课程,成人护理课程群理论教学与实践活动结合紧密,指导学生自主学习形式多样.提出我国的护理专业课程设置应该体现以人的健康为中心的理念,按照人的生命周期设置成人护理学课程,构建更加富有护理专业特色的课程框架与教学内容体系,围绕学生能力素质培养的核心,进一步改革教学方法与手段,密切理论教学与临床护理实践的联系.     

医院陪护人员心理需求调查分析及对策

目的:了解和探讨医院陪护人员的心理需求,以引起医院各级人员及社会的关注。方法:采用自行设计问卷,以无记名方式对在院正在执行陪护任务的40名陪护人员进行10项心理需求方面的调查。结果:陪护人员中以初中文化程度、30岁以上的女性居多,80%的陪护人员有满足心理需求的愿望。结论:陪护人员作为医院的一支重要的新生力量,医院各级人员应给予充分的理解、信任和支持,利用各种方式、方法关心他们的生活和心理需求,经常给予他们技术的指导和情感的沟通,使他们保持健康愉悦的心理状态,更好地为病人服务。     

Psychological capital mediates the association between nurses' practice environment and work engagement among Chinese male nurses

ObjectivesThis study aims to investigate the environmental and individual factors contributing to male nurses' psychological well-being and to explore the psychological mechanisms that may explain the links between nurses' practice environment and work engagement, thereby presenting the implications for nurse managers.MethodsA total of 161 male nurses from three tertiary first-class hospitals in Changsha City in China participated in the study. We collected the data using the Practice Environment Scale of the Nursing Work Index, the Psychological Capital Questionnaire, and the Utrecht Work Engagement Scale.ResultsScores of male nurses' practice environment (2.88 ± 0.31), psychological capital (4.42 ± 0.62), and work engagement (3.17 ± 1.39) were all above the midpoint; however, the subscales “the nursing staffing and resources adequacy” (2.72 ± 0.48), “hope” (4.33 ± 0.72), and “dedication” (2.96 ± 1.61)scored lowest. Nurses' practice environment and psychological capital positively predicted nurses' work engagement; psychological capital fully mediated the influence of nurses' practice environment on work engagement.ConclusionsCreating a supportive nursing practice environment can increase male nurses' work engagement by developing their psychological capital. Nurse managers can then provide reasonable workload and pathways for male nurses to achieve goals, thereby fostering their hope.