放松护理干预对高血压老年患者睡眠障碍的影响

目的 探讨放松护理干预对高血压老年患者睡眠障碍的影响.方法 选择本院100例老年高血压合并睡眠障碍患者,随机分为观察组和对照组.对照组给予常规护理,观察组在常规护理基础实施放松护理干预.采用睡眠状况自评量表对患者干预前后睡眠障碍情况进行评分.结果 观察组和对照组干预后睡眠时间评分和入睡困难评分分别与干预前比较,差异有统计学意义（P＜0.05）;观察组干预后睡眠时间评分和入睡困难评分与对照组比较,差异有统计学意义（P＜0.05）.结论 放松护理干预有助于改善高血压老年患者的睡眠障碍,护理效果显著.     

放松训练对喉部分切除患者焦虑抑郁情绪的影响

目的探讨放松训练对喉部分切除患者焦虑抑郁情绪的影响。方法80例行喉部分切除术患者,随机分为对照组和观察组。对照组采用喉部分切除常规护理,观察组在喉部分切除常规护理的基础上结合放松训练。结果治疗后,观察组喉部分切除术患者的SAS和SDS评分[（45．2±9．5）分、（45．4±8．6）分]均少于对照组SAS和SDS评分[（53．5±8．8）分、（53．5±7．8）分],差异有高度统计学意义（P〈0．01）。结论放松训练能有效改善喉部分切除术患者术后焦虑抑郁情绪,提高患者的生活舒适度。     

Evaluation of left ventricular diastolic function by fractional area change using cine cardiovascular magnetic resonance: a feasibility study

Background

Evaluation of left ventricular (LV) diastolic function is essential for the management of heart failure. We verified whether LV diastolic function could be evaluated by measuring the fractional area change (FAC) using cine cardiovascular magnetic resonance (CMR).

Methods

We collected clinical data from 59 patients who underwent echocardiography and cine CMR. Normal, impaired relaxation, pseudonormal, and restrictive LV filling were observed in 15, 28, 11, and 5 patients, respectively. We calculated FAC during the first 30% of diastole (diastolic-index%) in the short-axis view, by tracing the contours on only three MR cine images.

Results

The diastolic index was significantly lower (p < 0.0001) in patients with impaired relaxation (32.4 ± 7.5), pseudonormal filling (25.4 ± 5.6), and restrictive filling (9.5 ± 1.5) compared to those with normal diastolic function (67.7 ± 10.8), and the index decreased significantly with worsening of diastolic dysfunction. The diastolic index correlated positively with early diastolic mitral annular velocity measured by tissue Doppler imaging (r = 0.75, p < 0.0001), respectively.

Conclusions

Measurement of FAC can be useful for the evaluation of LV diastolic function using cine CMR.     

A meta-analysis of imagery rehearsal for post-trauma nightmares: Effects on nightmare frequency, sleep quality, and posttraumatic stress

This meta-analysis evaluates the efficacy of imagery rehearsal as a treatment for nightmares, general sleep disturbance, and symptoms of post-traumatic stress. Bibliographic databases and cited references were searched to identify clinical trials of imagery rehearsal in individuals with post-trauma nightmares. Thirteen studies met inclusion criteria and reported sleep and post-traumatic stress outcomes in sufficient detail to calculate effect sizes. Results indicate that imagery rehearsal had large effects on nightmare frequency, sleep quality, and PTSD symptoms from the initial to post-treatment assessments. These effects were sustained through 6 to 12months follow-up. Furthermore, interventions that included both imagery rehearsal and cognitive behavioral therapy for insomnia resulted in greater treatment-related improvement in sleep quality than imagery rehearsal alone. Combined treatment did not improve outcomes for PTSD or nightmares. Notably, effect sizes were small in the single study that included an active-treatment control condition. Future research should identify necessary and sufficient components of interventions for trauma-related sleep disturbance and post-traumatic stress (e.g., exposure, cognitive reappraisal, sleep and circadian regulation).     

放松疗法在膀胱癌术后膀胱灌注化疗中的应用

目的探讨放松疗法在膀胱灌注化疗中的护理效果。方法将85例膀胱癌患者随机分为观察（43例）和对照组（42例）,对照组行常规护理,观察组在此基础上进行身心放松训练。比较两组化疗后不适发生率及持续时间。结果观察组化疗后膀胱刺激征、发热、胃肠道反应发生率及持续时间与对照组比较,差异有统计学意义（P〈0．05,P〈0．01）。结论对膀胱癌患者在健康教育的基础上进行身心放松训练能有效地降低膀胱灌注化疗的应激反应,降低化疗后不适的发生率,缩短其持续时间。     

Bringing Up the Bodies: Psyche–Soma,Body Awareness and Feeling At Ease

This paper looks at how difficult early experiences can give rise to defences in which patients rely excessively on their minds, or on bodily activity, having little faith in good reliable objects, internal or external, and little capacity for relaxation and just being. Links are made between Winnicott's theories about mind and psyche–soma and Porges' more recent ideas about vagal tone and the parasympathetic nervous system. These ideas are illustrated with a number of clinical examples of patients who were distrustful of others and who were out of touch with their bodily states. Attention is paid to the need to become more ‘body aware’ in our clinical technique, and questions are asked as to how we might manage this.     

Effects of Alpha Feedback Training on Occipital EEG, Heart Rate, and Experiential Reactivity to a Laboratory Stressor

The intent of this study was to examine whether brief alpha biofeedback training would alter the degree of physiological and experiential stress evidenced in an aversive laboratory situation. While occipital alpha and heart rate were monitored, 36 subjects underwent 8 presentations of a warning tone preceding fingertip electric shock by 30 sec. Subjects were then placed into one of three treatments taking place in dim light with eyes open. Group 1 received 24 min of contingent feedback. Group 2 received an equivalent amount of non-contingent feedback and Group 3, a no-feedback control condition, listened to music. Following the treatment period, 12 additional tone-shock pairings were presented, equally divided between eyes-open and eyes-closed trials, also with and without continuation of the treatment period “signal” (i.e. contingent, non-contingent feedback, or music). The results revealed that, in general, enhanced alpha density was maintained by the contingent feedback group during the post-treatment aversive situation. However, the reduction in alpha suppression was not systematically accompanied by corresponding heart rate and self-report reductions in situational reactivity. It was concluded that alpha feedback training was not sufficient to produce a generalized relaxation to the aversive situation. Alternative accounts of the results, focusing primarily on independence of response systems, are discussed.     

Negative-resistance effects in flow through collapsible tubes: 1 Relaxation oscillations

Observations of flow through a collapsible tube with two elastic constrictions in series show that it exhibits a type of negative-resistance behaviour, where increasing the resistance of the downstream constriction decreases the overall resistance to flow. This behaviour occurs because the resistance to flow of an elastic constriction is greater in the transonic configuration than in the sonic, and it cannot be accounted for by the 1-dimensional theory of flow through such tubes. The possibility of conventional negative resistance is demonstrated, and experimental observations of relaxation oscillations are presented and interpreted in terms of a negative-resistance region.     

In Search of the General Tension Factor: Tensional Patterning During Auditory Stimulation

A partial replication of research by Balshan (1962) was undertaken in order to investigate the existence of a general tension factor operating during rest and during auditory stimulation. Thirty female subjects were each exposed to one 20-min session consisting of 15 min of quiet rest followed by 5 min of binaural white noise stimulation. A computer-controlled scanning electromyograph sampled integrated surface EMG activity from a total of eight muscle sites on the head, neck and limbs. Tensional profiles for all eight EMG sites were assembled every 1.84 sec, resulting in an 8×650 data array for each subject. Statistical analyses revealed overall EMG increments at stimulus onset. R-factor analyses on principal components for group data, as in Balshan (1962), revealed group general factors for both prestimulus and stimulus periods. However, P-factoring on principal components of the within-subject data arrays demonstrated that few subjects met minimal loading criteria for a general factor operating in individuals. Such within-subject EMG-site covariations as were observed were reduced considerably when startle responses at stimulus onset were excluded from the principal-component analyses. It is concluded that the group factors obtained in the present experiment and by Balshan (1962) were artifacts of two influences: the erroneous assumption of across-subject equivalence of EMG-site levels, and the summation of uncorrelated EMG activity which biased the group component solutions toward artifactual generality.