心理护理在眼部整形手术患者中的应用效果

目的 探讨在眼部整形手术患者的护理中实施心理护理的效果。方法 选取2022年2月-2023年2月 于我院行眼部整形手术的80例患者为研究对象,采用随机数字表法分成对照组和研究组,每组40例。对照 组给予常规护理,研究组在常规护理的基础上给予心理护理,比较两组负性情绪、心理弹性、希望水平及 护理满意度。结果 研究组护理后HAMA、HAMD、FAVS评分均低于对照组（P＜0.05）;研究组护理后心 理弹性评分高于对照组（P＜0.05）;研究组术前1 h及术后7 d希望水平评分均高于对照组（P＜0.05）;研 究组护理满意度为95.00%,高于对照组的77.50%（P＜0.05）。结论 心理护理在眼部整形手术患者中的应 用效果确切,能够有效缓解患者的焦虑、抑郁、恐惧等负性情绪,提高其心理健康水平,且患者对护理工 作的满意度较高,值得临床应用。     

Complementary and integrative health therapies in whole person resilience research

Complementary and integrative health approaches can improve health and well-being, as well as play an important role in disease prevention. The concept of whole person health builds on these concepts by empowering individuals, families, communities, and populations to improve their health in multiple interconnected domains: biological, behavioural, social, and environmental. Research on whole person health involves studies of interconnected biological systems and complex approaches to prevention and treatment. Some of these approaches may involve methods of diagnosis and therapy that differ from those used in conventional Western medicine. Of growing interest is how complementary, integrative, and whole person health approaches contribute to resilience. This brief commentary describes an integrated framework for mapping the connections between various complementary and integrative health therapeutic inputs onto aspects of resilience, including the ability to resist, recover (partially or fully), adapt, and/or grow in response to a following a stressor. The authors present selected examples of research studies supported by the National Institutes of Health that test whether complementary and integrative health approaches can promote some aspect of resilience. We conclude with a discussion of the challenges and opportunities in incorporating the study of resilience in complementary, integrative, and whole person health research.     

家庭参与式绘画治疗对心境障碍青少年的影响研究

目的 探索家庭参与式绘画治疗对心境障碍青少年情绪调节及亲子关系的干预效果。方法将70例心境障碍青少年按照病区分为对照组和观察组各35例,对照组进行常规治疗护理,观察组另予家庭参与式绘画治疗干预,共8次。比较两组干预前和干预后的情绪调节与亲子关系。结果观察组干预后情绪调节量表重新评价维度得分,青少年心理韧性量表的情绪控制、积极认知和家庭支持维度得分,父母依恋量表信任、沟通维度和总分显著高于对照组,情绪调节量表表达抑制维度得分显著低于对照组（均P<0.05）。结论家庭参与式的绘画治疗可改善心境障碍青少年的情绪调节能力,增进亲子依恋度,改善家庭关系。     

急性心肌梗死患者介入治疗术后心理弹性及影响因素分析

目的了解急性心肌梗死患者介入治疗(PCI)术后心理弹性现状及影响因素。方法采用便利抽样法对银川市3所三级甲等医院229例住院行PCI的急性心肌梗死患者,应用心理弹性量表、一般自我效能感量表、应对方式问卷进行调查。结果急性心肌梗死患者PCI术后心理弹性总分为(67.22±12.39)分。多元线性逐步回归分析显示:文化程度、居住地、自我效能、面对应对及屈服应对为心理弹性的影响因素(调整R~2=0.334)。结论急性心肌梗死患者PCI术后心理弹性处于中等水平,可提高患者自我效能及鼓励患者采取面对应对,以提升其PCI术后心理弹性水平。     

Conceptualizing a resilience research framework at The National Institutes of Health

The National Institutes of Health (NIH) have recently gathered internal and external input towards a shared understanding of resilience in the wide context of human health and the biomedical sciences that would help accelerate advances in human health and its maintenance. This shared view is that resilience refers in general to a system's capacity to recover, grow, adapt, or resist perturbation from a challenge or stressor. Over time, a system's response to a challenge might show varied degrees of reactions that likely fluctuate in response to the type of challenge (internal and/or external), severity of the challenge, the length of time exposed to the challenge, other external factors and/or biological factors (innate and/or external). We have embarked on this special issue as an opportunity to explore commonalities amongst viewpoints on the science of resilience covered by the various NIH Institutes, Centers, and Offices (ICOs) with respect to the characterization of various systems, stressors, outcomes measures and metrics, and interventions and/or protective factors that are shared within each domain and across multiple domains. Here, resilience is characterized broadly by four areas of scientific study: molecular/cellular, physiologic, psychosocial and spiritual, and environmental/community resilience. Each area or domain provides general frameworks for designing studies that may help advance the science of resilience within the context of health maintenance. This special issue will also acknowledge the remaining gaps that impede advancement of the science of resilience and offer considerations for potential next steps towards addressing the research gaps.     

学龄前孤独症患儿照顾者连带病耻感及影响因素分析

目的 探讨学龄前孤独症谱系障碍患儿照顾者连带病耻感现状及其与疾病获益感、心理弹性的相关性。 方法 采用一般资料问卷、连带病耻感量表、疾病获益感量表、心理弹性量表对258名学龄前孤独症谱系障碍患儿照顾者进行调查。 结果 学龄前孤独症谱系障碍患儿照顾者连带病耻感条目均分2.44±0.46,情感维度病耻感最高,且得分最高的5个条目均归属于情感维度。疾病获益感、心理弹性与连带病耻感呈显著负相关（均P＜0.05）。分层回归分析结果显示,学龄前孤独症谱系障碍患儿照顾者连带病耻感主要受就业状态、夫妻关系、疾病严重程度和心理弹性因素影响,在控制照顾者及患儿一般资料后,疾病获益感未影响连带病耻感,而心理弹性能解释连带病耻感总变异的8%（P＜0.05）。 结论 孤独症谱系障碍患儿照顾者连带病耻感处于较高水平,情感维度病耻感最为严重。医护人员应重视照顾者的心理感受,采取措施提高其心理弹性,引导其以积极的心态面对困难,从而降低连带病耻感。     

A resilience intervention involving mindfulness training for transplant patients and their caregivers

Solid organ and stem cell transplant patients and their caregivers report a substantial level of distress. Mindfulness‐based stress reduction has been shown to alleviate distress associated with transplant, but there is limited experience in this population with other mindfulness‐based interventions, or with combined transplant patient and caregiver interventions. We evaluated a novel, 6‐week mindfulness‐based resilience training (MBRT) class for transplant patients and their caregivers that incorporates mindfulness practice, yoga, and neuroscience of stress and resilience. Thirty‐one heart, liver, kidney/pancreas, and stem cell transplant patients and 18 caregivers at Mayo Clinic in Arizona participated. Measures of stress, resilience, depression, anxiety, health‐related quality of life, positive and negative affect, and sleep were completed at baseline, 6 weeks, and 3 months postintervention. At 6 weeks and 3 months, patients demonstrated significant (P<.005) improvements from baseline in measures of perceived stress, depression, anxiety, and negative affect. Quality‐of‐life mental component (P=.006) and positive affect (P=.02) also improved at follow‐up. Most participants adhered to the program, were satisfied with class length and frequency, and reported improved well‐being as a result of the class. MBRT holds promise as an intervention to enhance resilience and manage stress for transplant patients and their caregivers.     

家庭医生职业认同状况及社会弹性对其影响研究

背景　近年来,医生离职事件屡见不鲜,而家庭医生作为社区的健康管家,若产生离职意愿不仅影响其职业发展,更不利于实施全民健康规划。目前,国内的家庭医生主要由基层全科医生担任,在自身工作外还需提供上门服务,更容易使家庭医生产生职业倦怠。如何避免家庭医生离职,增强其职业认同是关键所在。目的　探讨社会弹性对家庭医生职业认同的影响,以期提高家庭医生的职业认同,促使家庭医生制度可持续推进,为基层患者提供更优质的医疗服务。方法　2018年10月-2019年6月,采用分层多阶段随机抽样的方法,以浙江省行政区分类作为分层的依据,根据经济发展程度,选取杭州、宁波、温州、金华、湖州、舟山、台州、丽水8个城市,再根据基层卫生院的发展状况抽取321个卫生院,选取其中的2 500名家庭医生进行问卷调查,调查内容包括一般资料及《家庭医生职业认同调查表》。通过多元逐步线性回归,分析社会弹性与家庭医生职业认同各维度间的关系。结果　共发放问卷2 500份,收回2 319份,有效问卷2 261份,有效回收率为90.44%。家庭医生职业认同总分（3.6±0.7）分,职业期望维度得分（3.0±1.0）分,职业归属维度得分（3.4±1.3）分,职业价值观维度得分（4.1±1.2）分,职业认知维度得分（3.5±1.0）分,职业行为维度得分（4.1±1.1）分。多元逐步线性回归结果显示,创新能力、心理弹性、社区包容、机会平等、社会支持是家庭医生职业认同的影响因素（P<0.05）,创新能力、机会平等是家庭医生职业期望的影响因素（P<0.05）,创新能力、心理弹性、社区包容、机会平等、社会支持是家庭医生职业归属的影响因素（P<0.05）,心理弹性、社区包容、机会平等、社会支持是家庭医生职业价值观的影响因素（P<0.05）,创新能力、社区包容、社会支持是家庭医生职业认知的影响因素（P<0.05）,创新能力、心理弹性、社区包容是家庭医生职业行为的影响因素（P<0.05）。结论　浙江省家庭医生的职业认同感总体水平处于中等偏上,仍有提升空间。社会弹性中的创新能力、心理弹性、社区包容、机会平等、社会支持均能影响家庭医生的职业认同感,其中机会平等是影响家庭医生职业认同的首要因素。     

叙事护理干预对心脏瓣膜置换术患者心理状态的影响

目的 探讨叙事护理在心脏瓣膜置换术患者围术期心理干预中的应用效果。 方法 将100例心脏瓣膜置换术患者随机分为观察组和对照组各50例。对照组实施常规心理护理,观察组在此基础上实施叙事护理干预。比较两组患者的焦虑、抑郁状态,自我效能感、心理弹性和护理满意度。 结果 干预后观察组患者的焦虑、抑郁评分显著低于对照组, 自我效能感、心理弹性得分及护理满意度显著高于对照组（P＜0.05,P＜0.01）。 结论 对心脏瓣膜置换术患者实施叙事护理,可有效缓解其围术期焦虑抑郁情绪,增强心理弹性和自我效能感,提高患者住院满意度。