心理干预对康复期脑卒中伴焦虑抑郁障碍患者情绪及幸福感的影响

目的：探讨心理干预对康复期脑卒中伴焦虑抑郁障碍患者情绪及幸福感的影响。方法将120例康复期脑卒中伴抑郁焦虑障碍患者随机分为两组,每组60例。两组均予以神经内科常规治疗及训练,研究组联合心理干预,观察12个月。于干预前后采用焦虑自评量表、抑郁自评量表评定焦虑抑郁情绪,症状自评量表评定心理健康状况,总体幸福感指数量表评定幸福感, Barthel指数量表评定日常生活活动能力;干预12个月评估两组患者的治疗依从性。结果干预前两组各量表评分比较差异无显著性（ P＞0．05）;干预12个月两组焦虑自评量表、抑郁自评量表及症状自评量表评分较干预前显著降低（P＜0．01）,研究组显著低于对照组（P＜0．01）;干预后各时间点两组Barthel指数量表评分和研究组总体幸福感指数量表评分较干预前显著升高（P＜0．01）,研究组显著高于对照组（P＜0．01）。干预后研究组依从率为96．7％,对照组为81．7％,研究组显著高于对照组（ P＜0．01）。结论心理干预能有效缓解或消除脑卒中患者的焦虑抑郁情绪,提高其心理健康水平、总体幸福感及日常生活活动能力,有利于疾病的预后。     

肺结核患者主观幸福感与社会关系质量的相关性分析

目的：了解肺结核患者主观幸福感和社会关系质量现状,并探讨两者的关系,为改善肺结核患者生活质量提供参考。方法采用纽芬兰纪念大学幸福度量表和社会关系质量量表对346例肺结核患者进行问卷调查,并采用Pearson相关分析法和多元线性回归分析法探讨主观幸福感和社会关系质量的关系。结果肺结核患者主观幸福感总分为（21．70±6．65）分,其中低主观幸福感者占31．21％,中等主观幸福感者占56．65％,高主观幸福感者占12．14％;正性因子总分为（14．33±4．31）分,低于负性因子总分（16．63±4．68）分,差异有统计学意义（t＝－6．724,P＜0．01）。肺结核患者社会关系质量总分为（44．93±5．21）分。 Pearson相关分析显示,主观幸福感与家庭亲密度、家庭承担、朋友关系和社会关系质量总分均呈正相关（r值分别为0．453,0．436,0．408,0．432;P＜0．05）。多元线性回归分析结果显示,家庭亲密度、家庭承担、朋友关系均为肺结核患者主观幸福感的影响因素（ P＜0．05）。结论肺结核患者主观幸福感和社会关系质量均较差,社会关系质量为其主观幸福感的影响因素,可从社会关系质量入手来改善其主观幸福。     

High prevalence of depression and sleep–wake disorders among female emergency medicine residents in South Korea

BackgroundDepression and sleep–wake disorders are recognized as one of the major problems among emergency physicians. While depression is more common in females than in males, the associated factors linking depression and sleep–wake disorders in emergency physicians, particularly females, remain unknown.ObjectiveTo analyze the prevalence of depression and sleep–wake problems among emergency medicine (EM) residents in South Korea and to identify the gender differences and situations that adversely predispose female residents to mental health problems.MethodsWe conducted a cross-sectional analysis using the data collected from the 2019 National EM Residents Wellness Survey targeting all of 630 EM residents in South Korea. The survey included variables potentially influencing depression and sleep–wake problems, such as personal characteristics, work-related stress, and extrinsic environment. Information regarding medical conditions, depression, job stress, and sleep deprivation was obtained using the self-administered Patient Health Questionnaire (PHQ-9), the Apgar Wellness Score (AWS), and the Epworth Sleepiness Scale (ESS). We analyzed the data using IBM SPSS Statistics version 25 and MedCalc version 17.ResultsA total of 384 residents participated in the survey. Overall, 27.5% of the EM residents met the criteria for at least moderate depression and 36.9% of the EM residents had sleep-related problems. We found that difficulty in trading the shift schedule and frequent night shifts was associated with depression (p = .001, p = .005; respectively). Female residents demonstrated an increased risk of depression and sleepiness compared to their male counterparts (odds ratio [OR] 1.95, OR 1.81; respectively). In addition, logistic regression analysis revealed significant differences by gender in depression with regards to flexibility of trading shifts (p = .005), level of training in the emergency medical centre (p = .035), and frequent night shifts (p = .010).ConclusionsApproximately, one-third of EM residents report depression and sleep–wake problems, with female residents showing a higher risk than male residents. Several risk factors were identified, and future strategies should be aimed to address these issues to improve the training environment and overall wellbeing of EM residents.

KEY MESSAGES

• The prevalence of depression and sleep-related problems were, respectively, 1.95 and 1.81 times higher in female residents compared to their male colleagues.
• The associated risk factors for depression were flexibility of shift trade, level of training in the emergency medical centre, and frequency of night shifts.
• Improving the training environment and facilities, as well as offering more flexible duty trading options can provide potential opportunities to reduce the risk.

     

The importance of transformational leadership style for the well-being of employees working with older people

Title.  The importance of transformational leadership style for the well-being of employees working with older people.
Aim.  This paper is a report of a study to explore the relationships between transformational leadership, followers' perceived working conditions and employee well-being and job satisfaction.
Background.  There is some evidence that transformational leadership style is linked to employee job satisfaction and well-being. However, it is not clear whether this is due to (i) a direct relationship between leadership and job satisfaction and well-being outcomes or (ii) whether followers' perceived working conditions mediate this relationship.
Methods.  A cross-sectional design was applied to data from a questionnaire study of 447 staff caring for older people in Denmark. Data were collected in 2005. A theory-driven model of the relationships between leadership, working conditions, job satisfaction and well-being was tested using structural equation modelling.
Results.  The transformational leadership style was closely associated with followers' working conditions, namely involvement, influence and meaningfulness. Involvement was associated with job satisfaction and meaningfulness was associated with well-being. However, working conditions were closely correlated with each other, and thus the mediating mechanisms may operate through several different working conditions. A direct path between leadership behaviour and employee well-being was also found.
Conclusion.  Considering working conditions in the absence of studying leadership behaviour (or vice versa) may reveal an incomplete picture of the impact of work and work relationships on well-being. Work re-design interventions focused on influence may benefit from the consideration of training managers to exert transformational leadership behaviours.     

完美主义对心理健康、自尊及主观幸福感的影响

目的探讨大学生完美主义对心理健康、自尊和主观幸福感的影响作用.方法采用完美主义量表、心理健康量表、自尊量表和幸福感量表对290名大学生进行测试.结果①担心出错、对行动的疑虑是心理健康的影响变量;担心出错、组织性和对行动的疑虑是自尊的影响变量;担心出错和组织性是主观幸福感的影响变量.②顺应不良的完美主义对心理健康、自尊及主观幸福感产生消极影响;顺应良好的完美主义对自尊和主观幸福感产生积极影响.结论完美主义维度对心理健康、自尊及主观幸福感具有不同程度的影响,顺应良好和顺应不良的完美主义对心理健康、自尊及主观幸福感具有不同性质的影响.     

贫困大学生生活事件、应付方式、社会支持与其主观幸福感的关系

目的:探讨贫困生生活事件、应付方式、社会支持与其主观幸福感的关系。方法:以哈尔滨工程大学214名贫困生和163名非贫困生为对象,采用大中专学生生活事件量表、应付方式量表、社会支持量表和总体幸福感量表进行测试。结果:贫困生的主观幸福感明显低于非贫困生;自责、解决问题、主观支持、人际矛盾和心理支持丧失四因素对贫困生主观幸福感有显著影响,解决问题、其他事件、退避、幻想这四个变量对非贫困生主观幸福感有显著影响。结论:贫困生主观幸福感较低,心理压力较大,主观支持、人际关系、应对方式等因素对其主观幸福感有显著的影响。     

医学生主观幸福感及其影响因素研究

目的:研究医学主观幸福感与应付方式、社会支持的关系及其影响因素。方法:采用总体幸福感量表、社会支持评定量表、简易应对方式问卷、大学生幸福感影响因素调查表和90项症状清单进行问卷调查。结果:①医学生男女和城乡比较,总体幸福感无明显差异。②在自我意识方面,城乡差异显著(P<0.01);恋爱方面,男女和城乡差异显著(P<0.01);工作与社会方面,男女和城乡差异显著(P<0.05);家庭环境方面,城乡差异显著(P<0.01);休闲活动方面,男女和城乡差异显著(P<0.05)。③消极应对方面,男女差异显著(P<0.01)。④主客观支持方面,城乡差异显著(P<0.01);在对支持的利用度方面,男女差异显著(P<0.01)。⑤主观幸福感与医学生的自我意识、学校学习、恋爱、工作与社会、家庭环境、休闲活动、积极应对、客观支持、主观支持、对支持的利用度呈正相关(P<0.05),与消极应对、SCL-90十个因子呈负相关(P<0.01)。⑥逐步回归分析显示,抑郁、家庭环境、睡眠饮食、偏执、母亲职业、自我意识等对主观幸福感有预测作用。结论:抑郁情绪、成长的家庭环境、自我意识、饮食睡眠等因素是影响医学生主观幸福感的因素。     

大学生主观幸福感及其影响因素

目的 考察大学生主观幸福感的现状,探讨自尊、社会支持、生活事件等对其主观幸福感的影响.方法 对1～4年级的300名大学生进行幸福感指数量表、自尊量表、社会支持评定量表和青少年生活事件量表等问卷测量.结果 ①大学生主观幸福感处于中等偏上水平(=9.71).②大学生主观幸福感得分在性别上存在显著差异(总分:t=2.239,P＜0.05).③大学生主观幸福感与自尊、社会支持呈显著正相关.④大学生主观幸福感与生活事件呈显著负相关.⑤自尊对大学生主观幸福感有显著的正向预测作用(β=0.308,P＜0.05).⑥社会支持对大学生的主观幸福感也有显著的正向预测作用(β=0.163,P＜0.01).结论 自尊和社会支持对大学生的主观幸福感有显著的正向预测作用,生活事件对大学生主观幸福感的影响较小.     

粤西农村地区居民主观幸福感调查

目的 了解农民主观幸福感和生活满总度状况.方法 采用主观幸福感单一项目测量、幸福感阶梯量表和生活满意度自编问卷,对粤西农村地区228例居民进行抽样调查.结果 ①大部分农村居民具有较高的主观幸福感,但农民幸福感的均值略低于中值水平;②农民的主观幸福感不存在性别差异,但在年龄上则表现出统计学上的显著差异,中年农民群体的主观幸福感显著低于年轻群体和老年群体;③农村居民的未来幸福感显著高于目前幸福感和过去幸福感;④农村居民的住房、经济与其主观幸福感的关系最大,有超过半数(51.3%)的农民对经济收入感到不满念.结论 应重点关注中年农民群体的幸福感和生活满意度,增加农民经济收入是提高他们主观幸福感的根本途径.     

自我概念和个体自尊、集体自尊对大学生主观幸福感的影响

目的:探讨大学生自我概念、个体自尊、集体自尊和主观幸福感的关系。方法:采用幸福感指数量表、自我概念量表、个体自尊量表、集体自尊量表对233名大学生进行测查。结果:①大学生的来源影响着主观幸福感,来自于城市的大学生比来自于农村的大学生体验到较高的生活满意度(P<0.01)。②自我概念、个体自尊、集体自尊和主观幸福感相关显著(P<0.01)。③自我概念、个体自尊、集体自尊对主观幸福感预测作用显著(P<0.001)。结论:自我概念、个体自尊、集体自尊是大学生主观幸福感的重要预测因素。