护理干预对首发精神分裂症病人生活质量的影响

目的探讨护理干预对首发精神分裂症病人生活质量的影响。方法将80例首发精神分裂症病人随机分为研究组和对照组各40例，两组均予以利培酮系统治疗，研究组在此基础上，予以综合性护理干预措施，时间为8同，随后进行为期半年的随访，采用阴性症状与阳性症状量表（PANSS）及生活质量综合评定问卷（GQOLI）分别于治疗前及随访结束时进行评估。结果随访结束时，两组病人的PANSS总分及阴性、阳性症状评分均较治疗前明显降低（P〈0．01）．但研究组明显优于对照组（P〈0．01）；并且研究组GQOLI评分显著高于对照组（P〈0．01）。结论护理干预有助于改善首发精神分裂症病人的精神症状，提高其生活质量。     

早期干预对高危儿智能发育影响的研究

目的探讨定期随访高危儿,进行早期发育评价及干预,对高危儿智能发育的影响。方法将82例高危儿随机分成干预组42例和常规组40例,干预组接受早期干预,两组患儿定期随访,以中国婴幼儿发育量表（CDCC）和《Ge-sell发育诊断量表》进行智能发育评估。结果3、6、9月龄时干预组患儿智力发育指数（MD I）和运动发育指数（PD I）均显著高于常规组;1岁时Gesell智能检查,干预组除大运动能区与常规组有显著性差异外（P〈0.05）,其他四大能区均存在非常显著性差异（P〈0.01）。结论早期干预可促进高危儿的智能发育,改善其预后。     

抗抑郁剂在脑卒中患者中的预防性应用

目的观察预防性应用抗抑郁剂对脑卒中后抑郁(PSD)发生率及神经功能康复的影响。方法64例脑卒中患者随机分成两组,分别接受帕罗西汀与安慰剂治疗,采用改良爱丁堡斯堪的那维亚评分量表(MESS)和日常生活能力量表(ADL)评定脑卒中患者治疗前及治疗后神经功能缺损程度及日常生活能力;治疗结束时评定患者的PSD发生率。结果与安慰剂对照组相比,在治疗结束时,帕罗西汀组患者的MESS、ADL得分分别为11.1±4.3,27.6±4.8,低于安慰剂组的13.6±3.2及32.8±4.1;帕罗西汀组患者的PSD发生率为10.7%,亦低于对照组的41.4%,差异均具有统计学意义。结论预防性应用抗抑郁剂可以降低PSD发生率,并有利于脑卒中患者的神经功能康复。     

支气管动脉超选择性介入治疗中晚期肺癌

目的 探讨支气管动脉超选择性介入化疗及栓塞治疗肺癌的疗效。方法 58例肺癌病人均行支气管动脉超选择性介入化疗栓塞术，观察治疗前后原发癌灶体积及最大直径与垂直直径的变化，比较肺CT影像学改变；观察栓塞剂用量与癌灶体积之间的关系；观察临床病征、介入并发症等情况，并进行分析。结果 支气管动脉超选择性介入化疗栓塞术治疗肺癌疗效显，术后原发癌灶的体积大多有不同程度缩小，肿瘤最大直径与垂直直径乘积缩小，降低50％以上的占89．66％，栓塞剂用量小，介入并发症出现率低，副反应轻。     

精神分裂症恢复期患者及家属家庭干预的对照研究

目的：以康复期出院精神分裂症患者和家属为对象，定期复诊进行家庭干预并对照研究。方法：干预组68例，对照组52例，采用BPRS评定；干预组家属74人，对照组家属65人，采用SCL－90评定。结果：6个月后干预组患者BPRS和入组时对照比较均有显著性差异（P＜0．01），说明干预组患者的精神症状，不良情绪及社会功能明显好转，入组时两组家属SCL－90评定与常模对照比较，均有明显差异（P＜0．05或0．01），经干预后干预组与全国常规比较无显著性差异（P＞0．05），说明患者家属普遍存在心理障碍，经干预后家属心理状况明显改善。结论：对康复期病人及家属进行门诊家庭干预，是有效的康复方法，值得推广应用。     

Cluster-Randomized Controlled Trial of An Athletic Trainer-Directed Spit (Smokeless) Tobacco Intervention for Collegiate Baseball Athletes: Results After 1 Year

Context: Athletes in the United States are at high risk for using spit (smokeless) tobacco (ST) and incurring its associated adverse health effects.Objective: To examine whether an athletic trainer-directed ST intervention could decrease initiation and promote cessation of ST use among male collegiate baseball athletes.Design: Stratified, cluster-randomized controlled trial.Setting: Fifty-two California colleges.Patients or Other Participant(s): A total of 883 subjects in 27 intervention colleges and 702 subjects in 25 control colleges participated, as did 48 certified athletic trainers.Intervention(s): For college athletic trainers and associated dental professionals, a 3-hour video conference, and for collegiate athletes, an oral cancer screening with feedback and brief counseling during the preseason health screenings, athletic trainer support for cessation, and a peer-led educational baseball team meeting.Main Outcome Measure(s): The subjects' ST use over 1 year was assessed by self-report. At the end of the study, the certified athletic trainers were mailed a survey assessing their tobacco use and perceptions and behavior related to tobacco control in the athletic environment. We used multivariable logistic regression models for clustered responses (generalized estimating equations) to test the difference between groups in ST-use initiation and cessation and to identify significant overall predictors of noninitiation and cessation of ST use.Results: Of the 1585 athletes recruited, 1248 (78.7%) were followed up at 12 months. In addition, 48 of the 52 athletic trainers (92%) responded to the 1-year follow-up survey. The ST-use initiation (incidence) was 5.1% in intervention colleges and 8.4% in control colleges (generalized estimating equation odds ratio = 0.58, 95% confidence interval = 0.35-0.99). Predictors of ST noninitiation were low lifetime tobacco and monthly alcohol use (odds ratio = 1.98, 95% confidence interval = 1.40- 2.82) and athletic trainers' report that the baseball coach supported ST-use prevention activities (odds ratio = 1.43, 95% confidence interval = 1.11-1.83). Although at 1 year, cessation of ST use was relatively high in both groups (36%), we noted no significant difference between the groups (odd ratio = 0.94, 95% confidence interval = 0.70-1.27).Conclusions: The intervention was significantly effective in preventing incident ST use but did not significantly increase cessation beyond that seen in the control group. The latter finding is inconsistent with previous studies and may be explained by spillover of the intervention to control colleges, other anti-tobacco activity in control colleges, and/or the small sample of dependent ST users enrolled in the study.     

健康教育与心理社会干预对2型糖尿病合并抑郁的影响

目的 :调查 2型糖尿病患者抑郁症状发生率并探讨健康教育及心理社会干预对抑郁症状及糖脂代谢的影响。方法 :采用Zung抑郁自评量表 (SDS)对 10 0例 2型糖尿病患者及 10 0例正常人群进行测评。将抑郁指数≥ 0 5的 5 9例患者随机分为研究组 30例 ,对照组 2 9例。研究组药物治疗的同时合并为期 3个月健康教育加心理社会支持治疗 ,分别于治疗前、治疗后进行抑郁自评量表及代谢控制水平评估。结果 :2型糖尿病并抑郁情绪检出率为 5 9% ,显著高于正常组 (P <0 0 1)。经健康教育加心理社会支持治疗 3个月后 ,观察组抑郁指数显著降低 (P <0 0 5 ) ,糖脂代谢显著改善 (P <0 0 5 )。抑郁转归发生率高 ,与对照组比较有极显著差异 (P <0 0 1)。结论 :2型糖尿病患者常合并忧郁症状 ,健康教育加心理社会支持治疗可改善抑郁症状及糖脂代谢     

Accessibility, clinical effectiveness, and practice costs of providing a telephone option for routine asthma reviews: phase IV controlled implementation study.

BACKGROUND: Attendance for routine asthma reviews is poor. A recent randomised controlled trial found that telephone consultations can cost-effectively and safely enhance asthma review rates; however, concerns have been expressed about the generalisability and implementation of the trial's findings. AIM: To evaluate the effectiveness of a telephone option as part of a routine structured asthma review service. DESIGN OF STUDY: Phase IV controlled before-and-after implementation study. SETTING: A large UK general practice. METHOD: Using existing administrative groups, all patients with active asthma (n = 1809) received one of three asthma review services: structured recall with a telephone-option for reviews versus structured recall with face-to-face-only reviews, or usual-care (to assess secular trends). Main outcome measures were: proportion of patients with active asthma reviewed within the previous 15 months (Quality and Outcomes Framework target), mode of review, enablement, morbidity, and costs to the practice. RESULTS: A routine asthma review was provided for 397/598 (66.4%) patients in the telephone-option group compared with 352/654 (53.8%) in the face-to-face-only review group: risk difference 12.6% (95% confidence interval [CI] = 7.2 to 17.9, P<0.001). The usual-care group achieved a review rate of 282/557 (50.6%). Morbidity was equivalent in the three groups; however, enablement (P = 0.03) and confidence (P = 0.007) in asthma management were greater in the telephone-option versus face-to-face-only group. The cost per review achieved by providing the telephone-option service was lower than the face-to-face-only service (10.03 pounds versus 12.74 pounds, mean difference 2.71 pounds; 95% CI = 1.92 to 3.50, P<0.001); usual-care costs were 11.85 pounds per review achieved. CONCLUSION: Routinely offering telephone reviews cost-effectively increased asthma review rates, enhancing patient enablement and confidence with management, with no detriment to asthma morbidity. Practices should consider a telephone option for their asthma review service.     

老年抑郁障碍患者的心理干预对比分析

目的 :探讨老年抑郁障碍心理干预的效果。方法 :采用对比研究的方法 ,在流行病学调查的基础上选择符合CCMD -Ⅱ -R诊断标准的 72例抑郁性神经症和 10例抑郁症患者 ,按性别、年龄、文化等基本相同 ,分成对照和实验组各一半 ,实验组给以 6周的心理干预 ,两组均不用药物治疗 ,分别于治疗前及三个月后 ,测评老年抑郁量表、生活满意度指数及社会支持评定量表 ,并进行对比分析。结果 :心理干预前两组老年抑郁量表 (SDS)得分分别为 17 41± 3 19、 17 5 1± 2 44,三个月后对照组下降不显著 ,而实验组明显下降 ( 17 5 1± 2 44/ 8 93± 5 5 2 ,t=10 89,P <0 0 0 1) ;生活满意度 (t=4 33,P <0 0 0 1)实验组显著提高 ;对照组无明显变化 ,社会支持评定实验组 ( 31 15± 6 37/ 36 32± 6 86 ,t =4 93,P <0 0 0 1)也显著提高 ,而对照组则不明显。结论 :社区综合性心理干预可改变抑郁性神经症患者的抑郁情绪 ,改善认知水平 ,从而提高生活满意度。     

音乐治疗对眼底手术病人焦虑的影响

目的：在于观察经听觉通道输入音乐对眼底手术病人焦虑状态的影响。方法：实验对象为39名择期进行眼底手术的男性病人，他们被随机地分为实验和对照两组，其中实验组19人，对照组20人，在手术过程中通过耳机给患者输入他们自己选定的音乐、观察焦虑（STAI），抑郁（SDS），视觉模拟焦虑（VAS）和脑电（BI）的变化。结果：实验组STAI，SDS，VAS值与对照组比明显降低，病人的焦虑、抑郁情绪有了明显改善，而脑电的变化没有显著性的差异。结论：音乐治疗可降低择期眼底手术男性病人的焦虑、抑郁与视觉模拟焦虑水平。