康复期乳腺癌患者应对方式与生活质量的相关性分析及护理对策

目的分析康复期乳腺癌患者应对方式与生活质量的相关性,并制订护理对策,为提高患者的生活质量提供理论依据。方法 2004年1月～2010年12月,采用医学应对问卷及癌症康复评价简表对本院收治的98例康复期乳腺癌患者进行调查,分析其应对方式与生活质量的相关性。结果康复期乳腺癌患者在屈服和回避两种应对方式上的得分高于常模(均P<0.01);面对应对方式与生活质量的4个维度及总分成正相关,屈服应对方式与生活质量各个维度及总分成负相关,回避应对方式与生理维度成负相关(均P<0.05)。结论康复期乳腺癌患者倾向于采用屈服和回避的应对方式去面对疾病,采用屈服应对方式的患者生活质量较低,采用面对应对方式的患者生活质量较高,临床或社区医护人员应针对患者的应对方式去制订相关的护理对策,以提高患者的生活质量。     

护理本科毕业生应对方式及心理健康水平的研究

[目的]调查武汉、北京两地护理本科毕业生应对方式及心理健康水平,分析不同应对方式对心理健康水平的影响,从而探讨最有效的应对方式,以保持和促进护理人员的身心健康。[方法]采用Folkman和Lazarus的应对方式问卷和症状自评量表(SCL-90),对85名护理专业本科毕业生进行问卷调查。[结果]采用最多的应对方式是解决问题和求助,护理专业本科毕业生多以积极的心态和方式面对压力源。成熟型应对方式与心理健康水平呈正相关。[结论]成熟型的应对方式对心理健康水平有着积极的促进作用。采取综合管理对策,改革教学和实践,医院体制更改等有效举措可提高学生应用成熟型应对方式的能力。     

ICU护士心理健康状况调查及应对方式分析

目的：了解ICU护士心理状况与应对方式,探索促进ICU护士心理健康的有效途径。方法：采用心理健康症状自评量表（SCL-90）、简易应对方式量表,对广州市和佛山市76名ICU护士进行测评。结果：ICU护士SCL-90筛选阳性率达53%,各因子得分均高于全国常模;因子中躯体化、强迫、抑郁、焦虑、敌对、恐怖、精神病性与全国常模比较有显著性差异（P〈0.05）。ICU护士应对方式中消极应对与SCL-90各因子得分均呈显著正相关,积极应对与SCL-90强迫、人际关系、恐怖呈显著负相关。结论：ICU护士心理健康水平低于全国常模,且在遇到问题多采用消极的应对方式。     

老年冠心病及其高危患者生活方式干预的效果

目的对老年冠心病及其高危患者进行生活方式干预,观察干预对象的生活方式、血脂水平变化情况以及心脑血管事件发生情况。方法选取2002年6月至2006年12月接受强化生活方式干预,且基线TC水平未达标的军队老年冠心病及其高危患者232例,作为观察组;同期从未进行生活方式干预的干休所中选取冠心病及其高危患者221例,作为对照组。结果与对照组比较,生活方式干预结束时,观察组控制饮食者提高了34.14%(P<0.01),体质量指数(BMI)均值减少了0.78 kg/m2(P<0.01),饮酒者减少了5.76%(P<0.05);总胆固醇(TC)、低密度脂蛋白-胆固醇(LDL-C)分别下降了10.54%、10.89%(P<0.01),高密度脂蛋白-胆固醇(HDL-C)高3.21%(P<0.05);缺血性脑卒中危险性降低了13.79%,心肌梗死、不稳定性心绞痛危险性降低了18.90%(P>0.05)。结论强化生活方式干预能显著降低老年冠心病及其高危患者的血脂水平,减少心脑血管事件的发生。     

团体心理辅导对女性不孕症患者情绪和应对方式的影响

目的:探讨团体心理辅导对女性不孕症患者负性情绪及应对方式的治疗效果.方法:选择适合参加团体心理辅导的女性不孕症患者30例,随机分为实验组和对照组各15例.实验组除接受正规药物治疗和常规护理措施外,接受为期6个月的团体心理辅导;对照组仅接受正规药物治疗和常规护理措施.结果:团体心理辅导前,实验组在SDS、SAS和应对方式量表评分与对照组相比,差异无统计学意义(P＞0.05);团体心理辅导后,实验组SDS和SAS量表评分较对照组降低(P＜0.05),应对方式量表中解决问题和求助因子分较对照组明显升高(P＜0.05),自责、幻想、退避因子分较对照组降低(P＜0.05);实验组团体心理辅导干预前后自身对照,干预后SDS和SAS量表评分较干预前显著降低(P＜0.01),应对方式量表中解决问题和求助因子分较干预前明显升高(P＜0.01),自责、幻想、退避、合理化因子分较干预前降低(P＜0.05).结论:团体心理辅导干预可有效改善女性不孕症患者负性情绪,提升其应对负性生活事件的技巧和效率.     

Store-operated calcium entry modulates neuronal network activity in a model of chronic epilepsy

Store-operated Ca²⁺ entry (SOCE) over the plasma membrane is activated by depletion of intracellular Ca²⁺ stores and has only recently been shown to play a role in CNS processes like synaptic plasticity. However, the direct effect of SOCE on the excitability of neuronal networks in vitro and in vivo has never been determined. We confirmed the presence of SOCE and the expression of the calcium sensors STIM1 and STIM2, which convey information about the calcium load of the stores to channel proteins at the plasma membrane, in neurons and astrocytes. Inhibition of SOCE by pharmacological agents 2-APB and ML-9 reduced the steady-state neuronal Ca²⁺ concentration, reduced network activity, and increased synchrony of primary neuronal cultures grown on multi-electrode arrays, which prompted us to elucidate the relative expression of STIM proteins in conditions of pathologic excitability. Both proteins were increased in brains of chronic epileptic rodents and strongly expressed in hippocampal specimens from medial temporal lobe epilepsy patients. Pharmacologic inhibition of SOCE in chronic epileptic hippocampal slices suppressed interictal spikes and rhythmized epileptic burst activity. Our results indicate that SOCE modulates the activity of neuronal networks in vitro and in vivo and delineates SOCE as a potential drug target.     

Nucleus accumbens facilitates nociception

We have previously demonstrated an opioid link in nucleus accumbens (NAc) that mediates antinociception produced by a novel ascending pain modulation pathway. For example, noxious stimulation induces heterosegmental antinociception that is mediated by both mu- and delta-opioid receptors in NAc. However, spinal intrathecal administration of the mu-receptor agonist [d-Ala², N-Me-Phe⁴,Gly⁵-ol]-enkephalin (DAMGO) also induces heterosegmental antinociception. The aim of the present study in the rat was to identify the intra-NAc opioid receptors that mediate the antinociceptive effects of spinally administered DAMGO and also to determine the effect of NAc efferent activity on nociception. Intra-NAc administration of either the mu-opioid receptor antagonist Cys²,Tyr³, Orn⁵,Pen⁷amide (CTOP) or the delta-opioid receptor antagonist naltrindole blocked the antinociceptive effect of spinally administered DAMGO on the jaw-opening reflex (JOR). Injection of quaternary lidocaine (QX-314) attenuated the JOR, suggesting that the output of NAc is pronociceptive. In support of this, intra-NAc injection of the excitatory amino acid agonist kainate enhanced the JOR. Thus, it is possible to modulate activity in NAc to bidirectionally attenuate or enhance nociception, suggesting a potential role for NAc in setting nociceptive sensitivity.     

Changes in the coping styles of spouses and the influence of these changes on their psychosocial functioning the first year after a patient's stroke

Objective

The objective of this study was to examine the changes in spouses' coping styles that occur in the first year after a patient's stroke and the influence of these changes on the spouses' psychosocial functioning.

Methods

A total of 211 spouses of patients with stroke were assessed at three different time points using self-reported questionnaires (at the time of the patient's admission to inpatient rehabilitation, 2 months after discharge and 1 year poststroke). We used linear mixed-model and multiple linear regression analyses to analyse the data.

Results

Spouses' use of an active coping style decreased significantly in the first year poststroke. There were no significant overall changes in the use of a passive coping style. The use of a passive coping style at admission and increases in passive coping style in the first year poststroke predicted worse psychosocial functioning 1 year poststroke. The models explained between 32% and 50% of the variance in quality of life, depressive symptoms and strain.

Conclusion

The present study indicates that spouses' passive coping style is maladaptive poststroke when used in the acute as well as in the chronic phase. Use of an active coping style decreases in the first year poststroke, but these decreases do not predict psychosocial outcomes.     

内地藏族初中生主观幸福感与社会支持、应对方式的关系

目的了解内地藏族初中生主观幸福感与社会支持和应对方式的关系,为开展心理健康教育提供依据。方法采用幸福感量表、领悟社会支持量表和应对方式问卷对311名内地藏族初中生进行问卷调查。结果 1社会支持、应对方式与主观幸福感各维度呈显著相关;2回归分析发现,家庭支持和问题解决的应对方式对总体主观幸福感具有一定的预测作用(R2=0.085,P0.05)。结论社会支持、应对方式对主观幸福感具有显著的影响。     

心理干预对老年冠心病患者应对方式的影响

目的探讨心理干预对老年冠心病患者应对方式的影响。方法将68例住院老年冠心病患者随机等分为干预组(34例)和对照组(34例),干预组在接受临床常规药物治疗的基础上进行心理干预,对照组只接受临床常规药物治疗,运用医学应对问卷(MCMQ)对两组患者分别于心理干预前及结束时进行评定。结果心理干预前两组患者MCMQ面对、回避和屈服维度得分无统计学差异(P0.05),实施心理干预后,干预组与对照组相比在面对、回避和屈服三方面均有显著差异(t=6.607,t=-2.796,t=-4.359,P0.01)。结论心理干预能有效改善老年冠心病患者的应对方式。