社区老年人抑郁、焦虑情绪状况及其与认知情绪调节策略的关系研究

背景　抑郁和焦虑是社区老年人常见的心理健康问题,认知管理情绪的方式与老年人生活密切相关。目前,关于认知情绪调节策略与负性情绪研究在老年人群中少见。目的　调查社区老年人抑郁、焦虑情绪状况,探讨社区老年人抑郁、焦虑情绪与认知情绪调节策略的关系,为老年人抑郁、焦虑的干预提供理论依据。方法　于2018年3—4月采用方便抽样法选取河南省新乡市年龄≥60周岁社区老年人550例为研究对象,采用一般情况调查表、简版老年抑郁量表（GDS-15）、广泛性焦虑量表（GAD-7）及认知情绪调节问卷（CERQ）进行调查。采用Spearman秩相关分析抑郁、焦虑与各认知情绪调节策略间的相关性,采用多元线性逐步回归分析抑郁、焦虑的影响因素。结果　共发放问卷550份,回收有效问卷514份,问卷有效回收率为93.5%。社区老年人抑郁、焦虑检出率分别为26.5%（136/514）、9.9%（51/514）。相关分析结果显示：抑郁得分与自责、沉思、灾难化、责备他人呈正相关（P<0.05）,与接收、自我安慰、重新关注计划、积极重新关注、积极重新评价呈负相关（P<0.05）;焦虑得分与自责、沉思、灾难化、责备他人呈正相关（P<0.05）,与接受、自我安慰、重新关注计划、积极重新关注、积极重新评价呈负相关（P<0.05）。多元线性逐步回归分析结果显示,年龄、受教育程度、患慢性病种数、好朋友数量、与家人关系、身体健康状况及沉思、灾难化、责备他人、自我安慰、积极重新评价的调节策略是社区老年人抑郁的影响因素（P<0.05）;年龄、患慢性病种数、与家人关系、月均收入及沉思、灾难化、责备他人、积极重新评价的调节策略是社区老年人焦虑的影响因素（P<0.05）。结论　社区老年人焦虑、抑郁发生率较高。认知情绪调节策略与抑郁、焦虑情绪密切相关,越多使用沉思、灾难化、责备他人非适应性策略,越少使用积极重新评价适应性策略的老年人越有可能产生抑郁、焦虑情绪。     

连续性院外管理对喉癌患者术后生活质量的影响

目的 探讨连续性院外管理对喉癌患者术后生活质量的影响。 方法 选择2016年1月至2017年6月于宜宾市第二人民医院进行手术治疗的喉癌患者82例,采用分层随机化方法随机分为对照组38例和干预组44例,对照组给予常规性院外随访,干预组进行连续性院外管理,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、成人希望特质量表(ADHS)、一般健康状况量表(SF-36)、癌症病人生活质量问卷(QLQ-C30)及癌症功能评价专用头颈量表(FACT-HN)评估患者生活质量,分析两组患者情绪、认知和生活质量的差异。 结果 出院6个月后对照组与干预组焦虑发生率分别为42.1%、15.9%,两组比较差异有统计学意义(χ2=6.933, P=0.013);对照组与干预组抑郁发生率分别为39.5%、9.1%,两组比较差异有统计学意义(χ2=10.573, P=0.001)。出院后6个月对照组与干预组SAS评分分别为(49.2±10.3)、(41.3±8.7)分,SDS评分分别为(47.4±9.2)、(40.5±7.0)分,ADHS评分分别为(27.1±7.8)、(34.7±6.9)分,两组比较差异均有统计学意义(t分别为3.77、3.85、4.68, P均<0.01)。在SF-36量表中,除一般健康状况(GH)和精力(VT)2个维度差异无统计学意义外,其余6个维度(生理机能、生理职能、躯体疼痛、社会功能、情感职能、精神健康)差异均有统计学意义,干预组高于对照组(t分别为2.31、2.54、4.15、2.66、3.59、2.59, P分别为0.02、0.01、<0.001、0.01、<0.001、0.01)。在QLQ-C30量表中,两组患者整体健康状况评分(t=2.42, P=0.02)、5个功能量表(躯体、认知、角色、情绪和社会)评分(t分别为3.06、3.95、2.27、2.23和0.01, P分别为<0.001、<0.001、0.03、0.03和0.01)和“失眠”和“食欲下降”2单项评分(t分别为2.69和2.33, P分别为0.01和0.02)差异有统计学意义。两组患者癌FACT-HN总分和3个维度(社会/家庭状况、情感状况和附加关注)差异有统计学意义(t分别为2.89、2.55、3.07和2.14, P分别为0.01、0.01、<0.001和0.04)。 结论 连续性院外管理能一定程度纠正喉癌患者心理问题,提高患者获得感和生存质量。     

自知力教育对精神分裂症患者负性情绪的影响

目的 深入了解自知力教育对精神分裂症患者负性情绪的影响,并进一步探索其原因,为自知力教育方式的改进和教育内容的完善提供科学依据.方法将精神分裂症患者217例随机分为教育组和对照组,两组均接受抗精神病药物系统治疗,教育组在此基础上予自知力教育8周,教育前后分别采用简明精神病评定量表(BPRS)、自知力与治疗态度问卷(ITAQ)、焦虑自评量表(SAS)、抑郁自评量表(SDS)进行评定;根据评定结果,对自知力恢复伴焦虑、抑郁的患者进行深入访谈,将获得的资料用Giorgi法分析.结果教育后BPRS评分两组间比较,差异无统计学意义(P＞0.05);ITAQ、SAS、SDS评分教育组均明显高于对照组(P＜0.05).对11例患者深入访谈,得出患者自知力恢复后产生负性情绪的社会心理因素有:对过去病态行为及其后果的羞愧和自责心理、归属感得不到满足、深刻的病耻感、对前途的绝望感.结论 对精神分裂症患者进行自知力教育,应根据患者负性情绪状况随时调整教育内容和告知策略,并针对患者的社会心理因素给予有效的情感支持,使患者在自知力恢复的同时减轻或消除负性情绪.     

护理学生情绪管理能力研究进展

情绪管理是一种在觉察自己和他人的情绪后,理解和运用自己的情绪,以某种方法进行情绪调控,最后表现出适合当情绪的过程。良好的情绪管理能力有助于减轻护理学生学业压力,同时缓解其进入临床角色的不适应心理,降低离职率。本文通过对情绪管理的概念、理论、工具及护理学生情绪管理能力现状进行综述,旨在为提高护理学生情绪管理能力提供理论依据。     

Health-related quality of life issues in women with polycystic ovary syndrome

OBJECTIVE: To evaluate the influence of obesity, fertility status, and androgenism scores on health-related quality of life in women with polycystic ovary syndrome (PCOS). DESIGN: Cross-sectional, correlational. SETTING: Private reproductive endocrinology practice in two southeast U.S. cities. PARTICIPANTS: Convenience sample of 128 women with PCOS, half of whom were attempting to conceive in addition to being treated for PCOS. Most were White (97%), married (78%), with a mean age of 30.4 years (SD +/- 5.5). MAIN OUTCOME MEASURES: The Health-Related Quality of Life Questionnaire (PCOSQ) for women with polycystic ovary syndrome. A laboratory panel and clinical measures, including body mass index, waist-to-hip ratio, and degree of hirsutism. RESULTS: The most common health-related quality of life concern reported by women with PCOS was weight, followed in descending order by menstrual problems, infertility, emotions, and body hair. CONCLUSIONS: The psychological implications of PCOS are easily underestimated and have been largely ignored. Nursing has a pivotal role in recognizing these concerns and implementing therapy to improve quality of life in women with PCOS.     

北京市350名职业人员睡眠质量和情绪调节的认知策略调查

目的 了解受过高等教育职员的睡眠质量及其所采用的情绪调节认知策略.方法 采用匹兹堡睡眠质量指数(PSQI)问卷、失眠严重指数(ISI)问卷、简式简明心境问卷(POMS-SF)和认知情绪调节问卷(CERQ),对采取整群随机抽样法抽取的北京市6所单位的350名大专以上在职人员的睡眠质量与情绪调节策略进行调查.结果 (1)98例(28%)存在睡眠质量问题(PSQI≥7分),146例(41.7%)日常状态受失眠影响(ISI＞7分);(2)遭遇负性生活事件后,在所有受访人员中使用频率最高的3种情绪调节策略依次为积极重新评价、重新关注计划、积极重新关注;(3)在情绪调节认知策略的灾难化维度上,主观不失眠组(ISI≤7分)得分(34.21±12.85)分,低于轻度失眠组(7分＜ISI≤14分)[(39.62±15.02)分]与中重度失眠组(ISI≥15分)[(41.48±11.25)分],差异有统计学意义(t=3.466,P=0.001;t=2.625,P=0.009);在沉浸维度上,主观不失眠组得分(46.43±12.78)分,低于轻度失眠组[(49.92±13.55)分]与中重度失眠组[(51.67±11.44)分],差异有统计学意义(t=2.332,P=0.020;t=1.974,P=0.049).结论 受访职员睡眠质量问题及主观失眠现象较多见,多能运用积极认知策略调节情绪;主观失眠组职员有更多灾难化、沉浸的消极认知策略的运用.     

The Beliefs about Emotions Scale: Validity, reliability and sensitivity to change

Objective

Beliefs about the unacceptability of experiencing or expressing negative emotions have been noted in individuals with a range of problems, including chronic fatigue syndrome (CFS), irritable bowel syndrome, somatization disorder, depression, eating disorders, social phobia, posttraumatic stress disorder, and borderline personality disorder. These beliefs are likely to have implications for emotion regulation and processing, and are addressed explicitly or implicitly within many therapies including cognitive behavior therapy (CBT), mindfulness-based cognitive therapy (MBCT), and Acceptance and Commitment Therapy (ACT). This article describes the development, validation, and internal reliability of the Beliefs about Emotions Scale (BES), a self-report questionnaire to assess such beliefs.

Methods

The new scale was completed by people with CFS (n=121) and healthy controls (n=73). Twenty-two individuals with CFS completed the scale before and after CBT.

Results

People with CFS had significantly higher scores on this new questionnaire than healthy controls. Principal components analysis identified one factor, and the scale had high internal consistency (0.91). Scores on the BES were most highly correlated with a measure of negative perfectionism (r=0.59) and also showed significant correlations with measures of dysfunctional attitudes, self-sacrifice, depression, anxiety, and fatigue. When completed before and after CBT for CFS, the questionnaire was sufficiently sensitive to detect a significant reduction in endorsement of unhelpful beliefs about emotions.

Conclusion

The new Beliefs about Emotions Scale showed good internal reliability, validity and sensitivity to change.     

State and Trait Emotions in Delinquent Adolescents

Objective To examine the structure of emotions and affective dysregulation in juvenile delinquents. Method Fifty-six juvenile delinquents from a local juvenile hall and 169 subjects from a local high school were recruited for this study. All participants completed psychometric testing for trait emotions followed by measurements of state emotions under two conditions (free association and stress condition). Finally, delinquent participants completed a detailed assessment of past trauma using the Childhood Trauma Interview (CTI). Results Delinquents exhibit significantly higher levels of negative state and trait emotions when compared to a high school sample. In the delinquent sample chronicity of physical trauma affects the longstanding variable of trait emotionality and severity of trauma, specifically emotional abuse and witnessing violence, shapes negative emotional outcomes in state emotionality. In addition, delinquents appear to experience a wider range of emotions than the comparison sample and were more likely to experience a confluence of state emotions of sadness and anger under stressed conditions. Conclusion Adolescent delinquents appear to have a different experience of negative emotions than comparison adolescents. The experience of emotions appears to differ in state and trait conditions. These emotions may be related to childhood experiences of trauma.