Emotional associations with skin: Differences between burned and non-burned individuals

Introduction

The appearance of skin is crucial for our physical and psychological integrity, and is strongly associated with our emotional self-awareness. Burn victims have to cope with negative and even threatening sensations resulting from the changed appearance of their skin after injury and also linked to experiences during the treatment.The aim of this study was to analyse differences regarding the emotional associations with skin in burn victims (burn group) to persons not having subdued any burn (control group).

Methods

In the first instance over 960 volunteers were recruited for the rating of emotional associations with skin in the control group and thereby a representative profile for non-injured individuals. In the second part, 44 burn patients of the Vienna Burn Center answered the same questionnaire. The quantitative rating of emotional associations with skin was performed with a newly designed questionnaire using a semantic differential on eight dimensions with a 5-point scale system.

Results

Both groups have positive associations with skin. One significant difference (p = 0.0090, Chi-square test for trend) was the overall rating of the item “importance”: for burn victims skin is more “important” than for controls. Patients with visible burns tended to put more emphasize on the possible exposure to danger (“threatened”) of skin, and patients with ≥20% TBSA rated skin as more “noticeable” and “strong” as compared to small burns (<20% TBSA). Patients with burns to the face, hands and neck (“visible burns”) were more likely to judge skin as threatened item.

Discussion

Our poll suggests that despite long treatment, rehabilitation and even near-death experiences burn patients continue to have positive associations with skin. This in turn, should encourage all specialists dealing with burns to engage in a continuous follow-up as well as enhance psychological and social support.     

基于社交文本的高中到大学过渡阶段青少年情绪研究

目的 分析大学生在社交网络平台上的文本信息,了解其在高中到大学过渡阶段时情绪状态及变化轨迹,为开展青少年心理健康教育提供参考。 方法 于2018年9—11月及2019年9—10月,通过线上和线下方式招募南昌大学534名本科生,提取其高三到大一时间区间内发布的QQ说说,以“月”为时间颗粒度进行标记。使用结巴分词程序和情绪词典,计算每月说说总词数、条数、积极情绪和消极情绪词平均词频。描述高中到大学阶段QQ说说的基本活跃度,使用多层线性模型分析消极情绪和积极情绪词词频的月变化趋势,进一步对高中和大学两阶段的基本活跃度和月变化趋势进行比较。 结果 青少年在进入大一后,对社交平台的使用度较高,说说总词数、条数、积极情绪、消极情绪词数均高于高三阶段(Wilcoxon Z值分别为-18.93,-18.03,-18.40,-13.60,P值均＜0.01);大一阶段,女生发表说说的说说总词数、条数、积极情绪、消极情绪词数均高于男生(Mann-Whitney U值分别为26 499.00,28 581.00,24 636.00,28 010.50,P值均＜0.05)。青少年说说积极情绪词比消极情绪词更多,积极情绪词的月平均词频(0.029)是消极情绪词(0.012)的2.40倍;在高三阶段的积极情绪词频、消极情绪词频会随着月份发生显著降低(β值分别为-6.01,-3.55;t值分别为-3.40,-2.86,P值均＜0.01)。 结论 青少年在高三阶段使用QQ说说的活跃度较低,但其说说中体现出的积极情绪、消极情绪波动均更为剧烈,高三阶段学生的情绪状态值得关注。     

Emotional Vitality: Concept of Importance for Rehabilitation

Objectives

To (1) provide a framework for the conceptualization of emotional vitality as an important construct for rehabilitation professionals; (2) outline the existing scope and breadth of knowledge currently available regarding the definition and measurement of emotional vitality in persons with chronic health conditions; and (3) identify the extent to which the components can be mapped to the International Classification of Functioning, Disability and Health (ICF).

Design

Activities included a scoping review of the literature, and a Delphi mapping exercise using the ICF.

Setting

Not applicable.

Participants

Not applicable.

Intervention

Not applicable.

Main Outcome Measure

Not applicable.

Results

The results of this study suggest that emotional vitality is a complex latent construct that includes (1) physical energy and well-being, (2) regulation of mood, (3) mastery, and (4) engagement and interest in life. Existing literature supported the presence of all 4 components of the construct. The mapping exercise showed that 3 of these components could be readily mapped to the Body Function chapter of the ICF (energy, mood, mastery).

Conclusions

Emotional vitality may influence both the physical and emotional adaptation to living with a chronic illness or disability and should be included in both assessment and treatment planning to optimize rehabilitation outcomes. Future research is needed to refine the definition and identify optimal methods of measuring this construct.     

音乐治疗对阿尔茨海默病患者干预效果的Meta分析

背景 阿尔茨海默病（AD）作为一种神经系统退行性疾病,发病率高,病情发展快,严重影响着患者的生活质量。近年来,音乐治疗干预AD的研究逐渐增多,但缺乏有效的系统评估与分析。 目的 对音乐治疗AD患者认知、情绪、生活能力、睡眠障碍等方面的干预效果进行Meta分析。 方法 计算机检索中国知网（CNKI）、万方数据知识服务平台（Wanfang Data）、维普网（VIP）、Medline、Elsevier Science Direct、PubMed、Embase中关于音乐治疗方法对AD患者干预效果的随机对照试验（RCT）,检索时限为建库至2023年2月,采用RevMan 5.3软件进行数据分析。 结果 研究纳入15篇RCT文献,共1 077例患者。Meta分析结果显示：音乐干预组对AD患者认知功能（MD=4.35,95%CI=1.64~7.05,Z=3.15,P=0.002）、负性情绪（SMD=-0.71,95%CI=-1.26~-0.15,Z=2.51,P=0.01）、生活能力（SMD=-0.91,95%CI=-1.55~-0.27,Z=2.77,P=0.006）干预效果优于对照组;两组在睡眠障碍干预效果方面比较,差异无统计学意义（MD=-1.04,95%CI=-3.10~1.02,Z=0.99,P=0.32）。亚组分析结果显示,治疗周期<12周（P=0.01）、治疗时长<45 min/次（P=0.02）、治疗频次≥3次/周（P<0.001）、实施方式为个体（P<0.001）、实施方式为个体+团体（P=0.002）、干预措施为接收式音乐治疗（P<0.001）的音乐干预组对认知功能的干预效果优于对照组。治疗周期≥12周（P=0.004）、治疗频次<3次/周（P=0.01）、实施方式为个体+团体（P=0.02）、干预措施为接收式音乐治疗（P=0.002）、干预措施为主动式音乐治疗（P=0.002）的音乐干预组对负面情绪的干预效果优于对照组。 结论 音乐治疗能够改善AD患者认知功能、精神状况,提升患者日常生活能力。但由于纳入研究质量不高,仍需要借助更多大样本、高质量的循证研究加以验证。     

心血管疾病与心理疾病流行病学及相关机制研究新进展

根据WHO公布的最新统计数据显示,心血管疾病是全球的头号死因——每年死于心血管疾病的人数多于任何其他疾病,因此心血管疾病研究是世界公共卫生需要攻克的重要难题。与此同时,根据2022年WHO发布的数据统计,中国心理疾病患病率高达17%,近20年,中国人抑郁症发病率增长了120倍,且研究发现心血管疾病和心理疾病之间有着显著的相关性并存在一定的内在机制。本文旨在阐述心血管疾病和心理疾病之间的相关关系及其内在机制最新研究进展,从而发现焦虑症和抑郁症是心血管疾病的重要驱动因素,其可以通过自主神经系统和下丘脑-垂体-肾上腺轴对心脏造成损伤,而缺血性心肌病和心肌梗死可以通过介导脑部缺血性损伤和炎症反应来诱发不良情绪以及认知障碍。本文能够为心血管疾病高风险患者提供更多预防思路,也为心理疾病患者的诊断治疗提供新的研究方向,并为双心学科的交融提供参考。     

理情行为疗法对卒中后抑郁患者睡眠及情绪的影响研究

背景 卒中后抑郁为卒中后常见的情绪障碍,严重影响患者各项功能的恢复,单纯抗抑郁药物治疗效果不佳。 目的 探究理情行为疗法对卒中后抑郁患者睡眠及情绪的影响。 方法 选取2019年6月至2020年6月就诊于郑州大学第二附属医院神经康复科的71例卒中后抑郁患者为研究对象,依据随机数字表法分为药物对照组35例、联合治疗组36例。药物对照组患者给予盐酸舍曲林片（第1周25 mg/d,第2周起50 mg/d,连续4周）,联合治疗组患者在药物对照组治疗基础上给予理情行为疗法（30 min/次,3次/周,连续4周）。分别于治疗开始前及治疗4周后应用匹兹堡睡眠质量指数量表（PSQI）、失眠严重指数量表（ISI）、汉密尔顿抑郁量表（HAMD-17项）、汉密尔顿焦虑量表（HAMA）及改良Barthel指数量表（MBI）分别对两组患者的睡眠质量、失眠程度、抑郁情况、焦虑情况及日常生活能力方面进行评定。 结果 两组患者治疗后PSQI、HAMA评分比较,差异无统计学意义（P>0.05）;联合治疗组患者治疗后ISI、HAMD-17项评分低于药物对照组,MBI评分高于药物对照组（P<0.05）。两组患者治疗后PSQI、ISI、HAMD-17项、HAMA评分低于组内治疗前,MBI评分高于组内治疗前（P<0.05）。联合治疗组患者治疗后抑郁情况、焦虑情况改善情况优于药物对照组（P<0.05）。 结论 理情行为疗法结合药物治疗较单独药物治疗能更好地减轻卒中后抑郁患者失眠程度,改善情绪状态,提高日常生活能力。     

Vocación y profesionalismo: reflexiones de los estudiantes catalizadas por el cine de Spielberg

The medical profession has a marked vocational sense that is closely linked to its ethical dimension. However, there are doubts about the role that undergraduate studies are playing in their development. In order to encourage reflection on this issue, a seminar was held with students and teachers, developed in 3 phases: a) free presentation by students about what they considered to be the medical vocation; b) presentation by professors of the theoretical framework of medical education, followed by the viewing of several scenes of films directed by Steven Spielberg that facilitate reflection on the meaning of the ethical and human components of medicine, and c) open discussion between students and teachers. The main conclusions were analysed: it is worth creating spaces for reflection on the vocational dimension of medicine throughout undergraduate studies. This, in some way, should already be considered in the selection and access procedures to medical school. In the teaching task it is essential that the lecturers are seen as role models, as well as providing individualised tutoring that includes vocational development. Thus, it is necessary to promote training that goes beyond the acquisition of knowledge and skills, paying attention to the management of emotions, the approach to the ethical problems, and the education of attitudes. Early contact with clinical activity, from the beginning of studies is considered a decisive factor to motivate students before the immense theoretical burden they have to face.