Psychological responses of patients receiving a diagnosis of cancer.

BACKGROUND: Current recommendations on how to break bad news are primarily based on expert opinion. Little is known about the association between communication practices and patients' psychological response. PATIENTS AND METHODS: One-hundred and thirty-one patients with newly diagnosed melanoma were surveyed 4 months after the initial consultation at the Sydney Melanoma Unit regarding their communication experiences and their satisfaction with these experiences. They completed the Hospital Anxiety and Depression Scale (HADS) at this time, and 4 and 13 months later. RESULTS: Both patients' satisfaction with communication and their psychological morbidity were found to be associated with particular communication practices. Practices linked to lower anxiety included preparing the patient for a possible diagnosis of cancer; having the people wanted by the patient present to hear the diagnosis; giving the patient as much information about the diagnosis as desired; providing written information; presenting the information clearly; discussing the patient's questions the same day; talking about the patient's feelings; and being reassuring. Practices linked with lower levels of depression included using the word 'cancer'; discussing the severity of the situation, life expectancy and how the cancer might affect other aspects of life; and encouraging the patient to be involved in treatment decisions. CONCLUSIONS: This study provided preliminary evidence that communication strategies recommended in the literature produce positive patient outcomes. Further studies are needed which document actual communication.     

Effects of Pediatric Chronic Physical Disorders on Child and Family Adjustment

Research conducted primarily over the past 5–8 years on the psychosocial effects of pediatric chronic physical disorders on children and their families is reviewed. A large body of studies show that both children and their mothers, as groups, are at increased risk for psychosocial adjustment problems compared to peers, but that there is considerable individual variation in outcome. Since the last review on this topic (Eiser, 1990a), many studies have been conducted to identify risk and resistance factors associated with differences in adjustment among these children and their mothers. Improvements are noted in the theoretical basis for this work, programmatic nature of some of the research, and efforts at producing clinically relevant information. Evaluations of interventions, however, are lagging. Critical issues and future directions regarding developmental approaches, theory, method, measurement and intervention are discussed.     

社区老年人主观幸福度及相关因素分析

目的探讨社区老年人心理健康水平及相关影响因素。方法采用Lawton费城老年中心(PGC)信心量表及自编老年人幸福度调查表,对405名老人进行问卷调查。结果老年人主观幸福度与娱乐活动,生活自理,自感身体状况,经济收入,文化程度,过去职业有非常显著性差异,与目前工作情况,婚姻状况,年龄,性别无明显差异。结论鼓励老年人多参加娱乐活动,保障其经济收入以及提高他们对卫生知识的认识,有利于老年人的身心健康。     

新时期医院制剂发展的思考

本文探讨新时期医院制剂的发展趋势.通过对"医院制剂存在的必要性"及"医院制剂特点"的分析,对"新时期医院制剂"的发展提出了几点建议,供医院药学工作者借鉴.     

健康教育对慢性乙型肝炎合并抑郁症患者的影响

目的调查慢性乙型肝炎患者抑郁症状发生率并探讨健康教育对抑郁症状及肝功能的影响。方法采用Zung抑郁自评量表(SDS)对106例慢性乙型肝炎患者进行测评。将抑郁指数≥0.5的56例患者随机分为干预组28例,对照组28例。干预组在住院期间药物治疗的同时并进行健康教育与心理社会干预,分别于入出院时SDS、肝功能、HBV DNA检测,对病情恢复时间进行评估。结果慢性乙型肝炎并抑郁情绪检出率为52.83%,SDS总分均值54.98±10.50,与国内常模比较,高度显著性差异(P<0.01),经健康教育与心理社会干预后,干预组抑郁指数显著降低(P<0.01),病情恢复时间(肝功能、HBV DNA复常时间)显著缩短(P<0.05)。结论慢性乙型肝炎患者常合并忧郁症状,健康教育与心理社会干预可改善抑郁症状及机体的免疫功能,提高抗病毒能力。     

论新编配体制下军队中小医院的建设与发展

分析和总结了军队中小医院在现行人员编配体制下,医院在管理、经营和发展中面临的主要问题和困难;结合工作实践,从正确认识新编制、积极适应新编制、认真落实新编制三个方面论述了解决问题的办法。     

SPECT探头系统的校正与调试

本文阐明了对SPECT探头校正与调试的重要性,特别是对探头校正与调试的具体方法与步骤作了详细介绍。     

扩肛式智能正压回流洗肠装置的设计与研制

目的设计并研制了一种新型的扩肛式智能正压回流洗肠装置。方法详细介绍此装置的组成结构、各组成部分的功能及其工作原理。结果其临床应用在一定程度上可减少病人的痛苦，同时减少护理人员的劳动强度，对于卧床不起或术后不能活动、大便困难的病人能提供很好的帮助，对结肠炎、便秘、降温亦有很好的疗效。结论扩肛式智能正压回流洗肠装置具有实用、高效、方便等特点，适合推广应用。     

Ajustement psychologique des couples confrontés à un cancer du sein : perceptions des comportements de soutien du conjoint

This cross-sectional study for couples explores the relationship between the perceptions within the couple of the spouse's supportive behaviors and the psychological adjustment of both partners during treatment for breast cancer. Forty-eight women operated on for a non-metastatic breast cancer and their spouses completed questionnaires assessing psychological adjustment (STAI, BDI-SF), and the spouse's support behaviors during discussions about the disease (PSE). Support behaviors are positively valued by both partners, especially non-verbal comfort and concrete actions. Support by minimization is associated with fewer depressive symptoms in patients and spouses. For spouses, the positive perception of support by concrete action is associated with a lower depression score. Moreover, high adjustment difficulties for spouses are linked to greater perception differences between partners on emotional support and minimization. These results highlight the importance of non-verbal comfort and minimization for the perception of social support within the couple, and the usefulness of support by concrete actions proposed by spouses. Advices for professionals are available.