延边地区中年女性健康促进生活方式影响因素分析

[目的]调查分析延边地区中年女性健康促进生活方式的影响因素,为中年女性干预健康促进提供依据.[方法]2006年10—11月,随机抽取延边地区中年女性406名,调查其健康促进生活方式、自觉健康、更年期症状、绝经知识、绝经态度及社会支持程度,对所获数据进行统计学分析.[结果]延边地区中年女性健康促进生活方式平均得分为(121.68±18.2)分,其中人际关系平均评分最高,其次为自我实现.不同职业、教育程度及经济状态女性的健康促进生活方式间差异有统计学意义,预测中年女性健康促进生活方式的变量为自觉健康状态、经济状态、社会支持及绝经知识,可解释健康促进生活方式变异量的46.87%.[结论]延边地区中年女性对健康促进行为不积极,建议在实施中年女性干预健康促进时重视自觉健康状态和经济状态不佳的中年女性,关注如何提高其社会支持系统和绝经相关知识.     

医学应对方式、社会支持对肾移植患者生活质量影响的路径分析

目的 探讨医学应对方式、社会支持与肾移植患者生活质量的关系.方法 采用方便抽样方法 ,应用医学应对问卷(Medical Coping Modes Questionnaire,MCMQ)、社会支持量表(Sodal Support Rating Scale,SSRS)和肾移植患者生活质量相关评定量表(Quality of Life Scale for Patients of Renal Transplantation,QOL-RT)对123名肾移植患者进行测评,然后用结构方程模型分析软件Amos(Analysis of Moment structures)7.0作路径分析.结果 肾移植患者医学应对方式中,面对维度得分为(20.89±3.60)分、回避维度得分(17.15±2.73)分、屈服维度得分(9.50±2.74)分;社会支持总分(42.89±8.48)分;总的生活质量(128.74±16.29)分.路径分析结果 显示:回避维度对生活质量有直接正向效应(β0.183,P<0.01),屈服维度对生活质量有直接负向效应(β0.388,P<0.01);面对维度对社会支持有直接正向效应(β0.232,P<0.01);屈服维度对社会支持有直接负向效应(β0.203,P<0.01);而社会支持对生活质量有直接正向效应(β0.428,P<0.01);医学应对方式还可通过社会支持间接影响生活质量.结论 医学应对方式对肾移植患者的生活质量有直接效应;医学应对方式还可通过社会支持间接影响肾移植患者的生活质量;社会支持可作为中介变量(Mediated variable)调节应对方式与肾移植患者生活质量的关系.     

骨质疏松症的影响因素及诊断治疗

原发性骨质疏松症作为一种中老年多发病,始于青少年,发病于中老年,骨质疏松症引起的骨折是老年人致残的重要因素。人体骨密度受多种因素的影响,如遗传、种族、年龄、营养、激素水平、环境、运动以及生活方式等。雌激素水平是影响女性骨密度的重要因素,随着女性一生中激素水平的变化骨密度发生明显改变。体质量尤其是人体瘦体质量成分与骨密度呈正相关。环境因素对骨密度的影响研究日益引起重视,如铅、镉、铝、钙等对骨密度的影响通过单一或协同作用发挥影响。     

心理干预对不同个性特征儿童诊疗性疼痛的影响

目的探讨心理干预对不同个性特征儿童诊疗性疼痛的影响。方法在住院7-13岁非危重症患儿中随机抽取70名,分别在入院第1～5天的每天静脉穿刺后进行疼痛评估（采用自评法和他评法）;人院第1天进行艾森克个性问卷（儿童版）个性特征评估;第2～5天实行心理干预。对3种不同个性（外向型、中间型、内向型）儿童,情绪稳定型及不稳定型儿童分别进行心理干预前后（第1天与第5天）疼痛强度的比较。结果诊疗性疼痛强度随着心理干预的实施,住院天数的增加逐渐减轻;中间型及内向型儿童,实行心理干预前后疼痛强度比较差异有显著性（P〈0．05）。情绪稳定型及不稳定型儿童,实行心理干预前后疼痛强度比较差异有显著性（P〈0．05）。结论心理干预可减轻诊疗性疼痛的强度;心理干预对中间型及内向型个性儿童的诊疗性疼痛有明显的效果;可降低情绪稳定及不稳定型儿童诊疗性疼痛的强度。     

应急机动卫勤分队136名队员心理应对机制的分析

目的了解应急机动卫勤分队队员心理应对机制的特点及应对方式与个性因素和心理健康水平的关系。方法采用临床症状自评量表（SCL-90）、卡特尔十六种个性因素问卷（16PZ）和简易应对方式问卷（SCSQ）对136名分队队员进行测试。结果应急机动卫勤分队队员积极应对和消极应对得分与全国常模比较均有非常显著差异,积极应对高于常模,而消极应对低于常模。积极应对与情绪稳定、有恒、敢为、忧虑、自律、紧张、适应焦虑、心理健康、专业成就和成长能力等因素相关,均达到显著水平（P〈0.05）以上。消极应对与情绪稳定、敢为、怀疑、忧虑、紧张、适应焦虑、内向外向、心理健康、专业成就、SCL-90总分和总均分等因素相关,达显著水平（P〈0.05）以上。结论应急机动卫勤分队队员应对方式成熟、积极,应对方式与某些个性因素及心理健康水平相关。     

Neurocognitive processes of the religious leader in Christians

Our recent work suggests that trait judgment of the self in Christians, relative to nonreligious subjects, is characterized by weakened neural coding of stimulus self‐relatedness in the ventral medial prefrontal cortex (VMPFC) but enhanced evaluative processes of self‐referential stimuli in the dorsal medial prefrontal cortex (DMPFC). The current study tested the hypothesis that Christian belief and practice produce a trait summary about the religious leader (Jesus) in the believers and thus episodic memory retrieval is involved to the minimum degree when making trait judgment of Jesus. Experiment 1 showed that to recall a specific incident to exemplify Jesus' trait facilitated behavioral performances associated with the following trait judgment of Jesus in nonreligious subjects but not in Christians. Experiment 2 showed that, for nonreligious subjects, trait judgments of both government and religious leaders resulted in enhanced functional connectivity between MPFC and posterior parietal cortex (PPC)/precuneus compared with self judgment. For Christian subjects, however, the functional connectivity between MPFC and PPC/precuneus differentiated between trait judgments of the government leader and the self but not between trait judgments of Jesus and the self. Our findings suggest that Christian belief and practice modulate the neurocognitive processes of the religious leader so that trait judgment of Jesus engages increased employment of semantic trait summary but decreased memory retrieval of behavioral episodes. Hum Brain Mapp, 2009. © 2009 Wiley‐Liss, Inc.     

Stress‐coping strategies of patients with gender identity disorder

Aims: Previous research has not addressed gender differences in coping strategies among patients with gender identity disorder (GID). Nor has the relationship of coping strategies to other demographic characteristics ever been clarified in GID. In this study, we tried to clarify the relationship between stress‐coping strategies and demographic characteristics among patients with GID. Methods: The coping strategies of 344 patients with GID [227 female‐to‐male (FTM) and 117 male‐to‐female (MTF)] were assessed using the Japanese version of the Ways of Coping Questionnaires, Lazarus Stress‐coping Inventory. Results: Comparison of the stress‐coping inventory between MTF and FTM GID patients revealed that FTM GID patients were significantly more reliant on positive reappraisal strategies in stressful situations than MTF GID patients (P = 0.007). Conclusions: The difference in the usage of positive reappraisal strategies between MTF and FTM type GID patients was not explained by other demographic characteristics, and we suppose that the gender difference in GID patients might influence the usage of positive reappraisal strategies. The ratio of FTM GID patients might be higher at our center because MTF GID patients can obtain vaginoplasty easily, whereas phalloplasty surgery for FTM GID patients is performed at only a few centers, including our clinic, in Japan. As a result, more FTM GID patients come to our clinic with a clear intention to undergo sexual rearrangement surgery, which might influence the gender difference in using positive reappraisal.     

Coping with challenges to memory in people with mild to moderate Alzheimer's disease: Observation of behaviour in response to analogues of everyday situations

Objectives: To describe ways of coping in people with mild to moderate AD when faced with situations that are challenging to their memory.

Method: Twenty-four participants (12 with mild and 12 with moderate AD) were presented with a set of seven tasks that were analogues of everyday situations that tax memory. The participants’ responses were videotaped and analysed.

Results: Participants’ coping responses were grouped into seven categories to best reflect the main strategies. Individuals used a significantly greater frequency of effortful problem solving (self-reliance and reliance on carers) (p < 0.01) than other ways of coping. Positive acknowledgement of memory difficulties was used significantly more than negative acknowledgement and defensive coping (concealment and avoidance) (p < 0.01).

Conclusion: This study used novel methodology of observation of behavioural responses in analogues of everyday situations. The predominance of effortful problem-solving emphasizes the role of the person with AD as an active agent in the management of memory loss. An emphasis in previous literature on defensive coping and denial is counter-balanced by the finding that participants commonly coped by acknowledging their memory impairment.     

Components of the difficulties,satisfactions and management strategies of carers of older people: A principal component analysis of CADI-CASI-CAMI

Objectives: To perform a psychometric evaluation of the Carers Assessment of Difficulties Index, Carers Assessment of Satisfactions Index and the Carers Assessment of Managing Index (CADI-CASI-CAMI).

Method: Data was collected in three European countries from informal carers of older people (n = 295) via a common protocol. Carers completed: (a) a questionnaire containing items on demographics and caregiving characteristics and (b) the CADI-CASI-CAMI indices. Principal component analysis of the CADI-CASI-CAMI indices was followed by internal consistency analysis of emergent components. Scales derived by summing items loading on the components were analysed for their association with the demographic and caregiving characteristic variables.

Results: CADI produced six internally consistent and interpretable components, CASI five and CAMI seven. Subscales derived from the components were significantly associated with the demographic and caregiving characteristic variables, providing initial support for construct validity.

Conclusion: The CADI-CASI-CAMI indices are recommended as an assessment tool for in-depth work with family carers of older people and as a research tool for large-scale studies of family care.     

Treatment-seeking behaviour, cost burdens and coping strategies among rural and urban households in Coastal Kenya: an equity analysis

Ill-health can inflict costs on households directly through spending on treatment and indirectly through impacting on labour productivity. The financial burden can be high and, for poor households, contributes significantly to declining welfare. We investigated socio-economic inequities in self-reported illnesses, treatment-seeking behaviour, cost burdens and coping strategies in a rural and urban setting along the Kenyan coast. We conducted a survey of 294 rural and 576 urban households, 9 FGDs and 9 in-depth interviews in each setting. Key findings were significantly higher levels of reported chronic and acute conditions in the rural setting, differences in treatment-seeking patterns by socio-economic status (SES) and by setting, and regressive cost burdens in both areas. These data suggest the need for greater governmental and non-governmental efforts towards protecting the poor from catastrophic illness cost burdens. Promising health sector options are elimination of user fees, at least in targeted hardship areas, developing more flexible charging systems, and improving quality of care in all facilities. The data also strongly support the need for a multi-sectoral approach to protecting households. Potential interventions beyond the health sector include supporting the social networks that are key to household livelihood strategies and promoting micro-finance schemes that enable small amounts of credit to be accessed with minimal interest rates.