女性围产期抑郁动态观察及相关因素研究

目的:观察女性围产期抑郁情绪动态变化及探讨女性孕期压力水平、应对方式与围产期抑郁的相关性.方法:采用便利抽样法选取在合肥市某三甲医院门诊孕期检查的162例孕妇为调查对象,运用妊娠压力量表(PPS)、简易应对方式问卷(SCSQ)评估孕期压力水平和孕妇应对压力的方式,运用爱丁堡产后抑郁量表(EPDS)评估孕期、产后的抑郁情绪.结果:孕产妇孕期抑郁、产后抑郁的发生率分别为47.53％ (77/162)、48.77％ (79/162);纵向追踪发现,孕期77例抑郁女性中,在产后有24例女性(31.17％)转为非抑郁;孕期85例非抑郁女性中,在产后有26例女性(30.59％)转为抑郁.其次,妊娠晚期孕妇妊娠总体压力为轻度水平[中位数(M)=1.57].孕妇应对方式总分(1.57 ±0.03)分,积极应对方式评分为(1.93±0.04)分,消极应对方式评分为(1.03±0.03)分.与常模比较,其中,积极应对方式评分比常模评分高,差异有统计学意义(t=1.96,P＜0.01).孕妇孕期抑郁情绪与妊娠压力总分、各压力因子得分呈正相关,与应对方式总分、积极应对分值呈负相关.产妇产后抑郁情绪与妊娠压力总分、各压力因子得分呈正相关,与积极应对分值呈负相关.多元逐步回归分析显示,孕期抑郁情绪是产后抑郁的危险因素,家庭关系是产后抑郁情绪的保护因素.结论:在产前对孕妇做好心理健康水平的筛查和干预,对于产后抑郁的预防有着重要意义.     

孕前体重指数和孕中期体重增加对妊娠期糖尿病发病影响的队列研究

目的 探讨孕前BMI和孕中期体重增加对妊娠期糖尿病(GDM)患病的影响。方法 采用以孕妇人群作为基础的队列研究, 在安徽省马鞍山市妇幼保健院围生期门诊选取首次孕期体检、孕周≤14周、马鞍山市常住户口的孕妇, 首次、孕中期和孕晚期体检时分别填写问卷、测量身高和体重, 在24～28周接受75 g口服糖耐量试验(OGTT)进行GDM诊断, 并追踪记录分娩结局。使用t检验、方差分析、χ²检验和logistic回归模型进行分析。结果 孕妇GDM的发生率为14.73%, 孕前BMI与孕中期增重呈负相关(r=-0.085, P<0.01)。GDM孕妇孕中期增重多于正常孕妇。孕妇年龄≥35岁、孕前超重和肥胖及孕早期血糖水平升高是GDM的危险因素, OR值(95%CI)分别为3.06(1.68～5.58)、2.08(1.38～3.13)、3.73(1.84～7.56)和2.17(1.57～3.00)。结论 孕前超重和肥胖以及孕期体重增加是GDM的危险因素.     

山东省居民24小时尿钠钾比与代谢综合征的关系

目的 分析山东省居民24 h尿钠钾比与MS的关系。方法 2011年在山东省采用四阶段分层随机抽样方法抽取18~69岁居民作为研究对象, 测量其血糖、血脂四项、尿钠、尿钾和尿肌酐等指标。依据24 h尿钠钾比值将研究对象按照四分位数法分组, 采用二分类logistic分析钠钾比与MS的关系。结果 1 906名研究对象纳入分析, 其中男性1 003人, 女性903人。MS患病率为24.7%。经多因素logistic模型分析, 与24 h尿钠钾比值<4.3组相比, 4.3~5.6、5.7~8.1和≥8.1组MS患病风险OR值(95%CI)分别为1.27(0.93~1.71)、1.06(0.78~1.46)和1.45(1.06~1.97), 趋势检验显示, P<0.05。在MS各组分中, 中心性肥胖和血压升高风险与24 h尿钠钾比之间存在线性趋势(线性趋势检验P<0.05)。结论 随着24 h尿钠钾比增加, MS患病风险呈上升趋势。     

Progressive exhaustion: A qualitative study on the experiences of Iranian family caregivers regarding patients undergoing hemodialysis

ObjectiveThe aim of this study was to explore the burden of care for patients undergoing hemodialysis from the experiences of family caregivers.MethodsIn this qualitative study, a content analysis approach was used for data collection and analysis. Participants were 16 family caregivers selected through purposive sampling from four medical education centers affiliated with Ahvaz Jundishapur University of Medical Sciences, Iran. Semi-structured interviews were held to collect data.ResultsFour categories were developed as follows: ‘care challenges’, ‘psychological vulnerabilities’, ‘the chronic nature of care ’and “care in the shade”. The categories led to the development of the main theme of ‘progressive exhaustion’ experienced by the family caregivers during the provision of care to patients undergoing hemodialysis.ConclusionFamily caregivers have a significant role in the process of patient care, and this role leads them to progressive exhaustion; therefore, the overall health of the caregivers should be taken into account and more attention should be paid to their quality of life, social welfare, and satisfaction level.     

Conocimiento y percepción de la nocividad del cigarrillo electrónico en población adulta de Barcelona

ObjectiveTo describe knowledge of electronic cigarettes (e-cigarettes) and their perceived harmfulness in the population of Barcelona in 2013-2014.MethodsWe used participants from a longitudinal study of a representative sample of the adult population in the city of Barcelona (n = 736). The field work was conducted between May 2013 and February 2014.ResultsAwareness of e-cigarette was 79.2%. The average level of knowledge was 4.4 points out of 10; there were statistically significant differences according to age, educational level, tobacco consumption, and nicotine dependence. Most participants had learned about e-cigarettes through traditional media (57.8%). Nearly half (47.2%) of the participants believed that e-cigarettes are less harmful than conventional cigarettes.ConclusionAdvertising of e-cigarettes in the media should be regulated because there is still scarce scientific evidence about the usefulness and harmful effects of these devices.