脊髓损伤患者压力应对方式及其影响因素的研究

目的探讨影响脊髓损伤患者压力应对方式的因素及其相关性。方法采用便利抽样法选取2015年9月至2016年4月广州市4所三级甲等综合性医院脊髓损伤住院患者90例为研究对象。采用一般资料调查表、脊髓损伤压力应对量表、简式简明心境问卷、社会支持评定量表对其进行调查,并进行影响因素分析。结果拒绝与否认维度中,家庭经济主要来源、愤怒-敌意为显著影响因素,能解释其65.2%的变异量;面对维度中,婚姻状况、排便情况及年龄为显著影响因素,能解释其43.8%的变异量;幻想维度中,迷惑-混乱情绪、病程为显著影响因素,能解释其52.1%的变异量;依赖与妥协维度中,自理能力、年龄、损伤程度、损伤结果及生育情况为显著影响因素,能解释其79.6%的变异量;寻求支持维度中,居住地、性别、日常照护、支持利用度为显著影响因素,能解释其47.9%的变异量;合理化维度中,精力-活力情绪、家庭人均月收入及受教育程度为显著影响因素,能解释其50.9%的变异量。结论脊髓损伤患者压力应对方式的运用受个体不同因素的影响。有必要采取相应的护理措施对脊髓损伤患者进行干预,以协助患者调整压力应对方式,提高压力应对水平,使其顺利回归社会。     

Determinants of perceived need for dental pain medication

Abstract – Objectives: To describe the perceived inability to cope (PIC) and impact on quality of life (QOL) in dental pain patients, and investigate their effect on perceived need for pain medication. Methods: Fully structured self‐complete questionnaire survey of a sample of patients with current experience of dental pain/discomfort and sensitivity. Subjects were recruited from a dental teaching hospital’s emergency and restorative clinics. Questions were asked on pain intensity, PIC, impact on QOL and perceived need for pain medication. Results: Of 318 subjects approached, 199 (63%) completed usable questionnaires. In expressing PIC, 48.2% of the sample reported that they felt dependent on somebody else doing something about the pain, whereas 69.3% reported feeling helpless in their effort to try and do something about the pain. The prevalence of impact on QOL ranged from 55.8% reporting feeling like isolating oneself from other people to 77.9% for feeling grumpy, irritable, bad‐tempered or miserable. Logistic regression analysis identified impact on QOL (OR = 1.17, 95% CI = 1.06–1.30), PIC (OR = 1.10, 95% CI = 1.01–1.21) and pain intensity (OR = 1.26, 95% CI = 1.05–1.50) as independent significant predictors of perceived need for pain medication. Conclusions: Pain intensity and PIC can enhance the ability of QOL measures in differentiating population groups into those who perceive the need for pain medication and those who do not.     

32例腔镜下乳腺癌腋窝淋巴结清扫术临床分析

目的探讨腔镜下乳腺癌腋窝淋巴结清扫手术方法、可行性及临床效果。方法回顾性分析32例乳腺癌腔镜下腋窝淋巴结清扫手术（腔镜组）的临床资料,并与46例同期临床分期类似而行传统腋窝淋巴结清扫（传统组）资料比较。结果两组均为Ⅰ～Ⅱ期乳腺癌。腔镜组无中转开放手术,未发生大出血、皮下气肿、脂肪栓塞等并发症。腔镜组淋巴结数目（15．5枚）、平均手术时间（80min）与传统组比较差异均无统计学意义。但缩短了引流时间（3～5d）、减少了出血量（380ml）和术后并发症发生率（仅1例）。结论在选择性乳腺癌患者行腔镜下腋窝淋巴结清扫术能够达到传统腋窝淋巴清扫治疗效果,可在保证腋窝淋巴结清扫质量的同时降低手术并发症发生率,达到了生理、心理的微创化,提高了患者的生活质量。腔镜下腋窝淋巴结清扫术是可行的。     

家庭功能对生育意愿影响的研究现状

介绍家庭功能的作用及我国计划生育政策的变革,重点阐述了不同家庭功能对生育意愿的影响,明确了家庭经济功能和情感功能对生育意愿影响的关键作用,为在推行"二孩"政策下开展家庭健康护理提供依据。     

大学生应对方式研究

介绍了大学生应对方式研究现状,重点阐述了大学生常用的应对方式、影响因素及应对方式对大学生心理健康的影响.     

Smack and Grab

In college students, solitary (i.e., while alone) heavy episodic drinking is associated with depression, suicidal ideation, drinking to cope, and having greater alcohol-related problems than heavy drinking only in social contexts. This study explored the possible explanatory factors for solitary heavy drinking. Social (n?=?58) and solitary heavy episodic drinking (n?=?32) emerging adult college students were compared in regards to: alcohol-related problems and dependence severity, negative affect, social relationship issues, socially related coping skills, and negative mood regulation. Multiple analyses of covariance revealed that solitary heavy drinkers were significantly higher in alcohol-related problems, severity of dependence, suicidal ideation, hopelessness, depression, loneliness, and drinking to cope and were lower in negative mood regulation expectancies and social competence. Heavy drinking groups did not differ in social network size, perceived social support, or in their drinking social network size or satisfaction. Our findings suggest that solitary heavy drinkers are not socially isolated or lacking in social support; however, they do experience greater social discomfort and difficulties with negative mood regulation than social heavy drinkers. Interventions focused on depression, affect regulation, adaptive coping, and alcohol abuse would be helpful with this population to address their related problems.     

Alopecia areata: Support groups and meetings – how can it help your patient?

Many people with alopecia areata find the fellowship of the support groups provides them with the help they need to cope. They find that they are not alone, how others have coped, what doctors and treatments have been tried, and what the results have been. The National Alopecia Areata Foundation offers support groups throughout the world to refer patients.     

Protective behavioral strategies mediate problem-focused coping and alcohol use in college students

Objective

Protective behavioral strategies have emerged as a construct protective against alcohol use. The current study examines the theoretical associations among general coping styles, protective behavioral strategies, drinking to cope motives, and alcohol use in college students.

Method

Analyses of fully latent variables were conducted using structural equation modeling in a sample of 327 college students.

Results

Protective behavioral strategies partially mediated the association between problem-focused coping and alcohol use. Behaviorally oriented problem-focused coping strategies accounted for the positive relationship between problem-focused coping and protective behavioral strategies whereas cognitively oriented problem-focused coping strategies were associated with less use of protective behavioral strategies and increased alcohol use.

Conclusions

This is the first study to find that protective behavioral strategies are more likely to be used by college students who endorse using a problem-focused coping style, especially if they tend to use behaviorally oriented problem-focused coping strategies. These findings extend the literature on protective behavioral strategies and indicate that students less likely to use problem-focused coping skills to deal with stress in general may need additional interventions to increase their use of protective behavioral strategies.