士官军人人际关系困扰与应对方式的相关性

目的:研究士官军人人际关系困扰和应对方式的关系。方法:以陆军士官军人为研究对象,采用人际关系综合诊断量表和应对方式问卷进行调查分析。结果:士官军人存在人际困扰的比例为78%;士官军人应对方式高于士官军人常模,其解决问题、求助因子显著高于常模(t=26.08,10.38;P0.01);士官军人人际关系困扰与应对方式存在相关,成熟型应对方式与人际关系困扰呈显著相关(r=-0.18~0.29,P0.05);回归分析显示,应对方式各因子可共同解决人际困扰问题的27%,解决问题、求助的运用能明显缓解人际困扰。结论:成熟的应付方式(解决问题、求助)有助于缓解士官军人人际关系困扰。     

Attachment and coping with chronic disease

BACKGROUND: In this clinical study, attachment theory was applied to research in the field of coping with chronic disease. The approach was to integrate concepts of coping within a framework of attachment theory. It was hypothesised that attachment concepts have an influence on coping strategies, and that they may predict the subjective emotional and physical health status during the course of medical treatment. METHOD: One hundred fifty patients were investigated with an adult attachment interview (AAPR coding system) and a coping interview (Bernese Coping Modes). Self-reported coping modes, social support, the subjective health status and quality of life were also assessed by self-report measures at two or more sampling points of measurement. Three subsamples of patients, suffering from (a) breast cancer, (b) chronic leg ulcers and (c) alopecia, were studied in order to include a broad range of subjective impairment caused by a disease. RESULTS: Findings indicate a moderate statistical effect of attachment patterns on coping strategies when controlling the influence of confounding variables. Insecure attachment was related to less flexible coping. Coping strategies also differed between the different types of insecure attachment; however, there were differences depending on the perspective of the coping behaviour (self- vs. observer ratings) as well. From the observer perspective, ambivalently attached individuals showed more negative emotional coping while avoidantly attached individuals showed more diverting strategies. In the self-report, ambivalently attached patients revealed hyperactivating tendencies in their coping behaviour while avoidantly attached individuals revealed deactivating tendencies. CONCLUSION: As a conclusion, two levels of coping should be differentiated. One level strongly corresponds with affect regulation, in particular the regulation of attachment-related emotions and concerns, while the other level shows a stronger tendency to outwardly oriented coping. A more secure attachment might be considered to be an important inner resource in the emotional adaptation to chronic diseases.     

Early psychological adjustment in breast cancer patients: a prospective study

Objective: A significant proportion of breast cancer patients experiences psychiatric morbidity in the first year after a breast cancer diagnosis and/or beginning of treatment. This study attempted to identify and understand the risk factors for developing such problems. Methods: A consecutive series of 87 patients, aged 40-75 years, was assessed prior to diagnosis of breast cancer and followed-up approximately 8 weeks after beginning of cancer treatment and again 9 months after first follow-up. Assessments included measures of psychiatric morbidity using the General Health Questionnaire (GHQ-12), coping style using the Mental Adjustment to Cancer (MAC) Scale, symptom attribution, beliefs about breast cancer, social support, socio-demographic and clinical variables. Results: A total of 85.1% of patients completed both follow-ups. Pre-diagnostically, 32.2% of breast cancer patients scored as a GHQ-12 ‘case.’ GHQ scores fell significantly between pre-diagnostic and both post-diagnostic assessments, especially in women who had thought they had cancer. Predictors of psychological morbidity at first follow-up included pre-diagnostic GHQ-12 score, lack of social support and feelings of ‘personal responsibility/avoidance.’ GHQ-12 ‘caseness’ at second follow-up was predicted by lack of social support alone. Conclusions: Overall, psychiatric morbidity is higher prior to, than following, a definitive diagnosis of breast cancer. Early reactions of this kind are predictive of post-treatment adjustment. However, only the presence of social support in this study seems to be associated with successful adjustment in the first year following a breast cancer diagnosis. Women at increased risk of psychological morbidity after a breast cancer diagnosis may be thus identifiable and targeted therapeutically.     

我院处方质量分析

目的了解新的《处方管理办法》实施以来我院的贯彻执行情况。方法随机抽取2008年3月-4月共1500张处方进行调查分析。结果门诊不合格处方为273张,占总抽查处方数的39.57%,住院不合格处方为278张,占总抽查处方数的34.32%,其中未写诊断结果、超剂量用药和用法含糊不清是处方质量管理中存在的主要问题。结论需要加强处方诊断与用药的相符性及用药方法与剂量合理性审核,提高医师对《处方管理办法》的掌握水平,促进药师为药品合理化管理及为患者合理化用药提供有效支持。     

Introduction

The question addressed in this paper is whether different coping styles mediate the relationship between psychopathology and related distress and the quality of life (QOL) among patients with schizophrenia. In a cross-sectional design, 161 schizophrenia inpatients were comprehensively evaluated with standardized measures of QOL, psychopathology, psychological distress and coping styles. Correlations and regression analyses were performed to examine the relationship among parameters and to estimate the mediating effect of coping styles on QOL in the framework of a distress/protection model. Life quality correlated positively with task- and avoidance-oriented coping styles and slightly negatively with emotion-oriented coping. Emotion-oriented coping mediated the relationship between the severity of activation, anxiety/depression symptoms, and QOL, while avoidance-oriented (distraction) coping was mediated between QOL and paranoid symptoms. Coping styles accounted for 25% of the variance in subjective QOL scores compared with 15% for psychological distress, and only 3% for clinical variables. The ability to cope with symptoms and associated distress substantially contributes to QOL appraisal in schizophrenia. Thus, different coping strategies may reduce the negative influence of specific symptoms and related distress on the subjective QOL of schizophrenia patients.     

Providing parents with information before anaesthesia: what do they really want to know?

BACKGROUND: Videotapes presenting information concerning children's anaesthesia are often based on what the makers of the videotape believe the parents want to know rather than what parents actually want to know. They frequently do not take into account the parent's coping style. Two common parental coping styles are information-seeking (monitoring) and information-avoiding (blunting). METHODS: We wished to take parent needs into account when making our local videotape and accordingly constructed a questionnaire designed to elicit these needs. RESULTS: Of the parents questioned, 55% wanted more extensive preoperative information and 41% of parents wanted a videotape as part of this preparation. Information about premedication, induction of anaesthesia, side-effects of anaesthesia and postoperative pain management were sought by more than 70% of parents. Parents had concerns about induction of anaesthesia, emergence from anaesthesia and postoperative pain and nausea. When asked a question concerning preference about being present at the induction of anaesthesia, 90% of parents wanted to be present at the induction and 75% of parents thought that their child should receive a premedicant. The number of parents requesting to be present at the induction decreased to 72% after an explanation about the purpose and effects of premedication. There was no correlation between the coping style of the parent and the responses given to the questions. There was no correlation between the level of education and the coping style of the parent. CONCLUSIONS: The use of a questionnaire of parental attitudes towards information and anaesthesia provided a useful tool in the production of a video as part of our preoperative preparation. Our videotape has proved a success with staff and parents and children and enhances the quality of our service. Its popularity stems from the fact that it addresses what the parents want to know and also conveys what the staff of this hospital would like the parents to know.     

Early traumatic life events,parental rearing styles,family history of mental disorders,and birth risk factors in patients with social anxiety disorder

Objective Childhood traumatic experiences, rearing styles, familial mental disorders and birth risk factors have been associated with the development of social anxiety disorder. Method Patients with social anxiety disorder (n = 50) and healthy controls (n = 120) were investigated using a retrospective interview with 203 questions. Results The frequency of reports of traumatic childhood experiences was significantly higher in patients than in controls, including separation from parents, parents marital discord, sexual abuse, familial violence, childhood illness, and other factors. On a 0–10 point severe trauma scale patients had significantly higher mean scores (2.0; SD 1.28) than control subjects (0.82; SD 1.1; p < 0.0001).Only 6 (12 %) of the social phobic patients, but 63 (52.5%) of the controls did not report any severe traumatic events at all (²= 24.0; p < 0.0001). Compared to controls, patients described their parents rearing styles as significantly more unfavourable. Patients reported higher rates of psychiatric disorders in their families in general, in particular anxiety disorders, depression, and suicidality. Birth risk factors did not differ between patients and controls. In a logistic regression model, the highest contribution was noted for familial anxiety disorders. Separation from parents also had a significant, but smaller influence. There was only a trend towards a significant contribution of childhood sexual abuse. Violence in the family, parental rearing styles and birth risk factors did not contribute significantly. Conclusions The present data suggest that the aetiology of social anxiety disorder is multifactorial and that familial mental disorders and separation experiences are the most important contributing factors.     

Research report: learning styles of biomedical engineering students

Examining students learning styles can yield information useful to the design of learning activities, courses, and curricula. A variety of measures have been used to characterize learning styles, but the literature contains little information specific to biomedical engineering (BMEN) students. We, therefore, utilized Felders Index of Learning Styles to investigate the learning style preferences of BMEN students at Tulane University. Tulane BMEN students preferred to receive information visually (preferred by 88% of the student sample) rather than verbally, focus on sensory information (55%) instead of intuitive information, process information actively (66%) instead of reflectively, and understand information globally (59%) rather than sequentially. These preferences varied between cohorts (freshman, sophomore, etc.) and a significantly higher percentage of female students preferred active and sensing learning styles. Compared to other engineering student populations, our sample of Tulane BMEN students contained the highest percentage of students preferring the global learning style. Whether this is a general trend for all BMEN students or a trait specific to Tulane engineers requires further investigation. Regardless, this study confirms the existence of a range of learning styles within biomedical engineering students, and provides motivation for instructors to consider how well their teaching style engages multiple learning styles. © 2002 Biomedical Engineering Society. PAC2002: 8780-y, 0140-d     

大学生依恋模式与对HIV/AIDS态度的关系

目的:调查大学生对HIV/AIDS的态度,探讨其与依恋模式之间的关系.方法:采用分层整群抽样方法抽取1298名在校大学生进行自填式问卷调查.结果:调查对象的依恋模式分剔为安全型56%;沉溺型20%;漠视型13%;恐惧型11%.调查对象接纳感染者的态度与安全型呈正相关,与沉溺型、恐惧型呈负相关.结论:依恋模式对大学生的HIV/AIDS的态度有重要影响.