精神心理、社会环境因素与妊高征关系的研究进展

随着生物医学模式向生物—心理—社会医学模式的转变 ,心理社会因素与妊高征的关系愈来愈受到医学界的普遍关注和重视。该文对精神心理因素、社会环境因素与妊高征发生、发展的关系及其原因作一综述。     

Involving mental health service users in quality assurance

OBJECTIVE: This study compares the process and outcomes of two approaches to engaging mental health (MH) service users in the quality assurance (QA) process. BACKGROUND: QA plays a significant role in health and care services, including those delivered in the voluntary sector. The importance of actively, rather than passively, involving service users in evaluation and service development has been increasingly recognized during the last decade. DESIGN: This retrospective small-scale study uses document analysis to compare two QA reviews of a MH Day Centre, one that took place in 1998 as a traditional inspection-type event and one that took place in 2000 as a collaborative process with a user-led QA agenda. Setting and participants The project was undertaken with staff, volunteers and service users in a voluntary sector MH Day Centre. Intervention The study compares the management, style, evaluation tools and service user responses for the two reviews; it considers staff perspectives and discusses the implications of a collaborative, user-led QA process for service development. RESULTS: The first traditional top-down inspection-type QA event had less ownership from service users and staff and served the main purpose of demonstrating that services met organizational standards. The second review, undertaken collaboratively with a user-led agenda focused on different priorities, evolving a new approach to seeking users' views and achieving a higher response rate. CONCLUSIONS: Because both users and staff had participated in most aspects of the second review they were more willing to work together and action plan to improve the service. It is suggested that the process contributed to an evolving ethos of more effective quality improvement and user involvement within the organization.     

医学生心理健康教育面临的挑战

随着知识经济、信息时代的到来以及医学事业自身的不断发展、现代医学模式转变、医学院校的心理健康教育的状况等都对医学院校的心理健康教育提出了严峻的挑战。面对挑战,医学院校应充分重视心理健康教育,大力开展和加强心理素质教育,提高医学生的心理素质。     

精神发育迟滞儿童特殊教育三年随访

采用Ｈ－ＮＴＬＡ量表及婴儿～初中学生社会生活能力量表对太原市一个培智学校４４例精神发育迟滞患儿从１９８９～１９９２年连续４次测查智力，２次测查适应行为。结果显示３年间ＩＱ值变化无显著统计学意义，但视觉联想、概念关系、注意力及视觉识知能力有明显提高。患儿适应行为明显提高。经多元逐步回归分析显示，精神发育迟滞儿童智商的提高和母亲文化程度较高、患儿智力低下程度较轻、母亲职业为科技或行政管理人员、患儿初始教育年龄早呈正相关。     

Interstitial deletion of 10q: Clinical features and literature review

We report on a patient with interstitial deletion of 10q and compare her to 8 previously described patients, 2 of whom have chromosomal breakpoints similar to our patient. Minor anomalies including broad forehead, hypertelorism, strabismus, prominent philtrum, and “dysplastic” pinnae are present in our patient. Psychomotor retardation and hypotonia are universal findings in 10q interstitial deletion. Growth retardation, not present in our patient, is seen in some. These clinical findings are sufficiently distinct to suggest early chromosome studies. © 1992 Wiley-Liss, Inc.     

Intimacy and mental disorder in late middle age. Report of the TURVA project

This study, which was carried out as part of the TURVA project on psychosocial adaptation in old age, is concerned with the significance of social support to people approaching retirement age. The population consisted of 200 urban dwellers and 189 rural dwellers, who were studied at the age of 62. The subjects were either about to retire in the near future or had already retired, and it was assumed that this event causes a certain amount of stress, which may lead to mental disturbance regardless of the amount of social support available to the individual. Intimate relationship and close friendship served as the measures of social support. Mental disturbances were assessed on the basis of the General Health Questionnaire (36-item version) and the number of psychic and especially depressive symptoms. The prevalence of mental disturbance and depressive symptoms was lowest in those people who lived in a close marital relationship and who also described their spouse as empathic. Psychic symptoms were most common in those people who said their relationship to their spouse was distant and who described them as unempathic. The subjects who were not married fell in-between these 2 groups regardless of whether they had an intimate relationship with someone of the opposite sex. A positive marital relationship seemed to provide a shield against depression, while a negative marital relationship tended to make the individual more vulnerable to depression. The role of a close non-marital friendship depended on the respondent's sex. In women, it was associated with a high prevalence of depressive symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)     

4409名学生心理健康状况及家庭环境与吸烟行为分析

目的:探讨中学生心理行为特征和心理健康状况及家庭心理环境与中学生吸烟行为的关系.方法:以苏州市4409名初中、高中、职业中学的学生为对象,采用SCL-90、家庭环境量表和自编问题进行问卷调查.结果:反叛性、冒险性强,倾向早熟、毅力差、顺从敏感性高是吸烟的危险因素,而情感调节性和认同敏感性与吸烟无关;吸烟组与对照组SCL-90在总分、阳性项目数、躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性方面的评分均高于对照组,且有统计学意义(P＜0.01);吸烟组在FES-CV中的亲密度、情感表达、知识性、道德宗教观、组织性平均分明显低于对照组(P＜0.01),而在FES-CV的矛盾性的平均分则明显高于对照组(P＜0.01).结论:中学生行为的反叛性、冒险性、早熟性、毅力性和不良心理健康水平是中学生吸烟的危险因素;同时不良家庭关系也是中学生吸烟的危险因素,一个亲密、融洽的家庭环境可能会减少中学生吸烟,而一个矛盾的家庭则可能会增加中学生吸烟.     

Psychological well‐being and psychosocial work environment characteristics among emergency medical and nursing staff

The aim of this study was to determine if the effect of psychosocial work environment on psychological well‐being was different for doctors and nurses who work in emergency departments in Spain. A cross‐sectional survey was carried out among 945 emergency doctors and nurses staff from Spain. The outcome variable was the psychological well‐being measured by two dimensions of SF‐36 Health Survey (SF‐36) (mental health, vitality) and one dimension of Maslach's Burnout Inventory (emotional exhaustion). The explanatory variable was the psychosocial work environment evaluated according to Karasek and Johnson's demand‐control model that includes the dimensions of psychological demands, job control, supervisor social support and co‐workers' social support. The adjusted odds ratios and their 95 per cent confidence intervals were calculated by logistic regression. The prevalence of low vitality, bad mental health and high emotional exhaustion was higher among doctors than nurses. Exposure to high psychological demands increased the probability of low vitality, bad mental health and high emotional exhaustion among doctors and nurses. Low job control and low co‐workers' social support at work were associated with poor psychological well‐being only among doctors. Low job supervisors' social support increased the risk of bad mental health among doctors and of high emotional exhaustion among nurses. There is a different effect of psychosocial work environment on psychological well‐being between doctors and nurses. Copyright © 2007 John Wiley & Sons, Ltd.     

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目的了解北京市0~6岁儿童视力、听力、肢体、智力、精神残疾的现患率及其分布特征,重点考察智力低下儿童(残疾)的现患及分布特点。方法2003-07—2004-11北京市残疾人联合会、北京市卫生局联合组织采用概率比例、二阶段分层整群抽样的方法进行现况调查,使用丹佛发育筛查测验及Gesell发育诊断量表进行智力筛查和诊断,采用SPSS10·0软件对数据进行统计分析。结果北京市0~6岁儿童智力低下现患率为9·31‰,城市为7·60‰,农村10·37‰,男童(11·24‰)高于女童(7·25‰)(χ2=12·42,P<0·01),现患率有随年龄增长而增高的趋势(趋势χ2=23·58,df=6,P<0·01),智力低下严重程度构成分别为轻度65·54%、中度20·97%、重度5·99%、极重度7·49%。结论北京市儿童智力低下的防治应以轻度类型为主,重点在农村地区;北京市需结合世界发达国家的经验,建立自己的智力低下监测、防治体系。     

When stress is mental illness: A study of anxiety and depression in employees who use occupational stress counselling schemes

A previous study found that 86 per cent of employees (n = 111) who experience stress in the workplace and sought help from their workplace counselling schemes (Employee Assistance Programmes) had serious mental health problems, but the low participation rate (24 per cent) restricted generalizability and the measure used [General Health Questionnaire (GHQ‐12)] did not allow diagnosis. The present study (n = 58) improved the participation rate to 35 per cent and used a different version of the original measure (GHQ‐28) that allowed diagnostic differentiation as well as validation of the original findings. This new study found almost exactly the same high levels of mental health problems existed (86 per cent) in employees who remained at their work and that participants had higher rates of anxiety than depression. This finding is at variance with the usual co‐morbid presentation of anxiety and depression found in community based mental health services and suggests that depression may be an important differentiating factor between those who can remain at work and use counselling and those who cannot. There are implications for those who provide mental health services. The results of this study further reinforce the suggestion that workplace stress may be yet another name for common mental health problems that require professional help and treatment. Copyright © 2005 John Wiley & Sons, Ltd.