北京市某医院结核科护士压力源调查分析

目的 对结核科护士工作压力源进行调查分析.方法 自行设计调查问卷,采用便利抽样方法,对首都医科大学附属北京胸科医院88名结核科护士工作压力源进行调查.结核科护士平均年龄为（33.04±9.07）岁,工作年限（12.70±9.04）年,每月夜班数（4.25±2.25）个.本研究结核科护士工作压力源问卷分为8个维度,共有61个条目,采用分量法计分.其中,没有压力1分,压力程度一般为2分,压力程度较高为3分,压力程度非常高为4分,可能的得分范围为61～244分,分数越高,表明护士所承受的压力越大.采用问卷调查法,调查前向被调查者说明调查的目的、方法,取得知情同意.由研究者亲自发放调查问卷,30 min后当场收回.本次共发放问卷90份,回收88份,有效88份,有效回收率97.8％.结果 （1）结核科护士压力源总体得分为（154.81±36.03）分.（2）压力源各维度得分从高到低依次是：结核护理专业特殊性的问题（3.07±0.81）分;工作环境及资源方面的问题（2.88±0.81）分;工作量及时间分配问题（2.67±0.78）分;社会环境带来的问题（2.63±0.78）分;护理专业发展方面的问题（2.55±0.74）分;患者护理方面的问题（2.52±0.68）分;护理专业及工作方面的问题（2.45±0.74）分;管理及人际关系方面的问题（1.89±0.64）分.（3）得分排在前10位的压力源条目分别是：长期接触排菌、耐药肺结核患者（3.55±0.78）分;担心自己患上结核病（3.47±0.88）分;同伴被确诊患上结核病（3.36±0.89）;担心消毒防护设施的效果（3.28±0.94）分;担心工作中出现差错事故（3.21±0.95）分;工作环境差（3.18±0.92）分;病区拥挤（3.02±1.07）分;收入差距大（2.98±0.94）分;工作量太大（2.97±0.94）分;经常倒班（2.94±1.03）分.结论 结核科护士承受着较高的工作压力,护理管理者应采取有针对性的措施,指导护士积极应对,减轻护士工作压力.     

学习障碍儿童心理问题及心理辅导效果评价

目的 探讨学习障碍（LD）儿童心理问题及心理辅导对改善LD儿童心理行为的效果评价。方法 分设干预组，LD对照组，学业一般组，学业优秀组。对各组儿童进行厌学情绪，心理健康和生活质量测定，并对干预组儿童进行2年心理辅导干预。结果 LD儿童和学业一般，学业优秀儿童在厌学情绪，对人焦虑，孤独倾向，自责倾向，过敏倾向和心理健康测量总分的差异有显意义（P＜0．05），均分结果显示LD组＞学业一般组＞学业优秀组。心理辅导后，干预组儿童在大学套学情绪，孤独倾向，自责倾向，过敏倾向和心理健康测量的总分均明显下降，亲子关系，同伴关系，师生关系，居住环境，活动机会性，社会心理状况，社会环境状况，生活质量总分则显提高，且心理辅导前后差异有显意义（P＜0．01）；干预组与LD对照组比较，在厌学情绪，心理健康状况，生活质量方面的上述各项指标，两组间差异有显意义（P＜0．05）。结论 LD组儿童存在一定的心理问题，心理辅导有助于改善LD儿童的心理健康状况，提高其生活质量。     

理性情绪疗法对脑卒中后抑郁康复治疗的影响

目的观察理性情绪疗法对脑卒中后抑郁康复治疗的影响。方法62例脑卒中后抑郁患者随机分为理性情绪疗法组和对照组，每组31例。分别于治疗开始前和治疗结束时，应用汉米尔顿抑郁量表（HAMD）及Barthel指数（BI）进行测评，比较两组的治疗效果。结果治疗结束时，理性情绪疗法组患者的HAMD和BI评分明显好于对照组（P〈0．01）。结论理性情绪疗法能明显改善脑卒中后抑郁患者的抑郁症状，提高患者生活质量。     

A comparison of hormone therapy,coping skills training,and relaxation for the relief of premenstrual syndrome

Approximately 10% of women are severely affected by premenstrual syndrome (PMS) during their reproductive years. Several biological theories of causation have been proposed and each has provoked treatment attempts through medication to little sustained effect. As many of the reported complaints are psychological, a new treatment approach was considered using cognitive-behavioral therapy. A preliminary study which combined cognitive-behavioral therapy with drug treatment produced considerable symptom reduction. The present study examined the efficacy of cognitive-behavioral therapy alone in direct comparison with hormone treatment. Relaxation instructions were provided to a control group. Initial rapid responses to drug treatment and relaxation diminishes after 2 months, together with marked attrition in the control group. Significant positive benefits from cognitive-behavioral therapy were achieved after the first treatment month that continued throughout and were maintained at follow-up 3 months later. Implications for future management are discussed.     

Rational-emotive theory: I. an integrated psychological and philosophical basis

Rational-emotive theory (RET) is reformulated on an epistemological basis (comprehensively critical rationalism [CCR] instead of logical empiricism) consistent with current mainstream philosophy and with the practice of rational-emotive therapy. The irrational beliefs that lead to dysphoric emotions can be defined logically and independently of their consequences. They are of two kinds: (a) grandiose beliefs that some object, state, or event in the world should be other than it is, because one wants it to be, and (b) beliefs that evaluations such as good, bad, right, wrong, wonderful, and awful are factual (inherent in the object of the evaluation) rather than definitional. Evaluations are arbitrary designations that we add to the value of a measure of some characteristic of an object or event. Dysphoric emotions (anger, anxiety, depression, guilt, jealousy, and shame) result from evaluative attributions that individuals believe to be inherently true, rather than definitional.     

心理干预辅助治疗产后抑郁的疗效观察

目的探讨心理干预对产后抑郁患者的辅助治疗效果。方法40例产后抑郁患者随机分为研究组、对照组各20例，研究组除了给予药物治疗外，同时实施家庭干预及合理情绪疗法，对照组单用药物治疗。治疗前和治疗后第4、6、8周及3个月随访分别用汉密尔顿抑郁量表（HAMD17）评定。结果两组治疗后第4、6周末，疗效未见统计学差异；治疗后第8周和3个月后随访，两组疗效差异有显著统计学意义。结论心理干预辅助治疗产后抑郁有更好的远期效果。     

家居晚期癌痛患者63例综合性干预治疗效果观察

目的:探讨晚期癌痛患者在家中应用综合性干预治疗后,对患者疼痛缓解度和生活质量的影响。方法:将63例晚期癌痛患者随机分为两组:综合性干预治疗组和对照组。两组除常规给予镇痛药物治疗外,综合性干预治疗组同时按预定方案定期做心理疏导、精神支持、社会帮助和辅助物理疗法,并派经专业培训的志愿者(义工)参加治疗小组工作。结果:随访两个月,综合性干预治疗组患者的疼痛缓解度、生活质量明显好于对照组患者。结论:综合性干预治疗能提高家居晚期癌症患者的镇痛效果,对缓解患者的心理症状,提高患者的生活质量较为理想。     

疏肝健脾升阳汤配合理性情绪疗法治疗腹泻型肠易激综合征疗效观察

目的:观察疏肝健脾升阳汤配合理性情绪疗法治疗腹泻型肠易激综合征的疗效。方法:将96例IBS-D患者随机分为治疗组48例给予疏肝健脾升阳汤配合理性情绪疗法治疗,对照组48例用西药常规治疗,疗程均为4周。观察患者治疗前后症状积分及疗效,并对临床治愈患者随访半年。结果:治疗组总有效率为83.3%,对照组总有效率为62.5%;前者在改善临床症状上优于后者,差异有显著性(P<0.05);治疗组复发率28.6%,对照组复发率为66.7%,差异有显著性(P<0.05)。结论:疏肝健脾升阳汤配合理性情绪疗法治疗腹泻型肠易激综合征疗效显著,复发率低。     

合理情绪疗法培训在防治护士职业倦怠中的应用

目的探讨合理情绪疗法在防治护士职业倦怠中的作用。方法对护士进行分阶段、分组合理情绪疗法培训,传授具体的干预方法,并于培训前后进行问卷调查。结果护士情感衰竭、去人格化评分下降,个人成就感评分升高,不同程度职业倦怠检出率明显降低。结论合理情绪疗法对缓解护士职业倦怠有一定的作用。     

Effect of rational and irrational beliefs on intensity and “inappropriateness” of feelings: A test of rational—emotive theory

This study tested the central rational-emotive hypothesis that greater inappropriate emotional distress is caused by irrational rather than rational beliefs about undesirable situations. Ellis and Harper (1975) have suggested that inappropriate emotions (such as anger) differ qualitatively from appropriate emotions (such as annoyance). Previous research, however, indicates that irrational beliefs are associated with greater appropriate as well as inappropriate negative emotions. In this study, a 3 ×2 pretest—posttest factorial design was used, in which 10 undergraduates of either sex were randomly assigned to one of three treatments, which involved imagining being in a situation. The control condition comprised an emotionally neutral scene, while the two experimental treatments contained rational and irrational statements about being left alone by one's partner at a party. The experimental manipulation was successful, and both inappropriate and appropriate negative emotions were found to be greater in the irrational condition as compared to the neutral or rational condition. Thus irrational beliefs were shown to have an effect on emotions, but the emotions associated with irrational beliefs differed from those associated with rational beliefs in quantity rather than in quality.