Analysis of the Current Status and Influencing Factors of Family Members’Collateral Stigma in Schizophrenia Patients

Objective: To investigate the associated collateral stigma of the family members of schizophrenia patients and analyze its current status and influencing factors. Methods: The Link Depreciation-Discrimination Perception Scale was used to investigate the status quo of the associated stigma of the family members of 169 schizophrenia patients diagnosed in 4 hospitals in a certain province. The results of the investigation were analyzed and summarized. Results: The detection rate of stigma associated with the family members of schizophrenia patients was 72.78%, with a score of 28.41 ± 3.92 points. The main influencing factors were the family member’s education level, the patient’s illness duration, the family member’s occupation, and the family-patient relationship. Conclusion: The detection rate of stigma associated with schizophrenia was relatively high. This requires increased attention and appropriate nursing intervention.

A Preliminary Study on the HCV Infection Status of Patients with Hemophilia and Their Family Members

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Associative stigma in family members of psychotic patients in Flanders:An exploratory study

AIM: To assess presence and severity of associative stigma in family members of psychotic patients and factors for higher associative stigma.METHODS: Standardized semi-structured interview of 150 family members of psychotic patients receiving full time treatment. This study on associative stigma in family members of psychotic patients was part of a larger research program on the burden of the family, using "Interview for the Burden of the Family" and the chapters stigma, treatment and attribution from the "Family interview Schedule". The respondents were relatives, one per patient, either partner or parent. The patients had been diagnosed with schizophrenia or schizo-affective disorder. All contacts with patients and relatives were in Dutch. Relatives were deemed suitable to participate in this research if they saw the patient at least once a week. Recruitment took place in a standardized way: after obtaining the patient's consent, the relatives were approached to participate. The results were analyzed using SPSS Version 18.0. RESULTS: The prevalence of associative stigma in this sample is 86%. Feelings of depression in the majority of family members are prominent. Twenty-one point three percent experienced guilt more or less frequent, while shame was less pronounced. Also, 18.6% of allrespondents indicated that they tried to hide the illness of their family member for others regularly or more. Three six point seven percent really kept secret about it in certain circumstances and 29.3% made efforts to explain what the situation or psychiatric condition of their family member really is like. Factors with marked significance towards higher associative stigma are a worsened relationship between the patient and the family member, conduct problems to family members, the patients' residence in a residential care setting, and hereditary attributional factors like genetic hereditability and character. The level of associative stigma has significantly been predicted by the burden of aggressive disruptions to family housemates of the psychotic patient.CONCLUSION: Family members of psychotic patients in Flanders experience higher associative stigma compared to previous international research. Disruptive behavior by the patient towards in-housing family members is the most accurate predictor of higher associative stigma.

Prediction of Tumor Microenvironment Characteristics and Treatment Response in Lung Squamous Cell Carcinoma by Pseudogene OR7E47P-related Immune Genes

Objective Pseudogenes are initially regarded as nonfunctional genomic sequences,but some pseudogenes regulate tumor initiation and progression by interacting with other genes to modulate their transcriptional activities.Olfactory receptor family 7 subfamily E member 47 pseudogene(OR7E47P)is expressed broadly in lung tissues and has been identified as a positive regulator in the tumor microenvironment(TME)of lung adenocarcinoma(LUAD).This study aimed to elucidate the correlation between OR7E47P and tumor immunity in lung squamous cell carcinoma(LUSC).Methods Clinical and molecular information from The Cancer Genome Atlas(TCGA)LUSC cohort was used to identify OR7E47P-related immune genes(ORIGs)by weighted gene correlation network analysis(WGCNA).Based on the ORIGs,2 OR7E47P clusters were identified using non-negative matrix factorization(NMF)clustering,and the stability of the clustering was tested by an extreme gradient boosting classifier(XGBoost).LASSO-Cox and stepwise regressions were applied to further select prognostic ORIGs and to construct a predictive model(ORPScore)for immunotherapy.The Botling cohorts and 8 immunotherapy cohorts(the Samstein,Braun,Jung,Gide,IMvigor210,Lauss,Van Allen,and Cho cohorts)were included as independent validation cohorts.Results OR7E47P expression was positively correlated with immune cell infiltration and enrichment of immune-related pathways in LUSC.A total of 57 ORIGs were identified to classify the patients into 2 OR7E47P clusters(Cluster 1 and Cluster 2)with distinct immune,mutation,and stromal programs.Compared to Cluster 1,Cluster 2 had more infiltration by immune and stromal cells,lower mutation rates of driver genes,and higher expression of immune-related proteins.The clustering performed well in the internal and 5 external validation cohorts.Based on the 7 ORIGs(HOPX,STX2,WFS,DUSP22,SLFN13,GGCT,and CCSER2),the ORPScore was constructed to predict the prognosis and the treatment response.In addition,the ORPScore was a better prognostic factor and correlated positively with the immunotherapeutic response in cancer patients.The area under the curve values ranged from 0.584 to 0.805 in the 6 independent immunotherapy cohorts.Conclusion Our study suggests a significant correlation between OR7E47P and TME modulation in LUSC.ORIGs can be applied to molecularly stratify patients,and the ORPScore may serve as a biomarker for clinical decision-making regarding individualized prognostication and immunotherapy.

The Impact of Nursing Staff’s Work Attitude on the Fear of Patients Recovering from Benign Tumors:Family Support as a Mediating Variable

The perception of nursing staff’s attitude influences patient fear.Understanding this dynamic is crucial for fostering a supportive environment conducive to patient well-being and effective healthcare practices.The purpose of this research is to investigate how the attitudes and behaviours of nursing staff influence the fear and anxiety levels of patients recovering from benign tumors,aiming to improve patient care and recovery outcomes.Data was collected from a sample of 100 participants,comprising 20 nursing staff and 80 patients recovering from benign tumors.Surveys were administered to gather quantitative data on attitudes and fear levels.Participants were selected randomly from hospital records and outpatient clinics.Our analysis encompassed nursing staff attitude,patient fear levels,the influence of family support,progression of tumor recovery,patient-reported satisfaction,and the quality of healthcare services provided.The quantitative aspect utilized PLS-SEM software to perform regression analysis,evaluating both direct and indirect effects.Statistical analysis assessed the relationships between nursing staff attitudes,patient fear during benign tumor recovery,and the mediating role of family support.The findings of the study demonstrate that better nurse attitudes(Hypothesis 1,β=0.45,p<0.001)and stronger family support(Hypothesis 2,β=0.32;p<0.001) are linked to lower levels of patient fear.Partially mediating the relationship between nurse attitudes and patient fear,according to Hypothesis 3(β=0.28,p<0.002),is family support.Patients’perceptions of family support are highly influenced by nursing behaviour,as demonstrated by Hypothesis 4(β=0.38;p<0.001).Our research showed a strong relationship between the attitudes of nursing personnel and patient fear levels.Family support demonstrated a strong mediating effect on patient fear.Patient-reported satisfaction is positively correlated with family support.However,no significant relationship was found between healthcare service quality and patient fear.

Downregulation of KIF1B mRNA in hepatocellular carcinoma tissues correlates with poor prognosis

AIM: To compare kinesin family member 1B(KIF1B) expression with clinicopathologic parameters and prognosis in hepatocellular carcinoma(HCC) patients.METHODS: KIF1 B protein and m RNA expression was assessed in HCC and paracarcinomatous(PC) tissues from 68 patients with HCC using Western blot and quantitative real-time reverse transcription-PCR, respectively. Student's t-tests were used to analyze relationships between clinicopathologic parameters and KIF1 B expression, the Kaplan-Meier method was used to analyze survival outcomes, and the log-rank test was used to compare survival differences between groups.RESULTS: Mean protein and m RNA levels of KIF1 B were similar between HCC and PC tissues. However, HCC tissues with vein invasions had significantly lower KIF1 B protein levels compared to those without vein invasions(2.30 ± 0.82 relative units vs 2.77 ± 0.84 relative units, P < 0.05). KIF1 B protein levels in HCC tissues from patients with recurrence during the followup period were significantly lower than those without recurrence(2.31 ± 0.92 relative units vs 2.80 ± 0.80 relative units, P < 0.05). However, KIF1 B protein and m RNA expression in HCC patients was not associated with other clinicopathologic parameters. Ratios of KIF1 B m RNA expression in HCC tissues to those in PC tissues were correlated with overall survival(13.5 mo vs 20.0 mo, P < 0.05) and disease-free survival(11.5 mo vs 19.5 mo, P < 0.05).CONCLUSION: Downregulation of KIF1 B in HCC tissues is associated with poor prognosis; additional clinical studies are needed to confirm whether KIF1 B can serve as a prognostic marker.

Tumor necrosis family receptor superfamily member 9/tumor necrosis factor receptor-associated f

Hepatitis C virus(HCV)infection is an excellent immunological model for understanding the mechanisms developed by non-cytopathic viruses and tumors to evade the adaptative immune response.The antigen-specific cytotoxic T cell response is essential for keeping HCV under control,but during persistent infection,these cells become exhausted or even deleted.The exhaustion process is progressive and depends on the infection duration and level of antigenemia.During high antigenic load and long duration of infection,T cells become extremely exhausted and ultimately disappear due to apoptosis.The development of exhaustion involves the impairment of positive co-stimulation induced by regulatory cytokines,such as transforming growth factor beta 1.This cytokine downregulates tumor necrosis factor receptor(TNFR)-associated factor 1(TRAF1),the signal transducer of the T cell co-stimulatory molecule TNFR superfamily member 9(known as 4-1BB).This impairment correlates with the low reactivity of T cells and an exhaustion phenotype.Treatment with interleukin-7 in vitro restores TRAF1 expression and rescues T cell effector function.The process of TRAF1 loss and its in vitro recovery is hierarchical,and more affected by severe disease progression.In conclusion,TRAF1 dynamics on T cells define a new pathogenic model that describes some aspects of the natural history of HCV,and sheds light on novel immunotherapy strategies for chronic viral infections and cancer.

Study on the Relationship between Psychological Stress and Doctor-Patient Relationship of Cancer Patients and Their Families

Objective: To research the relationship between psychological stress and doctor-patient relationship of cancer patients and their families. Methods: The patients were randomly divided into the intervention group and the control group, and PDRQ-15, pcl-c, SAS and SDS scales were selected as evaluation indexes, and the levels of norepinephrine and dopamine were compared between the patients diagnosed with PTSD cancer and those without PTSD. Results: 1) The total score of PCL-C, SAS, SDS, PDRQ-15 scale of the cancer patients and their families after the intervention of clinical psychological care was significantly lower than that of before intervention and the control group. 2) The correlation coefficients between PCL-C, SAS, SDS and PDRQ-15 of cancer patients and their relatives were 0.971, 0.952 and 0.939 respectively. The significant test P value was less than 0.05 and the difference was statistically significant. 3) The plasma levels of dopamine and norepinephrine in cancer patients under stress were significantly higher than those in cancer patients without stress (P Conclusion: After psychological Intervention of cancer patients and their families, post-traumatic stress disorder, anxiety, depression and doctor-patient relationship were all improved.

The extracellular secretion of miR-1825 wrapped by exosomes increases CLEC5A expression:A potential oncogenic mechanism in ovarian cancer

Background:Ovarian cancer(OC)is a leading cause of gynecological cancer-linked deaths worldwide.Exosomal miR-1825 and its target gene C-type lectin domain family 5 member A(CLEC5A)are associated with tumorigenesis in cancers that was further probed.Methods:Exosomal miR-1825 expression in exosomes and its impact on overall survival(OS)prediction were determined using Gene Expression Omnibus(GEO)and The Cancer Genome Atlas(TCGA)data.Target genes of miR-1825 were searched in five prediction databases and prognostically significant differentially expressed genes were identified.Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses were carried out.The ability of CLEC5A to predict OS was evaluated using univariate and multivariate Cox regression analyses and Kaplan-Meier curves.The CLEC5A expression pattern in OC was validated using immunohistochemistry.The CIBERSORT algorithm was used to compare the immune cell landscape,and the results were validated in a GEO cohort.Finally,the predicted half maximal inhibitory concentration(IC50)values for five commonly used chemotherapy agents were also compared.Results:MiR-1825 level was higher in exosomes derived from OC cells and served as a tumor suppressor.The CLEC5A gene was found to be a target of miR-1825,the upregulation of which was correlated with a poor prognosis.M2 macrophage infiltration was significantly enhanced in the CLEC5A high expression group,while T follicular helper cell infiltration was reduced in it.While the predicted IC50 for cisplatin and doxorubicin was higher in the CLEC5A high expression group,that of docetaxel,gemcitabine,and paclitaxel was lower.Conclusion:MiR-1825,a promising OC biomarker,may promote OC progression by increasing CLEC5A expression via exosome-mediated efflux from tumor cells.

急诊危重症患者替代决策者参与医疗决策期望现状及影响因素分析

目的了解急诊危重症患者替代决策者参与医疗决策期望现状及影响因素,为改善急诊危重症患者及家属就医体验,提升其医疗决策参与能力提供参考。方法采用便利抽样法,选取2022年10月至2023年6月在广西某三级甲等医院急诊科参与替代决策的226名危重症患者家属为研究对象,通过问卷调查一般资料、应对方式以及决策倾向性,分析其参与医疗决策期望现状及影响因素。结果急诊危重症患者替代决策者参与医疗决策期望的总分为(50.10±5.10)分;Pearson相关性分析显示,急诊危重症患者替代决策者参医疗决策期望总分与积极应对呈正相关,与消极应对呈负相关(P<0.05);多元线性回归分析显示,替代决策者文化程度、与患者的关系、患者疾病种类以及是否理解医生的病情谈话内容均是急诊危重症患者替代决策者参与医疗决策期望的影响因素(均P<0.05)。结论急诊危重症患者替代决策者参与医疗决策期望较高且受多种因素影响,文化程度较高、患者子女、急性病就诊患者、理解医生的病情谈话内容的替代决策者参与医疗决策期望更高,采用个性化的决策辅助方案能够帮助医护人员改善其决策参与意愿,提高决策质量。

ICU患者家属决策困境研究现状及启示

由于ICU环境的特殊性,家属探视时间被严格限制,家属不能与患者及时沟通以了解其意愿偏好,且疾病的突发性和临床的不确定性容易导致家属在决策时产生矛盾心理,从而陷入决策困境。概述了关于ICU患者家属决策困境的概念、评估工具、决策困境产生的原因、由于决策困境产生的影响,以及决策困境的应对策略,以期为未来ICU患者家属决策困境的干预提供理论依据,提高ICU患者家属代理决策质量,缩短患者住院时间,改善患者健康结局,从而提高医疗护理满意度。

利益相关者视角下开业护士在糖尿病管理中角色期望的质性研究

目的探讨利益相关者对开业护士糖尿病管理角色的期望。方法采取目的抽样法选取34名在不同省市工作的卫生行政管理者、内分泌科医生和护士,以及12例糖尿病患者及11名家庭成员作为研究对象进行半结构化访谈,采用内容分析法分析资料、提炼主题。结果共提炼出职业多元化角色(高级临床护理实践者,教育与咨询者,协调者,领导者),糖尿病管理职责(糖尿病评估与诊断,药物与非药物处方权限,长期管理与随访),开业护士的培训(教育模式探索,理论与实践相结合),角色推动因素与困难(推动因素,面临多种困难)4个主题及11个亚主题。结论开业护士参与糖尿病管理具有角色多元、责职具体,有待培训和面临较多困难等情况。

KIF20A在肿瘤中的作用及调控机制研究

驱动蛋白家族成员20A(KIF20A)是驱动蛋白家族的一员,在有丝分裂过程中负责运输染色体,在细胞分裂中发挥重要作用。现有研究已经证明,KIF20A在多种肿瘤中呈过表达,因此被视为一种极具潜力的肿瘤治疗靶点。KIF20A的高表达与较差的总生存期密切相关。本文首先概述了KIF20A的结构和功能,随后总结了KIF20A在肿瘤中的表达情况及其调控肿瘤的相关机制,最后介绍近年来与KIF20A相关的临床试验结果。这些发现对于肿瘤的临床诊疗具有重要的启示意义。

中国ICU转出患者家属迁移应激影响因素Meta分析

目的系统分析中国重症监护室(intensive care unit,ICU)转出患者家属迁移应激的影响因素,为减轻转出患者家属迁移应激水平提供循证依据。方法计算机检索中国知网、万方数据知识服务平台、维普、中国生物医学文献数据库、Web of Science、PubMed、the Cochrane Library、Embase中有关ICU转出患者家属迁移应激影响因素的队列研究、病例对照研究、横断面研究等观察性研究,检索时限为建库至2023年10月。由2名研究者按照纳入及排除标准单独进行文献筛选、质量评价和资料提取。采用RevMan5.4软件对数据结果进行Meta分析。结果最终纳入15篇研究,总样本量2558,共提取12个影响因素。将15篇文献根据测量结局指标的工具分为正向计分组(得分越高,迁移应激水平越高,共9篇文献)、反向计分组(得分越高,迁移应激水平越低,共6篇文献)。分析每个组别时,仅对组内提及≥2次的影响因素进行Meta分析。Meta分析结果显示:正向计分组内,家属文化程度、家属性别、患者意识、ICU治疗时间、家属疾病不确定感是ICU转出患者家属迁移应激的影响因素(P<0.05);反向计分组内,家属文化程度、家属性别、患者年龄、ICU治疗时间是ICU转出患者家属迁移应激的影响因素(P<0.05)。敏感度分析结果显示各个因素的结果均较为稳定。结论家属文化程度、家属性别、患者年龄、ICU治疗时间、家属疾病不确定感是中国ICU转出患者家属迁移应激的影响因素,家属宗教信仰、患者意识对其影响还需进一步论证。

GPRC5A在喉癌发生中的生物学作用及机制研究

目的探讨G蛋白偶联受体C家族5A(Gprotein-coupled receptor family C,member 5,group A,GPRC5A)在喉癌组织中的表达特征,分析其在喉癌发展进程中的作用及机制。方法选取河北医科大学第二医院收治的32例经病理检查确定为喉鳞状细胞癌患者的喉癌组织及癌旁组织,采用免疫组织化学方法检测GPRC5A在喉癌组织及癌旁组织中的表达,并分析其表达特征与患者临床资料的相关性。采用定量聚合酶链式反应(quantitative polymerase chain reaction,qPCR)方法对GPRC5A在喉癌组织与癌旁组织的表达进行组织水平的验证,在人支气管上皮细胞系BEAS-2B、喉癌细胞系TU686及下咽癌细胞系Fadu中进行细胞水平的验证。构建GPRC5A过表达质粒p-GPRC5A,转染至喉癌TU686细胞中采用cell counting kit 8、Transwell方法检测GPRC5A基因过表达对喉癌TU686细胞增殖、侵袭及迁移的影响。Western blot检测GPRC5A基因过表达对细胞凋亡相关蛋白表达的影响。Western blot验证GPRC5A基因过表达对表皮生长因子受体(epidermal growth factor receptor,EGFR)/STAT3(epidermal growth factor receptor/signal transducer and activator of transcription 3)通路的影响。结果免疫组织化学结果表明,GPRC5A在喉癌组织中的阳性表达率显著低于癌旁组织(χ^(2)=14.190,P<0.001)。GPRC5A在不同肿瘤分期、淋巴结转移、分化程度喉癌组织中表达差异无统计学意义(P>0.05)。GPRC5A在喉癌组中的表达显著低于癌旁组(t=3.175,P=0.003)。GPRC5A在喉癌TU686和Fadu细胞中表达为BEAS-2B的(0.73±0.08)和(0.78±0.04)倍,差异有统计学意义(F=9.060,P=0.015);CCK8结果表明,48 h后p-GPRC5A组的OD值为0.76±0.03,显著低于NC组1.20±0.01和对照组1.30±0.08(F=69.970,P<0.001);Transwell实验表明,p-GPRC5A组细胞迁移的细胞数为138.70±10.97,显著低于对照组251.3±16.9和NC组247.7±17.5(F=5731.100,P<0.001)。p-GPRC5A组细胞侵袭的细胞数为113.00±10.21,显著低于对照组193.3±010.02和NC组190.00±7.90(F=8894.100,P<0.001)。Western blot结果表明,与对照组相比,Caspase3蛋白在p-GPRC5A组表达显著升高(F=78.880,P<0.001),Bcl-2蛋白在p-GPRC5A组的表达显著降低(F=125.820,P<0.001)。EGFR和p-STAT3蛋白在p-GPRC5A组的表达显著降低(F=27.573,P=0.001;F=60.614,P<0.001)。结论GPRC5A在喉癌组织及细胞系中低表达。GPRC5A基因过表达可抑制喉癌细胞增殖,迁移和侵袭,促进细胞凋亡发生,并抑制EGFR/STAT3通路的激活。

溶质载体家族3成员2表达与双硫死亡、铁死亡及肿瘤关系的研究进展

铁死亡和双硫死亡与多种疾病相关。铁死亡的特征是铁离子和脂质活性氧的异常累积,而双硫死亡则是二硫化物的异常累积。溶质载体家族3成员2(SLC3A2)作为溶质载体家族的一员,不仅参与调控肿瘤细胞的增殖、迁移、侵袭和凋亡,还参与细胞铁死亡和双硫死亡,在肿瘤的发生发展中起关键作用。本文阐述了SLC3A2与双硫死亡、铁死亡和肿瘤关系的研究进展,旨在为癌症靶向治疗提供理论基础。

肺癌组织中ERO1L、TNFRSF4的表达与患者免疫功能、炎症反应因子及预后的关系

目的探究肺癌组织中内质网氧化物蛋白(ERO1L)、肿瘤坏死因子受体4(TNFRSF4)的表达与肺癌患者免疫功能、炎症反应因子及其预后的关系。方法选取2018年7月~2020年7月于本院进行手术治疗的108例肺癌患者,收集术中留取的癌组织和癌旁组织标本。采用qRT-PCR检测ERO1L和TNFRSF4的mRNA相对表达量;使用免疫组织化学法检测ERO1L和TNFRSF4蛋白表达情况,分析二者表达水平与患者临床病理特征的关系,采用Kaplan-Meier法分析ERO1L、TNFRSF4蛋白表达水平与患者预后的关系。肺癌患者预后生存率的影响因素采用Cox多因素分析。结果肺癌患者癌组织中ERO1L mRNA表达水平显著高于癌旁组织,TNFRSF4 mRNA表达水平显著低于癌旁组织(P<0.05);肺癌组织中ERO1L蛋白高表达率显著高于癌旁组织,TNFRSF4蛋白高表达率显著低于癌旁组织(P<0.05)。ERO1L蛋白高表达组患者CD3^(+)、CD4^(+)显著低于低表达组(P<0.05),IL-1β、IL-6、TNF-α显著高于低表达组(P<0.05);TNFRSF4蛋白高表达组患者CD3^(+)、CD4^(+)显著高于低表达组,IL-1β、IL-6、TNF-α显著低于低表达组(P<0.05)。ERO1L高表达组患者3年累积生存率显著低于低表达组(Log rankχ^(2)=6.100,P=0.014),TNFRSF4高表达组患者3年累积生存率显著高于低表达组(Log rankχ^(2)=11.296,P=0.001)。肺癌组织的低分化、淋巴结转移、TNM分期为Ⅲ-Ⅳ期、ERO1L高表达、TNFRSF4低表达是影响患者生存率的危险因素。结论肺癌组织中ERO1L、TNFRSF4表达与患者免疫功能、炎症因子以及预后具有一定关系。

与死亡打太极——临终患者及家属死亡应对策略的质性研究

目的:探究临终患者及家属的死亡应对策略,为构建本土化安宁疗护服务模式提供现实依据。方法:采用目的抽样法及滚雪球法,对20名临终患者及21名家属进行半结构式访谈,运用解释现象学分析法和隐喻法进行资料分析和主题归纳。结果:包括五大主题:逃避、转折与迂回——掤手回掌;隐藏、忍耐与艰难决策——藏锋敛锐;平衡、摇摆与稳定——攻守衡之;柔和行为、转化表达——柔化而出;寄托、仪式与传承——顺势而为。结论:五大主题整合出临终患者及家属的死亡应对策略为“与死亡打太极”,研究结果为临终患者及家属的死亡应对提供了更多文化视角下的理解,建议未来在顺应优秀中华文化基础上构建中国特色安宁疗护实践模式。

主动脉夹层患者及家属自我分化与焦虑抑郁关系的主客体互倚模型分析

目的 基于鲍温家庭系统理论,使用主客体互倚模型探查主动脉夹层患者及家属焦虑、抑郁的交互传递情况。方法 采用一般调查问卷、简版自我分化量表、广泛焦虑性量表、患者健康问卷抑郁量表对210对主动脉夹层患者及家属进行调查,建立自我分化、焦虑及抑郁的主客体互倚模型。结果 主动脉夹层患者及家属的自我分化水平分别为(79.95±4.43)分和(81.31±4.55)分,焦虑程度分别为(11.74±3.55)分和(10.98±3.04)分,抑郁程度分别为(12.33±3.34)分和(10.98±3.04)分。主客体互倚模型结果显示,主动脉夹层患者的自我分化水平与自身及对方的焦虑、抑郁水平呈负相关,家属的自我分化水平与自身的焦虑、抑郁和患者的抑郁呈负相关(均P<0.05)。结论 主动脉夹层患者及家属的焦虑、抑郁受双方自我分化水平的共同影响,提示医护人员应重视主动脉夹层患者及家属焦虑、抑郁的传递情况,积极探索以家庭为单位的干预方案。

EICU患者家属创伤后成长与社会支持的关系及影响

目的探讨急诊重症监护室(emergency intensive care unit,EICU)住院患者家属创伤后成长的影响因素及其与社会支持水平的相关性。方法选择2020年6月—2023年6月南通大学附属医院EICU 80名住院患者的家属作为研究对象。采用创伤后成长评定量表以及社会支持评定量表评价EICU住院患者家属创伤后成长水平及社会支持水平。分析患者家属创伤后成长水平与社会支持水平的相关性,并对患者家属创伤后成长水平的影响因素进行单因素、多因素logistic回归分析。结果80名EICU住院患者家属创伤后成长水平评分为(60.53±13.02)分,其中得分最高维度为与他人关系,其次为个人力量。经单因素分析可见,患者家属不同性别、学历、与患者关系、急性生理学和慢性健康状况评价Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)评分的创伤后成长水平评分比较,差异有统计学意义(P<0.05)。家属社会支持水平评分均低于国内常模(P<0.05)。经Pearson相关性分析,EICU住院患者家属创伤后成长水平与社会支持水平呈正相关(P<0.05)。经多因素分析可见,性别、学历、患者APACHEⅡ评分与社会支持水平是ICU住院患者家属创伤后成长的独立影响因素(P<0.05)。结论性别、学历、患者APACHEⅡ评分与社会支持水平是EICU住院患者家属创伤后成长的影响因素,临床应增强对患者家属关注度,积极鼓励家属缓解负面情绪,提升创伤后成长水平。