Psychological problems affecting the prognosis of stroke patients

BACKGROUND： It is believed that mental disorder influences the morbility and prognosis of cardio-cerebrovascular disease by biological factors. OBJECTIVE： To observe the characteristics of stroke patients complicated by psychological problems and the prognosis of such patients. DESIGN： Observational study. SETTING： Department of Neurology, Beijing Longfu Hospital. PARTICIPANTS： Totally 160 inpatients （46 males and 114 females） with stroke admitted to Department of Neurology, Beijing Longfu Hospital between June 2005 and June 2006 were recruited in this study. The involved patients all corresponded to the diagnosis criteria of cerebrovascular disease formulated in the 1995 National Conference of Cerebrovascular Disease and confirmed by skull CT or MRI examination. The age range was between 43 and 74 years. They all signed the informed consent for the detection and therapeutic regimen, and the application of this technique also gave the approval of the Ethics Committee of the hospital. METHODS： On admission, the patients were investigated on psychological problems using Hopkin symptom checklist. After admission, all the patients received oral administration of aspirin anti-platelet drugs and intravenous infusion of Fufang Danshen. Motor relearning program was used in the rehabilitation treatment for disability rehabilitation. Mental intervention was carried out in the end of observation period. On day 30 after admission, the recovery of two groups of patients was compared using activities of daily living scale, Scandinanvian Stroke Scale （SSS） and disability level. MAIN OUTCOME MEASURES： The activities of daily living were assessed with Barthel index. Higher scores of patients suggested better activities of daily living. For SSS, the higher points, the severer defect degree. The reduction of scores of neurologic impairment suggested that neurological function improved. Disability level was graded according to the method formulated in the Second National Cerebrovascular Conference. RESULTS： All the 160 involved stroke patients participated in the final analysis. （1） Hopkin symptom checklist assessment results： Of the 160 stroke patients, 94 （58.7%） were assessed as having any psychological problems. In this study, psychological problems were more likely to be seen in female patients （74.4%） than in male patients （26.1%）. Major psychological problems were depression （53.8%）, compulsion （52.5%） and anxiety （46.2%）. （2） Comparison of prognosis of patients： Significant differences in activities of daily living-Barthel index, SSS scores and disability level were found between pre- and post-treatment periods. It indicates that stroke patients complicated by mental disorder had poor prognosis. CONCLUSION： The incidence of complicated psychologic obstacle is high in stroke patients, and its prognosis is inferior to that of patients who have no psychological problems.

Psychological problems related to capillary blood glucose testing and insulin injection among diabetes patients

Objective:This review is aimed at explaining the psychological problems related to capillary blood glucose(CBG)testing and insulin injection,as well as recommending essential strategies to solve the fear thereof.Methods:Databases,including PubMed,Cumulative Index of Nursing and Allied Health Literature(CINAHL),Scopus,and Google Scholar,were searched to extract the relevant articles.Initially,the terms used to retrieve related studies were"fear of blood glucose monitoring","anxiety capillary blood glucose testing and insulin injection","psychological problems on blood glucose monitoring and insulin injection","diabetes management",and"diabetes mellitus".Results:Results showed that the psychological problems related to CBG testing and insulin injection were associated with the stress and depression experienced during diabetes self-monitoring of blood glucose.This psychological issue has its impacts such as nonadherence to medication as well as a lack of self-discipline in terms of CBG testing and insulin injection.Inadequate information,inappropriate perception,and pain/discomfort during pricking of fingers were the main reasons for the psychological issues in CBG testing and self-injection of insulin.Conclusions:The expected benefits of this review include the explanation of the issues related to the psychological problems in CBG testing and insulin injection among type 2 diabetes mellitus(T2DM)patients.This review article also provides the recommendations on providing counseling and empowering the patients on CBG monitoring and insulin injection.Moreover,family members should provide psychological support to reduce fear,anxiety,and distress arising from CBG testing and insulin injection.

An Analysis on Mental Health Education of College Students with Financial Difficulties

With the enrollment expansion of college and continuous reform of college education system and college charging system,the number of college students with financial difficulties is increasing. The college students with family financial difficulties not only bear the huge economic burden,but also bear the huge pressure of learning and mental stress,and they have many kinds of psychological problems including psychological distress of tension and anxiety,psychological conflict of self-respect and self-abasement,conflict of desire for interpersonal interaction and self-containment and strong vanity and dependence mentality. This paper puts forward the corresponding recommendations to solve these problems.