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.

SCL-90 test results of the family members of patients with schizophrenia in China:a meta-analysis

Objective To evaluate the mental health status of family members of patients with schizophrenia in China.Methods Wan Fang,CNKI,VIP,CBM,Springer Link,Science Direct and Pub Med databases were searched to collect the relevant studies published prior to August 2016 that were about the psychological health status of the family members of patients with schizophrenia measured with the SCL-90 scale and Software Stata 11.0 was used for their meta-analysis.Results A total of 20 studies was included in this meta-analysis.Scores of somatization affection,obsessive-compulsive symptoms,interpersonal sensitivity,depression,anxiety,hostility,phobic anxiety,and paranoia ideation of the family members were significantly higher than those of general population norms in 2006(P<0.05).Scores of somatization affection,interpersonal sensitivity,depression,anxiety,hostility,phobic anxiety,paranoia ideation,and psychoticism of the family members were significantly higher than control group(P<0.05).Moreover,the difference was not statistically significant between male and female family members in mental health status(P>0.05).Conclusion Compared with the general population,psychological distress was more reported in the family members of patients with schizophrenia.There was no statistic significantly difference between male and female members.

Effect of cognitive behavioral group therapy on rehabilitation of community patients with schizophrenia:A short-term randomized control trial

BACKGROUND The efficacy of cognitive behavioral group therapy(CBGT)for cognitive dysfunction and negative symptoms of schizophrenia is established,but more evidence is required.AIM To assess the effectiveness of CBGT combined with mental health education as a treatment for schizophrenia compared with mental health education alone.METHODS In all,120 schizophrenia out-patients were randomized into CBGT combined with mental health education or single mental health education.The primary outcomes were positive and negative symptoms,cognitive function,excitatory factor,anxiety and depression symptom improvements on the positive and negative syndrome scale score.Secondary outcome measures included social function and drug compliance.RESULTS There were significant differences between CBGT combined with mental health education and single mental health education on measures of positive and negative symptoms,cognitive functions,excitatory factor,anxiety and depression symptoms,and social functions.No other significant difference in outcomes was observed.CONCLUSION CBGT combined with mental health education may be relevant beneficial treatment method in reducing symptoms,cognitive and social functions of patients with schizophrenia.

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.

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.

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。

Ancient dormant virus remnant ERVW-1 drives ferroptosis via degradation of GPX4 and SLC3A2 in schizophrenia

Human endogenous retroviruses(HERVs)are remnants of retroviral infections in human germline cells from millions of years ago.Among these,ERVW-1(also known as HERV-W-ENV,ERVWE1,or ENVW)encodes the envelope protein of the HERV-W family,which contributes to the pathophysiology of schizophrenia.Additionally,neuropathological studies have revealed cell death and disruption of iron homeostasis in the brains of individuals with schizophrenia.Here,our bioinformatics analysis showed that differentially expressed genes in the human prefrontal cortex RNA microarray dataset(GSE53987)were mainly related to ferroptosis and its associated pathways.Clinical data demonstrated significantly lower expression levels of ferroptosis-related genes,particularly Glutathione peroxidase 4(GPX4)and solute carrier family 3 member 2(SLC3A2),in schizophrenia patients compared to normal controls.Further in-depth analyses revealed a significant negative correlation between ERVW-1 expression and the levels of GPX4/SLC3A2 in schizophrenia.Studies indicated that ERVW-1 increased iron levels,malondialdehyde(MDA),and transferrin receptor protein 1(TFR1)expression while decreasing glutathione(GSH)levels and triggering the loss of mitochondrial membrane potential,suggesting that ERVW-1 can induce ferroptosis.Ongoing research has shown that ERVW-1 reduced the expression of GPX4 and SLC3A2 by inhibiting their promoter activities.Moreover,Ferrostatin-1(Fer-1),the ferroptosis inhibitor,reversed the iron accumulation and mitochondrial membrane potential loss,as well as restored the expressions of ferroptosis markers GSH,MDA,and TFR1 induced by ERVW-1.In conclusion,ERVW-1 could promote ferroptosis by downregulating the expression of GPX4 and SLC3A2,revealing a novel mechanism by which ERVW-1 contributes to neuronal cell death in schizophrenia.

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。

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。

ICU重症脑卒中患者家属负性情绪与心理弹性、社会支持的关系分析

目的:探究ICU重症脑卒中患者家属负性情绪与心理弹性、社会支持的关系分析。方法:选取2022年4月—2023年4月河南科技大学第一附属医院ICU 96名重症脑卒中患者家属(共96名)作为研究对象。采用一般资料调查问卷、抑郁-焦虑-压力量表中文简版(DASS-21)、心理弹性量表(CD-RISC)、社会支持评定量表(SSRS)收集患者家属资料,并依据DASS-21评分将患者家属分为两组,分析家属负性情绪与心理弹性、社会支持的关系并分析家属负性情绪的影响因素。结果:根据DASS-21评分将56名患者家属纳入为情绪较差组,40名患者家属纳入为情绪良好组。情绪良好组患者家属CD-RISC、SSRS评分高于情绪较差组,差异均有统计学意义(t=2.852、3.074,P<0.05);Spearman相关性分析结果显示,患者家属CD-RISC、SSRS评分与DASS-21评分呈负相关(r=-0.642、-0.568,P<0.05);经logistic回归分析结果显示,患者年龄、受教育程度、家庭月收入、CD-RISC评分、SSRS评分是患者家属负性情绪的影响因素(OR=3.885、0.317、0.421、0.218、0.255,P<0.05)。结论:ICU重症脑卒中患者家属负性情绪与家属心理弹性、社会支持有关,心理弹性以及社会支持均为家属负性情绪的影响因素,此外还包括患者年龄、文化程度及家庭月收入。

肺癌患者家属感知脆弱影响因素分析

目的 探讨肺癌患者家属感知脆弱现状及其影响因素。方法 选择河北省秦皇岛市中医医院肺病科2022年5月至2023年4月接受肺癌治疗的171名患者家属作为研究对象。采用一般资料调查量表、家庭负担会谈量表(FBS)对其进行调查。多元线性回归分析肺癌患者家属感知脆弱的影响因素。结果 FBS量表调查结果显示肺癌患者家属的感知脆弱总分为(23.94±1.22)分;肺癌患者家属感知脆弱得分在家庭人均收入、家庭负担、家庭功能、应对方式和患者抑郁状态方面比较,差异有统计学意义(P<0.01)。将差异有统计学意义的变量代入多元线性回归模型,回归方程为:Y=23.65-0.38X_(1)+0.49X_(2)-0.58X_(3)+0.83X_(4)(X_(1)、X_(2)、X_(3)、X_(4)分别为家庭人均收入、家庭负担、家庭功能、患者抑郁状态)。结论 肺癌患者家属感知脆弱水平较高,并受家庭人均收入、家庭负担、家庭功能、患者抑郁状态的影响,应给予患者家属针对性干预措施,以降低其感知脆弱水平,进而促进患者的身心健康。

社区居家严重精神障碍患者家属的社会支持现状调查

目的探讨社区居家严重精神障碍患者家属的社会支持水平状况及影响因素,为居家严重精神障碍患者的社区管理提供依据。方法将纳入“上海市精神卫生信息管理系统”的444例白鹤镇在管居家严重精神障碍患者的家属作为研究对象,进行问卷调查。结果白鹤镇在管严重精神障碍患者家属的社会支持水平为(33.52±9.32)分,低于国内常模(t=-11.89,P<0.05)。不同年龄、受教育程度、婚姻状况、职业、与患者同住状况的家属社会支持得分差异有统计学意义(P<0.05);患者的年龄、就业状态、精神疾病种类、精神症状稳定程度、患病年限不同,其家属的社会支持得分也有显著性差异(P<0.05);与患者关系、家庭获补助数量不同家属的社会支持得分差异有统计学意义(P<0.05)。结论严重精神障碍患者家属的社会支持水平较低,其中年龄、文化程度、婚姻状况、职业和是否与患者同住是患者家属社会支持的影响因素。加强对患者家属的健康教育、争取社会救助、提升患者家属的个人技能等,有利于提高患者家属的社会支持水平,有助于严重精神障碍患者的管理和康复。

眼科患者“互联网+护理服务”平台问诊现况及影响因素分析

目的 调查眼科患者“互联网+护理服务”平台问诊现况,分析其影响因素,为优化护理服务提供参考。方法 采用自制一般资料调查表及眼科患者“互联网+护理服务”平台问诊现况调查表对使用“互联网医院”行“互联网+护理服务”线上问诊的781例眼科患者进行调查。结果 781例问诊患者中主动问诊330例(42.3%),重复问诊117例(15.0%),家属代问诊169例(21.6%)。logistic回归分析显示,年龄、文化程度、问诊人员、疾病类型、问诊用药、复查时间及生活运动方式是主动问诊的主要影响因素(均P<0.05)。结论 眼科患者主动问诊率低、较少重复问诊;医护人员应根据影响因素进行针对性干预与平台优化,从而提高患者线上问诊意愿。

以家庭为中心的群组式容量管理在慢性心力衰竭患者中的应用

目的探讨以家庭为中心的群组式容量管理在慢性心力衰竭患者中的应用效果。方法将心内科住院的慢性心力衰竭患者80例按时间段分为对照组(40例)和观察组(40例)。对照组采用常规护理;观察组采用以家庭为中心的群组式容量管理模式,在建立干预团队的基础上,给予互动式多样化健康教育、整体性规范化自我管理和持续性多元化社会支持等干预措施。结果两组干预6个月后长效依从性和服药依从性、生活质量、6分钟步行距离、左室射血分数、再住院率比较,差异有统计学意义(均P<0.05)。结论采用以家庭为中心的群组式容量管理模式可提升慢性心力衰竭患者治疗依从性和心功能,改善生活质量,降低再住院率。

20年前后精神分裂症患者家属对精神疾病态度的变化

目的:了解20年前后精神分裂症患者家属对精神疾病态度的变化。方法:采用方便抽样法,抽取北京回龙观医院住院及门诊精神分裂症患者家属。1999年入组精神分裂症患者家属217例,2019年入组206例,用精神疾病态度调查问卷调查家属对精神疾病的态度。结果:精神疾病态度调查问卷分量表“精神疾病不能治疗”、“精神疾病患者无社会价值”、“应回避精神疾病患者”、“应限制精神疾病患者的社会角色”2019年得分低于1999年的得分,差异有统计学意义(P均<0.05),但仍高于50分。多重线性回归分析提示,受教育程度高(β=-0.14、-0.17、-0.18、-0.20、-0.28,P均<0.05)、住院时间短(β=0.16、0.18,P均<0.05)、职业好(β=-0.16,P<0.05)、女性(β=0.21、0.23、0.30、0.33,P均<0.05),与其接触更频繁(β=-0.12、-0.16、-0.18、-0.21,P均<0.05)、年轻家属(β=0.13、0.16,P均<0.05)更容易接纳患者。结论:2019年精神分裂症患者家属对精神疾病的态度较1999年有显著改善,其中受教育程度高、住院时间短、职业好、女性的患者,与患者接触更频繁、年轻家属对精神疾病的态度更积极乐观;但仍存在一定程度的歧视。