On the Literary Psychology Evolution of Denial Novels of the Qing Dynasty

This paper introduces the denial of the popular novels of the Qing Dynasty,and based on such introduction,it further analyzes the reasons why literary works represented by popular novels in the Qing Dynasty were denied and the influence upon cultural communication of denial.From the perspective of the mainstream cultural status and the actual situation,it explores the guidance function of literary psychology evolution,showing that the Chinese novels,as literary works,have the rational and responsible value.

Impact of specialized nursing outpatient case management on postcoronary artery bypass grafting patients

BACKGROUND Some patients with coronary atherosclerotic heart disease experience major adverse cardiac events(MACE)and require readmission after Coronary Artery Bypass Grafting(CABG)surgery.This is often attributed to patients'unhealthy lifestyles and dietary habits,inadequate understanding of the disease,and poor disease management compliance.Thus,searching for more targeted nursing intervention models that can enhance patients'self-management abilities and reduce the risk of readmission after CABG surgery is significant.AIM To observe the impact of specialized nursing outpatient case management on patients after CABG surgery.METHODS A total of 103 patients who underwent CABG surgery in our hospital between April 2021 and April 2022 comprised the study sample.The patients were divided into two groups using an odd-even number grouping method.The control group received routine nursing care,while the case management group received specialized nursing outpatient case management.The differences in psychological status,adherence to medical treatment,self-care ability,knowledge mastery,quality of life scores,and the occurrence rate of MACE were compared between the two groups.RESULTS After the intervention,the case management group had lower scores on the selfrating depression scale and self-rating anxiety scale and lower MACE rate,as well as higher scores for adherence to a healthy diet,medication adherence,good lifestyle habits,regular exercise,and timely follow-up,higher scores on the Coronary Heart Disease Self-Management Scale,higher scores for managing adverse habits,symptoms,emotional cognition,emergency response,disease knowledge,general lifestyle,and treatment adherence,higher scores for understanding coronary heart disease,recognizing the importance of medication adherence,understanding selfcare points after CABG surgery,and being aware of post-CABG precautions,higher scores for physical well-being,disease condition,general health,social-psychological well-being,and work-related aspects(P<0.05).CONCLUSION Specialized nursing outpatient case management can enhance patient adherence to medical treatment,knowledge mastery,psychological well-being,and overall quality of life in patients after CABG surgery.

Psychological Distress, Social Support and Medication Adherence in Patients with Ischemic Stroke in the Mainland of China

Stroke research and rehabilitation have traditionally focused on the physical and functional impact of a stroke. Less attention has been given to the psychosocial factors associated with this chronic condition. By the few studies that have specifically focused on psychosocial factors in the context of stroke, poststroke depression is demonstrated to significantly influence stroke outcomes. Associations of stroke with psychological symptoms other than depression have rarely been evaluated. This study was aimed to investigate the changes of psychological stress, social support and medication adherence in patients with ischemic stroke in the mainland of China. In this study, 90 patients with hemiplegia one year after first-ever middle cerebral artery infarction（stroke group） in the Zhongnan Hospital of Wuhan University from June 2008 to June 2011 were recruited for interview. Ninety age- and sex-matched normal volunteers（control group） were also examined at the same period. The psychological distress was assessed by the Symptom Checklist 90（SCL-90）, the social support by the Social Support Rating Scale（SSRS）, and medication adherence by Morisky＇s self-reported inventory, respectively. Group differences were analyzed using unpaired-t test and chi-squared test. The results showed that total mean scores of the SCL-90 in the stroke group were higher than those in the control group（P〈0.01）. Except two dimensions, paranoid ideation and psychoticism, mean scores of the rest dimensions（including somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, and phobic anxiety） of SCL-90 were significantly higher in the stroke group than those in the control group（P〈0.05, or P〈0.01）. The objective support, subjective support, support availability and total social support scores in the stroke group were significantly higher than those in the control group（P〈0.05, or P〈0.01）. Those in the ＂SCL-90 total scores 〉150 group＂ were significantly higher than in the ＂SCL-90 total scores 〈100 group＂ and the ＂SCL-90 total scores between 100 to 150 group＂（P〈0.05, or P〈0.01）. Those in the ＂SCL-90 total scores between 100 to 150 group＂ were significantly higher than in the ＂SCL-90 total scores 〈100 group＂（P〈0.05）. In 90 patients with ischemic stroke, 26（28.89%） patients obtained high medication adherence, 47（52.22%） patients medium medication adherence, and 17（18.89%） patients low medication adherence, respectively. Among these stroke patients, there were 17（50.00%） patients with high medication adherence in the ＂SCL-90 total scores 〉150 group＂, 28（75.67%） patients with medium medication adherence in the ＂SCL-90 total scores between 100 to 150 group＂, and 12（61.16%） patients with low medication adherence in the ＂SCL-90 total scores 〈100 group＂, respectively. There was significant difference in the medication adherence rate among the different SCL-90 scores groups in these stroke patients（P〈0.05 or P〈0.01）. It was led to conclude that ischemic stroke patients one year after hemiplegia have psychological distress, low level of social support and poor medication adherence in the mainland of China. Therefore, it is necessary to mobilize the government, medical institutions and various social support groups to offer psychological interventions to relieve the stress of patients with ischemic stroke, and improve their medication adherence.

Motivation dimensions for running a marathon:A new model emerging from the Motivation of Marathon Scale(MOMS)

Purpose：The aim of this study was to test and expand the Motivation of Marathoners Scale（MOMS） model（Masters et al.,1993）.Methods：The MOMS questionnaire was distributed to 306 male and female marathon runners（age range：20–77 years） with experience in marathon running（range：1–44 runs）.A confirmatory factor analysis（CFA） revealed that the original Purpose：The aim of this study was to test and expand the Motivation of Marathoners Scale（MOMS） model（Masters et al.,1993）.Methods：The MOMS questionnaire was distributed to 306 male and female marathon runners（age range：20-77 years） with experience in marathon running（range：1-44 runs）.A confirmatory factor analysis（CFA） revealed that the original model failed to fit the data.Hence,exploratory factor analysis（EFA） was performed to test the best factorial solution for the current data,and a subsequent CFA was performed on the revised factorial structure.Then,a series of EFAs using maximum likelihood factor extraction method were performed.Results：The best structure solution for model-data fit resulted in 11 factors：psychological coping-emotional-related coping,psychological coping-everyday-life management,life meaning,self-esteem,recognition,affiliation,weight concerns,general health orientation-reduced disease prevalence and longevity,general health orientation-keep fit,competition,and personal goal achievement.Conclusion：This study provides a sound and solid framework for studying motivation for physically demanding tasks such as marathon runs,and needs to be similarly applied and tested in studies incorporating physical tasks which vary in mental demands.

The Research on the Psychological Tactic of the Northern and Southern Dynasties

Psychology’s military use was discovered by ancient Chinese strategists in a very early time.In the Spring and Autumn period(770 B.C.-476 B.C.),psychological tactics were put into practice.After coming to the Northern and Southern Dynasties(420-589),psychological tactics had become the required course of strategists.Therefore,many generals of this period could use it adroitly.There were many classic examples which could help us analyze the psychological tactics of this era.The purpose of this paper is to introduce a few classic examples and summarize their characteristics.Then,we can better understand the psychological tactics of the Northern and Southern Dynasties.

PAC心理弹性理论模型联合运动康复训练对老年原发性高血压患者的影响

目的:探讨PAC心理弹性理论模型联合运动康复训练对老年原发性高血压患者的影响。方法:选取2022年1月—2023年1月于厦门大学附属第一医院就诊的98例老年原发性高血压患者,利用掷硬币法分为研究组与对照组,各49例。对照组采用常规健康教育,研究组在常规健康教育基础上给予PAC心理弹性理论模型联合运动康复训练。评价两组干预前后的血压水平、治疗依从性、心理状态、知觉压力和生活质量。结果:干预前,两组血压水平、心理状态和知觉压力及生活质量比较,差异无统计学意义(P>0.05);干预后,研究组血压水平、心理状态评分和知觉压力评分低于对照组,治疗依从性总分和生活质量评分高于对照组,差异有统计学意义(P<0.05)。结论:PAC心理弹性理论模型联合运动康复训练可降低老年原发性高血压患者的血压水平和知觉压力,调节心理状态,提高治疗依从性和生活质量。

《鼓吹新编》与清初遗民文化和文学

《鼓吹新编》是程棅、施禋在清初辑录时人七言律诗的选本。尽管程、施二人未见于各种明遗民录,但他们入清后的隐者身份、多遗民朋友、行为和心态符合遗民特征等足证两人当是明遗民。《鼓吹新编》奉明代为正朔,为明代诸帝(包括南明诸王)避讳,成为清初避明讳的一个样本,丰富了遗民文化的表现形式。入选该书者多明清之际的忠烈遗逸,入选诗歌题材集中于家国兴亡,旧国旧君之哀婉、命运无常之凄愤等情感贯穿全书,较卓尔堪《遗民诗》更具易代特征。

心理干预联合人文关怀对慢性心力衰竭患者心理状态、治疗依从性及睡眠质量的影响

目的:分析心理干预与人文关怀在慢性心力衰竭(CHF)患者中的应用效果。方法:选取2023年3月至2024年2月泉州市第一医院收治的CHF患者150例作为研究对象,按照随机数字表法分为观察组和对照组,每组75例。2组均接受常规治疗与护理,观察组在常规治疗、护理基础上接受心理干预与人文关怀。比较2组干预后焦虑与抑郁情绪、服药依从性、睡眠质量与生命质量。焦虑采用焦虑自评量表(SAS)评价,抑郁采用抑郁自评量表(SDS)评价,睡眠质量采用匹兹堡睡眠质量指数(PSQI)评价,生命质量采用明尼苏达心力衰竭生命质量量表(MLHFQ)评价。结果:观察组在干预后SAS、SDS评分低于对照组,服药依从率高,PSQI评分与睡眠障碍发生率较低,差异有统计学意义(P<0.05)。观察组在干预后MLHFQ评分显著低于对照组,差异有统计学意义(P<0.05)。结论:心理干预与人文关怀可改善CHF患者心理障碍与睡眠障碍,提升治疗依从性,改善生命质量。

认知-心理-疼痛维度专项护理在晚期胰腺癌疼痛患者中的应用研究

目的探讨认知-心理-疼痛维度专项护理在晚期胰腺癌疼痛患者中的临床价值。方法选取2022年1月至2023年4月该院收治的晚期胰腺癌患者94例,采取随机数字表法将其分为观察组与对照组,每组47例。对照组给予常规干预,观察组在对照组基础上联合认知-心理-疼痛维度专项护理。比较2组干预前后焦虑自评量表(SAS)、抑郁自评量表(SDS)、数字疼痛评分法(NRS)、Morisky用药依从性量表8条目中文版(MMAS-8)及欧洲癌症研究与治疗组织生活质量测定量表(EORTC QLQ-C3)评分。结果2组干预前SDS、SAS评分比较,差异无统计学意义(P>0.05)。2组干预后SDS、SAS评分低于治疗前,且观察组各指标低于对照组,差异有统计学意义(P<0.05)。2组干预前NRS、MMAS-8评分比较,差异无统计学意义(P>0.05)。2组干预后NRS、MMAS-8评分优于治疗前,且观察组各指标优于对照组,差异有统计学意义(P<0.05)。2组EORTC QLQ-C3各项评分比较,差异无统计学意义(P>0.05)。2组EORTC QLQ-C3各项评分高于治疗前,且观察组各指标高于对照组,差异有统计学意义(P<0.05)。结论对晚期胰腺癌患者实施认知-心理-疼痛维度专项护理不仅能有效改善其焦虑、抑郁情绪与疼痛症状,还能提高其用药依从性及生活质量。

社会心理因素对新药临床试验初期慢性病受试者依从性的影响及其提升策略剖析

目的 探讨在新药临床试验初期,社会心理因素对慢性病受试者治疗依从性的影响,并提出优化策略。方法 收集并分析2020年12月至2023年12月于嘉兴市第一医院参与新药临床试验慢性病受试者的观察数据,包括社会人口学信息、艾森克人格问卷(Eysenck personality questionnaire,EPQ)调查结果、90项症状自评量表(symptom checklist 90,SCL-90)评分、贝克焦虑量表(Beck anxiety inventory,BAI)评分、贝克抑郁量表(Beck depression inventory,BDI)评分,并将SCL-90按10个因子维度分类评估得分、EPQ按4个维度标准T分分类评估得分。应用单因素和多因素Logistic对数据进行分析。结果 单因素分析结果显示,性别、外出意愿、EPQ_T神经质、SCL-90、SCL躯体、SCL强迫、SCL人际、SCL抑郁、SCL焦虑、SCL精神病、SCL其他、BAI评分和BDI评分与慢性病受试者的依从性相关。多因素分析结果显示,较强外出意愿、较高的BAI及BDI评分与非依从性风险呈正相关,而SCL-90躯体因子得分的增加与慢性病受试者依从性风险降低有关。结论 在新药临床试验初期识别并管理慢性病受试者的焦虑和抑郁状态,关注外出计划,对提升依从性至关重要。在特定情况下,慢性病受试者对身体的不适感知可反向促进其依从性。

赋能教育联合问题导向护理在肝癌介入治疗中的应用效果

目的探讨赋能教育联合问题导向护理在肝癌介入治疗中的应用效果。方法采用便利抽样法,选取2021年8月至2022年8月收治于赣州市某医院行肝癌介入治疗的患者作为研究对象,按入院先后顺序进行分组,以2021年8-12月入院的患者作为对照组,以2022年1-8月入院的患者作为观察组,每组各33例。对照组给予常规护理干预,观察组则采用赋能教育联合问题导向护理干预,均持续干预3个月。采用健康信念水平调查表、汉密尔顿焦虑量表、汉密尔顿抑郁量表、Morisky服药依从性问卷及欧洲癌症治疗与研究生命质量核心量表进行评分比较。结果干预3个月后,观察组患者健康信念水平、Morisky评分、生命质量评分均高于对照组(P<0.05);焦虑及抑郁得分均低于对照组(P<0.05)。结论赋能教育联合问题导向护理能帮助肝癌介入治疗患者有效构建健康信念,促使其保持健康心理状态,有利于提升患者的服药依从性,并促进其生命质量改善和提升。

易代之际的遗民园林雅集与文学书写——以水绘园与稊园为中心

水绘园和稊园的设计都出于对现实中王朝兴替带来的痛苦的规避,但又各具特色,分别代表了明末清初与清末民初遗民园林的两种典型。易代之际的遗民园林雅集是“诗可以群”的文化传统与文人雅集的文化记忆之承续,“园隐”则是园林雅集文学书写的一大主题,是易代之际文人面临复杂的政治环境和生存困境后作出的安全选择。遗民园林对易代之际文化传承起到重要作用,象征着“精神桃源”。易代之际的遗民借助现实的文化空间,将非常态的人生境遇、改朝换代的沧桑之感揉进纵情逸乐的极致享受中,勾连起对往事的追忆与挽留,代表着一种重返故国、回归故园的人生渴望。园林的封闭性与自足性隔绝了永失故园的沉痛悲苦,代替故园成为一处超越现实的精神存在,存放鼎革之际的文化记忆,寄托着遗民们对现实世界与个人处境的迫厄之感与避世之愿。

靶向心理干预对女性精神分裂症患者心理状态及服药依从性的影响

目的 探讨以问题为导向实施靶向心理干预对女性精神分裂症患者心理状态及服药依从性的影响。方法 选取2021年1月至2023年6月来我院就诊330例的女性精神分裂症患者,按照单双号法随机分为干预组和对照组各165例。干预组实施以问题为导向实施靶向心理干预,通过分析患者个体的心理特征和问题根源,制定针对性的干预计划,对患者心理状态和行为进行干预,帮助其解决心理问题或提升心理健康水平;对照组予以常规心理干预,通过心理咨询、药物治疗等,帮助其更好地认识和应对自己的情绪,调节内心的焦虑和压力。在干预前、干预1个月后,比较两组患者的精神症状改善情况[简明精神病量表(BPRS)、症状自评量表(SCL-90)]、自我管理能力[自我护理能力测定量表(ESCA)]、社会功能[精神障碍患者社会功能缺损评定量表(SSFD-MD)]、心理状态[中文版卡尔加里精神分裂症抑郁量表(CDSS-C)、自我感受负担量表(SPBS)]、服药依从性[药物依从性量表(MARS)、药物信念问卷(BMQ)]。结果 干预1个月后,两组患者BPRS、SCL-90、SSFD-MD、CDSS-C和SPBS评分均较干预前降低,且干预组低于对照组(P<0.05);两组ESCA、MARS和BMQ评分较干预前提高,且干预组高于对照组(P<0.05)。结论 以问题为导向的靶向心理干预方法在女性精神分裂症患者的护理中具有显著的优势,通过改善患者的精神状态、自我管理能力和社会功能,提高患者心理状态和服药依从性,为患者重建健康的生活奠定坚实的基础。

明遗民文学家徐芳年表

徐芳是清初成就颇为突出的明遗民文学家。学界对其生平了解不够。笔者在此前《清初明遗民文学家徐芳的生卒年及其他》一文的基础上,根据徐芳别集《悬榻编》、文言小说集《藏山稿外编》、散见于地方志等各种文献的徐芳轶文以及其友朋文字,按年排比、勾勒其生平事迹,制作年表,以期为徐芳研究提供新线索。

明遗民徐芳寓言散文之刍议

明遗民文学家徐芳素以寄托深远、发人深省的寓言体散文名世。他的讽世寓言多以动物为喻,或指陈人性的善恶两面;或借喻明末的社会现实,讽刺自私自利的朝廷官员;或嬉笑怒骂,暗藏机锋,直指儒林丑态。他的志怪故事则驰骋幻想,书写异域风情、鬼神灵异,寄寓惩恶扬善之旨,启发世人反躬自省,对蒲松龄创作《聊斋志异》或有一定启发。徐芳作品包含深刻的现实关切与批判意识,负载着作家意欲捍卫儒家道德体系的功能。

商周金文所见“五”族略考——兼论晋南地区在商周之际的特殊性

商周时期的■族之■可以释为“五”。晚商时期五族已生活于晋南一带,此后有一支五族人迁往关中居住。西周时期居于晋南的五族氏名为“■”,属于姞姓,很可能是晋国的附庸,与倗、霸相类,属于怀姓九宗的一支。五族所作铜器多反映婚嫁情况,且该族亦称姓,与周人近似,而与来自殷商核心区的族氏不同,可能与其所处地域晋南在商周之际历史中的特殊性有关。

徐芳交游考

徐芳是文学史界较为关注的明遗民文学家。但其交游情况学界尚未全面论述。徐芳的交游对象既有师长辈,如马世奇、钱谦益、苗蕃、李元鼎、熊文举、李明睿等;也有友朋辈,如方以智、傅瀛宾、文德翼、傅占衡、吴嘉纪、施闰章、归庄、周亮工、陈允衡、汤来贺、竺庵禅师等。就这些人物的具体身份而言,既有殉明烈士、明遗民,也有仕清官员与僧人等。徐芳与这些士人的交游,不仅为其散文与寓言小说创作提供了素材,也体现了知识分子以学术为宗的理念,从中还可看出遗民的隐居生活看似高雅闲适,实则贫病交加的状况。

应用心理疏导与关爱结合支持管理对抑郁症合并高血压患者睡眠质量的影响

目的:探究应用心理疏导与关爱结合支持管理对抑郁症合并高血压患者睡眠质量的影响。方法:选取2021年8月至2023年1月泉州市第三医院精神科收治的抑郁症合并高血压患者94例作为研究对象,通过随机抽签方式随机分为对照组和观察组,每组47例,对照组实施心理疏导与关爱干预,观察组在此基础上联合支持管理。比较2组的抑郁自评量表(SDS)评分、匹兹堡睡眠质量指数(PSQI)评分、用药依从性、血压控制达标率、不良心血管事件。结果:干预后,观察组的SDS、PSQI评分均低于对照组(均P<0.05),用药依从性、血压控制达标率均高于对照组(均P<0.05),不良心血管事件发生率低于对照组(P<0.05)。结论:对抑郁症合并高血压患者实施心理疏导与关爱结合支持管理,能有效减轻患者的抑郁症状,改善睡眠质量,提升用药依从性,促使血压控制达标率提升,减少不良心血管事件的发生。

论江西堪舆文化对明遗民治生抉择的影响--以清初文学家徐芳为例

明清易代,受传统儒家名节意识的影响,明遗民拒绝清廷招揽,但他们又不得不面对生计抉择的问题。明遗民为风水先生者不在少数。徐芳以地师身份行脚大江南北,以堪舆相地自谋生计,这一人生选择受到江西民间信仰与文化传统等大历史环境的影响。细查徐芳一生行迹,他奔走四方,流连明朝陪都南京,屡屡与众遗民同道交游,或有借“看风水”之名从事抗清活动之可能。

朱彝尊与易堂诸子交谊考述

朱彝尊与魏禧相识于扬州,因二人年龄、经历、出身与职志等多方面存在相似之处,逐渐结为至交。诗文方面,朱氏不仅与魏禧有密切的交流,与其兄魏际瑞亦有书信往来。朱彝尊与曾灿相识于京师,游处累月,朱氏仕清后,重逢于苏州,因身份迥异,曾氏遂有“云泥之叹”。康熙二十三年(1684),朱氏因小事被谪官,其心境为之转变,希冀通过曾灿与魏禧之侄魏世傚搭建与“南园词客”接续前谊的桥梁。