目的:了解地震住院伤员的身心状态,进行针对性心理干预。方法:采用方便抽样,应用作者根据应激理论设计的应激身心反应调查表［1］,通过对地震伤员的观察和访谈,对在2008年5月12日至5月30日在四川大学华西医院住院的371名地震伤员进行身心状态的评估,并进行有针对性的心理干预。结果:①地震伤员灾后急性期心身应激反应较严重,其中出现频率最多的症状是睡眠困难,对突然的噪音或声音感到紧张害怕,心情沮丧,感到身体紧张,心情难以平静;②不同性别地震伤员身心反应存在一定差异,女性反应症状重于男性;③年龄在小于12岁、12～18岁和41～50岁年龄段地震伤员的身心反应与其他年龄段地震伤员的身心反应存在差异;④地震伤员的身心反应与其性别、年龄、文化、个人受伤情况有关。结论:地震伤员灾后身心反应严重,急性期给予针对性心理干预十分重要。
目的探讨对达芬奇机器人纵隔肿瘤切除术的患者实行心理干预有无积极的影响。 方法选取沈阳军区总医院胸外科2012年1月至2013年1月行达芬奇机器人纵隔肿瘤切除术患者40例为研究对象，按就诊顺序分为两组。对照组20例，男11例、女9例，平均年龄43.7（32～70）岁；观察组20例，男10例、女10例，年龄45.6（32～68）岁。两组均按照胸外科常规护理，观察组在此基础上加强围手术期的心理干预，使用焦虑自评量表（self-rating anxiety scale，SAS）和抑郁自评量表（self-rating depression scale，SDS）进行评估，比较两组患者干预前后的心理状态差异。 结果观察组和对照组SAS、SDS评分干预前与干预后均有不同程度的降低。与对照组相比，观察组降低较为明显，且差异有统计学意义（SAS干预后44.55±5.33 vs.39.90±2.34，P＜0.05；SDS干预后35.64±4.26vs.33.28±1.93，P＜0.05）。 结论心理干预可有效改善达芬奇机器人纵隔肿瘤切除术患者的心理状态，对提高治疗效果有积极的推动作用。
Objective To assess the effectiveness of psychological intervention on post-stoke depression. Methods Such databases as the JBI Database of Systematic Review (1980 to June, 2010), The Cochrane Library (1980 to June, 2010), PubMed (1966 to 2010), CINAHL(1982 to May, 2000), CBM (1978 to 2010), and CNKI (1979 to 2010) were searched to collect randomized controlled trials (RCTs). In accordance with the predefined inclusion and exclusion criteria, the quality of included studies was evaluated, and then meta-analyses were performed by using RevMan 5.0 software. Results A total of 33 RCTs were included. The results of meta-analyses showed: (1) Compared with the control group, the short-term effect of psychological intervention was more effective in decreasing depression score. The subgroup analysis showed that the intervention effects at the time of four weeks, six weeks, eight weeks, and 12 weeks were better than those of the control group. (2) The long-term effect of psychological intervention was more effective in decreasing depression score. The subgroup analyses showed that the intervention effects at the interval of eight weeks, 24 weeks, and 48 weeks were better than those of the control group. (3) The combined or single application of either cognitive-behavioral psychotherapy or supportive psychotherapy was more effective in decreasing depression score than the control group. However, there was no significant difference between the general psychological treatment group and the control group. (4) The subgroup analyses showed that the different qualities of the included studies were more effective than those of the control group. Conclusion Various psychological intervention is effective in decreasing the patient’s depression score, and cognitive-behavioral therapy and supportive psychotherapy, especially, can significantly improve the depression state and promote recovery.
肿瘤患者常常具有不适应情绪和行为反应,如焦虑、抑郁、悲伤、愤怒、恐惧等。针对这类患者的特征,我们对肿瘤科查房模式进行探讨,旨在缓解患者的不良情绪,提高肿瘤患者的治疗疗效,降低医疗风险。
Objective To assess and report on the current situation of the families of students, who were involved in the Wenchuan earthquake, to provide data for the government to make decisions that should help with recovery from the earthquake. Methods We selected 2 towns and 4 villages using stratified sampling to take account of different levels of destruction. We performed on-site surveys and secondary research. Results The psychological problems of the parents of the students were serious. These families’ economic situations were not good. Conclusion We should build ‘Mutual Aid’ organization and take the advantage of rural hospitals to promote the long-acting mechanism of the psychological intervention.