33例耐多药肺结核患者督导服药现状研究

为了解耐多药肺结核患者督导服药情况,本文对33例耐多药肺结核患者与12名医务人员进行调查.结果显示,没有接受过直接面试下督导服药和访视的患者分别占40%和50%,患者确诊后的管理情况并没有比确诊前有明显好转.因此,要加大政府的投入力度,加强专科医院和结防机构之间的医防合作,从而强化对患者的服药管理.     

耐多药肺结核患者首次就诊过程调查

了解现阶段耐多药肺结核患者的首次就诊过程,分析医患双方对耐多药肺结核患者就诊过程的影响。在全国选取5个项目市,使用自制调查问卷采取面对面方式对样本人群进行访谈式调查。耐多药肺结核患者以文化水平较低、年龄偏大的农民为主。32.6%的患者初次就诊时有全身乏力或消瘦症状,37.6%的患者初次就诊单位为村卫生室或乡镇卫生院,28.4%的患者初次就诊时被误诊,31.6%的患者发生就诊延迟,79.8%的患者在结核病专科医院或防治机构确诊,33.3%的患者确诊延迟。加大对群众结核病相关知识宣传力度,加强结核病防治机构技术力量尤其是实验室诊断技术,加强对参与结核病防治工作医生尤其是村医的专业培训,针对医疗机构转诊建立适当的激励机制。     

中国五城市耐多药肺结核筹资机制分析

耐多药肺结核与非耐多药肺结核相比,具有传染期长,诊断、治疗、管理技术复杂,治疗费用高等特点,越来越受到国际社会的广泛关注.依托科技部重大专项的实施,对中国五城市耐多药肺结核的筹资机制进行研究分析,为各地探索开展耐多药肺结核治疗的筹资机制提供理论依据.     

耐多药肺结核患者首次就诊过程调查

了解现阶段耐多药肺结核患者的首次就诊过程,分析医患双方对耐多药肺结核患者就诊过程的影响.在全国选取5个项目市,使用自制调查问卷采取面对面方式对样本人群进行访谈式调查.耐多药肺结核患者以文化水平较低、年龄偏大的农民为主.32.6%的患者初次就诊时有全身乏力或消瘦症状,37.6%的患者初次就诊单位为村卫生室或乡镇卫生院,28.4%的患者初次就诊时被误诊,31.6%的患者发生就诊延迟,79.8%的患者在结核病专科医院或防治机构确诊,33.3%的患者确诊延迟.加大对群众结核病相关知识宣传力度,加强结核病防治机构技术力量尤其是实验室诊断技术,加强对参与结核病防治工作医生尤其是村医的专业培训,针对医疗机构转诊建立适当的激励机制.     

初治肺结核患者服药依从性的相关因素分析

为了了解初治肺结核患者服药依从性状况及影响因素,采用分层整群随机抽样方法抽取样本,利用自制调查表和Morisky依从性量表获取数据信息,并用SPSS 16.0软件进行统计分析.参与调查的578例初治肺结核患者中,依从性低组为194例,占33.6％,依从性正常组为384例,占66.4％.影响服药依从性的主要因素为职业、治疗时期、生活满意度、病情严重程度等（P＜0.05）.可见初治肺结核患者不规则服药受多方面因素影响,应加强各方督导,提高服药依从性.     

结核患者服药依从性的研究现状

结核病控制是全球卫生工作的一个重点,服药依从性则是其中关键的一环。本文对结核患者服药依从性的重要性、影响因素及提高依从性的措施进行综述,认为实施直接督导短程化疗（DOTS）、强化督导、改善患者对服药依从性的认识、简化给药方案、减轻患者经济负担、设置患者提醒物等可提高服药依从性。     

结核患者服药依从性的研究现状

结核病控制是全球卫生工作的一个重点，服药依从性则是其中关键的一环。本文对结核患者服药依从性的重要性、影响因素及提高依从性的措施进行综述，认为实施直接督导短程化疗（DOTS）、强化督导、改善患者对服药依从性的认识、简化给药方案、减轻患者经济负担、设置患者提醒物等可提高服药依从性。     

耐多药肺结核的最优化治疗模式的几点思考

耐多药结核病是结核病治疗中的一个难点,由于耐药成因和耐药种类的多样性决定了治疗应该个体化,对耐多药肺结核的最优化治疗模式的应用和价值进行了思考和总结,这对结核病的治疗有极为重要的意义。     

耐多药肺结核的最优化治疗模式的几点思考

耐多药结核病是结核病治疗中的一个难点,由于耐药成因和耐药种类的多样性决定了治疗应该个体化,对耐多药肺结核的最优化治疗模式的应用和价值进行了思考和总结,这对结核病的治疗有极为重要的意义.     

武汉市耐多药结核病患者抑郁症状检出率及影响因素分析

为了解耐多药结核病患者抑郁症状检出情况及其影响因素,对武汉耐多药结核病患者进行问卷调查。结果显示,126例耐多药结核病患者抑郁症状检出率48.4%,年人均收入少于1万元(P0.001)、对支持的利用度(P0.001)和客观支持得分低于平均值(P0.05)、痰菌未转阴(P0.05)是抑郁症状的危险因素。抑郁症状普遍存在于耐多药结核病患者中,应联合民政、财政、医保等部门合力减轻患者的经济负担,加强耐多药结核病患者心理辅导,提高其应对技能,指导患者获得有效的社会支持。     

Results of long-term treatment with depot neuroleptics in schizophrenic patients

An examination was instituted to determine the effectiveness of maintenance therapy involving depot neuroplegics in out-patient after-care during an average follow-up of six years. At the time of examination, 172 patients treated with Depot-Lyogen showed statistically significant lower relapse and rehospitalisation rates, a reduction of the productive schizophrenic symptoms, and improved chance of rehabilitation, compared with 55 patients without treatment. In 22% of the 270 patients on Depot-Lyogen, there were early extrapyramidal side-effects, in 4.7% late dyskinesis, and in 4.3% depressive symptoms relating to medication. 35% of the patients did not receive consistent maintenance therapy. The improvement of after-care is discussed.     

Length of survival and lymphocyte percentage in women with mammary cancer as a function of psychotherapy

50 patients suffering from terminal mammary cancer and visceral metastases received chemotherapy, and in addition half of them received psychotherapy, while half did not. A lymphocyte count was undertaken seven times in all, once before initiation of chemotherapy, the others after six applications of the therapy. As hypothesized, the 25 women who received psychotherapy lived longer and had significantly higher lymphocyte counts on Occasions 5, 6 and 7 than did the 25 women who did not receive psychotherapy. Of the types of psychotherapy employed, a specially designed form of behaviour therapy was significantly more helpful than dynamic psychotherapy in prolonging life.     

Aversive and positive conditioning treatments of homosexuality

Thirty-one male homosexual patients were randomly allocated to receive either aversive therapy, in which unpleasant shocks were associated with pictures of nude males; or positive conditioning, in which pictures of nude women were associated with similar pictures of men and later with pictures of heterosexual relationships. The patients were further randomly allocated to receive either procedure according to a forward or backward conditioning paradigm. Before, 3 weeks and 1 yr following 5 days of treatment, the patients were shown a film containing at 1-min intervals 10-sec segments of pictures of nude women or men. During this and all treatment procedures their penile volume responses were measured.

The positive conditioning technique proved ineffective and hence acted as a placebo treatment control for the aversive therapy. Patients reported significantly greater reduction in homosexual feelings and behaviour following the latter. After both the aversive and the positive conditioning technique, patients showed significantly less penile volume increase to the pictures of men. There was no trend for this change to be greater following aversive therapy. It was concluded that this therapy reduced the secondary reinforcement value of homosexual stimuli but did not alter sexual orientation.     

Quality of object relations as a moderator of the relationship between pattern of alliance and outcome in short-term individual psychotherapy

In this study, we investigated the personality variable quality of object relations (QOR) as a moderator of the relationship between the pattern of the therapeutic alliance and treatment outcome in two forms (interpretive, supportive) of short-term individual psychotherapy. In a sample of 72 psychiatric outpatients who completed interpretive therapy, QOR emerged as a moderator for the outcome factor general symptomatology and dysfunction. For high-QOR patients, an increasing level of alliance was directly related to benefit, whereas for low-QOR patients, a decreasing level of alliance was directly related to benefit. An explanation for these findings emphasized the importance of patients repeating their typical pattern of maladaptive interpersonal behavior in the therapy sessions in the context of the therapist working with the transference. In a sample of 72 psychiatric outpatients who completed supportive therapy, QOR did not emerge as a moderator. These findings in combination with evidence from previous studies suggest that QOR should be investigated as a moderator variable in future studies of short-term psychotherapy.     

Not starting psychotherapy is more often initiated by the therapist than the patient

The phenomenon of not starting psychotherapy is seldom investigated. The present study of psychotherapy in the Swedish mental health services differentiates between patients applying for and being offered psychotherapy but choosing not to start (n = 69), patients recommended to receive no treatment, another type of treatment or treatment at another clinic (n = 133), and therapy starters (n = 1294). After the initial assessment, nearly twice as many patients did not start based on the therapist’s decision than on the patient’s. Cases of not starting psychotherapy decided by the therapist were more frequent among patients whose occupational status was less stable, presented a danger to others, had lower levels of initial therapeutic alliance, and by therapists with lower levels of psychotherapy training and those at less structured and more unstable clinics. Patients choosing not to start therapy had lower levels of mental ill-health than both starters and therapist-initiated nonstarters. The most frequently presented reason for a patient-initiated decision to not start therapy was “patient wished another treatment or therapist,” whereas the most common therapist-initiated reason was “recommended or referred to another treatment or clinic”.     

石家庄市区缺血性心脑血管病级预防中阿司匹林的应用状况初探

调查在河北省石家庄市区冠心病和缺血性脑血管病二级预防中阿司匹林的应用状况。通过对原住院患者随访,对内科门诊、专家门诊和社区门诊患者通过问卷调查,收集服用阿司匹林的有关资料,根据阿司匹林的应用情况,将患者分为两组：1组为服药组：患者规范或不规范服用阿司匹林;2组为未用药组：患者从未服阿司匹林。共1885例,其中缺血性脑血管病925例、冠心病711例、冠心病与缺血性脑血管病并存249例。患者来自住院随访患者567例、内科门诊882例、社区门诊436例。全组1885例患者中,服用阿司匹林组为1226例（占比例为65．1％）,其中,规范服用阿司匹林957例（50．8％）,不规范用药269例（14．3％）,未服用阿司匹林659例（34．9％）。阿司匹林在本调查地区缺血性心脑血管病二级预防中的应用率较高,用药的依从性较好,但和阿司匹林规范化应用的专家共识还有较大的差距。     

EGFR基因突变NSCLC全程管理

表皮生长因子受体（EGFR）基因突变的非小细胞肺癌（non-small cell lungcancer,NSCLC）是一类具有独特病理和临床特征的恶性肿瘤。目前由于针对EGFR基因突变阳性NSCLC治疗中TKIs的应用,患者的生存期已超过三年,所以此类患者从诊断到治疗应进行全程管理。首先要进行分子检测,发现EGFR基因突变NSCLC,以避免失去EGFR—TKIs的治疗机会。研究证明,EGFR基因突变NSCLC任何线接受第一代抑制剂治疗,患者疗效及生存获益且耐受性良好。一代EGFR—TKIs耐药后根据失败模式选择后续局部或全身治疗,或根据耐药失败分子机制给予新的分子靶向治疗。对EGFR基因突变NSCLC应实施科学、有序的全程管理。     

Combining group psychotherapy and pharmacotherapy: a survey

Group psychotherapists, primarily members of the American Group Psychotherapy Association, were surveyed to determine their practice and attitude toward inclusion of patients receiving psychotropic medication in their "typical" outpatient psychotherapy groups. One hundred forty-three questionnaire responses were received from 258 contacted practitioners (55.4% return rate). More than two-thirds of the physicians, social workers, and psychologists reported including medicated members, and the professions did not significantly differ. Mood disordered patients were most frequently and schizophrenic and manic patients were least frequently reported to receive medication. Overall, clinicians' attitudes favored including medicated patients in the group. Indeed, therapists did not view inclusion of drugs as a detriment to the treatment process. Clinicians having only one medicated patient in their group felt more strongly that such individuals did not interfere with the treatment process when compared with those having none or more than one medicated patient. The one difference by discipline was that social workers and psychologists did not endorse the idea that medicated patients needed to be in groups led by psychiatrists.     

Manipulating Self-Complexity with Communication Role Assignment: Evidence for the Flexibility of Self-Concept Structure

This article reports an experimental technique for manipulating self-complexity, a characteristic of self-concept organization related to affective reactivity. The assignment of different communication roles is examined as a possible manipulation of self-complexity. In Experiment 1, participants who expected to transmit information about themselves (transmit group) had lower self-complexity than participants who expected to receive information about themselves (receive group). In Experiment 2, an additional communication role condition was included as a control group. Following the self-complexity manipulation and assessment, we observed affective reactions to feedback on academic ability. The mean self-complexity of the receive and control groups did not differ, and both exceeded the mean of the transmit group. Affective reactivity did not differ among the groups and was not significantly correlated with self-complexity. The implications of the self-complexity manipulation are discussed in terms of the flexibility and functionality of self-concept structure.     

Sigmund Freud: Four Centenary Addresses by Ernest Jones

Group psychotherapists, primarily members of the American Group Psychotherapy Association, were surveyed to determine their practice and attitude toward inclusion of patients receiving psychotropic medication in their “typical” outpatient psychotherapy groups. One hundred forty-three questionnaire responses were received from 258 contacted practitioners (55.4% return rate). More than two-thirds of the physicians, social workers, and psychologists reported including medicated members, and the professions did not significantly differ. Mood disordered patients were most frequently and schizophrenic and manic patients were least frequently reported to receive medication.

Overall, clinicians' attitudes favored including medicated patients in the group. Indeed, therapists did not view inclusion of drugs as a detriment to the treatment process. Clinicians having only one medicated patient in their group felt more strongly that such individuals did not interfere with the treatment process when compared with those having none or more than one medicated patient. The one difference by discipline was that social workers and psychologists did not endorse the idea that medicated patients needed to be in groups led by psychiatrists.