基于眼动数据的一例角色书信疗法临床案例的分析与启示

采用眼动法,探究来访者阅读去信与回信时认知信息的变化,以及新手型咨询师与来访者在阅读角色书信时认知信息的差异。结果表明,来访者阅读回信时,对去信中诱发不良情绪的部分认知因素予以回应;新手型咨询师的注视时间显著短于来访者,注视次数多于来访者,热点区域不同于来访者。结果说明,往复的角色书信可以促进来访者转变不良认知;新手型咨询师对角色书信的理解与来访者存在不同。     

从乳腺癌患者的生活质量谈医学模式的转变

随着医学模式从生物医学模式向生物-心理-社会医学模式的转变,乳腺癌患者的生活质量亦日益引起社会的普遍关注.至今,许多通科医生的医学模式还没有完全转变过来.只有医学模式的彻底改变,才能真正提高乳腺癌患者的生活质量.介绍生活质量的概念、影响因素,以及乳腺癌患者的生活质量与医学模式的关系.     

Treatment of chronic global aphasia with a nonverbal communication system

Four chronic global aphasics were treated with Blissymbols (C. K. Bliss, 1965, Semantography-Blissymbolics, Sydney: Semantography Pub.). As soon as possible the therapeutic communication was based solely on the use of the symbols. Three patients seemed to benefit from therapy. In one case therapy had to be discontinued because of massive perseveration. In one patient expression of needs relied solely on the use of the symbols. In another, expressive speech could be restored to such an extent that communication by the use of symbols was discontinued.     

垂体腺瘤诊疗过程中应重视对垂体腺瘤患者生命质量评估

垂体腺瘤是一种常见的颅内神经内分泌肿瘤,约占颅内肿瘤的10%~15%,常伴有不同程度的肿瘤占位效应(头痛、视力受损等)、功能性腺瘤引起的激素水平过高和正常垂体受压破坏引起的垂体功能低下等症状,因此多数患者的生命质量受到影响。随着生物-心理-社会医学模式理念的逐步深入,除了关注患者的内分泌紊乱、肿瘤大小以及肿瘤引起的症状外,患者的生命质量也应该受到密切关注。本文将针对国内外对垂体腺瘤患者生命质量评估的相关进展进行综述。     

Clinical Predictors of Depression in Patients with Low-Grade Brain Tumors: Consideration of a Neurologic Versus a Psychogenic Model

Few studies have examined quality of life issues in patients with brain tumors, though coping with cancer is stressful and is associated with heightened levels of depression. We used regression to examine the clinical factors that might predict depression in a group of 57 adults with low-grade brain tumors after surgery but prior to radiotherapy and chemotherapy. A neurological model comprised of tumor characteristics and treatment was compared with a psychogenic model comprised of both psychosocial and psychodynamic variables. Demographic variables and level of fatigue were also included. A model consisting primarily of fatigue (also clinically elevated) and secondarily of tumor location and aggressiveness of surgical treatment accounted for 33% of the depression score. In a small group at a later follow-up when patient depression was clinically elevated (4–6 years after baseline), fatigue, female sex, cognitive dysfunction, increased family support, and increased report of physical symptoms were associated with depression. The late out findings remain exploratory because of the small sample size, but they suggest that depression develops over time and results from a combination of neurological and psychosocial problems that ensue initial treatments. Treating these collateral problems may reduce the complications from depression.     

Depression and anxiety correlate with disease-related characteristics and quality of life in Chinese patients with gout: a case-control study

This study aims to evaluate the prevalence of depression and anxiety and investigate the potential risk factors for depression and anxiety in Chinese gout patients. A self-report survey was administered to 226 gout patients and 232 age- and gender-matched healthy individuals. Patients were asked to complete a set of standardized self-report questionnaires. Univariate and mutiple regression were used to analyze the data. We found 15.0% of gout patients had depression, and 5.3% had anxiety. After adjusted demographic variables, the prevalence of depression was significantly higher than the healthy controls (6.0%). There were significant correlations among education, total pain, disease duration, stage of gout, functional disability, number of tophi, number of flares/last year, presence of tender joints, nephropathy comorbidity, health-related quality of life (HRQoL), and psychological status. Meanwhile, logistic regression analysis identified number of tophi, functional disability, and mental component summary (MCS) as predictors of depression in gout patients. Education and MCS were significantly accounted for anxiety. In summary, the prevalence of depressive symptoms among gout patients was higher than healthy individuals. Education, disability, tophi and HRQoL were important risk factors linked to depression/anxiety in Chinese gout population.     

Positive factors associated with quality of life among Chinese patients with renal carcinoma: a cross-sectional study

Quality of life and positive psychological variables has become a focus of concern in patients with renal carcinoma. However, the integrative effects of positive psychological variables on the illness have seldom been reported. The aims of this study were to evaluate the quality of life and the integrative effects of hope, resilience and optimism on the quality of life among Chinese renal carcinoma patients. A cross-sectional study was conducted at the First Hospital of China Medical University. 284 participants completed questionnaires consisting of demographic and clinical characteristics, EORTC QLQ-C30, Adult Hope Scale, Resilience Scale-14 and Life Orientation Scale-Revised from July 2013 to July 2014. Pearson’s correlation and hierarchical regression analyses were performed to explore the effects of related factors. Hope, resilience and optimism were significantly associated with quality of life. Hierarchical regression analyses indicated that hope, resilience and optimism as a whole accounted for 9.8, 24.4 and 21.9% of the variance in the global health status, functioning status and symptom status, respectively. The low level of quality of life for Chinese renal carcinoma patients should receive more attention from Chinese medical institutions. Psychological interventions to increase hope, resilience and optimism may be essential to enhancing the quality of life of Chinese cancer patients.     

Assessing the quality of life in patients with multiple sclerosis in Kuwait: a cross sectional study

The main objective of this paper was to assess the level and the determinants of quality of life (QOL) amongst patients with multiple sclerosis (MS). A cross-sectional study was conducted among a convenience sample of 200 adult MS patients. Inclusion criteria were: MS diagnosis for at least one year, and aged 21+ years. However, exclusion criteria were: having other neurological diseases, serious cardiovascular, orthopedic or other disability precluding participation. Self-administered questionnaire employed MSQOL-54 with two outcomes: Physical Health Composite (PHC) and mental health composite (MHC). Satisfaction with Daily Occupation scale was adopted through face to face interviews. The median of PHC and MHC scores were 48.9/100, and 53.4/100 respectively. Multivariate analysis revealed that unemployment was a determinant of poor PHC, while low monthly income was a predictor of poor MHC. Additionally, low endurance and sensory problems were associated with poor PHC, and MHC, while motor problems were allied with only poor PHC. Patient’s satisfaction level with performing activities of daily living was positively associated with PHC and MHC. Assessment of QOL is suggested to be comprised in medical settings.     

Diabetes Rehabilitation: Effects of a Multidisciplinary Intensive Education Programme for Diabetic Patients with Prolonged Self-Management Difficulties

This study aimed to determine effects of a Multidisciplinary Intensive Education Programme (MIEP) based on the empowerment approach for diabetic patients with prolonged self-management difficulties. In 89 participants, glycaemic control (HbA1c), health related quality of life (HR-QoL) and indicators of empowerment were measured before MIEP (10 days in 10 weeks, follow-up after 6 and 12 weeks) and at 12 weeks follow-up. The participants were compared with 231 average outpatients who were measured once. Overall, participants improved their glycaemic control, mental health, satisfaction with treatment and became more empowered. Subgroup analyses revealed that especially patients with poor baseline control improved their HbA1c. At baseline, participants with poor mental health scored worse on all other HR-QoL subscales too and were less empowered compared to the satisfactory mental health group. The poor mental health participants improved in most of these aspects. MIEP has beneficial effects in HbA1c, HR-QoL, and empowerment, especially in patients with poor status at baseline.     

The effect of religiosity on quality of life in Muslim patients with heart failure: a study in Qom,the religious capital of Iran

Due to the low quality of life (QoL) in patients with heart failure, many researchers attempted to find new ways to improve the QoL in these patients. This study was conducted to determine the relationship between QoL and religious attitudes of patients with heart failure. In this cross-sectional study, 130 male and female patients with heart failure were selected based on the inclusion criteria. Data were collected using 36-item short form Quality of Life and structured Religious Attitude Questionnaires. The average age of subjects was 59.50?±?12.29; also, 52.3% of them were female. A significant relationship was observed between patients’ QoL and their religious attitudes in mental (p?=?.03) and general health (p?=?.04) dimensions, but religious attitude had no significant correlation with physical health dimension (p?=?.66) and the total score of QoL (p?=?.30). At the end, it was concluded that religious beliefs can improve patients’ quality of life.