冠状动脉介入治疗的合理应用

近年来我国的冠心病介入治疗迅速发展,但有许多问题必须引起注意。本文讨论了我国目前冠脉介入治疗存在的问题;如何正确选择冠心病介入治疗、冠状动脉搭桥和药物治疗;重视冠脉介入手术病人的综合治疗等问题。     

辩证地探讨精神应激与冠心病的关系

冠心病是严重威胁人们生命和影响生活质量的一种心身疾病,精神应激不仅是不可忽略的重要危险因素之一,而且是一种致病因素。但是精神应激不一定都会引起冠心病,这其中有个体的基因素质和心理素质的作用。它的中介机制主要有脂肪途径和非脂途径。     

宠物犬对"空巢父母"身心健康影响的研究

采用量表法以642个成年人为被试研究了是否拥有宠物犬、依恋宠物犬和身心健康之间的关系。差异检验表明,饲养宠物犬的空巢父母身体更健康,一年内就医次数更少、生活满意感更高。相关分析表明,是否拥有宠物犬与身心健康显著相关。回归分析表明,是否拥有宠物犬、依恋宠物犬对就医次数和生活满意感有较好预测作用。     

构建高质量的外科医学教育体系

医学教育是贯穿医疗职业生涯全过程的行为,是伴随医学进步和发展的重要工程.医学教育的质量直接影响医疗的质量和医学人才的素质,尤其是外科学领域,是以有创性的手段、方法治疗疾病.医生的职业素养、医疗水平均取决于医学教育的结果.医疗质量不能简单地用医生的学历衡量,学历教育是载体,其中应充实培养能力的教育项目、内容,以适应未来就职、就业的社会需求.医疗质量、医疗水平对医院而言是生命线,是生产力.同时,医生的教育及教育的质量是医疗质量的基础与保障.随着医学的飞速发展,医疗技术的日新月异,医学模式的改变,构建新的医疗环境下的医学教育体系,显得更为重要.     

Depression Screening,Assessment, and Treatment for Patients with Coronary Heart Disease: A Review for Psychologists

Depression prevalence is between 15% and 20% in coronary heart disease patients, such as those with angina, or after a myocardial infarction or coronary artery bypass graft surgery. The presence of depression places a coronary heart disease patient at twofold higher risk for further major cardiac events and death, as well as poor quality of life and early exit from the labour force. As a consequence, several learned societies, including the National Heart Foundation of Australia, have published guidelines that recommend questionnaire screening to improve identification and management strategies for depression in coronary heart disease patients. Psychologists in hospitals, community settings, and private practice can have a key role in the realisation of the National Heart Foundation of Australia's aims. We review the recent guidelines and outline implications for psychologists to identify and manage depression in coronary heart disease patients. The evidence reviewed suggests that cognitive‐behavioural therapy and problem‐solving therapy are frontline non‐pharmacological interventions for depression in CHD patients.     

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.     

冠心病诊治中的过度医疗

近年来,过度医疗问题引起了医学伦理学界的普遍关注。过度医疗是一个经济现象,同时也是一个伦理问题．确切的说是一个医学一社会问题。结合冠心病过度医疗的特点,从医学伦理学角度剖析冠心病过度医疗的原因,并提出了医者、患者、医疗机构和社会针对冠心病过度医疗应采取的措施。     

肿瘤内科治疗的疗效评价

肿瘤内科治疗是肿瘤综合治疗三大手段之一,在肿瘤治疗中占有举足轻重的地位。肿瘤内科治疗的疗效评价也逐步发展和完善。新的疗效评价指标逐渐被接受,延长生存期和提高肿瘤病人的生存质量已成为肿瘤内科治疗疗效评价的原则,临床肿瘤学工作者应转变观念,以利于更好地开展临床工作。     

Quality of Life in Heart Transplant Candidates

Research on quality of life with heart transplant patients is complicated by the physical and psychological variables associated with heart failure. This study examined quality of life with several instruments in order to sample more general and more idiosyncratic aspects of quality of life in this particular patient population. We also examined the relationship between various aspects of quality of life and several psychosocial variables, including sensitivity to social desirability effects. The quality of life measures used in this study were found to be significantly correlated with each other and with measures of psychological distress. Implications of these findings are discussed.     

浅析阿尔贝特·施韦泽的医学伦理人格

阿尔贝特·施韦泽作为20世纪西方社会中极具影响力的人物,他所主张的敬畏生命的伦理思想固然值得我们今天学习研究、发扬光大,而他作为一名著名医学家,他传奇智慧的人生中所进行的一系列医学实践活动,更是展示了他热爱生命、热爱人类、热爱医学、富有理想、淡泊名利、甘于奉献医学的高尚医学伦理人格、炽热的医学伦理情怀,更值得我们当今每一位医务工作者和在校医学生敬仰、学习。     

冠心病患者用药管理与个性化健康指导效果研究

选取2018年2月~2019年5月首都医科大学附属北京康复医院接收的132例冠心病患者作为研究对象,采用随机数字法将研究对象分为对照组(67例)与干预组(65例)。对照组给予常规冠心病治疗,干预组在对照组基础上给予用药管理与个性化健康指导,两组干预时间均为8周。干预前两组相关指标比较无统计学差异(P>0.05)。干预后,两组服药依从性、生活质量均有提高(P<0.05),且干预组高于对照组(P<0.05);两组焦虑、抑郁自评值均有降低(P<0.05),且干预组焦虑、抑郁自评值均低于对照组(P<0.05)。研究表明,用药管理与个性化健康指导对冠心病患者有积极效果。     

Variables that favour successful ageing / Variables que favorecen un envejecimiento exitoso

Abstract

The construct of successful ageing appears in the sixties, with a focus on physiological factors. However, its definition progressively develops into a more multidisciplinary construct and begins to include psychological, psychosocial and environmental factors; today, all these aspects are seen as essential to its study. In this monograph devoted to successful ageing, both this work and those that appear beside it aim to highlight the different areas of research that have been forged — mainly from psychology but also, in certain cases, together with associated disciplines — to try to outline a comprehensive model of ageing with the ultimate goal of creating intervention tools to foster successful ageing. Thus, this issue analyses the roles played by the Mediterranean diet, resilience, training programmes and training caregivers, among others, as explored by different experts in the area in an attempt to unveil the keys to ageing successfully from a psychosocial perspective.     

三级查房制度在围手术期管理中的实践与思考——以日间手术为例

三级查房制度是我国十八项医疗质量核心制度之一。围手术期落实三级查房制度能够推动高质量手术开展,促进术后高效率康复,降低围术期医疗成本,实现良好的医疗体验。日间手术的开展存在“分散”“集中”两类管理形式,在三级医生的划分、查房形式、频率及记录等细节上仍存在问题。通过组建跨科三级医疗团队、借助信息化技术实现远程查房、拓展住院查房概念实现“院外+院内”全程查房与全程记录等措施,既符合三级查房制度的初衷,又实现该制度实施细节的优化,能够促进日间手术“更高质量、更快康复、更低成本、更优体验”的目标的实现。

     

Structural Evaluation of the Contemporary Psychological Models of Chronic Pain: Does Fear of Pain Work for All?

The aim of the present study was to test Turk and Okifuji's (2002) model of chronic pain and in particular the moderating role of self-efficacy. We assessed 207 consecutive chronic pain patients (53.1% female) on a range of relevant measures and tested the model using structured equation modelling. The model was supported. These results support Turk and Okifuji's model of chronic pain and suggest that it can account for the relationships between variables in chronic pain patients. In particular, the results support the central role of fear-based avoidance and self-efficacy in chronic pain. Future research should be aimed at testing the alternative contemporary models of chronic pain at different stages of the development and maintenance of chronic pain and over time.     

心脏病患者非心脏手术风险的规避

社会老龄化,老年人口的相对比例以及绝对值不断增长,外科手术患者中合并心脏病的患者比例也在不断增加。这类患者都具有较高的围手术期心肌梗死、心衰及心源性死亡的危险。如何评价这些患者的围手术期风险,细致调整心脏病用药,使患者获得最佳治疗,保证患者的医疗安全,同时避免术前不必要的检查。     

The Role of Optimism/Pessimism in HRQOL in Chronic Hepatitis C Patients

One hundred and twenty three outpatients with compensated chronic hepatitis C (CHC) completed the SF-36, BSI, and questions regarding the expected impact of CHC on their health. Respondents were categorized as optimists (N = 17, 13.8%), realists (N = 98, 79.6%), and pessimists (N = 8, 6.5%). Pessimism was associated with lower scores on nearly all SF-36 subscales (p < .001 –.03) and higher scores on 6 BSI subscales indicative of greater emotional distress (p < .05). Pessimism was not associated with demographics, liver disease severity, substance abuse, or comorbid medical conditions. However, pessimism was associated with the presence of a psychiatric comorbidity and self-reported health status (p < .05). We conclude that optimism/pessimism may be an important determinant of QOL and emotional status in CHC patients and that additional studies of cognitive predispositions and coping skills in CHC patients are warranted.     

从冠心病主要危险因素的流行特点谈医学模式的转变

随着人民生活水平的提高,冠心病的发病率呈逐年上升趋势,不仅造成个人很高的致残率或致死率,而且给家庭和社会带来沉重的经济负担,冠心病已成为当前一个重要的公共卫生问题。而冠心病是一个多病因疾病,是可防可控的。充分了解冠心病危险因素的流行现状及危害,转变理念,着眼预防,逐步改变目前"重治轻防"的医学模式,是我们心血管医生神圣的使命。