腰椎间盘突出症患者MED术前心理状态调查与分析

为了研究腰椎间盘突出症患者行MED微创治疗前的心理状况,对442例行MED手术治疗的患者应用焦虑自评量表（SAS）、抑郁自评量表（SDS）进行术前心理评估。结果显示MED微创治疗前患者SAS、SDS测量分明显高于常模组。患者性别、年龄、婚姻状况、文化程度、病程长短等都与心理状况的改变相关。有34.9%的患者SAS得分和36.7%的患者SDS得分显示阳性。因此,临床骨科医师应重视心理因素的作用,在MED术前应对患者进行心理状况评估,并对心理状况较差的患者进行术前干预,才能取得更好的临床疗效。     

U.S. mental health policy. Doomed to fail.

Changes in the de facto system of mental health care in the last decade reflect organizational and entrepreneurial responsiveness to changes in health policy, not mental health policy. Various other actions described here reduced statutory or institutional leadership roles in mental health and increased the pace at which mental health policy was becoming dependent on health policy. In turn, U.S. health policy in the 20th century has been inherently flawed. The short-term general hospital--the "doctors' workshop"--emphasizing acute care and surgery, has been the cornerstone of U.S. health policy throughout the 20th century. The mimicry of health services by mental health leads to demonstrably more expensive and less effective mental health care and dooms mental health policy to failure.     

Mechanisms by which childhood personality traits influence adult health status: educational attainment and healthy behaviors.

OBJECTIVE: The purpose of this study was to test a life span health behavior model in which educational attainment and health behaviors (eating habits, smoking, and physical activity) were hypothesized as mechanisms to account for relations between teacher ratings of childhood personality traits and self-reported health status at midlife. DESIGN: The model was tested on 1,054 members of the Hawaii Personality and Health cohort, which is a population-based cohort participating in a longitudinal study of personality and health spanning 40 years from childhood to midlife. OUTCOME: Childhood Agreeableness, Conscientiousness, and Intellect-Imagination influenced adult health status indirectly through educational attainment, healthy eating habits, and smoking. Several direct effects of childhood traits on health behaviors and health status were also observed. CONCLUSION: The model extends past associations found between personality traits and health behaviors or health status by identifying a life-course pathway based on the health behavior model through which early childhood traits influence adult health status. The additional direct effects of personality traits indicate that health behavior mechanisms may not provide a complete account of relations between personality and health.     

Betrayal Trauma,Health Care Relationships,and Health in Patients with a Chronic Neurovascular Condition

Individuals who have been exposed to trauma are at a greater risk of developing a chronic physical health condition and use health services more frequently than individuals who have not experienced trauma. The mechanism by which trauma affects health is not fully understood, but relationships with health care providers could be important in understanding this association. The purpose of this study was to explore the relationships among betrayal trauma, health care relationships, and physical and mental health in a chronic medical population. Participants (N = 272) diagnosed with a chronic neurovascular condition (cavernous malformation) completed an online survey. Questionnaires assessed self-rated health, instances of betrayal trauma, posttraumatic stress disorder (PTSD) and depression symptoms, income, and other demographic factors, and health care relationships. Level of income and the experience of betrayal trauma predicted mental health symptoms (depression, PTSD, or both) and also predicted health care relationships. After controlling for income and previous trauma, mental health symptoms significantly predicted health care relationships. Finally, mental health symptoms, health care relationships, and income predicted self-rated health, although the associations were not straightforward. These results suggest complex interrelations among trauma, mental health, income, health care relationships, and physical health, and a model is proposed for explaining these associations.     

高师生心理健康教育实验研究

本文采用自然教学实验的研究方法,探讨心理健康教育对高师生健康信念、健康行为和健康水平的影响,以高师９５级大学三年级学生１２６个为实验组,进行５４个课时的心理健康课程教学,并以同校同级学生１０９个对照组。采用健康信念和健康行为调查表和Ｃａｗｔｅ健康量表,对实验组和控制组被试进行调查和测试。结果表明,心理健康教育不仅明显改善了高师生的健康信念和健康行为,而且提高了他们的身心健康水平。     

Online Information and Communication Systems to Enhance Health Outcomes Through Communication Convergence

The growing use of digital health communication channels has produced dramatic changes, providing broad access to information for making health decisions and addressing users' emotional needs. Digital health communication channels combine mass and interpersonal communication in different ways. Type 1 convergence occurs sequentially: Individuals obtain health information online that they discuss interpersonally with health providers. Type 2 convergence involves discussions occurring via online health information systems. The effectiveness of these systems depends upon seven communication design and implementation strategies. Emerging interactive health information systems provide customized responses tailored to individuals' specific needs and situations. All these forms of media convergence can improve health education, health promotion, and health behavior change.     

Health promotion from the perspective of social cognitive theory

Abstract

This article examines health promotion and disease prevention from the perspective of social cognitive theory. The areas of overlap with some of the most widely applied psychosocial models of health are identified. The models of health promotion and disease prevention have undergone several generational changes. We have shifted from trying to scare people into health, to rewarding them into health, to equipping them with self-regulatory skills to manage their health habits, to shoring up their habit changes with dependable social supports. These transformations have evolved a multifaceted approach that addresses the reciprocal interplay between self-regulatory and environmental determinants of health behavior. Social cognitive theory addresses the socio structural determinants of health as well as the personal determinants. A comprehensive approach to health promotion requires changing the practices of social systems that have widespread detrimental effects on health rather than solely changing the habits of individuals. Further progress in this field requires building new structures for health promotion, new systems for risk reduction and greater emphasis on health policy initiatives. People's beliefs in their collective efficacy to accomplish social change, therefore, play a key role in the policy and public health approach to health promotion and disease prevention.     

Parental illness,attachment dimensions,and health beliefs: testing the cognitive-behavioural and interpersonal models of health anxiety

The cognitive-behavioral and interpersonal models of health anxiety propose that parental illness could be a contributory factor to the development of health anxiety but through different mechanisms. The cognitive-behavioral model suggests that exposure to parental illness may lead to health beliefs that could increase health anxiety. In contrast, the interpersonal model proposes that parental illness may contribute to the development of an insecure attachment pattern and consequently health anxiety. To assess the additive value of the models, 116 emerging adults (i.e. aged 18–25) who had a parent diagnosed with a serious medical illness (e.g. cancer, multiple sclerosis) completed measures of health anxiety, adult attachment dimensions, and health beliefs. Attachment anxiety, attachment avoidance, health beliefs, and death of the ill parent were statistically significant predictors of health anxiety. The results provide support for both models of health anxiety. Theoretical implications and directions for future research are discussed.     

Associations between social capital and health status in an Australian population

This study investigated the association between social capital and health related quality of life in a sample of Australian adults. Information was collected from a sample of adults in Queensland, Australia relating to health status, health related quality of life and related social determinants of health by computer-assisted-telephone-interview survey. Significant associations were observed between social capital and physical health when adjusting for selected demographic measures. No significant association was observed between social capital and mental health. The research produced equivocal results regarding the associations between social capital and the selected measures of health-related quality of life. Evidence is presented in support of the association between social capital and physical health status, whereas no associations were observed between mental health status and social capital. The role and relationship between health and social capital remains elusive. More work is required to clearly support social capital's role in physical and mental health and well-being.     

Concepts of health and illness: different constructs or variations on a theme?

Although health and illness concepts are thought to be important mediators of health and illness behaviors, little work has been done examining health concepts, and no research has examined the two conceptual structures simultaneously. This study examined concepts of health and illness in 218 adolescents between the ages of 11 and 18 years. Results were consistent with the hypothesis that concepts of health and illness are not opposite ends of a single health dimension, but reflect different and overlapping constructs. The degree of overlap varied as a function of age, with health concepts showing less emphasis on "the absence of illness" with greater maturity. The results suggest that models of health behavior that focus on illness avoidance neglect many components of health salient to lay persons.     

Perceived overqualification and health: a longitudinal analysis

The authors examined the effects of perceived overqualification on health and health decline by means of a 2-wave panel study of members of a midwestern American Postal Workers Union local. The 1st hypothesis was that overqualification was negatively related to health at Time 2 (T2); the second hypothesis was that overqualification was positively related to perceived health decline at T2. Neither was supported by the data. However, the relationships were in the expected direction for perceived mismatch but not for the perceived no grow dimension of overqualification. The results imply that perceived no grow may have immediate threats to health, whereas perceived mismatch may have longer term implications for health. The stability of perceived health between Time 1 (T1) and T2 could overshadow a longitudinal effect of overqualification on health and health decline at T2.     

Perceived Overqualification and Health: A Longitudinal Analysis

Abstract

The authors examined the effects of perceived overqualification on health and health decline by means of a 2-wave panel study of members of a midwestern American Postal Workers Union local. The 1st hypothesis was that overqualification was negatively related to health at Time 2 (T2); the second hypothesis was that overqualification was positively related to perceived health decline at T2. Neither was supported by the data. However, the relationships were in the expected direction for perceived mismatch but not for the perceived no grow dimension of overqualification. The results imply that perceived no grow may have immediate threats to health, whereas perceived mismatch may have longer term implications for health. The stability of perceived health between Time 1 (T1) and T2 could overshadow a longitudinal effect of overqualification on health and health decline at T2.     

Psychosocial Predictors of Health Status and Health Care Costs among People with Fibromyalgia

The purpose of the present study was to examine the effects of psychosocial characteristics on health status and the relationship between health status and health care use and costs in a group of people with fibromyalgia (FMS) over a 1-year period. The participants were 600 members of a large health maintenance organization. Demographic characteristics (age, education, employment status, ethnicity and income), need variables (comorbid conditions and baseline health status), and psychosocial variables (self-efficacy, helplessness, coping, and depression) were examined. Better health status at baseline, use of emotion-focused coping, and higher self-efficacy predicted better health status the following year. Higher health care use at baseline, being Caucasian, being older, and having more co-morbid conditions predicted higher health care use at 1 year. Only health care costs at baseline predicted health care costs the following year. Our results indicate that health care use and cost tend to be stable. Intense interventions focused on changing patterns of health care use and methods for coping with the change need to be developed and tested.     

墨西哥医疗保障体系改革及其对我国的借鉴

墨西哥近年的医疗卫生改革取得了巨大的成就。通过简要地描述墨西哥人群健康状况、医疗卫生资源现状、卫生系统绩效以及与中国的比较,分析了墨西哥三轮卫生改革的特点、存在的问题以及面临的挑战,旨在提出墨西哥卫生系统与医疗保障体系改革对我国医疗卫生改革的启示和借鉴。     

论公共卫生决策的伦理模式

公共卫生决策的伦理问题是公共卫生伦理研究的一个核心问题。近年来我国公共卫生领域出现了大量严重的伦理问题,其主要根源在于公共卫生决策的伦理缺失。强调指出公共卫生伦理决策应当树立科学健康观,并以此为基础,从转变政府职能、强化公共卫生信息系统和加大政府投入等方面详细论述了公共卫生伦理决策的一种新模式。     

Promoting Mental Health Equity: The Role of Integrated Care

People suffering from mental illness experience poor physical health outcomes, including an average life expectancy of 25 years less than the rest of the population. Stigma is a frequent barrier to accessing behavioral health services. Health equity refers to the opportunity for all people to experience optimal health; the social determinants of health can enable or impede health equity. Recommendations from the U.S. government and the World Health Organization support mental health promotion while recognizing barriers that preclude health equity. The United States Preventive Services Task Force recently recommended screening all adults for depression. The Satcher Health Leadership Institute at the Morehouse School of Medicine (SHLI/MSM) is committed to developing leaders who will help to reduce health disparities as the nation moves toward health equity. The SHLI/MSM Integrated Care Leadership Program (ICLP) provides clinical and administrative healthcare professionals with knowledge and training to develop culturally-sensitive integrated care practices. Integrating behavioral health and primary care improves quality of life and lowers health system costs.     

我国大学生心理健康教育研究的现状与展望

大学生心理健康教育研究已经成为我国心理学研究的一项重要课题。只有对大学生心理健康教育研究的现状有所了解,才能够更好地进行大学生心理健康教育。文章从理论研究和实证研究两方面阐述了当前我国大学生心理健康教育研究的现状,其中理论研究包含了大学生心理健康教育的内容、途径、模式研究;实证研究则包括了大学生心理健康状况的研究、大学生心理健康与自我概念相关的研究以及大学生心理健康教育研究方法的研究。最后展望了我国大学生心理健康教育研究的趋势。     

我国妇幼保健机构公共卫生属性淡化的机制研究

妇幼卫生是公共卫生体系的重要组成部分,妇幼保健机构是妇幼卫生工作的实现主体,为了促进我国妇幼保健机构的健康和可持续发展,提高妇女、儿童健康水平,通过对妇幼保健机构的社会功能、行为动因和行为特征的系统分析,构建出妇幼保健机构公共卫生属性淡化的作用机制模型.公共卫生的实质是公共政策,建议政府要实现市场机制与政府宏观调控的有机结合,促进妇幼保健事业健康发展.     

健康教育对大学生心身健康影响的研究

为探讨健康教育对大学生心身健康影响的效果,将非医学专业的大学生分为健康教育干预组(97名)和对照组(93名);干预组进行了近12周健康教育选修课,采用了课堂教学、团体和个别辅导、同伴教育等,分别采用症状自评量表(SCL-90)进行前后对照测试.结果发现,教育后的多项指标明显低于教育前,说明健康教育对大学生心身健康水平是很有效果的.     

The effect of health value and ethnicity on the relationship between hardiness and health behaviors

Associations among hardiness, health value, and health protective behaviors were examined as a function of ethnicity among 80 African American and 100 European American college students. The role of health value as moderator versus mediator in the hardiness-health behavior link was explored. Racial differences in correlations among hardiness, control, and commitment were found, with stronger relations for African American than European Americans. Moderate positive relations between hardiness, control, commitment, and health value for African American, as contrasted with weak relations between commitment and health value for European Americans, were also shown. A partial mediational effect for health value with personal distress and moderator effects for health value with personal distress and health habits were found for African American only. Race predicted hardiness variables, tobacco and alcohol use, personal distress, and health habits beyond what was accounted for by occupation and income. The ramifications of these data with regard to future studies on hardiness, health value, and health behaviors for African American are discussed.