Spiritual Health and Outcomes in Muslim ICU Patients: A Nationwide Cross-Sectional Study

The aim of the present study is to describe how religiosity and spirituality affect the psychiatric morbidity of Muslim intensive care unit (ICU) patients. We conducted a prospective nationwide cross-sectional study of ICU patients discharged from 45 medical centers spanning 31 proivinces in Iran. Adults (age ≥ 18 years) admitted to the ICU and treated with invasive mechanical ventilation were eligible. Nine validated survey tools were administered to detect direct and indirect associations between spiritual health (SH) and depression, anxiety, and post-traumatic disorder. The Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale—Revised (IES-R), Post-Traumatic Stress Syndrome 14 question (PTSS-14) quality-of-life (QoL), and quality of patient to physician or nurse communication (PP-QoC and PN-QoC) scales were modeled through two mediators by structural equation modeling (SEM). Sex, ICU type, LOS, and APACHE II score were added in the independent variable list. 338 eligible patients were discharged from the ICUs during the study period. 56 were excluded (clinical status), and 282 were administered the survey. 278 returned it, with 272 complete and 6 partial responses. SH displayed no direct or indirect association to QoL. SH was indirectly associated with decreased depression and anxiety (B = ? 0.081, p < 0.05) via PP-QoC mediator. Both direct and indirect positive associations were observed between SH and IES-R (B = 0.293, p < 0.05; via PP-QoC) and PTSS-14 scores (B = 0.267, p < 0.001; via PP-QoC). Medical ICU location was associated with decreased PTSS-14 scores via the same mediator. In this survey of Muslim ICU patients treated with invasive mechanical ventilation, SH correlated with decreased depression and anxiety, but paradoxically increased post-traumatic stress. The most influential mediator was patient–physician quality-of-communication.     

Post-Adoption Services for High-Risk Families and Their Children: Preliminary Results of a State-Wide Intervention

Despite well-documented post-adoption needs of adoptive families, most states provide no or very limited post-adoption services. This study describes Right Turn® (RT), a state-wide program for strengthening adoptive families and preventing adoption dissolution. Results suggest: (a) RT is serving its targeted audience of adoptive families with challenging problems indicated by older adopted children with a history of multiple placements, extended time in social services systems, and a host of mental health challenges; and (b) adoption training, family support when navigating access to post-adoption services, and collaboration with adoption-competent therapists appeared to have helped improve program outcomes.     

选择最佳证据加强多学科协作

循证医学给医学带来了一次变革,极大地促进了医学的发展,使医生在对患者的诊治过程中有证可循,大大提高了临床诊治的准确性,也使各种诊治方法趋于规范化.循证医学首先强调的是应用当前所能获得的最好的研究证据,那么什么是最好的研究证据?如何获得最好的研究证据?又如何通过运用循证医学使患者得到最佳的治疗效果呢?本期"临床决策研究"栏目中陈懿等撰写的文章"循证医学与实事求是"对此进行了深入的探讨和评论.     

五岳同祈 祝福中华——道教界隆重举行庆祝新中国60华诞系列文化活动

为了表达道教界对新中国60华诞的热烈庆贺和虔诚祝福,进一步发扬道教“爱国爱教、团结进步”的优良传统,展现道教“护国佑民、济世利人”的真诚情怀,发挥道教在构建和谐社会和促进经济社会发展中的积极作用,在国家宗教局的大力支持下,由中国道教协会主办,