品管圈对卒中偏瘫患者肢体功能锻炼的效果观察

探讨品管圈活动在卒中偏瘫患者肢体功能锻炼中的应用效果。将66例患者随机分为对照组（常规锻炼组）和试验组（品管圈组）,分别行不同模式的功能锻炼。采用康复护理日常生活活动（RNADL）量表分别对其日常生活活动能力（ADL）进行评定。试验组自理能力高于对照组,差异有统计学意义（P〈0．01）,且其依从性与对照组比较,差异有统计学意义（P〈O．05）。品管圈有助于提高卒中偏瘫患者功能锻炼的依从性。     

Perseverative thoughts and subjective health complaints in adolescence: Mediating effects of perceived stress and negative affects

Stable tendency to perseverative thoughts such as trait rumination and worry can influence somatic health. The purpose of the study was to investigate the relationship between perseverative thoughts and somatic complaints, and the possible mediating effects of perceived stress, negative and positive affectivity in adolescence. Having an acute or a chronic condition was also assessed to be controlled for and to reveal their effects on symptom reporting. Three hundred and six adolescents from 7th to 12th grade with mean age of 16.33 (SD = 1.29) participated in the study. Mediation analysis suggested that impact of trait-like perseverative thoughts on complaints were mediated by perceived stress and negative affectivity. Having an acute condition had also an effect on symptom reporting through increased negative affectivity. Our results highlight that ruminations or worry as stable intrapersonal characteristics are relevant processes in health and can be potential targets in prevention programmes in adolescence.     

The psychosocial predictors of long-term distress in partners of patients with acute coronary syndrome

Objective: Partners of acute coronary syndrome (ACS) patients are at risk of experiencing long-term distress and the purpose of this study was to identify its predictors.

Design: Using an observational design, 80 partners of ACS patients completed validated questionnaires at three time points. The predictor variables, marital satisfaction and optimism were assessed three weeks after patient hospital discharge (T1). The outcomes, depressive symptoms and physical health status (from a quality of life scale) were measured 6 (T2) and 12 (T3) months post-discharge, and scores were combined to indicate the long-term response.

Main outcome measures: Depressive symptoms and physical health status.

Results: Partner depressive symptoms increased and physical health status deteriorated over the months following the patients’ ACS. After controlling for demographics, clinical severity of ACS and T1 levels of the outcome variable, partners’ long-term depressive symptoms were predicted by poor marital satisfaction and low optimism at T1, and poor physical health status was predicted by low T1 optimism.

Conclusion: Psychosocial factors are predictors of long-term distress for ACS partners. Partners in an unhappy marriage or with low optimism after ACS are at an increased risk of depression and low physical health status, and should be the target of additional support.     

The short-term influence of high and low intensity physical exercise on mood

Abstract

This study was designed to replicate and extend previous observations that the acute response to high intensity exercise is an increase in anxiety and other negative feelings. Forty female volunteers were allocated to two conditions—20 exercised at high level (100W) for 1.5 min, while 20 exercised at a low level (ZW). The purpose of the experiment was disguised. Mood was assessed before. during and immediately after exercise, and over a 1.5-min recovery period. Subjects were subsequently divided into highly and moderately fit groups on the basis of cardiac responses to a standard workload. It was found that tensiodanxiety increased immediately after high intensity exercise, declining over the recovery period. A similar pattern was found for mental fatigue. During exercise itself, anxiety diminished in the low but not the high intensity condition, No differences between fitness groups were observed in these patterns, although highly fit subjects reported greater mental vigour and exhilaration than moderately fit subjects following high intensity exercise. The mechanisms that may mediate these responses are discussed.     

Cognitive predictors of posttraumatic stress symptoms six months following acute coronary syndrome

This study examined patients’ illness representations assessed shortly after an acute coronary syndrome (ACS) as predictors of posttraumatic stress symptoms six months later. Illness representations were assessed in ACS patients using standard measures at a home visit three weeks after discharge from hospital. Posttraumatic stress symptoms were assessed at the same time, and again six months later. Patients were aged 61 years on average, the majority being men (89.8%) of white European decent (89%). Greater posttraumatic symptoms at six months were associated with beliefs that the illness would last a long time (timeline), that it had an unpredictable time course (timeline – cyclical), greater consequences, less personal and treatment control, poorer illness coherence and stronger negative emotional representations (emotional upset relating to the illness; p?<?0.05). In multiple regression analyses, controlling for demographic, clinical and psychological factors (age, gender, ethnicity, social deprivation, ACS severity, negative affectivity and cardiac symptom recurrence), more intense emotional representations (β?=?0.146, p?=?0.041) and reduced illness coherence (β?=??0.133, p?=?0.029), emerged as independent predictors of posttraumatic symptom severity at six months. There was a near significant effect for personal control (β?=??0.113, p?=?0.058). These results demonstrate the importance of illness representations of ACS in predicting longer-term posttraumatic stress symptoms.     

The role of social support as a moderator of the acute stress response: In Situ versus empirically-derived associations

Abstract

This investigation was designed to (1) evaluate the role of social support during an acute naturalistic stressor i.e., emergency dental treatment, (2) assess whether an in situ and an empirical measure of support exhibited consistent relationships with anxiety and (3) examine the relationship between the in situ and empirical measures of support. All participants completed a measure of social support prior to treatment and an anxiety measure prior to and following treatment. The effect of support on pre-treatment anxiety, post-treatment anxiety and change in anxiety during the treatment process was assessed. According to the in situ support measure, individuals high in support were accompanied to the clinic, and individuals low in support were unaccompanied. According to the empirical support measure, individuals high in support had actual support scores above the sample median. Individuals low in support had actual support scores below the sample median. Individuals high in in situ support were found to have significantly higher levels of pre-treatment anxiety. No other effects of support were observed for either support measure. Furthermore, while there was some evidence that the in situ and empirical measures of support were associated with consistent outcomes, in the main, they exhibited independence.     

Tired,moody and pregnant? Exercise may be the answer

Negative psychological states such as depression, fatigue and anxiety are experienced by many women during pregnancy. This study examined whether engaging in an exercise programme during pregnancy is associated with improvements in psychological well-being among previously inactive women (n?=?56, M age?=?30.34, SD?=?4.57; M weeks pregnant?=?22.58, SD?=?5.32). Participants completed the Profile of Mood States–Short Form and State Trait Anxiety Scale-Trait version at baseline and after four weeks of exercise. Exercise was assessed using accelerometers and these data were used to determine bouts of 30-min of moderate-to-vigorous exercise. Factorial repeated measures ANOVAs demonstrated that participants who met Canadian guidelines for exercise during pregnancy at week four (n?=?17) experienced significant decreases in depression (p?=?.004, η²?=?.13), anger (p?=?.03, η²?=?.08), tension (p?=?.03, η²?=?.08), fatigue (p?=?.01, η²?=?.10), trait anxiety (p?=?.01, η²?=?.12) and increases in vigour (p?=?.001, η²?=?.19) compared to those who were not meeting guidelines (n?=?39). From a psychological health perspective, these findings highlight the importance of continuing to promote exercise during pregnancy.     

Failure to alter psychophysiological reactivity in type a men with physical exercise or stress management programs

Abstract

Psychophysiological reactivity has been associated with heightened risk of coronary heart disease. Since behavioral processes may contribute to disease etiology, the possibility arises that they might also contribute to disease prevention. The capability of behavioral interventions to modify exaggerated reactivity in Type A men. was therefore, brought under experimental scrutiny. Subjects were 107 male managers. who met the following criteria: (1) no history or current signs of heart disease. (2) presence of Type A behavior pattern, and (3) exaggerated psychophysiological reactivity to mental stress. After matching for age and physical fitness level. participants were randomly assigned to one of three 10-week intervention programs: aerohic training, weight training and cognitive-behavioral stress management. Heart rate and blood pressure were monitored while challenging mental tasks were performed in pre-training and post-training laboratory sessions before and after the intervention programs. Although participants in the two physical activity programs showed the expected physical adaptations, no changes in psychophysiological reactivity were seen in the three groups. This negative result may indicate either that reactivity was not altered owing to the conditions of the present experiment, or that these behavioral interventions are truly without effect.     

Stress management and exercise training in chronic stable angina pectoris

Abstract

Patients suffering from chronic stable angina pectoris were allocated to one of four conditions: stress management training, exercise training, combined stress management and exercise, or waiting list control. Patients undertook an exercise tolerance test before and after intervention, and at follow-up assessment eight weeks later. They also kept a daily diary of the frequency, duration and intensity of all angina episodes, and recorded the amount of medication taken, for the week preceding and the week following intervention, as well as for the eighth week of follow-up. Patients who undertook the combined stress management and exercise programme faired best. They showed sustained gains in achieved workload on the exercise tolerance test at no cost in terms of ischaemia, as measured by ST-segment depression. They also registered less frequent angina attacks following intervention than the exercise only and waiting list control patients, and reported reduced reliance on medication; the latter benefit was sustained at follow-up. These clinical dividends invite further study of combined stress management and exercise training in angina pectoris.