乳腺癌患者自我管理行为与生活质量的相关性研究

探讨乳腺癌患者自我管理行为、生活质量及两者之间的相关性.应用慢性病自我管理研究测量表中的自我管理行为量表、乳腺癌患者生活质量测定量表调查260例乳腺癌患者的自我管理行为和生活质量.乳腺癌患者自我管理行为及生活质量现状均不理想,自我管理行为与生活质量呈正相关（P＜0.05）.乳腺癌患者自我管理行为与生活质量间有密切关系,临床护理工作中可对患者进行护理干预来增强其自我管理行为,进而提高生活质量.     

广泛期小细胞肺癌一线化疗进展

小细胞肺癌(small cell lung cancer,SCLC)生长迅速,具有高度的侵袭性,就诊时多数患者已发生远处转移,对于广泛期小细胞肺癌,治疗仍以全身化疗为主,在过去30余年里,EP/CE方案作为标准一线化疗方案在治疗广泛期小细胞肺癌中取得了较高的缓解率,但多数患者在化疗停止6个月内疾病发生进展,2年的生存率不足5％,我们需要更加积极有效的一线化疗方案,本文综述了近10余年来广泛期小细胞肺癌的一线化疗进展.     

胃部恶性肿瘤临床实践中的医疗艺术

医学是一门讲求艺术性的科学.随着社会的发展,医疗艺术在整个医学临床实践中的重要性越来越突出.医疗艺术体现了医生对生命的尊重和伦理的理解.讲求医疗艺术对于建立和谐的医患关系具有重要意义.因此,如何在过硬的现代医学技术基础上提高临床医疗的艺术性,是医学教育和临床实践领域都应该思考的问题.本文以胃部恶性肿瘤的临床实践为例,从态度、语言、表情以及医患互动等细节方面入手,探讨在初诊、术前、康复以及面对晚期临终患者的不同情况中应该如何提高医疗艺术.     

胰腺癌综合治疗面面观

在胰腺癌的综合治疗中,手术切除是清除肿瘤负荷的最有效的局部治疗方法,但其效果会受到胰腺癌恶性行为和解剖位置的限制.从“重视全面、避免关注片面”的哲学高度,科学看待手术和其他综合治疗手段的关系和意义,有助于对胰腺癌的综合治疗有一个正确的理解,也有助于临床治疗措施的制定.本文首先对胰腺癌治疗过程的若干问题进行再思考,在此基础上再认识胰腺癌的综合治疗,最后对胰腺癌诊治发展进行展望,以期有一个相对全面的解读.     

代谢组学在结直肠癌中的研究进展

结直肠癌是常见的恶性肿瘤,近年来其发病率和病死率都很高,因此做到早发现、早诊断、早治疗很有必要,肿瘤标志物在结直肠癌的诊治中发挥了重要作用,但癌胚抗原等传统肿瘤标志物远远不能满足临床需要,代谢组学的出现解决了这一难题.代谢组学是近年来新发展起来的一门组学技术,随着各种代谢组学分析技术的发展和联用,使其在结直肠癌中有着越来越深入的研究,可用此技术在结直肠癌患者的组织、血液和尿液中寻找差异性代谢产物作为新的肿瘤标志物,在结直肠癌的诊断和治疗上有很大优势.本文将对代谢组学的概况及其在结直肠癌中的研究进展做一综述.     

早期乳腺癌患者术后心理状况研究

早期乳腺癌的检出率越来越高,关注治愈率同时,人们越来越关心患者术后的心理状态及生活质量.本文对保乳术及根治术后5年患者进行心理调查.保乳组患者术后心理障碍发生率明显低于根治组.保乳组患者术后心理状况影响因素主要为术后美容效果,而根治组患者心理障碍发生率与年龄、职业、家庭收入相关.两种手术方式对患者5年生存率及无病生存率的影响无明显差异,所以对于早期乳腺癌患者,在符合保乳原则的前提下,保乳手术是一种既安全又能提高生活质量的手术方式.     

Treatment-related anxieties in children and adolescents with cancer

Abstract

Side-effects of anti-cancer treatment like nausea and vomiting and frightening medical procedures are relevant sources of anxiety in children and adolescents with cancer. Anticipatory nausea and vomiting can be described in terms of respondent conditioning. Hypnosis, systematic desensitization, relaxation training and employment of video-games are effective in mitigating these unpleasant concomitants of chemotherapy. Venipunctures, bone marrow aspirations, and lumbar punctures are repetitive painful procedures. Responses of pain and anxiety are ubiquitous, but still difficult to differentiate by psychological assessment. Rating scales and checklists have been developed to evaluate various intervention programs. Hypnotherapeutic approaches and comprehensive cognitive-behavioral treatment packages have been employed successfully to reduce anxiety reactions. In the future, it might be promising to match specific intervention programs with the coping behaviors spontaneously shown by the child; for instance, patients avoiding anxiety-provoking stimuli should be supported by additional distraction techniques, whereas vigilant patients that spontaneously focus their attention on these stimuli should be shown how to transform them in a positive context.     

Theology and Epidemiology as Complementary Perspectives on Aging

ABSTRACT

The religiousness of individuals and communities can be effective resources for healthcare practitioners serving older Americans. Such effectiveness can be more fully realized if theology and epidemiology are recognized as complementary ways of understanding aging and health. The ways in which theologians and epidemiologists can be complementary consist of the different modalities of hope they engender, the different types of preferential recollection they exercise, and the different stages of life they address. The complementarity of theology and epidemiology is dependent upon a spiritual but not supernatural conception of the relationship between religion and health.     

Cancer survivors’ and partners’ key concerns and quality of life

Objective: Understanding the concerns of cancer survivors is essential for effective interventions. This study was designed to identify the primary concerns of dyads coping with cancer, how concerns differed by role and sex, and whether concerns expressed during counselling were associated with survivors’ psychosocial well-being and adjustment.

Design: Forty-three dyads with breast and prostate cancer (N = 86 participants) were enrolled in an interpersonal telephone counselling intervention. Audio recordings of 228 counselling sessions were transcribed and content analysed qualitatively to identify major themes and key concerns. A total of three 30-min sessions were coded for each study participant. Quantitative data and statistical analyses were used to predict changes in survivors’ quality of life.

Main Outcome Measures: Participants completed psychosocial well-being measures (depression, positive/negative affect, and relationship satisfaction), pre- and post-counselling.

Results: Survivors’ concerns focused on cancer- and treatment-related issues, whereas partners’ concerns centred on the well-being of their spouse/partner with cancer, and what they were doing to help their loved one cope with his/her illness. Key concerns for all consisted of relationship maintenance and communication issues. Further, discussion of these concerns was predictive of significant improvements in adjustment post-counselling for women with breast cancer.

Conclusion: Discussion of interpersonal concerns may play a more important role in the well-being of women, than men, coping with cancer.