Helpful processes in psychological therapy for patients with primary cancers: A qualitative interview study

Aims: The purpose of this study was to identify what patients with primary cancers found helpful in therapy. Method: In‐depth qualitative interviews were conducted with eight patients who had completed a course of psychological therapy within an NHS psychology service for cancer patients. Data were analysed using thematic analysis. Results: The participants identified a range of helpful processes in therapy: talking and expressing their feelings to someone outside of the family; forming a relationship with their therapist; normalisation through the therapists' expert knowledge; problem‐solving and CBT. Limitations: As with all qualitative studies, the small sample and size and dependence on participant recall limits generalisability of the findings. Implications: The findings of this study are consistent with a pluralistic perspective: that multiple therapeutic processes ‐ aligned to a range of different orientations ‐ can be of value to patients with primary cancers. This supports the provision of a range of therapeutic interventions and strategies for this patient group.     

Construction and evaluation of a self rating scale for stress‐induced Exhaustion Disorder,the Karolinska Exhaustion Disorder Scale

Prolonged stress (≥ six months) may cause a condition which has been named exhaustion disorder (ED) with ICD‐10 code F43.8. ED is characterised by exhaustion, cognitive problems, poor sleep and reduced tolerance to further stress. ED can cause long term disability and depressive symptoms may develop. The aim was to construct and evaluate a self‐rating scale, the Karolinska Exhaustion Disorder Scale (KEDS), for the assessment of ED symptoms. A second aim was to examine the relationship between self‐rated symptoms of ED, depression, and anxiety using KEDS and the Hospital Anxiety and Depression Scale (HAD). Items were selected based on their correspondence to criteria for ED as formulated by the Swedish National Board of Health and Welfare (NBHW), with seven response alternatives in a Likert‐format. Self‐ratings performed by 317 clinically assessed participants were used to analyse the scale's psychometric properties. KEDS consists of nine items with a scale range of 0–54. Receiver operating characteristics analysis demonstrated that a cut‐off score of 19 was accompanied by high sensitivity and specificity (each above 95%) in the discrimination between healthy subjects and patients with ED. Reliability was satisfactory and confirmatory factor analysis revealed that ED, depression and anxiety are best regarded as different phenomena. KEDS may be a useful tool in the assessment of symptoms of Exhaustion Disorder in clinical as well as research settings. There is evidence that the symptom clusters of ED, anxiety and depression, respectively, reflect three different underlying dimensions.     

宫颈癌根治术前预处理减少输尿管损伤及下肢静脉血栓临床观察

通过对术前考虑盆腔粘连可能比较严重的宫颈癌根治术（RH）术中穿着医用弹力袜行双下肢弹力加压,并经膀胱镜放置输尿管导管作预处理,减少下肢静脉血栓及输尿管损伤的临床效果。回顾性研究在我院行手术治疗的术前考虑盆腔粘连可能比较严重的宫颈癌患者364例,其中182例接受广泛子宫切除及盆腔淋巴结清扫术,术中穿着医用弹力袜行双下肢弹力加压,作为研究组,另182例单纯接受广泛子宫切除及盆腔淋巴结清扫术,未作预处理,作为对照组。结果研究组无一例损伤输尿管,对照组2例发生输尿管损伤（P ＜0．05）。因此,术前考虑盆腔粘连可能比较严重的 RH 术中穿着医用弹力袜行双下肢弹力加压,并经膀胱镜放置输尿管导管常规作预处理,可明显减少下肢静脉血栓、尿潴留及输尿管损伤,值得临床推广应用。     

肿瘤患者的认知纠治及“圆桌诊疗”的启示

分析肿瘤患者认知过程中常见的不良认知,认为改变不良认知是治疗肿瘤的第一步。在认知纠治中,通过“圆桌诊疗”模式可巧妙地树立肿瘤患者的正确认识;有助于分析其错误的思维类型;并通过树立榜样的“示范”、成立自救组织与“集体疗法”以及提供沟通倾述的平台和管道,进而实现对肿瘤患者不良的认知纠治。“圆桌诊疗”的模式和方法正是在潜移默化中,通过融合了集体治疗、心理疏导、示范疗法、情境疗法、交友疗法等而起到了纠正不良认知的作用。     

把握年轻子宫内膜癌妇女保留生育功能的决策点

年轻子宫内膜癌妇女的生育功能保护现已成为临床医生在临床处置中难以回避的问题之一。选择保留生育功能的同时则必须面对可能存在的病灶残留、病情进展、肿瘤复发,甚至死亡的风险。如何权衡利弊,选择对患者最为有利的治疗方案,如何把握年轻子宫内膜癌妇女保留生育功能的决策点？需深入了解疾病知识、研究进展、患者病情及保守处置的适应证,综合分析判断进行决策。     

卵巢上皮性癌治疗后血清CA125再升高的治疗选择：积极化疗，抑或是观察等待？

卵巢上皮性癌是恶性程度、病死率极高的卵巢肿瘤,几乎所有的经规范治疗后的卵巢上皮性癌都存在复发风险,复发较大程度上意味着不良预后,甚至死亡。与卵巢癌相关的肿瘤抗原（CA125）是观察、诊断卵巢上皮性癌术后复发的敏感指标,对复发早期无影像学证据,仅单纯 CA125升高的卵巢上皮性癌患者是积极化疗,抑或是观察等待？一直是妇科肿瘤学术界争论的问题。怎样既能通过积极治疗快速缓解病情,又避免过度化疗带来的副作用？本文对此争论作一讨论,以期得出明确的观点,指导临床工作。     

老年膀胱癌患者术后生活质量及其影响因素的研究

调查老年膀胱癌患者术后生活质量现状及其影响因素,为护理干预和健康管理提供依据。选择我院2013年6月至2014年1月收治的老年膀胱癌患者142例作为研究对象,于患者术后3个月采用膀胱癌特异性量表（FACT-BL）,社会支持评定量表（SSRS）进行数据收集。结果老年膀胱癌患者术后FACT-BL平均得分为（94．33＆#177;8．31）分,SSRS平均得分为（33．70＆#177;4．42）分,不同手术方式躯体状况（PWB）,社会/家庭状况（FWB）,FACT-BL 得分差异具有统计学意义（P＜0．05）,老年膀胱癌患者术后生活质量与社会支持呈正相关关系（P＜0．05）。手术方式与老年膀胱癌患者术后生活质量密切相关,应结合患者的具体情况选择合适的手术方式,实时观察患者的社会支持水平。     

手术治疗在晚期乳腺癌中的应用价值

乳腺癌已经成为女性最常见的恶性肿瘤。虽然乳腺癌的早期诊断和治疗水平已经得到了很大水平的提高,但是仍有相当一部分患者在诊断时就已经存在远处转移,或者在术后出现局部复发以及远处转移。对于手术治疗在这些晚期乳腺癌患者中的作用,目前还存在很大的争议。本文对相关内容进行了探讨,认为晚期乳腺癌的治疗需要多学科协作的综合治疗,不应该忽视手术这个重要的治疗手段,从而使晚期的患者也能获得长期生存甚至治愈的机会。     

纳米金材料在肿瘤诊治研究中的相关进展

目前肿瘤的早期诊断依然是需要攻克的难关,现有的抗肿瘤药物因具有较大毒性且缺乏组织特异性而存在很大的局限性.纳米金基于能够被多种基团修饰后获得对肿瘤细胞的靶向性的特点逐渐成为当前抗肿瘤研究的热点.纳米金自身具有独特的生物活性,同时具有光热效应,也可以作为载体负载药物,以上3种特点均可应用于新药物的开发,用于肿瘤诊治方面的研究.本文从这三个方面描述了近期纳米金的研究进展.