老龄患者人工关节置换术时骨水泥反应综合征的危害及其应对策略

人工关节置换术在老龄化社会中的客观需求性愈来愈突出,而老龄患者在人工关节置换术时发生的骨水泥反应综合征是一个不容忽视的严峻问题。笔者指出了老龄患者人工关节置换术时骨水泥反应综合征的严重危害性,剖析了这种并发症的可能原因,并且对它的有效预防措施和急救处理策略进行了深刻的思考。     

中青年冠心病患者冠脉介入治疗后精神心理改变及影响因素调查分析

应用焦虑、抑郁自评量袁对84例行冠脉介入治疗的中青年冠心病患者分别进行术前、术后3个月的问卷调查,分析其变化的影响因素后进行综合评价。发现此类人群大多有焦虑、抑郁倾向,其发病率与性别有关而与年龄无关;其影响因素与对疾病的认识、医疗保险、家庭结构有一定相关性。     

老年患者的外科治疗决策及围手术期处理

泌尿外科老年患者多,老年患者必然手术并发症多,手术死亡率高。虽然现在泌尿外科近70％的手术已进入了微创时代,手术时间大幅缩减,但是老年患者的临床决策仍常常是个非常纠结的问题,手术要达到什么目的？何时要做适当的放弃？除了充分的围手术期准备,医生要敢于承担,家属要充分理解和合作。     

临床决策中患者及其家属的地位与作用

医生、医院每天都在为患者做临床决策。而在各个决策中患者与家属应该处于什么地位的问题早有争论。除了疾病外患者性别、年龄、家庭、经济、社会地位的个体差异决定了医生决策的不同。患者要真正参与,就必须真正全面知情。关于患者参与多少的问题要因人而异,可能只是提出意愿,可能提出耗资的底线,可能权衡费效比,可能以生活质量为唯一原则。总之,临床决策中患者及其家属的地位因人而异。     

急诊室濒死病人临床诊治决策的影响因素

正确、合理的临床决策为病人提供理想的诊疗方案。在急诊室濒死病人的诊治过程中,急诊医生应本着以人为本的原则,根据病情的轻重缓急,抓住重点进行紧急处理。其中,病人疾病的性质与预后、疾病严重程度、医生技术水平、医院护理水平、医院的医疗设备与管理水平、诊治费用、医患关系、家属对待诊治的态度、医德医风、政策法规等对医生的临床诊治决策均有不同程度的影响。     

Risk and Resistance Factors for Psychological Distress in Icelandic Parents of Chronically Ill Children: An Application of Wallander and Varni’s Disability-Stress-Coping Model

The purpose of the study was to investigate Wallander and Varni’s (1998) disability-stress coping model in a sample of 105 Icelandic parents of chronically ill children. The Revised Adult Attachment Scale (RAAS), the Attributional Scale (AS), the Defence Style Questionnaire (DSQ), the Sense of Coherence Scale (SOC), the World Assumption scale (WAS), The Coping Style Questionnaire (CSQ), The Impact on Family scale (IFS), the Trauma Symptom Checklist (TSC), and the Harvard Trauma Questionnaire (HTQ), were completed by the parents of children with various diseases. Despite the heterogeneity of the sample in terms of disease type, PTSD was present in 13.2% of the parents and an additional 28.6% had subclinical PTSD. Emotional coping, extent of daily care, time since diagnosis, and changes in employment due to the disease explained 71% of the variance in HTQ total score.     

阿尔兹海默氏症患者的家属照顾者(隐形的病患)健康状况探讨

台湾地区有超过91.5%的阿尔兹海默症照顾者为家庭成员。他们平均对轻度、中度和重度此症患者的全部照顾时间为2166、4299和5871小时。根据一项以“中国人健康问卷”所做的调查,照顾者身体健康状况平均值为2.73(标准差0.85);心理健康状况平均值为2.74(标准差0.8);社会健康状况平均值为2.98(标准差0.78);在压力的排序上以情绪上的压力和困扰为最高(3.02)。这些数据显示照顾者的身心健康已受到严重的负面影响。因此,照顾者应该首先照顾好自身,才能给予被照顾者亲属更好的必要照顾。     

Gender Awareness Inventory-VA: A Measure of Ideology,Sensitivity, and Knowledge Related to Women Veterans' Health Care

Within the Veterans Health Administration, it has become increasingly important to assess health-care workers' attitudes toward and beliefs about female patients, sensitivity to the unique needs of female patients, and knowledge about women veterans and the programs and services available to them. The current study describes the development of the Gender Awareness Inventory-VA, an instrument that assesses 3 components: gender-role ideology, gender sensitivity, and knowledge among health-care staff. Data were drawn from various samples of Veterans Health Administration employees in a large geographical region (overall N > 1,100; nationally, this population includes roughly 37% minorities). In a series of psychometric inquiries, evidence for reliability and validity was established, and preliminary evidence was provided for the instrument's underlying factor structure.     

正确认识和对待"举证责任倒置"

“举证责任倒置”作为处理民事诉讼中的例外原则运用于医疗纠纷的处理必将对医患关系的根本好转提供有利的措施保证,如何认识和对待“举主责任倒置”是一个崭新的课题,就此,我们谈点不成熟的看法。     

心理干预在化疗患者中的应用

本研究针对化疗患者常见的恶心呕吐、烦躁不安等副作用．运用心理行为技术．采用病例对照研究方法,对129名化疗患者进行了比较研究。结果为：各项情绪指标和总的情绪状况以及恶心呕吐反应。干预组患者比对照组改善明显;生活质量各指标在组问和组内比较中,有不同程度的改善,角色、社会、认知功能和疼痛症状在两组比较中改善不明显。由此认为,对化疗患者实施恰当的心理行为技术．干预效果是明显的