中国城市农民工子女心理健康研究述评

城市农民工子女是指户籍身份还是农民, 有承包土地, 但主要从事非农产业、以工资为主要收入来源的进城务工人员的子女, 他们一般为6~18周岁的适龄上学儿童少年。中国城市农民工子女心理健康的总体水平低于城市当地儿童, 社会认知方面存在着一定的歧视知觉、相对剥夺感和身份认同危机, 情绪情感方面表现为情绪不平衡、孤独(抑郁)倾向较强和自卑(自责)心理严重, 社会适应方面显示出社会适应不良、人际关系紧张与敏感、学习适应性较差和问题行为较多。性别、年龄、人格、应对方式、生活满意度等个体因素以及家庭、学校、社会等环境因素是其心理健康水平的主要影响因素。而关于城市农民工子女的教育干预还没有形成系统, 主要是一些质性的研究。今后研究的重点应包括研究对象与内容的拓宽、研究方法的改进与完善及系统研究和理论建构的加强等。     

青少年药物滥用的防治

随着社会转型所带来的生活方式多元化,青少年药物滥用现象,在威胁着青少年身心健康的同时,也破坏了社会的和谐与发展。一般来说,其形成原因包括自身、家庭、学校和社会等多种因素,因而,预防和解决青少年药物滥用问题,就需要建立一套涉及多个层面的防治体系。     

The Survivor Health and Resilience Education (SHARE) Program: Development and Evaluation of a Health Behavior Intervention for Adolescent Survivors of Childhood Cancer

Few evidence-based health behavior interventions for adolescent survivors of childhood cancer currently exist. These interventions are necessary to address a range of lifestyle and behavioral factors (e.g., diet and physical activity, tobacco and alcohol use, excessive sun exposure) that may place survivors at increased risk for secondary cancers other chronic diseases. To address this need, the development and evaluation of a health promotion and disease prevention program for childhood cancer survivors is described, with an emphasis on the steps leading up to conducting a randomized controlled trial to test its efficacy. Data gathered from trial participants suggest the preliminary evaluation of the intervention is favorable. Trends and future directions in behavioral intervention research with childhood cancer survivors are discussed, along with the role of behavioral research in health promotion and disease prevention.     

A Pilot Randomized Controlled Trial of the Insomnia Coach Mobile App to Assess Its Feasibility,Acceptability, and Potential Efficacy

Insomnia is highly prevalent among military veterans but access to cognitive-behavioral therapy for insomnia (CBT-I) is limited. Thus, this study examined the feasibility, acceptability, and potential efficacy of Insomnia Coach, a CBT-I-based, free, self-management mobile app. Fifty U.S. veterans, who were mostly male (58%) and mean age 44.5 (range = 28–55) years with moderate insomnia symptoms were randomized to Insomnia Coach (n = 25) or a wait-list control condition (n = 25) for 6 weeks. Participants completed self-report measures and sleep diaries at baseline, posttreatment, and follow-up (12 weeks postrandomization), and app participants (n = 15) completed a qualitative interview at posttreatment. Findings suggest that Insomnia Coach is feasible to use, with three quarters of participants using the app through 6 weeks and engaging with active elements. For acceptability, perceptions of Insomnia Coach were very favorable based on both self-report and qualitative interview responses. Finally, for potential efficacy, at posttreatment, a larger proportion of Insomnia Coach (28%) than wait-list control participants (4%) achieved clinically significant improvement (p = .049) and there was a significant treatment effect on daytime sleep-related impairment (d = −0.6, p = .044). Additional treatment effects emerged at follow-up for insomnia severity (d = −1.1, p = .001), sleep onset latency (d = −0.6, p = .021), global sleep quality (d = −0.9, p = .002), and depression symptoms (d = −0.8, p = .012). These findings provide preliminary evidence that among veterans with moderate insomnia symptoms, a CBT-I-based self-management app is feasible, acceptable, and promising for improving insomnia severity and other sleep-related outcomes. Given the vast unmet need for insomnia treatment in the population, Insomnia Coach may provide an easily accessible, convenient public health intervention for individuals not receiving care.     

冠心病患者药物支架的合理应用

药物支架的出现使冠脉成形术产生了质的飞跃,合理地应用药物支架将对患者带来福音。但是药物支架同样有中、晚期血栓形成,再狭窄等弊病。介入医生应从药物支架的适应证、禁忌证,支架操作的技术层面及中国国情,价/效比几个方面详细考虑应用药物支架的得失,遵循指南的建议,使患者获益并保证手术安全是最基本的要求。     

Results of an Intervention for Individuals and Families with <Emphasis Type="Italic">BRCA</Emphasis> Mutations: A Model for Providing Medical Updates and Psychosocial Support Following Genetic Testing

Providing medical management updates and long-term support to families with hereditary cancer syndromes in rural areas is a challenge. To address this, we designed a one-day retreat for BRCA1/2 carriers in our region. The retreat included educational updates about medical management, genetic privacy and discrimination, and addressed psychological and family issues. Evaluations completed at the conclusion of the retreat were overwhelmingly positive with requests for a similar event in the future. The impact of this retreat on a variety of health behaviors was assessed. Eligible participants completed questionnaires before and 6 months after the retreat. Questionnaires focused on lifestyle, cancer screening and prevention practices, psychological history and distress, decision-making regarding genetic testing, and family communication issues. For individuals who completed both the pre and post retreat questionnaires, one-half made lifestyle changes and nearly two-thirds increased cancer screening, initiated chemoprevention, completed or planned to complete preventative surgery in the future. We conclude that this type of forum provides a valuable opportunity for BRCA carriers and their families to receive updated medical information, share personal experiences, provide and receive support, as well as change health behaviors.     

灾难中的心理危机干预——精神病学的视角

灾难事件是一种特殊类型的生活事件,因其超出个体应对能力,因此灾难事件后常并发一系列的精神卫生问题。急性应激障碍、创伤后应激障碍、抑郁症、自杀是灾后常见精神卫生问题。本文回顾了近年来灾难事件相关精神障碍的研究,并总结了去年发生在我国的两次重大灾难性事件的相关研究结果,从精神病学视角对灾难事件后心理危机干预策略进行了探讨。     

牙科焦虑症患者心理干预的疗效分析

为了探讨心理诱导对牙科焦虑（dental anxiety,DA）患者治疗的影响,采用焦虑自评量表及汉密顿焦虑量表对门诊就诊患者进行焦虑调查,筛选出伴焦虑者82例,随机分为两组,分别进行心理干预治疗和一般治疗,并对数据进行统计分析。结果显示,心理诱导指导组与时照组相比较焦虑水平明显降低,患者无论在完成第一次治疗还是复诊情况均优于对照组（P〈0．01）。提示心理干预对DA患者治疗有显著效果。     

晚期喉癌患者的个体化治疗和心理干预

晚期喉癌患者往往伴有严重的心理负担。这种负性心理状态因疾病的特殊性以及患者本身个体就医背景的差异而产生有别于其他癌症的个体特征。把握患者的个体负性心理状态,运用相应的心理干预措施,使患者的期望和医生的治疗目的趋向统一,将有助于晚期喉癌个体化治疗模式的有效实施。     

心理性胰岛素抵抗及应对策略

糖尿病易导致严重的慢性并发症,已成为影响人们生活质量的一种常见疾病。早期应用胰岛素是使2型糖尿病患者血糖得到良好控制、减少并发症发生的有效手段。但许多患者不愿接受或延迟胰岛素治疗。本文旨在探讨胰岛素应用过程中患者及医护人员存在的心理障碍,即心理性胰岛素抵抗,并进一步阐述其应对策略。