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331.
军事应激障碍是部队常见的心理障碍,也是严重影响部队战斗力的主要因素。探讨军事应激障碍的评估方法和防治措施是军事心理学研究的重要内容。本文系统地回顾了国内外军事应激障碍的评估原则和方法,并结合过去的研究成果,提出了军事应激障碍的防治措施。目的是为我军制定切实可行的军事应激防治措施提供科学依据,以维护部队官兵的心理健康,提高部队的战斗力 相似文献
332.
董雷 《医学与哲学(人文社会医学版)》2005,26(4):49-50
患者的医疗权可以表现为宪法上的应然权利和实践中的实然权利。在具体医疗实践中 ,患者获得公正、必须和费用节省的医疗服务的权利 ,是以患者支付医疗费用为前提的。在特定情况下 ,虽然患者无支付能力 ,也可以享有医疗权。患者有拒绝医疗的权利 相似文献
333.
乙肝病毒(HBV)感染是我国肝硬化和肝癌的主要致病因子,因此抗HBV治疗十分重要。但是,由于对抗HBV的治疗现状不够了解,不少人在盲目追求彻底清除体内的HBV,以至于弄巧成拙,所以,有必要客观地看待慢性乙型肝炎的抗病毒治疗,以求得到最佳的治疗效果。 相似文献
334.
《Counselling psychology quarterly》2012,25(4):361-375
This study examined the client–therapist early working alliance effect on retention in outpatient substance abuse treatment. The study was implemented on naturalistic principles adopting a prospective design. Data were collected in southern and western Finland in a multisite clinical trial including outpatient treatment units (N = 7). The sample consisted of clients (N = 327, 111 women, 216 men) starting a new treatment period. Clients were assigned randomly to therapists (N = 33). Both clients and therapists’ ratings of the working alliance were measured. Generalised linear mixed model was used in the analyses. The covariate was client's per cent days abstinent before treatment. Therapist's rating of the alliance of the first therapy session and the client's percentage of days abstinent predicted treatment retention. The therapists’ ratings were better for clients whose treatment continued than for those whose treatment was discontinued. There was considerable between-therapist variation in retention and this became wider as treatment progressed. Lower per cent days abstinent at baseline negatively predicted retention. Since the therapist's evaluation of the working alliance has proved to be a predictor of retention in treatment and differences between the therapists exist in this particular and also in earlier studies, future research should be directed more towards the therapists and their characteristics associated with good treatment results. 相似文献
335.
烧伤救治是一个复杂的系统工程,涉及急救、复苏、感染、创面、营养、康复及心理等.营养支持已成为中度以上烧伤患者的重要治疗措施之一:积极正确的营养支持,可促进合成、增强免疫和加速创面愈合,对烧伤救治疗效有明显的改善作用.相反,营养不良可使创面愈合延缓、降低身体抵抗力、易并发感染等并发症,严重影响预后.给予合理的营养支持治疗来维持烧伤患者的营养是严重烧伤治疗中重要措施之一.因此,重视营养支持,相关治疗措施才会发挥应有疗效,烧伤的整体治疗水平才可能提高. 相似文献
336.
《Behavior Therapy》2023,54(4):682-695
In treating an acute episode of winter depression, cognitive-behavioral therapy for seasonal affective disorder (CBT-SAD) and light therapy are comparably efficacious, with improvement in depression symptoms during CBT-SAD mediated by reduced seasonal beliefs (i.e., maladaptive thoughts about the seasons, light availability, and weather). Here, we tested whether the enduring benefit of CBT-SAD over light therapy following treatment is associated with offsetting seasonal beliefs during CBT-SAD. Currently depressed adults with Major Depression, Recurrent with Seasonal Pattern (N = 177) were randomized to 6 weeks of light therapy or group CBT-SAD and followedup one and two winters after treatment. Outcomes measured during treatment and at each follow-up included depression symptoms on the Structured Clinical Interview for the Hamilton Rating Scale for Depression—SAD Version and Beck Depression Inventory—Second Edition. Candidate mediators measured at pre-, mid-, and posttreatment were SAD-specific negative cognitions (Seasonal Beliefs Questionnaire; SBQ); general depressogenic cognitions (Dysfunctional Attitudes Scale; DAS); brooding rumination (Ruminative Response Scale-Brooding subscale; RRS-B); and chronotype (Morningness-Eveningness Questionnaire; MEQ). Latent growth curve mediation models found a significant positive path from treatment group to the slope of SBQ during treatment, with CBT-SAD showing larger improvements in seasonal beliefs with overall change in seasonal beliefs in the medium-effect range, and significant positive paths from SBQ slope to depression scores at the first and second winter follow-ups, indicating greater change towards more flexible seasonal beliefs during active treatment was associated with less severe depression symptoms following treatment. Estimated indirect effects (treatment group → SBQ change * SBQ change → outcome) were also significant at each follow-up for each outcome with βindirect ranging from .091 to .162. Models also found significant positive paths from treatment group to the slope of MEQ and RRS-B during treatment, with light therapy showing a greater increase in “morningness” and CBT-SAD showing a greater decrease in brooding during active treatment; however, neither construct emerged as a mediator of follow-up depression scores. Change in seasonal beliefs during treatment mediates both the acute antidepressant and long-term effects of CBT-SAD and explains lower depression severity following CBT-SAD relative to light therapy. 相似文献
337.
338.
《Cognitive and behavioral practice》2023,30(3):314-325
Cognitive Processing Therapy (CPT) is an empirically supported psychotherapy for posttraumatic stress disorder (PTSD). The complex issue of treatment attrition is a frequently cited concern regarding CPT and other evidence-based psychotherapies for PTSD. The current study investigated the feasibility and effectiveness of “intensive” CPT, a treatment-consistent modification of CPT in which sessions are conducted more frequently than standard protocol. Fifty-four military veterans (20% female; Mage = 46; 80% Caucasian) seeking outpatient treatment for PTSD were included in this study. Patients who elected to receive intensive CPT (n = 27) were matched with archival records of individuals who received standard CPT (n = 27). Patients across treatment conditions were matched based on baseline symptom severity as measured by the PTSD Checklist for DSM-5 (PCL-5; MPCL-5 = 52.61). Treatment outcomes were compared and longitudinal multilevel modeling was used to compare rate of symptom change over time. Patients who elected to engage in intensive CPT were twice as likely to complete treatment (88.9%) as those who received standard CPT (44.4%), X2(1, N = 54) = 12.00, p = .001. On average, intensive CPT patients completed treatment in about 25% of the time as standard CPT patients (33.8 days vs. 125.7 days). Patients in intensive CPT also demonstrated greater benefit: 81.4% reported a clinically significant improvement in PCL-5 scores compared to 51.8% of those in standard CPT, X2(1, N = 54) = 5.33, p = .020, φ = −0.314. Intensive and standard CPT performed comparably in regard to final PCL-5 score, change over time, and screening cutoff. In addition, there were no differences in treatment outcomes based on licensure status of the provider nor whether treatment was delivered in person or virtually. Intensive CPT represents a novel, treatment-consistent adaptation that was utilized to treat a group of veterans with PTSD with minimal treatment dropout. Patients who elected to engage in more frequent treatment were more likely to complete treatment, did so in one quarter of the time, and reported similar to better treatment outcomes. Providers may consider encouraging their patients to participate in treatment as frequently as they are able. However, preliminary findings are based on a nonrandom sample and design limitations temper conclusions. 相似文献
339.
340.
《Cognitive and behavioral practice》2023,30(3):471-494
Sexual minority women (SMW) experience an elevated risk of mental health problems compared to heterosexual women. However, knowledge gaps remain regarding whether cognitive-behavioral therapy (CBT) interventions meet SMW’s mental health needs. Further, virtually no studies have integrated stakeholder (i.e., researchers with content expertise in SMW’s health and clinical providers who work with SMW) and community member (i.e., SMW) perspectives to identify CBT approaches that address SMW-specific issues. This study used qualitative data gathered from 39 SMW who reported depression, anxiety, suicidality, and heavy drinking in the past 3 months and 16 content experts and clinical providers to obtain information relevant to enhancing CBT for SMW. In addition, we used thematic analysis to identify themes related to the adaptation and delivery of CBT for SMW. Building on prior literature, this study’s findings revealed seven considerations for delivering mental health services to SMW: (1) attending to SMW’s diverse gender identities and expressions; (2) focusing on SMW’s nonbinary stressors; (3) formulating SMW’s gender-based stressors within a feminist framework; (4) applying intersectionality frameworks; (5) incorporating issues of diversity, multiculturalism, and social justice; (6) addressing the role of trauma exposure; and (7) addressing the role of alcohol use in SMW’s lives. These considerations are reviewed in terms of their implications for clinical practice, with a focus on enhancing applications of existing CBT interventions to best respond to the unique needs of this population. 相似文献