The utility of McGill pain questionnaire subscales for discriminating psychologica disorder in chronic pain patients

Abstract

The practice of separately scoring the sensory, affective and evaluative suhscules of the McGill Pain Questionnaire has not bccn unequivocally supported hy rcsearch, While there is moderate support for the three-factor Structure of this scale, recent studies have revealed strong intercorrelations among these factors and have not supported thcir differential predictive ahility. Present factor analytic results provide support for solutions involving a global factor in conjunction with either two or three subscale factors. The differential relationships of the sensory and affective factors to the Minnesota Multiphasic Personality Inventory and Zung Dcpression Inventory demonstrate support for the validity of separately scoring the two factors in chronic pain patients. Preliminary guidelines are provided for the clinical use of the MPQ to discriminate psychological disorder in chronic pain patients.     

Psychological factors in hiv testing among sexually transmitted disease clinic patients: An exploratory study

Abstract

Substantial numbers of persons at risk for HIV infection do not seek HIV testing and factors influencing testing decisions are not well understood. To identify psychological characteristics of persons who remain unwilling to receive HIV testing, we surveyed patients of an inner-city sexually transmitted disease (STD) clinic (n = 181). Participants completed an anonymous survey and were grouped on the basis of HIV testing history and compared on measures of testing perceptions, attitudes, and decision making influences. Results showed that untested participants feared testing and had a sense of not knowing if they needed to be tested. In contrast, participants who were getting tested believed that testing would help them feel better about their health. Results also showed that participants lacked accurate information about some HIV testing procedures. We conclude that identifying concerns which inhibit seeking HIV testing can be useful in developing effective methods of promoting HIV testing.     

对急危重症患者家属签署知情同意书中不同意的病例回顾分析

分析在急危重症患者中签署知情不同意的原因,探讨对策.选择我院2010年6月1日～2011年12月30日在ICU抢救已出院归档的急危重症患者家属签署的600份知情同意书中52份不同意的病例进行分析总结.52份病例的知情同意书签字不同意,原因多方面.知情不同意是患者或家属的权力,如何保障更好行使此权利,同时保障其健康是医务人员努力的目标,也需要对出现的问题进一步探讨.     

红色标识腕带在急诊危重患者安全管理中的应用

为使急诊危重症患者得到及时、快捷、有效的救治,确保急救绿色通道畅通,保证医疗护理安全,2007年7月起,我院急诊科开展了“红色标识腕带”服务.凡佩戴红色标识腕带的急诊危重患者在院内接受就诊、挂号、缴费、检查、治疗、用药、用血、手术、住院等一系列流程中,享有全程优先特权.红色标识腕带的应用不仅起到了准确的身份识别的作用,更增强了医护人员的急救服务意识,尤其缩短了危重患者的急诊等候时间,有效地减少了纠纷,提升了抢救成功率,提高了医院整体的急诊工作效率和急救服务水平,在急诊安全管理中具有非常重要的意义.     

Perversion: a clinical possibility

Abstract

Clinical work with perverse patients presents numerous difficulties to psychoanalysis, be that due to the characteristics typical of the perverse structure, which is founded on the mechanism of disavowal, or to the inefficiency of neutrality and free association in this kind of practice. A study of existing literature on the subject and a thorough examination of their own clinical findings led the authors to propose a different kind of strategy for dealing with transference that would make clinical work with these patients plausible and indicate options for the paralyzing position that is imposed on the analyst by the perverse patient in order to derange the analytic process. By proposing an alternative for the “semblance subject-supposed-knowledge,” the authors defend the idea that clinical work with perverse patients is possible, resulting in a subject less captive of the phantasmagoric scene.

Drummond S et al. Perversion: eine klinische Möglichkeit

Klinische Arbeit mit perversen Patienten bildet zahlreiche Schwierigkeiten für die Psychoanalyse, sei es wegen der Eigenart der perversen Struktur, welche durch den Mechanismus der Verleugnung begründet wird oder sei es wegen der Ineffektivität der Neutralität und freien Assoziation bei dieser Art von Praxis. Ein Studium der vorhandenen Literatur über das Thema und eine gründliche Überprüfung eigener klinischer Befunde führte die Autoren dazu, eine unterschiedliche Art von Strategie des Umgangs mit Übertragung vorzuschlagen. Das würde klinische Arbeit mit diesen Patienten plausibel machen und auf Optionen für die paralysierende Position hinweisen, die dem Analytiker durch den perversen Patienten aufgebürdet wird, um den analytischen Prozess zu stören. Ein Alternative für das “semblance subject-supposed knowledge” vorschlagend, verteidigen die Autoren die Idee, daß klinische Arbeit mit perversen Patienten möglich ist, mit dem Ergebnis eines Subjekts, welches weniger durch die phantasmagorische Szene gefesselt ist.

Drummond S et al. perversión: una posibilidad clínica.

El trabajo clínico con pacientes perversos presenta numerosas dificultades para el psicoanálisis, puede ser debido a las características típicas de la estructura perversa, fundamentado en le mecanismo de repudio, o debido a la ineficacia de la neutralidad y asociación libre en este tipo de práctica. Un estudio de la literatura existente sobre el tema y un examen completo de los hallazgos clínicos, llevó a los autores a proponer un tipo diferente de estrategia para el manejo de la transferencia, que pudiera hacer posible el trabajo clínico con estos pacientes, también indicar opciones para la situación de paralización que estos pacientes imponen al analista para desorganizar el proceso analítico. Con la proposición de una alternativa para la “semblance-subject-supposed knowledge(apariencia del sujeto-supuesto saber),” el autor defiende la idea de que el trabajo clínico con pacientes perversos es posible, resultando un asunto menos cautivo de la escena fantasmagórica.     

Intellectual, behavioral, and personality correlates of violent vs. non-violent juvenile offenders

The overall aim of this study was to examine the relationship between offender status (violent vs. nonviolent) and selected predictor variables from personality, behavioral, and intellectual domains. The two main sub goals were (a) to determine which variables from these domains were most closely associated with offender status, and (b) to construct a stepwise logistic regression model that could help identify which juveniles were more likely to be incarcerated for violent vs. nonviolent offenses. The participants for this investigation were juvenile offenders referred to the Juvenile Court Assessment Center by the Juvenile Justice Division of the Eleventh Judicial Circuit. The court-ordered assessment included the following measures: (a) The Millon Adolescent Clinical Inventory (MACI), (b) the Behavior Assessment System for Children (BASC), (c) the Peabody Picture Vocabulary Test-Third Edition (PPVT-III), (d) the Wide Range Achievement Test-Third Edition (WRAT-III), (e) the Kaufman Brief Intelligence Test (K-BIT), and (f) records of school achievement. The ten variables that had the strongest association with offender status were entered into the stepwise logistic regression analysis; five of these strategically chosen predictor variables accurately differentiated violent from nonviolent offenders 86.3% of the time. Reading Percentile (β=-.051), PPVT-III (β=-.059), MACI-Inhibition (β=-.033), MACI-Eating Dysfunction (β=.051), and BASC-Sense of Inadequacy (β=-.072). Gender differences were explored.     

浅谈老年患者择期手术麻醉问题

随着社会老龄化,老年患者占手术麻醉比例逐年增加。对手术和麻醉危险因素、各重要器官的储备功能和应激能力的评估,以及了解老年人随年龄变化而产生的药效学和药代学改变,给予老年择期手术患者个体化麻醉是极其重要的。     

晚期癌症患者静脉管理的重要性

恶性肿瘤作为我国的常见病、多发病,其死亡率高居首位。手术、化疗和放疗成为现代医疗对于癌症的常见治疗手段。中晚期癌症患者作为癌症临床诊疗对象的主体,常伴有各种慢性疾病或营养不良。从而,化疗、中药辅助巩固治疗及营养支持治疗成为中晚期癌症患者临床治疗过程中的主体。治疗方法决定给药途径,静脉输液成为了中晚期癌症患者治疗肿瘤的主...     

患者致残后的心理变化与康复

探讨患者致残后复杂的心理变化一些常见因素,然后根据各种因素制定治疗方案。对所治疗残疾人为研究对象,通过与残疾人交谈,观察其言行变化,问卷调查,随访调查,将获得的资料进行分析整理,得出患者各种复杂心理变化的病因。患者由正常人变为残疾人这个复杂心理变化由自身的应激、自我认识及社会文化等各种因素所引起,根据各种因素制定一些有...     

西藏老年病房2型糖尿病患者的血糖管理

西藏老年2型糖尿病患者有着知晓率低、病程长、慢性并发症多、其他相关疾病多等特点。加强糖尿病教育、控制饮食、合理用药、注意相关疾病的处理和个体化治疗是血糖管理的有效方案。