【摘要】 目的 研究綜合醫院心理咨詢初診患者的特征。 方法 對2007年1月1日-2009年12月31日初診患者的性別、年齡、居住地、學歷、職業、咨詢目的與疾病分布等特征進行統計分析。 結果 共納入1 933例初診患者，女性略多于男性（男女比1∶1.1）；年齡3~75歲，以青少年（10~19歲，34.5%）和青年（20~29歲，29.7%）為主；當地居民居多（66.0%），外地居民亦占較大比例（34.0%）；學歷主要分布在中學（初中:21.5%；高中:35.6%）和大學（33.6%）；職業分布以學生比例最大（40.0%），其次為無固定職業者（14.9%），專業技術人員（12.5%），商業、服務人員（9.4%），辦事人員和有關人員（7.7%）。患者中有心理問題的健康人占27.5%，以親子教育咨詢（53.4%）和婚戀咨詢（41.5%）為主；患精神障礙的患者占72.5%，以心境障礙（30.6%）、神經癥（23.1%）和精神分裂癥（10.1%）為主，新確立的精神障礙網絡成癮占1.1%。 結論 綜合醫院心理咨詢初診患者來源廣泛，需要更加關注青少年、學生和無固定職業者的心理問題。【Abstract】 Objective To investigate the characteristics of the new clients from the psychological counseling clinic in general hospital. Methods The clients’ data were prospectively analyzed from the successively registered database of the counseling clinic from January 1, 2007 to December 31, 2009. The data included sex, age, habitation, educational background, career, problems, and diagnosis of the new clients. Results A total of 1 933 clients were included in the study, and the sex ratio was 1∶1.1(male∶female). The age ranged from three to 75 years old. The clients aging from 10 to 29 yeas old accounted for 64.2%. Sixty-six percent of the clients were local residents. The education backgrounds of them were middle school (21.5%), high school (35.6%), and graduate (33.6%). Forty percent of the clients were students and 14.9% had no regular works. Special technician, business and service workers, and office workers accounted for 12.5%, 9.4%, and 7.7%, respectively. The percentage of healthy clients was 27.5%, whose main problems were child education (53.4%), and marriage relationship (41.5%). And 72.5% of the clients suffered from mental disorders, with mood disorder (30.6%), neurosis (23.1%), and schizophrenia (10.1%). Internet addiction, as a new established mental disorder in China, accounted for 1.1%. Conclusion At present, the clients of counseling clinic in general hospital are more widespread, and more attention should be paid to the young, the students, and the people without regular work.
Objective To integrate the falling experience and coping styles of stroke home patients with falls through Meta synthesis, summarize existing problems based on the integration results, and propose suggestions. Methods We searched databases including PubMed, Medline, Embase, Web of Science, etc., from database establishment to January 2023, to collect qualitative studies on stroke patients’ falling experience at home. The quality of included studies was evaluated by “JBI Australian Evidence-based Health Care Centre (2008) Qualitative Research Quality Assessment Criteria”. The results were integrated by integrating methods. Results A total of 6 references were included, and 18 clear research results were extracted. Similar results were summarized and combined to form 6 new categories, and integrated into 3 main themes. The integration results showed that stroke patients with falls had severe psychological problems, poor coping styles, and unmet needs for fall prevention, resulting in reduced social participation and exercise. Conclusions It is necessary to improve the content of fall assessment and provide corresponding fall prevention health education based on the assessment results. It helps stroke patients and caregivers at home to establish correct coping strategies, thereby avoiding the occurrence of falls.
ObjectiveThrough neuropsychological assessment, explore the factors that may cause cognitive impairment in patients with focal epilepsy.MethodsCollected 53 epilepsy patients in outpatients and inpatients of Tianjin Medical University General Hospital from March 2016 to January 2020, including 25 males and 28 females, with an average age of (23.58±13.24) years old, and the course of disease (6.49±7.39), all met the 2017 ILEA diagnostic criteria for focal epilepsy, and there was no history of progressive brain disease or brain surgery. Carry out relevant cognitive assessments for the enrolled patients, use SPSS statistical software to conduct Spearman correlation analysis on the cognitive functions of the study subjects, and further analyze the related factors of cognition through Logistic regression analysis to clarify the factors related to cognition whether it may be a risk factor for cognitive impairment in patients with focal epilepsy.Results Spearman correlation analysis showed that the FIQ of patients with focal epilepsy was related to education level, age of onset, seizure pattern, total number of seizures, AEDs and EEG interval discharge side (P<0.05). Binary Logistic regression analysis shows that among all cognitive-related factors, only the number of AEDs (P=0.003) and EEG interval discharge (P=0.013) are the risk of cognitive impairment in patients with focal epilepsy factor.ConclusionIn the clinical treatment of epilepsy, seizures should be actively controlled, but the types of drugs should be minimized. When there are more than 3 kinds of drugs, surgical treatment or other non-surgical treatments can be considered. At the same time, the EEG should be reviewed regularly to understand the changes in epileptiform discharges between episodes.
目的:探討氟西汀聯合心理干預治療心血管疾病患者伴焦慮抑郁癥狀的臨床療效。方法:選擇伴有抑郁、焦慮情緒障礙的85例冠心病患者(心功能Ⅱ、Ⅲ級),并將其隨機分成研究組和對照組。觀察6w,對照組患者僅給予常規的治療,研究組患者在常規治療基礎上給予氟西汀聯合心理干預治療。觀察治療前后兩組患者采用漢密頓焦慮量表( Hamilton Anxiety Scale,HAMA) 評定焦慮癥狀,漢密頓抑郁量表( Hamilton Depression Scale,HAMD) 評定抑郁癥狀;并對治療后心功能分級(NYHA)恢復到Ⅰ級的例數及左室射血分數進行分析評價。結果:治療6 周 后,研究組均較對照組的漢密頓焦慮量表及漢密頓抑郁量表評分下降顯著( P lt;0.01),研究組抗焦慮顯效率為87.16%、抗抑郁顯效率為82.26%,對照組分別為43.75%、45.36%,研究組均顯著高于對照組( P lt;0.01);研究組患者的左室射血分數顯著高于對照組 ( P lt;0.05),心功能分級(NYHA)恢復到Ⅰ級的例數顯著高于對照組 ( P lt;0.05)。結論:氟西汀聯合心理干預治療不僅能改善心血管疾病伴焦慮抑郁患者的焦慮、抑郁情緒障礙,還能改善患者的心功能,療效顯著優于單用心血管藥物治療。
