【摘要】目的对一线临床科室参与汶川地震抗震救灾的外援护士和本土护士的社会支持系统进行调查研究。方法随机抽取抗震救灾一线科室(ICU、骨科、急诊)外援护士及本土护士各175名,设为外援组和本土组,采用对地震的自我认知问卷及社会支持评定量表(SSRS)进行测评。结果两组护士对地震相关知识的知晓情况、响应抗震救灾的行为表现、地震对专业的影响等方面无明显差异(Pgt;0.05);两组护士的社会支持总分均低于国内常模 (Plt;0.01),除外援组主观支持维度得分与国内常模无显著差异(Pgt;0.05)外,两组的社会支持其它各维度得分均低于国内常模,外援组的社会支持总分及主观支持、客观支持得分均高于本土组(Plt;0.01),两组对支持的利用度无明显差异(Pgt;0.05)。结论为抗震救灾一线科室护士提供积极的社会支持是保证心理健康的重要措施。【Abstract】ObjectiveTo evaluate the difference of psychological state between local and nonlocal nurses during the Wenchuan Earthquake. Methods A total of 175 local nurses and 175 nonlocal nurses were randomly selected and investigated by SSRS and the earthquake questionnaire. Results There were no significant differences in their knowledge about the earthquake, professional identity and action (Pgt;0.05). The total and the three dimensions scores of SSRS of the two groups were lower than those of the domestic norms (Plt;0.01) except the subjective support dimensions. The total scores, objective support and subjective support dimensions scores of nonlocal group were higher than that in the local group (Plt;0.01). In coping style questionaire, there were significant differences in solving problems and retreat factor(Plt;0.01)and no significant differences in remorse, salvation and illusion(Pgt;0.05). Conclusion The earthquake affected mental health of the nurses and their psychological state need to be much concerned,especially the nonlocal ones.
Objective To understand the current situation of the care burden of primary caregiver of patients with oral diquat poisoning, analyze its influencing factors, and analyze the mediating effect of psychological resilience in social support and care burden, so as to provide a theoretical basis for further clinical intervention. Methods The primary caregivers of patients with oral diquat poisoning who received treatment at Qilu Hospital of Shandong University between October 2019 and October 2021 were selected. The general information questionnaire, Zarit Burden Interview (ZBI), Connor-davidson Resilience Scale (CD-RISC), and Social Support Revalued Scale (SSRS) were used to investigate the primary caregivers of patients with oral diquat poisoning. The influencing factors of the care burden on primary caregivers were analyzed. Results A total of 218 patients and their primary caregivers were included. The age of the primary caregivers, whether they were an only child, physical condition, educational level, economic income, daily care time, patient’s condition, and patient’s urinary concentration of diquat were the influencing factors of ZBI. The SSRS score of the primary caregiver was 26.97±10.21, the CD-RISC score was 56.95±26.64, and the ZBI score was 52.95±16.06. The burden of care was negatively correlated with social support (r=−0.369, P<0.05), the burden of care was negatively correlated with psychological resilience (r=−0.467, P<0.05), and social support was positively correlated with psychological resilience (r=0.288, P<0.05). The role of psychological resilience in the influence of social support and care burden was partly mediated, accounting for 41.905%. Conclusions The level of social support and psychological resilience of the primary caregivers is low, and the burden of care is heavy. Psychological resilience plays an intermediary role in the social support and care burden of the primary caregivers of patients with oral diquat poisoning. Clinical staff can carry out targeted intervention to improve the level of social support and psychological resilience and reduce the care burden.
ObjectiveTo construct a nomogram prediction model for pain crisis occurrence based on clinical data of patients with advanced non-small cell lung cancer (NSCLC), with the aim of providing a scientific basis for clinical decision-making.MethodsA total of patients with advanced non-small cell lung cancer (NSCLC) admitted to our hospital from January 2022 to January 2024 were selected as the study subjects. Demographic data, disease information, pain severity (assessed using the Numerical Rating Scale, NRS), psychological status (anxiety and depression assessed using the Self-Rating Anxiety Scale, SAS, and the Self-Rating Depression Scale, SDS), and social support (assessed using the Perceived Social Support Scale, PSSS) were collected. Univariate and multivariate Logistic regression analyses were performed to identify independent factors influencing pain crisis. The R software was used to visualize the nomogram, and the Receiver Operating Characteristic (ROC) curve, calibration curve, and Hosmer-Lemeshow test were employed to evaluate the discrimination and calibration of the model.ResultsA total of 500 questionnaires were distributed, and 448 qualified questionnaires were collected, with a qualification rate of 89.6%. The patients were divided into a modeling group (n=314) and a validation group (n=134). Univariate analysis showed significant differences between the pain crisis group and the pain-free group in terms of gender, age, education level, PSSS score, bone metastases, pleural metastases, depression and anxiety levels, and antitumor efficacy (P<0.05). Multivariate Logistic regression analysis showed that bone metastasis, PSSS score, age, depression, and anxiety levels were independent factors influencing pain crisis in patients with advanced NSCLC. Based on the results of the multivariate Logistic regression analysis, a nomogram prediction model for pain crisis occurrence in patients with advanced NSCLC was constructed. The Area Under the Curve (AUC) of the ROC curve in the modeling and validation groups was 0.948 and 0.921, respectively, indicating high discrimination of the model. The calibration curve and Hosmer-Lemeshow test results showed good consistency of the model.ConclusionThis study successfully constructed and validated a nomogram prediction model based on independent factors such as bone metastasis, social support (PSSS score), age, depression, and anxiety levels. This model can objectively and quantitatively predict the risk of pain crisis occurrence in patients with advanced NSCLC, providing a scientific basis for clinical decision-making. It helps identify high-risk patients with pain crisis in advance and optimize pain management strategies, thereby improving patient prognosis and quality of life.
ObjectiveTo explore the prevalence of anxiety symptoms and its related factors among the family caregivers of the disabled elderly. MethodsA cross-sectional survey based on convenience sampling was conducted among family caregivers between November and December, 2013 in Dongcheng district in Beijing. The Self-rating Anxiety Scale (SAS) and the Social Support Rating Scale (SSRS) were used to evaluate caregivers' anxious symptoms and social support status respectively. The degree of functional impairment of the elderly was measured by Barthel index. ResultsA total of 243 family caregivers took part in the study including 88 males and 155 females. The average age of the family caregivers was (60±1.7) years old, ranging from 25 to 85. The prevalence rate of anxiety was 29.2% reported by family caregivers. The average score of SAS was 35.6±8.6. The risk factors of caregivers' anxiety included Barthel index score ≤20 (OR=1.51), SSRS score ≤33 (OR=4.56), no time to relax (OR=1.57) and poor health status caregivers feeling (OR=3.48). ConclusionA relative high level of anxiety exists in family caregivers for the disabled elderly. Caregiver anxiety is a complex process, influenced by diverse care receiver and caregiver characteristics.
ObjectiveTo investigate the current status and influencing factors of self-care behavior of non-dialysis patients with chronic kidney disease (CKD).MethodsA total of 336 patients with CKD were investigated by a general data questionnaire, the CKD Self-care Behavior Scale, Social Support Scale, Generalized Anxiety Self-assessment Scale, and 9-item Patients Health Questionnaire through WeChat platform, and the influencing factors of self-care behavior were explored by binary logistic regression analysis.ResultsThe median score of self-care behavior of CKD patients without dialysis was 60, and the patients with median and high level of self-care behavior accounted for 97.6%. The score of self-care behavior of CKD patients without dialysis was positively correlated with the total score of social support (r=0.210, P<0.001), objective support score (r=0.127, P=0.020), subjective support score (r=0.195, P<0.001), and social support utilization score (r=0.164, P=0.002), and negatively correlated with the anxiety score (r=–0.132, P=0.015), depression score (r=–0.230, P<0.001), body mass index (r=–0.181, P=0.001), and systolic blood pressure (r=–0.168, P<0.001). The results of binary logistic regression analysis showed that the influencing factors of non-dialysis CKD patients’ self-care behavior were gender [(odds ratio, OR)=2.179, 95% confidence interval, CI (1.134, 4.187), P=0.019], systolic blood pressure [OR=0.967, 95%CI (0.947, 0.987), P=0.002], and depression score [OR=0.844, 95%CI (0.765, 0.931), P=0.001].ConclusionsThe self-care behavior of CKD patients without dialysis is at the median and high level. Healthcare workers can improve the self-care behavior of CKD patients by reducing their negative emotions such as depression, and guiding patients to carry out blood pressure management, to delay the progress of the disease.
ObjectiveTo systematically review the correlation between sleep quality and social support of the elderly.MethodsDatabases including PubMed, MEDLINE, The Cochrane Library, Springerlink, ProQuest, CMB, CNKI, VIP, and WanFang Data were searched to collect studies on the correlation between sleep quality and social support of the elderly from January 1996 to January 2020. Two reviewers independently screened literature, extracted data and evaluated risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsA total of 9 studies involving 2 427 elderly people were included. The meta-analysis showed that the combined correlation coefficient between sleep quality and social support was -0.40 (95%CI −0.54 to −0.26). The correlation between sleep quality and social support of the elderly varied with the year of publication and sample size, however without regular change. The correlation coefficient of the elderly from institutions (hospital or pension institutions) was higher than that of the community (−0.33 vs. −0.26); the correlation coefficient of the elderly with health problems was higher than those without health problems (−0.32 vs. −0.25); the results measured by non-random sampling method were higher than those measured by random sampling (−0.37 vs. −0.23); and the results measured by Pittsburgh sleep quality index (PSQI) and social support rating scale (SSRS) were higher than those measured by PSQI and perceived social support scale (PSSS) (−0.30 vs. −0.13).ConclusionsThe higher the level of social support of the elderly in China, the lower the score of PSQI, and the better the sleep quality, in which there are differences in different sample sources and physical conditions.
Objective To investigate the current status of control preference in the surgery of lung cancer patients and explore its correlation with perceived social support. MethodsGeneral information questionnaire, control preference scale, and perceived social support scale were used to investigate the lung cancer patients who underwent surgery in Beijing Cancer Hospital from February to May 2022. Results A total of 360 survey questionnaires were distributed, and 344 valid questionnaires were collected, with an effective rate of 95.6%. The expected participation style of patients was passive in 145 patients (42.2%), while the actual participation style was more inclined to be active in 154 (44.8%) patients. The compliance rate of patients’ expected and actual participation styles in the treatment control preference process was 61.9% (Kappa=0.437, P＜0.001). The results of the analysis of influencing factors showed that the level of cultural education was an influencing factor in the actual participation of lung cancer patients in surgery control preference (P=0.029). The results of Spearman's correlation analysis showed that the actual participation of lung cancer patients in surgery control preference was positively associated with perceived social support (r=0.159, P＜0.01), and its dimensions including family support (r=0.152, P＜0.01), friend support (r=0.133, P＜0.05), and other social support (r=0.142, P＜0.01). ConclusionPatients’ expected control preference style is generally consistent with their actual control preference style, which is influenced by their cultural education and positively correlated with perceived social support. Medical and nursing staff should pay attention to the participation style of patients taking surgery decisions, develop decision aids according to different education levels, and develop individualized interventions from the perspective of improving social support initially, to improve patients’ treatment compliance and treatment care satisfaction.
Objective To understand the incidence of stigma in non-dialysis chronic kidney disease (CKD) patients, and to explore its influencing factors, so as to provide a basis for scientific management of non-dialysis CKD patients. Methods Convenience sampling method was used to select non-dialysis CKD patients hospitalized in the Department of Nephrology, West China Hospital, Sichuan University between December 2019 and December 2020 as the research subjects. The general information questionnaire, Social Impact Scale and Social Support Rating Scale were used to investigate, and logistic regression analysis was used to explore the influencing factors of stigma in CKD patients without dialysis. Results A total of 300 questionnaires were distributed in this study, and 272 valid questionnaires were recovered, with an effective recovery rate of 90.67%. The age of the patients ranged from 15 to 83 years old, with an average of (38.34±13.64) years old. The disease course ranged from 1 month to 18 years, with a median of 3 years. The patients’ stigma score ranged from 23 to 86 points, with an average score of (40.14±1.67) points, of which 101 patients had a score of ≥48 (with stigma), accounting for 37.13%. Logistic regression analysis showed that gender [odds ratio (OR)=1.871, 95% confidence interval (CI) (1.018, 3.347), P=0.042], place of residence [OR=2.991, 95%CI (1.645, 5.824), P=0.001], personal monthly income [OR=0.575, 95%CI (0.260, 0.857), P=0.013], received CKD self-management education or not [OR=0.468, 95%CI (0.258, 0.843), P=0.011], and social support level [OR=0.418, 95%CI (0.230, 0.737), P=0.003] were influencing factors of stigma in CKD patients without dialysis. Conclusion The stigma of non-dialysis CKD patients is at a moderate level. Female, living in rural areas, personal monthly income ≤ 3000 yuan, not receiving CKD self-management education, and low social support level are risk factors for stigma in non-dialysis CKD patients.
ObjectiveTo investigate the current status and influencing factors of medical coping strategies in patients with gastrointestinal stromal tumors (GIST). MethodsA convenience sampling method was used to select 181 GIST patients who visited the First Affiliated Hospital of Nanjing Medical University from September 2022 to May 2024. The fear of progression questionnaire (FoP), brief illness perception questionnaire (BIPQ), social support rating scale (SSRS), and medical coping modes questionnaire (MCMQ) were administered for data collection. Multiple linear stepwise regression analysis was conducted to explore the influencing factors of the three types of medical coping strategies. ResultsMultivariate linear stepwise regression analysis showed that patients without tumor metastasis (P=0.016) and high support utilization (P=0.006) had higher score of confrontation coping. Patients with high education level (P=0.016) and subjective support (P=0.002) had higher score of avoidance coping. Patients with lower fear of physical health deterioration (P=0.003), high education level (P=0.010) and subjective support (P=0.027) had higher score of submission coping.ConclusionsThe influencing factors of medical coping strategies in GIST patients are complex, involving social support, disease-related fear, tumor metastasis, and education level. Providing comprehensive GIST-related knowledge and information to patients may help establish correct health beliefs and attitudes.