Objective:To explore the related factors of nutritional status in hospitalized elders with mental disorders.Methods:A total of 584 elders with mental disorders admitted to Beijing Huilongguan Hospital from June 2020 to June 2021 were selected by convenience sampling method. General questionnaire, Barthel Index Scale, Frailty Phenotype, Mini Nutritional Assessment, Simple Physical Fitness Scale (SPFS) , Family Function Assessment Scale were collected. Univariate analysis and Pearson correlation analysis were used to analyze the related factors of patients' nutritional status. Multivariate correspondence analysis was performed for significant variables in univariate analysis.Results:The incidence of malnutrition in hospitalized elders with mental disorders was 51.88% (303/584) , and patients were divided into three groups according to nutritional status, including good nutritional status group, risk of malnutrition group, and malnutrition group for statistical analysis. Univariate analysis showed that there were significant differences in age, diagnosis, frailty, smoking, drinking, BMI, Barthel score, SPPB, family function among three groups ( P<0.01) . Correlation analysis showed that BMI ( r=0.144, P<0.01) , Barthel index ( r=0.087, P<0.05) , family social function ( r=0.257, P<0.01) and nutritional status were positively correlated with nutritional status, while age ( r=-0.252, P<0.01) , frailty ( r=-0.216, P<0.01) were negatively correlated with nutritional status. Multiple correspondence analysis showed that dementia, over 81 years old, frailty, impaired activities of daily living, and family dysfunction were the related factors of malnutrition; schizophrenia, 71-80 years old, pre-debility, good ability of daily living were the associated factors of good nutritional status; bipolar disorder, 60-70 years old were the associated factors of malnutrition. Conclusions:The health supervision and nutrition screening of hospitalized elders with mental disorders should be strengthened, and targeted nutritional intervention strategies should be adopted for patients with different mental disorders, so as to reduce the health problems.

[目的]调查了解精神科护理人员法律知识掌握及依法执业现状,为规范精神科护理人员依法执业行为提供依据.[方法]用自行设计的调查问卷对北京市4家精神卫生专科医院的护理人员进行法律知识及依法执业行为进行调查.[结果]精神科护理人员接受法律知识相关学习培训较少,不同性别、职称和医院的护理人员对法律知识的认知程度比较差异有统计学意义(P<0.05);不同性别、年龄、职称、工作年限和医院的护理人员依法执业行为比较有统计学意义(P<0.05).[结论]精神科护理人员对相关法律知识认知及依法执业行为总体情况较好,低年资、低职称以及地区性医院的护士法律风险意识不强,依法执业观念薄弱,存在不良执业行为.医院要重视法制教育,通过系统的干预提高精神科护理人员的法律意识,规范依法执业行为,保证精神疾病病人护理质量和医疗安全,预防医疗纠纷的发生.

中国传统观念认为家庭具有促进、保护家庭成员健康的功能,父母、配偶和子女应给予患病的家庭成员精神、经济、物质的支持和营养及生理上多方位的照顾. 目前需要居家照护的多为失能老年人,居家护理人员多为配偶,也有父母、子女,家庭请来的陪护人员,上门服务的医院护理人员等.

Objective To explore the effects of continuous three-level nursing quality management on adverse events and severity among inpatients in mental health specialized hospital. Methods This study was based on data of 202 adverse events from 26 wards at a Class ⅢGrade A mental health specialized hospital from 2014 to 2017. The regression analysiswas used to explore the effects of continuous three-level nursing quality management on the incidence of adverse events and severity. Results Continuous three-level nursing quality management could reduce the incidence of adverse events (R2=0.278,F=5.421,P＜0.05) and decrease the severity (R2=0.73,F=3.872,P＜ 0.05) with statistical differences. Conclusions Three-level nursing intervention can reduce the adverse events and decrease the severity. However,it has no idea effects on dealing with emergency events of mental disorder patients. Improvements of nursing intervention for patients with one-level or two-level nursing should be paid attention to when using this method.

Objective? To analyze the characteristics of adverse events among elderly inpatients with mental disorders so as to provide a basis for formulating targeted nursing intervention. Methods? From 2014 to 30th June 2018, a retrospective analysis was used to analyze the adverse events at a Class Ⅲ Grade A mental health specialized hospital. We compared the adverse events between elderly (≥ 60 years old) patients with mental disorders and non-elderly (＜60 years old) inpatients without mental disorders. Results? From 2014 to 30th June 2018, there were 217 adverse events, in which 111 fell or fell off bed, 75 were accidents, 11 were pressure ulcers, 4 medication errors and 1 were pipeline slippage. The incidence of adverse events among elderly inpatients with mental disorders was 1.18% higher than that (0.38%) among non-elderly in patients without mental disorders. Among elderly patients, the severity of adverse events was (2.71±1.14). In the patients who had been through adverse events, there were statistical differences in age, disease diagnosis, nursing levels, scores of activities of daily living (ADLs) on admission, hospital stay and self-care ability between elderly and non-elderly inpatients with mental disorders(P＜ 0.05). There was statistical difference in the incidences of accidents between elderly and non-elderly patients (χ2=10.694,P=0.030). Conclusions? Falling is an adverse event with high incidence. It has special characteristics among patients in mental health department there there are many accidents, and the situation is complex with great varieties. The management of reported accidents should be improved. We should also pay attention to the consistency in the scores and judgment criteria of ADL among nurses, and make incident reporting system standardized so as to provide a firm basis for improving quality of medical management by analyzing and summarizing.

Objective? To discuss the effects of creatiue story therapy of the inpatients with moderate dementia. Methods? From January 2017 to June 2018, a total of 40 patients with moderate dementia from a ClassⅢ Grade A psychiatric hospital were selected as the research subjects. All the subjects were randomly divided into experimental group and control group, with 20 cases in each group. The control group was given routine nursing, while the experimental group received creatiue story therapy on the basis of routine nursing. The intervention lasted for 7 weeks. The Mini-mental State Examination (MMSE), Chinese Version of the Cohen-Mansfield Inventory (CMAI-CV) and Chinese Version of the Cornell Scale for Depression in Dementia (CSDD-CV) were applied to compare the effects of the two groups. Results? There was no significant difference in the total score of the MMSE scale between the two groups after 7 weeks (P＞0.05). The total score of CMAI-CV was (118.15±8.21) and the score of CSDD-CV was (4.01±1.34) in the experimental group after intervention, where were both lower than the control group, and the differences were statistically significant (t=-4.417,-6.535;P＜0.01). Conclusions? Creatiue story therapy can effectively improve cognitive function, reduce aggressive behaviors and improve depression in patients with moderate dementia.

目的 探讨在精神科护理质量管理方面,持续使用PDCA( Plan-Do-Check-Action)循环、根据原因分析法( Root Cause Aralysis,RCA)等质量管理工具对护理质量的长期影响.方法 以该院26个病区为例,分析比较2016~2017年各病区使用护理质量管理工具进行管理后的护理质量的评分结果.结果 持续使用护理质量管理工具能有效提高护理质量总分,减少过失扣分,在发挥主观积极作用的加分项上比较,差异无统计学意义(P>0. 05).结论 建议持续使用护理质量管理相关工具进行管理,同时应提高相关管理人员护理质量管理工具使用的熟练程度,并增加其他措施提高护理人员积极性.

ObjectiveTo investigate the experience and attitude of discrimination among family members of hospitalized patients with schizophrenia.Methods A total of 83 family members of hospitalized patients with schizophrenia were investigated using questionnaires of families experienced by discrimination and families' view on social discrimination of patients with mental illness.Results In the study,the three most common experiences included:68.7% of family members kept patients' schizophrenia as a secret in fear of discrimination;48.2% of family members failed in love or divorced because of discrimination;40.7% of family members were despised by neighbors. For the attitude of family members to discrimination,84.3% of family members thought that discrimination put too much stress on family members;79.5% of family members thought that social discrimination to patients with schizophrenia were more severe than to other disabled patients;71.0% of family members thought that social discrimination reduced their social activities;43.3% of family members thought that people discriminated patients with schizophrenia;and 77.1% of family members thought that in the past 20 years there was no reduction in the discrimination of patients with mental illness.Conclusions Discrimination commonly exists in schizophrenia patients' families and seriously affects family members both on psychological and social life. Doctors and nurses should assess the discrimination as part of the standard work not only for patients with mental illness but also for the family members,identify the high risk individual and help family members reduce the effects of discrimination on their lives.

Objective To understand the current situation of knowledge and attitude on depression in nurses in psychiatric and general hospitals of partial regions nationwide so as to provide targeted training on relevant knowledge for nurses.Methods A totals of 5497 nurses (2902 in psychiatric hospitals, 2595 in general hospitals) from 8 provinces were investigated with the adapted questionnaire of knowledge and attitude on depression.Results The scores of knowledge and attitude of nurses in psychiatric hospitals were (13.55±3.58) and (95.34±12.69), which were higher than those [(10.81±2.97), (89.02±15.31)] of nurses in general hospitals with significant differences (t=30.636, 16.824;P<0.01). The single factor analysis showed that there were statistically significant differences in the score of knowledge on depression of nurses between different departments, ages, marriages, educational background and working years (t=30.952, 23.217, 23.266, 40.065, 23.266, 40.065;P<0.05). Besides, there were statistically significant differences in the score of attitude on depression of nurses between different departments, ages, marriages, positional titles, educational background and working life (t=16.656,19.127,17.228,17.894,10.713,17.894;P<0.05). The regression analysis revealed that the influencial factors on knowledge were the property of department, educational background, positional titles and working years; the influencing factors for attitude were the property of department, educational background.Conclusions Clinical nurses are with low awareness of knowledge on depression along with negative attitudes with patients. Managers should draw up a training plan based on the property of department, educational background, positional titles, working years and so on for the nurses to strengthen the training on knowledge of disease and humanities, thus improving their service ability for patients with depression.

Objective To explore the efficacy of group cognitive behavioral therapy for improving depressive symptoms and social functional in patients with major depressive disorder.Methods A total of 160 patients with major depressive disorder were randomly divided into intervention group (n=80) and control group (n=80).Intervention group was treated with conventional antidepressants combined with group cognitive behavioral therapy.Control group was treated with one conventional antidepressants.All participants were assessed with Hamilton Depression Scale (HAMD)and Scale of Social function of Psychosis Inpatients (SSFPI) before and 8 weeks after the treatment.Results After 8 weeks treatment,the scores of HAMD (14.76±9.48) was significantly reduced and the scores of SSFPI(30.09±4.34) were significantly increased in intervention group compared with the baseline ((37.91± 10.58),(12.40±2.56),all P＜0.01).The scores of HAMD were significantly lower and the scores of SSFPI were significantly higher in intervention group than that in control group((20.71±7.85),(22.63±3.63),all P＜0.01).Conclusion Group cognitive behavioral therapy is effective for major depressive disorder patients by reducing depressive symptom and improving social function.

目的 调查精神专科医院护理工作环境及护士工作满意度现状,并分析二者的相关性.方法 采用横断面调查方法,纳入符合条件的154名精神科护士为研究对象,采用一般资料调查表、护理工作环境量表、护士工作满意度量表进行问卷调查.结果 精神科护理工作环境各维度得分均低于综合医院(P＜0.05),护理工作环境与护士工作满意度呈正相关(P＜0.01),工作环境现状是护士工作满意度的影响因素.结论 精神科护理工作环境水平较低,影响护士工作满意度,护理管理者应当继续优化护理工作环境各要素,进一步提升护士工作满意度,提高护理工作质量.

Objective To investigate the attitudes of nurses and nursing students to mental illness, and to compare the status quo. Methods A mental illness attitude questionnaire survey was conducted among 100 nurses who worked in a psychiatric hospital and 100 nursing students with technical secondary school education who studied course related Psychiatry in one health school.Results The attitudes presented that each sub-scale and nursing students mean score were beyond 51 compared between nurses of Department of Psychiatry and nursing students in health school;for the psychiatric disease being hard to cure and treat well, patients with no social value, avoiding, the differences of scores between nurses of Department of Psychiatry and nursing students had statistical significance ( P<0. 01 ) . Conclusions Nurses and nursing students have a negative attitude towards mental illness, and the nurses are more negative than nursing students;they are more accepted the discrimination for the patients and their families which causes impacts.

Objective To evaluate the effects of combination use of Glasgow Coma Scale(GCS)and the Standardized Swallowing Assessment(SSA)in the assessment of choking following Modified Electroconvulsive Therapy(MECT)in psychiatric department. Methods Totally,136 patients treated with MECT were divided into the observation group and the control group. Conventional assessment was used in the control group,while the observation group was assessed by GCS and SSA jointly,then comparison was conducted in two groups in eating,medicine time and choking situation. Results The average time of delaying food(medi-cine)in the observation group was significantly shorter than that of the control group. The number of people eating within 135 minutes after treatment was statisti-cally significant( P ﹤ 0. 05 ). The inicidence of choking in the observation group was significantly lower than that of the control group( P ﹤ 0. 05). Conclusion The GCS and SSA jointly quantitative assessment can effectively should patients’delaying food(medicine)time,and reduce the incidence of cho-king after MECT.

Objective To explore the correlation between coping mode and professional identity, self-efficacy, social support in clinical nurses, so as to provide references for nursing supervision. Methods A total of 142 clinical nurses were selected by convenience sampling in a grade three,first class hospital. Professional identity scale of nurses, GSES ( general self-efficacy scale) ,social support and coping mode scale were used to conduct the investigation. Results Social support, self-efficacy had correlation with personal response level (r=0. 325,0. 394;P<0. 01). The interaction was statistically significant between Cognition of occupation and self-efficacy (β= -0. 180,P<0. 05) and Cognition of occupation and social support with individual negative response (β=0. 220,P<0. 05). Conclusions Clinical nurses with high social support, high self-efficacy show more positive response when they face setbacks and pressure. Effect of occupation Cognition on individual passive coping style is adjusted by social support degree.

Objective To explore the positive effects of dancing train to self-esteem and social function in chronic schizophrenia patients.Methods By random sampling,40 male and 40 female chronic schizophrenic inpatients with dancing train were enrolled as the research group in our study training.According to gender,age,education,diagnosis,hospital stays and other factors,80 inpatients without dancing train were enrolled as the control group by paired choice.Both groups were evaluated with Self-esteem Scales (SES) and Scales of Social Practice of Inpatients (SSPI) at pre-and post-training.Results Comparison between the research group and control group showed that it had no significant difference between every value of scales in male and female before training; after training the research group's every indicants was better than that of the control group,and there were significant differences.Compared between pre-and post-training,the research group had significant differences but the control group did not.Before training,no significant differences between male and female of the research group.Compared with male inpatients,females achieved significantly better scores in SES,SSPI and 2 items of daily living and positive social communication after dancing train for 8 weeks.There were significant differences between male and female inpatients in SES,SSPI and 3 items of SSPI at pre-and post-train.Conclusions Dancing train can be effective to the residue symptoms in schizophrenic patients and improve social function and self-esteem of male and female inpatients.

<正>噎食是精神科常见的意外事件之一,而55.9%的老年精神病患者窒息是由于噎食所致[1]。精神疾病患者因疾病症状、药物作用、病程长等危险因素,以致发生噎食的危险性增高,因此,设计应用噎食风险评估表成为噎食风险管理的重要环节。

Objective To investigate the level of general self-efficacy and well-being among the junior employed nurses in military hospitals,and to analyze their correlation.Methods A total of 119 junior employed nurses in a military hospital were investigated with general self-efficacy scale and index of well-being.Results The score of general self-efficacy among junior employed nurses in military hospitals was(2.56 ± 0.48).The score of well-being index was(10.97 ± 2.05),both were lower than the norm(P 0.01),and they were positively correlated(P 0.05).Conclusion Nursing administrators should improve junior employed nurses' general self-efficacy,and then improve their well-being.This is a great significance to improve the clinical nursing quality and complete the medical support tasks.

Objective To investigate the effect of movie enjoyment on emotion of male patients with chronic schizophrenia.Methods A total of 62 standard patients with chronic schizophrenia from September to November 2011were selected and randomly divided into the experimental group(30) and the control group(32) by using a random number table.Patients in experimental group received movie enjoyment and routine rehabilitation project,while those in the control group received only routine rehabilitation project.Before the intervention and 12 weeks after the intervention,the patients were investigated with the Positive and Negative Affect Scale for efficacy assessments.Results After the nursing intervention,the scores of positive and negative affect were (30.79 ± 7.54) and (18.07 ± 5.97) respectively in the experimental group in contrast to (22.29 ± 8.14) and (18.00 ± 7.79) before the intervention,the difference was statistically significant (t =3.97,4.85,respectively;P ＜0.01).After the nursing intervention,the scores of positive and negative affect were(21.41 ±7.40) and (17.72 ± 7.03)respectively in the control group while were (23.25 ± 6.37)and (16.50 ± 6.08) before the intervention,the difference was statistically significant (t =2.67,1.98,respectively; P ＜ 0.05).There was statistically significant between the two groups in the scores of positive and negative affect after intervention(t =5.69,6.78 ;P ＜ 0.01).Conclusions The movie enjoyment can help improve positive emotions affect of patients with chronic schizophrenia.

Objective To investigate social avoidance and distress of military basic health workers and their perceived social support.Methods A total of 71 health workers who came for a training course from 16 military basic units were investigated by two scales which were Perceived Social Support Scale(PSSS)and Social Avoidance and Distress Scale(SAD).Results The military basic health workers got higher PSSS(t=12.435,P<0.01)and lower SAD(t=-7.839,P<0.01)than the theoretical value respectively.The level of basic health workers’ SAD from rural areas were significantly higher than those from urban areas(t=2.593,P<0.05).And the score of SAD and avoidance factor in the high PSSS group were both significantly lower than those of the low PSSS group’s(t=2.174,P<0.05).PSSS and outer family support factor score had a negative correlation with the scores of SAD and each factor(P<0.01).Conclusion The perceived social support of military basic health workers is in medium or above level,while the level of their social avoidance and distress is in low medium.And their social avoidance and distress differs from their sources,rural and urban.Perceived social support is an individual factor which affects the social avoidance and distress.

目的 探讨酒依赖患者自尊、自我效能及应对方式情况并分析三者之间的关系.方法 选取52例酒依赖患者为患者组,52名非医学工作者为对照组,采用自尊量表(SES)、一般自我效能感量表(GSES)及简易应对方式问卷(SCSQ)分别对两组进行评估,比较两组各量表得分并分析自尊与自我效能和应对方式间的关系.结果 患者组自尊、积极应对及消极应对方面的得分分别为(21.79±4.23),(21.06±6.60),(19.98±3.45)分均明显低于对照组的(26.85±3.29),(36.37±2.37),(25.13±2.93)分,差异均有统计学意义(t分别为-6.813,-15.745,-8.210;P＜0.01)；患者组的自尊与自我效能、积极应对呈正相关(r=0.199,0.564;P＜0.05),与消极应对呈负相关(r=-0.352,P＜0.01)；多元回归分析显示,积极应对是自尊的预测因子(t=4.860,P＜0.01).结论 护理人员应重视住院酒依赖患者的自尊水平,善于识别患者的应对方式,改善自我效能,帮助患者提高应对酒精的能力,降低复饮率。