目的 调查精神科护士的职业认同与社会支持、执业环境等的相关性分析.方法 采用护士职业认同感量表、领悟社会支持量表(PSSS)、护士职业倦怠量表、护士工作压力源问卷及护士执业环境量表,对某三级甲等精神专科医院的护理人员进行随机抽样调查.结果 精神科护士职业认同与性别、学历、婚姻状况、职务、护士层级、岗位、工作性质、在编情况、经济收入、家庭结构、是否有改行想法等存在相关性(P<0.05).职业认同3个因子评分均与领悟社会支持3个因子评分及护士执业环境总分呈正相关(P<0.01);职业认同的职业自我概念因子与护士工作压力源的工作环境及仪器设备问题、患者护理方面的问题2个因子以及护士职业倦怠的生理心理因子呈正相关(P<0.05),与护士职业倦怠中的护士工作中常见的压力源因子呈负相关(P<0.05).护士执业环境总分、领悟社会支持朋友支持因子是职业认同的影响因素(P<0.05).结论 了解精神科护士的职业认同感以及相关因素,制定相关的支持措施和制度,降低精神科护士的职业倦怠,改善其执业环境有着重要的意义.

Objective:To explore the relationship between the psychiatric nurses' generall well-being and personality characteristics, and provide the basis for manages to implement humanized management and improve the nurses'happiness from the perspective of positive psychology.Methods:The general questionnaire, general well-being scale and big five personality questionnaire were used to investigate 205 nurses in Shandong Mental Health Center.Results:Psychiatric nurses had a subjective well-being score of (76.50±13.33). The difference of subjective well-being between nurses of different genders was statistically significant( P<0.05). The multivariate stepwise regression analysis of nurses' subjective well-being and personality characteristics showed a significant correlation. Conclusions:The generall well being of psychiatric nurses' was in the medium level.The psychiatric nurses' personality characteristics is an important factor affect their happiness.Under the guidance of positive psychology, hospital managers should put people first, implement humanized management, and strive to build humanistic care, so as to improve the subjective well-being of nurses.

目的 探讨应对方式在精神分裂症患者家属病耻感与领悟社会支持间的中介作用,为临床制定有效干预措施,减轻其病耻感提供依据.方法 采用方便抽样法对2019年4-11月在山东省精神卫生中心住院的155例精神分裂症患者及其家属(均选取1位与患者有血缘关系的家属),应用一般资料调查表、病耻感系列量表中的贬低-歧视感知量表、简易应对方式问卷和领悟社会支持量表进行调查,并使用AMOS 22.0建立结构方程模型进行验证分析.结果 患者家属病耻感均分为(2.59±0.50)分;积极应对均分为(1.86±0.52)分,消极应对均分为(1.24±0.45)分;领悟社会支持总分为(59.77±13.39)分,其中家庭支持(20.50±4.82)分、朋友支持(19.32±4.73)分、其它支持(19.94±4.87)分.精神分裂症患者家属病耻感与积极应对、家庭支持、朋友支持及其它支持呈负相关(r=-0.650～-0.356,P<0.01),与消极应对呈正相关(r=0.232、0.183、0.159、0.215,P<0.01),积极应对与家庭支持、朋友支持、其它支持呈正相关(r=0.363～0.314,P<0.01),家庭支持与朋友支持和其它支持成正相关(r=0.741、0.784,P<0.01).结构方程模型显示:领悟社会支持→消极应对→病耻感"的中介效应不显著(β=0.025,P=0.268),予以剔除."领悟社会支持→积极应对→病耻感"间接效应显著,领悟社会支持可直接负向预测病耻感,路径系数为-0.25,领悟社会支持也可通过积极应对间接影响病耻感,效应值为-0.331,中介效应比例占总效应的56.64％.结论 积极应对在精神分裂症患者家属病耻感与领悟社会支持间起中介作用,关注精神分裂症患者家属的领悟社会支持和应对方式,有助于降低其病耻感水平.

目的 调查精神科护士受攻击情况的现状以及与护士的职业认同、社会支持、执业环境等的相关关系分析.方法 采用一般资料调查问卷、护士职业认同感、领悟社会支持、护士执业环境、护士职业倦怠及护士工作压力源量表,对200名某三级甲等精神专科医院护士进行调查,有效问卷186份(93％).结果 186名精神科护士中,受攻击者112名,总发生率60.2％.护士受攻击与工作年限、婚姻状况、职称、聘用性质、职业认同感、社会支持和执业环境等因素有关.护士压力源量表和护士职业倦怠量表各因子分与护士受攻击发生情况未发现显著性关系.结论 精神科护士受攻击的发生率高,职业风险大,改善精神科护士执业环境,提高精神科护士的职业认同感以及对精神科护理工作的积极的接纳态度和正性认识水平,对降低精神科护士受攻击风险具有重要意义.

Objective To explore the feasibility and effectiveness of quality control circle (QCC) activities in psychiatric hospital to improve the hospital management ability and knowledge in grass-roots employees.Methods A series of QCC activities had been held in psychiatric hospital,such as establishing leading group of QCC,formulating activity plan,holding QCC knowledge training,founding QCC groups,carrying out QCC promotion conference,and inviting specialist to be the supervisor,evaluating the process and result of the activities,giving rewards to excellent QCC group.Results 29 QCC groups had been established and their themes were about clinical medical,nursing care,pharmaceutical affairs,logistical support,public administration and etc.27 QCC groups had completed their final report and 2 QCC groups fell off;the completive rate was 93.1％.The target achievement ratio was 110.3％,and the progress rate was 47.3％.44 research results were put into use and standardization;the intangible results and knowledge were upgraded.Conclusion It's practicable and effective for QCC to be used in psychiatric hospital,which may resolve practical issues in work and improve management ability and knowledge level in grass-roots employees.

Objective To explore the relationship among psychological resilience, self-efficacy and core competence in psychiatric nurses. Methods Totally 237 psychiatric nurses in a psychiatric hospital in Shandong province were recruited and assessed with general information questionnaire, Connor-Davidson Resilience Scale, General Self-Efficacy Scale and Competency Inventory for Registered Nurse. Results The total core competence of psychiatric nurses was (2.59 ± 0.66) points, at a moderate level. Psychological resilience were positively corrected with self- efficacy (r=0.454,P=0.000) and core competence (r=0.647, P=0.000), self-efficacy were positively corrected with core competence (r=0.487, P=0.000). Psychological resilience partially mediate the relationship between self- efficacy and core competence, It′s mediating effect was 44.8%. Conclusions Psychological resilience plays an important role to core competence in psychiatric nurses.Nursing managers should carry out related training, improve the psychological resilience and self-efficacy of psychiatric nurses, and comprehensively improve the level of core competencies.

目的:探讨品管圈(QCC)活动在精神病专科医院护理质量管理中的应用效果.方法:在精神病专科医院启动QCC,鼓励临床科室参与QCC,通过培训、推进会及专家指导等方式,严格按照QCC十大步骤,完成QCC并按完成情况进行专家评审.结果:本期QCC共启动护理质量管理品管圈14个,主题涉及患者安全防护5个、护理管理4个、差错预防2个、健康教育2个及服务满意度1个;通过专家评审共结题11个,结题率78.57％,平均目标达成率109.73％,平均目标进步率57.64％;在实施过程中,质量管理工具技术的掌握率和圈能力均明显提高,通过标准化圈成果得到很好应用,促进了护理质量管理水平.结论:在精神病专科医院护理质量管理中非常适合使用QCC,且具有良好的可行性和有效性.

Objective To explore the correlation between self-esteem,trust levels and life experience related factors in high school students.Methods A total of 1 787 high school students in Jinan were selected through convenience sampling combined with stratified cluster random sampling and assessed with Self-esteem Scale(SES),Trust Scale(TS)and general information questionnaire.There were 1 552 students finishing the whole investigation process.Results The total scores of SES and TS in high school students were 29.29 ±4.91 and 79.62 ±14.44 respectively.The SES score was correlated with family type,family harmony level,economic condition,parents’occupations,father’s marital status,mother’s education background,abuse and neglect in childhood as well as intimate relationship with parents (P <0.05).The TS score was correlated with family harmony level,emotional abuse and neglect in childhood as well as intimate relationship with parents (P <0.05).High school students with low levels of self-esteem and trust had worse academic performance and interpersonal relationship (P <0.05).Conclusion Self-esteem and trust levels of high school students are influenced by their parents,family,life experience and etc.,and they are correlated with students’academic performance and interpersonal relationship.

Objective To explore the incidence of impulsive and aggressive behavior and the personality characteristics of inpatients with schizophrenia.Methods A total of 195 inpatients with schizophrenia were evaluated by Impulsive scale,Aggressive scale,Positive and Negative Symptoms Scale(PANSS).Results 56 patients(28.72%)had impulsive and aggressive behavior before admission,and 20 patients(10.26%)had the behavior during hospitalization.The patients with impulsive and aggressive behavior had significantly higher sub-score of behavior in Impulsive scale,higher total score and sub-scores of physical attacks and self-attacks in Aggressive scale than patients without the behavior.The differences of total and factor scores in PANSS were not found between the two groups.The total scores and sub-scores of Impulsive and Aggressive scale had no significant correlation with total and factors scores of PANSS.Conclusion The impulsive behavior of patients with schizophrenia would be related to impulsive and aggressive personality,and not to psychotic symptoms.

对精神病患者进行健康教育是精神科治疗和护理的重要措施之一.本文通过复习近5年我国精神科开展健康教育的有关文献,分析了精神科临床健康教育的实施现状,指出了精神科健康教育实施过程中存在的问题,并提出了改进措施.现报告如下.

自知力缺乏会直接影响患者的住院、治疗的依从性,进而影响患者的治疗效果和社会功能康复.2003年2～11月,通过对104例男性住院精神分裂症患者进行有关健康教育的对比研究,结果显示,健康教育能促进患者自知力的恢复,提高患者治疗的依从性,进而提高患者的治疗效果。

整体护理是以现代护理观为指导,以护理程序为框架,根据病人身心、社会、文化等需要,系统地整体地进行护理服务和护理管理的工作模式.整体护理的核心是以病人为中心的护理程序,其基础是建立健康的护患情感交流.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">应用抑郁自评量表（ＳＤＳ）调查１４１例恢复期住院精神分裂症患者，５０．３５％的患者有不同程度的抑郁症状，主要影响因素为：与医务人员交流感情的机会、从家中得到安慰和理解的机会、婚姻、与家人交流感情的机会、对前途的担心。</span>