目的 探讨CYP2D6基因多态性与利培酮治疗精神分裂症的相关性.方法 共计收集296例精神分裂症患者,并进行CYP2D6基因多态性检测.根据检测结果,将98例检测结果08CYP2D6基因检测为TT、10CYP2D6基因检测为GG、06CYP2D6基因检测为CC,基因型分析结果为*10/*10,代谢型为IM的患者视为研究组,将198例其他基因型的患者视为对照组,均应用利培酮系统治疗,共6周.在基线和治疗后第2、4、6周末使用阳性和阴性综合征量表(PANSS)、临床总体印象量表-病情严重程度(CGI-SI)、治疗中需处理的不良反应症状量表(TESS)评定疗效和安全性.结果 在治疗后第6周末,研究组的利培酮用量低于对照组(P<0.05).治疗后第4、6周末,两组CGI评分、PANSS总分及各因子分均较各自基线时降低(P<0.05).在治疗后第2、4、6周末,研究组的TESS评分及不良反应例次数均低于对照组(P<0.05).在治疗后第6周末,研究组的总不良反应发生率低于对照组(P<0.05).结论 CYP2D6基因多态性检测结果:08CYP2D6基因检测为TT、10CYP2D6基因检测为GG、06CYP2D6基因检测为CC、基因型分析结果为*10/*10,代谢型为IM的精神分裂症患者选用利培酮系统治疗,可取得较好的临床疗效,更低的药物治疗剂量,更高的治疗安全性.

Objective:To investigate the situation of nursing handover among psychiatric nurses, and explore the association between perceived organizational support, self-efficacy and quality of nursing handover.Methods:A total of 186 clinical nurses in Shandong Mental Health Center were enrolled by convenience sampling method. They were assessed with handover evaluation scale, perceived organizational support scale and general self-efficacy scale for the evaluation of nursing handover, perceived organizational support and self-efficacy.Results:The average score of quality of nursing handover was 5.85±1.14, and bi-variate correlations were found between perceived organizational support, self-efficacy and quality of nursing handover. Self-efficacy could mediate the relationship between organizational support and nursing handover, and the value of mediating effect was 13.4%.Conclusions:Self-efficacy might mediate the relationship between perceived organizational support and nursing handover among psychiatric nurses.

Objective To examine the potential mediating effect of perceived social support on job insecurity and psychological distress among clinical nurses. Methods A total of 462 clinical nurses in Shandong Province were selected by convenience sampling method. They were assessed with job insecurity scale, perceived social support and 10-item Kessler Psychological Distress Scale ( K10) for the evaluation of job insecurity, self-esteem and psychological distress. Results The mean score of K10 was (23.72 ± 7.22) points among clinical nurses, and 85.9% (397/462) of them had psychological distress problems. The K10 scores were positively correlated with the scores of job insecurity (r=-0.282, P＜0.01), and the K10 scores were negatively correlated with perceived social support scores (r=-0.282, P＜0.01). Job insecurity was negatively correlated with perceived social support (r =-0.365, P＜0.01). The confidence interval from Bootstrap method indicated perceived social support played a partial mediating role between job insecurity and psychological distress,and the value of mediating effect was 13.7% . Conclusion The relation of perceived social support to job insecurity and psychological distress among clinical nurses are intimate. Perceived social support might mediate the relationship between job insecurity and psychological distress.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">&lt;正&gt;照顾准备度是指照顾者为照顾家庭成员或患者生理及心理需求所做的准备,包括提供服务和处理紧急情况相关的准备^[1]。目前关于照顾者准备度研究多集中在脑卒中、痴呆及癌症姑息治疗患者,针对精神分裂症照顾者准备度的研究较少,对照顾者准备度影响因素及干预策略尚处于探索阶段^[2]。因此,本研究主要探讨精神分裂症照顾者准备度的影响因素,以期为完善相关支持项目、实施干预策略提供依据和新思路。1对象与方法</span>

从运动疗法的概念及其应用必要性、研究现状及影响因素进行分析,以期为精神分裂症患者的运动康复提供理论依据.提出为取得患者配合,确保运动安全,护士需做好健康教育、运动准备,监督运动过程,以及做好心理支持.并提出应依据患者自身状况,制定个性化运动方案,提高患者运动兴趣,积极关注患者锻炼过程中动机的动态变化对运动行为的影响.

目的:了解国内精神科保护性约束研究热点,明确目前该领域存在的问题,为精神科临床实践提供指导依据.方法:从中国知网(CNKI)、万方数据库、维普数据库(VIP)搜索相关文献,运用文献计量学方法进行分析.结果:共纳入文献118篇,量性研究占60.2％;约束器具类型多样化、功能人性化;应用不同质量管理理论;以约束率及约束时间、精神症状改善、约束护理质量、患者及家属心理反应及满意度、生活质量作为结局变量;存在主要问题:约束环节缺乏明确细化标准、样本量小、研究指标单一.结论:我国精神科保护性约束日益受到重视,但应用过程中存在一些局限,如缺乏约束操作规范及长期随访研究,需要后续进行深层次、多角度研究.

[目的]分析精神科护士遭受暴力伤害行为的影响因素.[方法]回顾我院2013年1月—2016年9月上报至护理部遭受精神疾病病人暴力伤害护理人员的档案资料,进行统计分析.[结果]发生暴力伤害行为106起,共140名护士遭到暴力伤害.男护士、年龄＜40岁、护士及护师职称、工作年限≤5年的精神科护士更易遭受暴力伤害;年龄＜40岁、住院时间＜7d、精神分裂症病人更易发生暴力伤害行为.[结论]精神科护士遭遇暴力攻击行为发生率较高,对精神科护士进行针对性暴力行为应对技能培训,提高其防护意识,有助于减少暴力伤害行为发生,维护护士身心健康.

精神科护理工作是一门兼具专业性、技术性及风险性等综合特征的临床工作.仅就精神科护理工作的风险而言,具有高发性、随时性和不可预测性,致使降解风险难度很大.

探讨家庭护理干预对抑郁症患者的疗效。方法:将100例抑郁症患者随机分为实验组和对照组各50例,两组患者均接受常规治疗及护理,观察组在此基础上进行为期3个月的家庭护理干预,并用汉密尔顿抑郁量表(HAMD)评分,进行疗效比较。结果:干预前两组HAMD评分差别无统计学意义(P>0.05)。干预3个月后,观察组HAMD评分明显低于对照组,差异有统计学意义(P<0.05)。实验组患者的生活质量总评分优于对照组(P<0.05)。结论:家庭护理干预对抑郁症患者疗效显著,值得推广应用。