目的:观察摄食指导联合吞咽功能训练在多发性肌炎合并吞咽障碍患者中的应用效果.方法:选取64例多发性肌炎合并吞咽功能障碍患者为研究对象,按照随机数字表法分为对照组和观察组各32例.对照组采用常规护理,观察组在对照组基础上采用摄食指导联合吞咽功能训练,比较两组临床疗效、护理前后生命质量[安德森吞咽困难量表(MDADI)]评分、营养指标[血红蛋白(Hb)、白蛋白(ALB)、上臂三头肌肌围(MAMC)]水平及并发症发生率.结果:观察组治疗总有效率为87.50％,高于对照组的59.38％,差异有统计学意义(P<0.05);干预后,观察组总体状况、情感、功能、生理等生命质量评分均高于对照组,差异均有统计学意义(P<0.05);观察组Hb、ALB、MAMC水平均高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为3.13％,低于对照组的28.13％,差异有统计学意义(P<0.05).结论:摄食指导联合吞咽功能功能训练联合常规护理应用于多发性肌炎合并吞咽障碍患者,可提高临床疗效和营养指标水平,提高生命质量,且可降低并发症发生率,其效果优于单纯常规护理.

目的 探讨积极心理学视野下表达性艺术治疗对慢性阻塞性肺疾病(COPD)患者自我效能及心理韧性的影响.方法 选取2018-2019年90例COPD患者,随机分为观察组与对照组,每组45例,对照组给予常规干预措施,观察组给予积极心理学视野下表达性艺术治疗干预,比较两组患者自我感觉负担、自我效能、自我管理、焦虑抑郁、心理韧性、总体幸福感.结果 干预前,两组在自我感觉负担、自我效能、自我管理、焦虑抑郁、心理韧性、总体幸福感方面的评分,差异均无统计学意义(P值均＞0.05).干预后,①观察组自我感觉负担中身体负担评分低于对照组[(12.01±1.93)vs.(13.40±1.75),P＜0.05],情感负担评分低于对照组[(8.06±1.11)vs.(9.88±1.03),P＜0.05],经济负担评分低于对照组[(2.65±0.38)vs.(3.14±0.95),P＜0.05],自我感觉负担总分低于对照组[(22.64±1.89)vs.(26.43±1.96),P＜0.05];②观察组自我效能评分高于对照组[(29.88±2.14)vs.(27.02±2.25),P＜0.05],观察组自我管理评分低于对照组[(2.91±0.97)vs.(3.38±0.86),P＜0.05];③观察组焦虑SAS评分低于对照组[(37.31±4.05)vs.(43.06±5.12),P＜0.05],抑郁SDS评分低于对照组[(45.45±5.80)vs.(50.88±5.27),P＜0.05];④观察组心理韧性中坚韧性评分高于对照组[(37.65±6.38)vs.(33.88±5.80),P＜0.05],自强性评分高于对照组[(28.78±4.25)vs.(24.92±4.63),P＜0.05],乐观性评分高于对照组[(15.07±3.19)vs.(12.57±2.97),P＜0.05],心理韧性总分高于对照组[(81.88±5.42)vs.(72.65±8.14),P＜0.05];⑤观察组总体幸福感维度中对健康的担心评分均高于对照组[(11.73±1.91)vs.(8.06±1.66),P＜0.05],精力评分均高于对照组[(20.13±3.01)vs.(14.19+2.59),P＜0.05],对生活满足与兴趣评分均高于对照组[(5.98±1.14)vs.(4.97±0.36),P＜0.05]、忧郁或愉快心境评分均高于对照组[(16.66±2.18)vs.(12.25±2.17),P＜0.05],对情感和行为控制评分均高于对照组[(13.43±1.23)vs.(11.01±1.48),P＜0.05],松弛与紧张评分高于对照组[(19.88±1.73)vs.(15.60±2.36),P＜0.05].结论 积极心理学视野下表达性艺术治疗可有效减轻COPD患者自我感觉负担,提高自我效能与自我管理能力,降低心理焦虑抑郁状态,改善心理韧性,提高总体幸福感.

Objective:To explore the effects of smart stress balls on the compliance of functional exercise and the incidence of complications in patients with midline catheters.Methods:By convenient sampling, totally 59 patients who received midline catheterization in the Department of Gastroenterology at the First Affiliated Hospital of Zhengzhou University from June to August 2019 were selected as the control group, while 58 patients who underwent midline catherization between October and December 2019 were selected as the observation group. Patients in the control group used traditional stress balls in function exercise after catherization, whereas patients in the observation group used smart stress balls in function exercise. The compliance of functional exercise and incidence of catheter-related complications after catherization were compared between the two groups of patients.Results:The functional exercise compliance score in the observation group was (39.66±2.62) , higher than (18.58±6.37) in the control group, and the difference was statistically significant ( t=-50.470, P<0.01) . The total incidence of complications in the observation group was 3.4% (2/58) , lower than 15.3% (9/59) in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:The use of smart stress balls can improve the functional exercise compliance and reduce the incidence of catheter-related complications after catheterization in patients with midline catheters, which is worth promoting in clinical practice.

Objective:To explore the application of attributional training in postoperative emotion management of patients with non-small cell lung cancer (NSCLC) .Methods:Using the convenient sampling method, a total of 128 NSCLC patients after surgery who were admitted to the First Affiliated Hospital of Zhengzhou University from August 2017 to July 2019 were selected as research objects. A total of 64 NSCLC patients after surgery who were enrolled from August 2017 to July 2018 were set as the control group, and the other 64 NSCLC patients after surgery who were enrolled from August 2018 to July 2019 were set as the observation group. Patients in the control group were given routine nursing while patients in the observation group were given attribution training based on routine nursing. Attribution Style Questionnaire (ASQ) , Hospital Anxiety and Depression Scale (HADS) and Functional Assessment of Cancer Therapy-Lung Cancer (FACT-L4) were used to evaluate the effect of intervention.Results:After intervention, the total ASQ score of the observation group was higher than that of the control group, and the difference was statistically significant ( P<0.01) . After intervention, the scores of anxiety and depression dimensions in HADS of the observation group were lower than those of the control group, and the differences were statistically significant ( P<0.01) . After intervention, the total score and scores of all dimensions of FACT-L4.0 of the observation group were all higher than those of the control group, and the differences were statistically significant ( P<0.01) . Conclusions:Attribution training can help postoperative NSCLC patients to establish positive attribution styles, effectively alleviate their negative emotions and improve their quality of life.