Objective To systematically review the psychological resilience intervention in China, so as to evaluate its effectiveness. Methods Studies published as of October 2012 were searched in CBM, VIP, CNKI and WanFang Data. The randomized controlled trials (RCTs) and controlled before-and-after trials (CBAs) about psychological resilience intervention were included. Two reviewers independently performed screening, quality assessment and data extraction, and then reached a consensus after cross-check and discussion. Qualitative synthesis was adopted instead of meta-analysis for the existed significant deviations in outcomes of included studies. Results A total of 8 studies including 3 RCTs and 5 CBAs were included for the analysis. All the studies referred to the objects of students, including 6 for college students, 1 for secondary school students and 1 for left behind students in rural junior school. All 8 studies evaluated the effectiveness of group psychological guidance, 1 of which also compared the outcomes of psychological lectures. All the included trials suggested that group psychological guidance and psychological lectures might significantly improve the psychological resilience of subjects. Conclusion Current studies on psychological resilience intervention are limited, the measure has been taken seems relatively single, which mainly focuses on students and lacks of high-quality research design. It suggests take more diverse psychological resilience interventions for different population, and evaluate both short-term and long-term effectiveness by performing large sample, strictly designed and high-quality trials.
In the hospital where centralized treatment was applied for the victims after Yiliang earthquake (on 7th September, 2012), a holistic rehabilitation service mode which centred on supportive psychological intervention promoting was developed by the Yiliang psychological crisis intervention team designated by the National Health and Family Planning Commision of the People’s Republic of China. The pattern takes psychological nurses as liaison, bases on the integrity and continuity of medical service, roots in comprehensive health assessment and key assessment of mental trauma stress, emphasizes on solving realistic problems for patients and their caregivers, provides supportive psychological intervention, and encourages psychological nurses to offer psychological support for earthquake victims with the help of quantitative self-assessment of social psychological support service. In practice, the mode of psychological services, which could be contiuously conducted, is welcomed by hospital managers, work staff, and earthquake victims and their caregivers.
Shortly after the earthquake in Min county and Zhang county, the department of health of Gansu province immediately established a leadership team for earthquake relief and medical rescue, subordinated by psychological crisis intervention teams, which was responsible for training relevant personnel to carry out psychological intervention, and spreading related knowledge about earthquake. Then, emergency psychological intervention was provided for the key population (more than 90 times in total, involving 8 194 person-times). We also offered individualized psychological services (617 person-times), and diagnosed 31 patients with mental disorders through consultation. After the earthquake, the emotion of victims including depression, anxiety and acute stress disorder increased. The workload of psychological crisis intervention after earthquake was heavy and hard. However, Gansu province needs national support due to poor resources.
Objective To systematically review the methodological quality of guidelines concerning pharmacological intervention for complicated hypertension. Methods The databases and relevant guideline websites such as MEDLINE, EMbase, CBM, WangFang Data, National Guideline Clearinghouse (NGC), Guidelines International Network (GIN), National Institute for Health and Clinical Excellence (NICE) and Clinical Practice Guideline Network (CPGN) were searched to collect the clinical guidelines concerning pharmacological intervention for complicated hypertension. By adopting the Appraisal of Guidelines for Research and Evaluation (AGREE), the methodological quality of guidelines was assessed. Meanwhile the similarities, differences and features of drug recommendation in guidelines for different areas and diseases were analyzed by means of analogy comparison.Results A total of 21 guidelines concerning pharmacological intervention for complicated hypertension were included. The number of guidelines concerning hypertension complicated with coronary heart disease (CHD), stroke, diabetes mellitus (DM) and kidney disease (KD) was 5, 5, 7 and 4, respectively. The publication year ranged from 2000 to 2011. According to the AGREE instrument, 19 and 2 guidelines were graded as Level B and C, respectively. The overall guidelines got low average scores in the domain of “Stakeholder involvement” and “Applicability”, including 9 evidence-based guidelines. There were totally 4 and 3 classes in terms of the level of evidence and recommendation, respectively; moreover, 10 and 6 expression forms were adopted in the level of evidence and recommendation, respectively. For hypertension with angina pectoris, -blocker (BB) and calcium channel blocker (CCB) were recommended unanimously. For hypertension with myocardial infarction, angiotensin converting enzyme inhibitor (ACEI) and BB were recommended unanimously. For hypertension with heart failure, ACEI, angiotensin-receptor blocker (ARB) and BB were recommended unanimously. For hypertension with later stage of post-stroke, 76.47% guidelines recommended diuretic (D) and ACEI. For hypertension with acute stroke, recommendations were mainly based on the guidelines developed by American Heart Association/American Stroke Association (AHA/ASA). For hypertension with DM or KD, the guidelines basically recommended that systolic/diastolic pressure should be controlled in the range of less than 130/80 mmHg. For hypertension with DM, ACEI were recommended unanimously, followed by D and CCB. For hypertension with KD, ACEI/ARB was recommended, while 3 of the 5 guidelines recommending CCB were from Asian. Conclusion The overall methodological qualities of complicated hypertension guidelines differs, with high proportion of evidence-based guidelines. The classification criteria of the levels of evidence and recommendation are still suboptimal. For hypertension with CHD, DM, KD and later stage of stroke, results from high quality clinical evidence are consistent, and the recommendations are basically unanimous, with no regional and quality difference. But in some clinical researches beyond reaching a consensus at present, the recommendation discrepancy exists, and there still remains controversy for hypertension with acute stroke.
目的 监测重症医学科（ICU）呼吸机相关性肺炎（VAP）的发病率，探讨实施干预组合措施对VAP发病率的影响。 方法 对2011年6月1日－2012年5月31日ICU使用呼吸机患者478例为监测对象并按时间先后分为两组，对照组按规范方法进行干预，试验组在规范干预基础上再采取组合干预措施，包括：每日评估患者、用一次性呼吸机螺纹管、用床角量角标识抬高床头、床尾设置黄色警示线、调查手卫生依从性等，统计分析两组VAP发病率。 结果 共监测ICU患者5 937个住院日，使用呼吸机1 510个机械通气日，呼吸机使用率25.43%，发生VAP 60例，VAP发病率为39.74例/1 000机械通气日，其中对照组发生VAP 21例，使用呼吸机343个机械通气日，VAP发病率为61.22例/1 000机械通气日；试验组发生VAP 39例，使用呼吸机1 167个机械通气日，VAP发病率为33.42例/1 000机械通气日，两组发病率差异有统计学意义（χ2=12.702，P=0.000）。 结论 实施干预组合措施可使VAP发病率显著下降，但仍高于国内外大型医院，基层医院还需不断努力控制好VAP的发病率。
目的:探讨护理干预对减少新生儿溢乳的效果。方法:将159例新生儿依随机数字法分为干预组(80例)与对照组(79例),干预组按计划进行护理干预与常规护理,对照组仅进行常规护理。结果:干预组溢乳发生13例,发生率1625%,对照组46例,发生率5823%,两组比较差异有显著性(Plt;001)。结论:护理干预降低了溢乳发生及生理性体重下降过快过长,促进新生儿身心发育。