Objective To explor the influence of the hospital-community-family mental rehabilitation mode on the quality of life of patients with schizophrenia. Methods We selected 101 patients diagnosed as schizophrenia according to ICD-10, who were hospitalized in mental health center of the West China Hospital and took part in rehabilitation voluntarily after discharge. Those patients were randomly assigned to two groups. Hospital-community-family mental rehabilitation mode intervention was applied to the patients based on inpatient rehabilitation in the trial group (n=52), while inpatient rehabilitation alone was applied in the control group (n=49). The total score of quality of life, psycho-social dimension, motivation and energy dimension, score of mental disability and social function, and family social care index were recorded. Then, statistical analysis was performed using SPSS 17.0 software. Results After 3 months and 6 months, the trial group had lower scores of the total score of quality of life, psycho-social domain, and motive and energy dimension than those of the control group (Plt;0.05). After 6 months, the trial group had lower scores of mental disability and social function (Plt;0.05) but a higher score of family social care index (Plt;0.05). The scores of WHO-DSA II and SQLS were positively correlated, while the scores of APGAR and SQLS were negatively correlated. Conclusion The integral mode of hospital-community-family mental rehabilitation effectively improves the quality of life of patients with schizophrenia, which also positively improves patients’ rehabilitation.
Objective To investigate the prognostic factors of severe chronic obstructive pulmonary disease ( COPD) in elderly patients, and to guide the clinical assessment and appropriate interventions. Methods A prospective cohort study was carried out from May 1993 to December 2010. A total of 178 elderly patients with severe COPD were recruited for baseline survey, and followed up for the living conditions, whether used non-invasive ventilation, and causes of death. A survival analysis was performed on all patients stratified by lung function. The significant factors on survival rate were analyzed. Results In this cohort the survival rates were 49% and 12% in five and ten years, respectively. The important factors for prognosis were age [ relative risk( RR) = 1. 043, 95% confidence intervals( 95% CI = 1. 010-1. 050] , forced expired volume in one second ( FEV1 , RR = 0. 019, 95% CI = 0. 007-0. 052) , FEV1% pred ( RR = 1. 045, 95% CI = 1. 012-1. 079) , lung function grade ( RR = 2. 542, 95% CI = 1. 310-4. 931) , body mass index ( BMI, RR= 0. 945, 95% CI = 0. 895-0. 952) , and pulmonary heart disease ( RR = 1. 872, 95% CI = 1. 188- 2. 959) . In severe COPD, non-invasive ventilation ( NIV, RR = 1. 167, 95% CI = 0. 041-1. 674) , pulmonary heart disease ( RR = 3. 805, 95% CI = 1. 336-10. 836) , FEV1 ( RR = 0. 081, 95% CI = 1. 001-1. 168) , and arterial partial of oxygen ( PaO2 , RR=0. 956, 95% CI =0. 920-0. 993) were the independent predictors.The patients using NIV had longer survival than those without NIV. The 5 and 10 years survival rate in the patients with NIV were 78% and 50% , much higher than those without ventilation which were 30% and 25% , respectively. In extremely severe COPD, FEV1 ( RR=1. 059, 95% CI =1. 015-1. 105) , arterial partial of carbon dioxide ( PaCO2 , RR=1. 037, 95% CI = 1. 001-1. 074) , age ( RR= 1. 054, 95% CI = 1. 013-1. 096) and pulmonary heart disease ( RR = 1. 892, 95% CI = 1. 125-3. 181) were the independent predictors. Conclusions Age, BMI, FEV1 , PaO2 , PaCO2 , pulmonary heart disease, and NIV were prognostic factors in elderly patients with severe COPD. The prognostic factors between severe and extremely severe COPD were not identical. Patients with severe COPD should be given early intervention, including progressive nutritional support, and long-term home oxygen therapy combining with NIV.
Objective To investigate the family burden of depression inpatients, analyze the influencing factors and explore the approach to reduce the family burden. Methods On-the-spot investigation was conducted for the family members of 200 depression inpatients in Mental Health Center of West China Hospital of Sichuan University from January to December, 2008. Following questionnaires used for investigation were all self-scale and filled out by the family members: “Basic Information Scale of Patients and Family Members”, “Family Burden Scale of Patients with Depression” revised from Pai’s scale of “Burden on the Family of Disease” (scoring 0-48 points and covering 24 items under 6 dimensions, namely, financial burden, disruption of routine family activities, disruption of family leisure, disruption of family interactions, effect on physical health of family members, and effect on mental health of family members; rating each item on a 3-class scale, namely, zero for no burden, one for moderate burden, and two for severe burden) , and Xiao Shuiyuan’s “Social Support Scale” (10 items in total, a higher score indicates a better social support). SPSS 13.0 software was adopted to perform statistical analyses. Results The total score of family burden was 26.3±12.6, the positive answer rate of family burden was 100.0%, and the positive answer rate of the every dimension was above 80%. The score of family burden for parents and spouse was higher than that of children (Plt;0.05). The total score of social support was 40.22±9.06, and the correlation coefficient between family burden and family social support was –0.485 (Plt;0.001). Conclusion It is common for family members of depression patients to get family burden at different levels. The more social support family members get, the less the family burden is.
Objective To understand the situation of commonly-used drugs, medical device and their storages in rural households among model well-off township hospitals in eastern, central and western China, and to provide the basis for the guidance of reasonably using and scientifically storing drugs. Methods The methods of combining simple random sampling and cluster sampling were used to investigate and analyze the situation of commonly-used drugs, medical device and their storages in 162 households from three well-off township hospitals in Shanghai, Zhejiang, and Sichuan provinces, respectively. Results The storage rates of commonly-used drugs of rural households in well-off towns were cold medicine (72.2%), wound paste (51.9%), cooling oil (39.5%), essential balm (36.4%), antihypertensive (27.8%), iodine tincture (14.2%), anti-diabetic drugs (13.0%) and other drugs (17.3%). The storage rates of medical devices were thermometer (50.0%), cotton swab (47.5%), sphygmomanometer (9.3%), injector (1.2%) and other devices (22.2%). A total of 66% of respondent families stored drugs and medical devices in a fixed drawer. Only 3.1% families stored drugs and medical devices in the special portable medical kit. Conclusion Rural families have a higher rate of household drugs among model well-off township hospitals in eastern, central and western China, and most drugs are OTC drugs. The storage rates of medical devices are not high. Many rural family-owned medical devices are linked with special chronic diseases in the family. A lot of rural families place drugs and medical devices randomly. There are many security risks, and it may affect the rational utilization of drugs.
Objective To investigate the family-dependence status in patients with tumor, and analyze the related factors of family dependence. Methods The self-made family-dependence scale was distributed to 432 patients with tumor to asses their family dependence status. Results The mean score of family-dependence was 40±5.8. A total of 198 cases (45.8%) were family-dependent, including 52 mild cases, 98 moderate cases, and 48 severe cases. The logistic regression analyses showed that sex (OR=3.873, P=0.022), age (OR=2.378, P=0.035), and personality type (OR=1.079, P=0.028) were the related factors of family-dependence. Conclusion More attention should be paid to patients with tumor about their family-dependence. After being instructed, the family members should use proper emotional expression method to provide family support to the patients with tumor. The female patients, older patients, and patients with dependent personality should be encouraged to improve their self-care ability to avoid family-dependence as possible as they can.
Objective To research whether systemic family therapy is a useful intervention for behavioral problems. Methods Two hundred and seventy six children who were in the fourth grade of elementary school were assessed by family dynamics questionnaires and their parents were tested by Achenbach Child Behavioral Checklist. Fifty-seven children with behavioral problems were divided into two groups: 20 children and their parents agreed to receive systemic therapy for four weeks and 37 children and their parents who refused this therapy formed the control group.All children and their parents were reassessed after four months. Data were analyzed by SPSS 11.5. Results The characteristics of family dymanmic and children’s behavior improved significantly after systemic therapy. The "depressing and hostile family" at mosphere became "harmonious and open" (P=0.000) and this was also significantly better than the control group after therapy(P=0.000). "Self-differentiation of family members" was significantly improved after therapy (P=0.000) and also was significantly better than the control group after therapy (P=0.005). "Patient is helpless victim" changed to "Patient can do something" (P=0.000) and this was significantly better than the control group after therapy (P=0.003) . Total CBCL score decreased in the treatment group after therapy (P=0.003 for father, P=0.000 for mother). Compared with the control group. Total CBCL score also showed decreases (P=0.033 for father, P=0.014 for mother). Conclusions The techniques of systemic family therapy are practical and effective methods to intervene children’s behavioral problems.