目的 了解5.12汶川大地震24个月后震区小学生的心理健康状况，为进行震后长期心理危机干预提供依据。 方法 于2010年5月即汶川大地震发生后24个月，分别使用创伤应激量表儿童版（CRIES-13）、儿童抑郁障碍自评量表（DSRSC）、长处与困难问卷（SDQ）学生版，调查了553名来自于彭州灾区的小学生的心理健康状况及其影响因素。 结果 ① 灾区小学生CRIES-13总分为（22.98 ± 12.29）分，其中大于划界分（30分）者为143人，占总人数的25.9%；女性总分高于男性（Z=?2.031，P=0.042）；震后被转移至安全地点的时间越长（OR=1.025，P=0.012）、家人伤亡越严重（OR=1.141，P=0.021），其CRIES-13总分大于划界分的可能性越高。② 灾区小学生DSRSC总分为（11.07 ± 5.78）分，其中总分大于划界分（15分）者为120人，占总人数的21.7%；女性总分高于男性（Z=?2.508，P=0.012）；灾区小学生的年龄（r=0.098，P=0.021）、震后被转移至安全地点的时间（r=0.117，P=0.004）与DSRSC总分呈正相关。③ 灾区小学生SDQ总困难因子得分为（14.97 ± 5.44）分，62.9%的人报告自身存在主观困难；女性的情绪因子、亲社会因子得分高于男性（Z=?3.123，P=0.002；Z=?2.243，P=0.025）；年龄越大，品行因子（χ2=7.604，P=0.023）、亲社会因子（χ2=8.102；P=0.017）得分增加。 结论 震后灾区小学生的心理健康状况受到性别、年龄、震后被转移至安全地点的时间、家人伤亡程度的影响，震后长期心理危机干预应综合考虑这些相关因素以确定高危人群。
【摘要】 目的 了解全开放管理的急性期精神分裂症患者的抑郁状况，为急性期开放管理提供参考信息。 方法 2009年10-11月，采用卡尔加里精神分裂症抑郁量表（CDSS）对95例精神分裂症患者进行调查。 结果 精神分裂症患者抑郁的发生率为38.95%。且与性别、文化程度、住院次数无关。但与病程密切相关，病程5年以上的患者抑郁状况突出。 结论 精神分裂症患者的抑郁状况明显，需要加强对病情的评估；加强对家属的教育，提高患者的社会支持；早期对患者进行心理干预；以预防自杀的发生。【Abstract】 Objective To find out the depressive situation of patients with schizophrenia in the acute phase under a whole open management, and to provide a scientific basis for the open management. Methods From October to November 2009, 95 patients with schizophrenia were investigated via Calgary depression scale with schizophrenia (CDSS). Results The incidence of depression in patients with schizophrenia was 38.95%, which had no relationship with gender, education level, or frequency of hospitalization. However, the course of the disease was closely related. The depressive symptoms were prominent in patients with the duration more than five years. Conclusion The patients with schizophrenia have obvious depressive symptoms we should. strengthen the evaluation of the disease, improve the family education and the patient′s social support, and implement psychological intervening with patients in the early phase in order to prevent the occurrence of suicide and improve the quality of management.
With the transformation of modern medical models, patient-reported outcomes, clinician-reported outcomes, observer-reported outcomes, and performance outcomes have become internationally recognized clinical outcome assessment indicators, and scales have also become important evaluation tools, among which translation and cross-cultural adaptation are one of the important sources of scales. However, at present, there are fewer guidelines for scale translation in China. At present, domestic scale translation has not yet been unified and standardized in clinical reporting. Most translation reports provide readers with incomplete information, which affects the development of scale translation, and the methodology related to the translation of clinical outcome assessment scales still focuses on patient-reported outcome scales, which creates a gap in terms of the recommendations for the rest of the types of translations, a gap which leads to inconsistencies in the translation methodology and process. In this paper, we will develop specific translation methods and processes for each of the four current types of clinical outcome assessments by combining scale translation guidelines to support a standardized approach to translation, cross-cultural adaptation, and linguistic validation for use in standardizing the process of recommending translations of patient-reported outcome scales, clinical-reported outcome scales, observer-reported outcome scales, and behavioral outcome scales.
ObjectivesTo establish statistical analysis and result reporting model for evaluation of the applicability of the clinical guidelines. We conducted empirical study for clinical guidelines for diagnosis and treatment of renal transplantation rejection in China.MethodsA cross-sectional survey was conducted to select 16 medical institutions in China which had carried out kidney transplantations. In each medical institution, 6 to 8 clinicians from the kidney transplantation department or related departments were selected to complete the questionnaire. Descriptive analysis was carried out for characteristics of evaluators, scores of each dimension, access to guidelines and factors affecting implementation. The Kruskal-Wallis rank sum test and Nemenyi test were used for multi-group comparison and pairwise comparison. Multiple linear regression with stepwise strategy were used to screen out the association factors.ResultsIn this survey, 128 questionnaires were distributed, in which 105 valid questionnaires were collected, and the recovery rate was 82.03%. The subjects of this survey were all kidney transplant clinicians from public tertiary hospitals, with an average 10.95 years of working time. The results showed the accessibility score was lowest and the acceptability score was highest. The results of multi-group comparison and multiple linear regression analysis showed that familiarity with the guidelines was the influencing factor of each score (P<0.05). The guidelines were primarily obtained from biomedical literature database (73.3%), academic journals (55.2%) and academic conferences (55.2%). Among the evaluators, 44 (41.9%) believed that there were implementation obstacles in the guidelines, among which 40 (38.1%) believed that implementation obstacles were environmental factors.ConclusionsThe applicability of clinical guidelines for diagnosis and treatment of renal transplantation rejection in China is adequate. However, the publicity of the guideline requires improvement. As the guideline is updated, consideration should be given to including access to the guideline, adding free public information promotion, and familiarizing clinicians with the guidelines through training programs to promote application of the guideline.
ObjectiveThe current medical questionnaire resources are mainly processed and organized at the document level, which hampers user access and reuse at the questionnaire item level. This study aims to propose a multi-class classification of items in medical questionnaires in low-resource scenarios, and to support fine-grained organization and provision of medical questionnaires resources. MethodsWe introduced a novel, BERT-based, prompt learning approach for multi-class classification of items in medical questionnaires. First, we curated a small corpus of lung cancer medical assessment items by collecting relevant clinical assessment questionnaires, extracting function and domain classifications, and manually annotating the items with "function-domain" combination labels. We then employed prompt learning by feeding the customized template into BERT. The masked positions were predicted and filled, followed by mapping the populated text to labels. This process enables the multi-class classification of item texts in medical questionnaires. ResultsThe constructed corpus comprised 347 clinical assessment items for lung cancer, across nine "function-domain" labels. The experimental results indicated that the proposed method achieved an average accuracy of 93% on our self-constructed dataset, outperforming the runner-up GAN-BERT by approximately 6%. ConclusionThe proposed method can maintain robust performance while minimizing the cost of building medical questionnaire item corpora, illustrating its promotion value of research and practice in medical questionnaire classification.
Objective To evaluate the reliability and validity of IBS-QOL scale in irritable bowel syndrome (IBS) patients. Methods IBS-QOL scale was applied to survey the quality of life of 123 IBS patients. The split-half and internal consistency method were used to evaluate the reliability, and with the construct method to evaluate the validity. Results The split-half reliability was 0.86. Cronbach’s α-coefficient of all domains was between 0.71 and 0.89 except body image and food avoidance; In the correlation analysis, the correlations between items and its subscale structure were above 0.60 (except interference with activity), but there were no correlations between items and other subscale structure. Eight components from factorial analysis were in accordance with theoretical structure.The cumulative contribution rate was 72.7%. Conclusions The reliability and validity of IBS-QOL scale are acceptable. It might be useful for us to assess the QOL of IBS patients in China.
Objective To assess the appropriateness of Barthel Index (BI) and Modified Rankin Scales (MRS) used as long-term outcome measures in a stroke data register and to investigate the correlation between cutoff points of the two scales in different stroke patients with and without disability. Methods Nine hundred and twelve patients were registered prospectively. BI and MRS were evaluated at the end of 1, 3, 6 and 12 months after stroke onset. The distribution, ceiling effects and floor effects of the two scales were evaluated. A logistic regression model was established to investigate correlation of cutoff points of BI and MRS. Results There were a total of 2 829 evaluation points of BI and MRS. The percentages of patients reaching the maximum scores of BI at the end of 3, 6 and 12 months (54.8％, 62.2％ and 68.3％, respectively) were higher than those of MRS. There was significant correlation between the two scales (Spearman’s correlation coefficient 0.887, P＜0.05), when MRS scores of ≤1 and ≤2 were taken as cutoff points, the corresponding cutoff points of BI score were ≥90 and ≥85, respectively. Conclusions BI has significant ceiling effects when used as long-term outcome measurement in a stroke data register. There was significant correlation between BI and MRS scores. In future clinical studies, an MRS score ≤2 or BI score ≥85 could be used as cutoff points in predicting stroke patients with and without disability.
Objective To compare the cl inical results between high-flexion and standard cruciate-stabling prostheses in total knee arthroplasty (TKA) by using the 36-item short form health survey (SF-36). Methods Between August 2007 and January 2009, 98 patients (106 knees) underwent TKA with standard cruciate-stabl ing prostheses (standard group), and 46 patients (50 knees) underwent TKA with high-flexion prostheses (high-flexion group). In standard group, there were30 males (32 knees) and 68 females (74 knees) with an age of (70.0 ± 3.5) years, including 78 cases (82 knees) of osteoarthritis (OA) and 20 cases (24 knees) of rheumatoid arthritis (RA) with a disease duration of (14.5 ± 3.3) years; the Hospital for Special Surgery Scoring System (HSS) and the range of motion (ROM) were 56.1 ± 21.6 and (89.0 ± 16.1)°, respectively. In high-flexion group, there were 8 males (10 knees) and 38 females (40 knees) with an age of (68.6 ± 8.9) years, including 44 cases (47 knees) of OA and 2 cases (3 knees) of RA with a disease duration of (13.9 ± 4.1) years; the HSS and ROM were 58.9 ± 25.3 and (91.0 ± 19.3)°, respectively. There was no significant difference in the general data (P gt; 0.05) between 2 groups, so the cl inical data of 2 groups had comparabil ity. Results In standard group, poor wound heal ing and persistent headache caused by cerebrospinal fluid leakage occurred in 1 case, respectively. In high-flexion group, transient common peroneal nerve palsy occurred in 1 case. There was significant difference (P lt; 0.05) in the hospital ization expense between standard group [ (39 000 ± 6 000)] and highflexion goup [ (52 000 ± 8 000)]. The follow-up time was 12-26 months (18 months on average) in standard group (91 cases, 98 knees) and 11-19 months (13 months on average) in high-flexion group (44 cases, 47 knees). The SF-36 showed significant difference in role-physical score (P lt; 0.05), but no significant difference in other 7 indices scores (P gt; 0.05). At the final follow-up, the ROM was (129.1 ± 19.2)° in high-flexion group and (123.6 ± 16.7)° in standard group; showing significant difference (P lt; 0.05). The HSS was 91.2 ± 17.6 in high-flexion group and 92.5 ± 14.5 in standard group; showing no significant difference (P gt; 0.05). Conclusion After TKA, the ROM in high-flexion group is superior to that in standard group, but there is no obvious advantages in terms of the HSS and SF- 36 outcomes.