Psychiatric

精神病
  • 文章类型: Journal Article
    脑电图(EEG)数据的多变量模式分析(MVPA)代表了研究大脑如何编码信息的革命性方法。通过在个体层面考虑时空特征之间的复杂相互作用,MVPA克服了单变量技术的局限性,这往往无法解释显著的个体间和个体内神经变异性。这在研究临床人群时尤其重要,因此,脑电图数据的MVPA最近开始被用作研究脑部疾病认知的工具。这里,我们回顾了这种方法在自闭症等疾病中神经活动异常模式研究中提供的见解,多动症,精神分裂症,诵读困难,神经和神经退行性疾病,在不同的认知领域(感知,注意,记忆,意识)。尽管潜在的缺点应该得到认真解决,这些研究揭示了MVPA在揭示信息处理的功能失调和代偿性神经认知动力学方面的特殊敏感性,通常对传统的单变量方法视而不见。表征个体神经认知谱的这种更高的灵敏度可以提供优化评估和促进个性化干预的独特机会。
    Multivariate pattern analysis (MVPA) of electroencephalographic (EEG) data represents a revolutionary approach to investigate how the brain encodes information. By considering complex interactions among spatio-temporal features at the individual level, MVPA overcomes the limitations of univariate techniques, which often fail to account for the significant inter- and intra-individual neural variability. This is particularly relevant when studying clinical populations, and therefore MVPA of EEG data has recently started to be employed as a tool to study cognition in brain disorders. Here, we review the insights offered by this methodology in the study of anomalous patterns of neural activity in conditions such as autism, ADHD, schizophrenia, dyslexia, neurological and neurodegenerative disorders, within different cognitive domains (perception, attention, memory, consciousness). Despite potential drawbacks that should be attentively addressed, these studies reveal a peculiar sensitivity of MVPA in unveiling dysfunctional and compensatory neurocognitive dynamics of information processing, which often remain blind to traditional univariate approaches. Such higher sensitivity in characterizing individual neurocognitive profiles can provide unique opportunities to optimise assessment and promote personalised interventions.
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  • 文章类型: Journal Article
    这项研究的目的是探索精神科护士在急性单元中照顾幻听患者的经验。使用主题分析进行了定性研究。该研究涉及对18名急性单元护士的半结构化访谈,所有这些护士都为幻听患者提供了干预措施。总的来说,参与者确定了他们在急性单位风险管理中的作用,他们的治疗作用的重要性和对药物管理作为主要护理干预的过度依赖。因此,这些发现证明了护士在急性病房与经历幻听的患者一起工作时面临的个人和职业冲突。护士处于首要位置,可以为急性单元中的幻听患者提供有效的干预和帮助。这项研究的结果表明,心理健康护士可能需要额外的支持和教育,以真正基于康复的方式提供护理,为听到声音的人提供具体干预和参与技能的培训。由于不可预测的环境和有时高风险的工作场所,护士也可以从这一领域的组织援助中受益。
    The aim of this study was to explore psychiatric nurse\'s experiences of caring for people with auditory hallucinations in an acute unit. A qualitative study was conducted using thematic analysis. The study involved semi-structured interviews with 18 acute unit nurses all of whom provided interventions to patients with auditory hallucinations. Overall, participants identified their role in the management of risk within an acute unit, the importance of their therapeutic role and a perceived over-reliance on medication administration as a primary nursing intervention. These findings thus demonstrate the personal and professional conflict that nurses face when working in an acute unit with patients who experience auditory hallucinations. Nurses are in a prime position to provide effective interventions and assistance for people with auditory hallucinations in an acute unit. The findings of this study indicate that mental health nurses may require additional support and education to provide care in a truly recovery-based manner, with training in specific interventions and engagement skills for people who hear voices. Due to an unpredictable environment and sometimes high-risk workplace, nurses may also benefit from organisational assistance in this area.
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  • 文章类型: Journal Article
    背景:对紧急精神病护理的需求正在增加,但在西班牙,对于急诊部门(ED)如何优化精神病患者的护理并没有明确的建议.我们旨在就综合医院急诊科治疗有紧急精神症状的患者的要求提供专家共识建议。
    方法:我们使用了一种改进的Delphi技术。一个科学委员会根据文献检索和临床经验编制了36份声明。这些声明涵盖了组织模式,设施,人员配备,安全,患者干预,和员工培训。由38名具有精神病紧急情况专业知识的精神病学专家组成的小组分两轮对问卷进行了评估。
    结果:经过两轮投票,36个拟议项目中有30个(83%)得到了同意。小组同意精神病紧急情况应在综合医院进行管理,有专门的病人评估设施,直接监督有风险的患者,还有一个由精神病院管理的观察组.除了精神科医生,ED应有24/7全天候的专科护士和安全人员。社会工作者也应该随时可用。ED和咨询室的设计应确保患者和工作人员的安全。应该为有精神病症状的病人建立分诊制度,在精神病学评估之前进行医学评估。关于供应的指导,设备,还提供员工培训。
    结论:综合医院的所有ED都应该有足够的资源来处理任何精神病紧急情况。本文就实现这一目标的最低要求提供了建议。
    BACKGROUND: The demand for urgent psychiatric care is increasing, but in Spain there are no clear recommendations for emergency departments (ED) on how to optimize care for patients with psychiatric emergencies. We aimed to provide expert consensus recommendations on the requirements for general hospitals´ emergency departments to treat patients with urgent psychiatric symptoms.
    METHODS: We used a modified Delphi technique. A scientific committee compiled 36 statements based on literature search and clinical experience. The statements covered the organizational model, facilities, staffing, safety, patient interventions, and staff training. A panel of 38 psychiatry specialists with expertise in psychiatric emergencies evaluated the questionnaire in two rounds.
    RESULTS: After two rounds of voting, 30 out of 36 proposed items (83%) were agreed upon. The panel agreed that psychiatric emergencies should be managed in a general hospital, with dedicated facilities for patient assessment, direct supervision of patients at risk, and an observation unit run by the psychiatric service. In addition to the psychiatrist, the ED should have specialist nurses and security staff available 24/7. Social workers should also be readily available. ED and consulting rooms should be designed to ensure patient and staff safety. A triage system should be established for patients with psychiatric symptoms, with medical evaluation preceding psychiatric evaluation. Guidance on supplies, equipment, and staff training is also provided.
    CONCLUSIONS: All ED in general hospitals should have adequate resources to handle any psychiatric emergency. This paper provides recommendations on the minimum requirements to achieve this goal.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    (1)背景:全球对精神科护士的需求越来越多,护理专业学生对精神疾病的态度和在精神卫生机构的工作在他们的职业选择中起着关键作用。这项研究旨在评估沙特阿拉伯护理本科生对在精神卫生机构工作的态度,在接触精神病学课程之前和之后,并检查他们与精神疾病认知的关系。(2)方法:采用定量的描述性和相关的横断面设计。使用对精神病学18(ATP-18)的态度问卷和对精神疾病的信念(BMI)量表评估了护理学生对在精神卫生机构工作的态度。(3)结果:ATP-18的负面观点频率与BMI之间没有显着关系。和接触精神病学课程。然而,完成精神病学课程的护士对精神科医生持更积极的看法,发现精神病患者要求不高,不太可能认为心理障碍是危险的,更有信心信任精神病同事,与那些没有参加该课程的人相比,对“心理障碍”一词感到不那么尴尬。(4)结论:根据我们的发现,很明显,接触精神病学课程和培训可以增强护理专业学生为精神病学领域做出有效贡献的潜力。因此,将心理健康和疾病社区服务培训纳入护理教育计划可以在提高认识和吸引对精神疾病患者持消极态度的学生方面发挥关键作用。
    (1) Background: There is a global demand for more psychiatric nurses, with nursing students\' attitudes toward mental illness and working in mental health facilities playing a pivotal role in their career choices. This study aims to evaluate attitudes toward working in mental health facilities among undergraduate nursing students in Saudi Arabia, both before and after exposure to psychiatry courses, and examine their relationship with perceptions of mental illness. (2) Methods: A quantitative descriptive and correlational cross-sectional design was employed. Nursing students\' attitudes toward working in mental health facilities were assessed using the Attitude Toward Psychiatry 18 (ATP-18) questionnaire and the Beliefs Toward Mental Illness (BMI) scale. (3) Results: No significant relationship has been found between the frequency of negative views of both ATP-18 and BMI, and exposure to the psychiatry course. However, nurses who completed the psychiatry course held more positive views towards psychiatrists and found psychiatric patients less demanding, were less likely to view psychological disorders as dangerous, more confident in trusting mentally ill colleagues, and felt less embarrassed by the term \"psychological disorder\" compared to those who had not taken the course. (4) Conclusion: Based on our findings, it is evident that exposure to psychiatric courses and training enhances the potential of nursing students to contribute effectively to the psychiatric field. Therefore, integrating mental health and illness community services training into nursing education programs can play a pivotal role in raising awareness and attracting students who may hold negative attitudes towards individuals with mental illness.
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  • 文章类型: Journal Article
    用途:通用劳拉西泮口服溶液在30毫升多剂量瓶中提供,需要避光和冷藏保护,一旦瓶子打开,超过90天的使用日期。将1毫升剂量的劳拉西泮口服溶液重新包装到口服注射器中,便于分配,然而,没有可用的数据支持在注射器中重新包装和储存劳拉西泮口服液。通过验证和应用指示稳定性的高效液相色谱和紫外检测(HPLC-UV)方法来定量劳拉西m,可以确定在口服注射器中储存时劳拉西m口服溶液的稳定性。方法:建立了稳定性指示的HPLC-UV法测定口服溶液中劳拉西泮的含量。该方法使用USP<1225>的指导进行验证。对于稳定性调查,将2mg/mL劳拉西泮口服溶液以1毫升剂量从2个多剂量储备瓶中分装到透明塑料口服注射器中,并随机分配在室温或冷藏环境中储存。在研究开始的当天测量基线劳拉西泮浓度,并指定为100%初始浓度样品。随后的样品在24、48和96小时以及7、10、14、21、30和60天的时间点一式三份进行分析。结果:三个非连续天的校准曲线符合R2>0.99的线性标准。日间和日内精密度和准确度(相对标准偏差百分比和误差百分比)在三天内≤2%。在稳定性调查期间,在研究期间,室内和冷藏注射器中劳拉西泮的初始浓度百分比保持在90%以上.结论:稳定性指示HPLC-UV方法成功地用于研究劳拉西m口服溶液在室温和冷藏温度下在注射器中储存时的稳定性。住院患者对使用劳拉西泮浓缩物的迫切需求以及对药物供应方式的限制,需要评估重新包装到单位剂量注射器中,以便从自动分配柜立即获得。储存在透明塑料注射器中的劳拉西泮口服溶液在室温和冷藏温度下保持大于90%的初始浓度60天。
    Purpose: Generic lorazepam oral solution is supplied in a 30 mL multi-dose bottle requiring protection from light and refrigeration, with a beyond use date of 90 days once the bottle is opened. The repackaging of 1 mL doses of lorazepam oral solution into oral syringes allows for facilitated dispensing, yet no available data supports repackaging and storing lorazepam oral solution in syringes. The validation and application of a stability-indicating high-performance liquid chromatography with ultraviolet detection (HPLC-UV) method for the quantification of lorazepam allowed for the determination of the stability of lorazepam oral solution when stored in oral syringes. Methods: A stability-indicating HPLC-UV method was developed for the quantification of lorazepam in oral solution. The method was validated using guidance from USP < 1225 >. For the stability investigation, 2 mg/mL lorazepam oral solution was aliquoted into clear plastic oral syringes in 1 mLmilliliter doses from 2 multi-dose stock bottles and randomly allocated for storage in room temperature or refrigerated environment. Baseline lorazepam concentrations were measured on the day the study was initiated and designated as 100% initial concentration samples. Subsequent samples were analyzed in triplicate at time points of 24, 48, and 96 hours and 7, 10, 14, 21, 30, and 60 days. Results: The calibration curves on three non-consecutive days met the linearity criteria of R 2 > 0.99. Inter- day and intra-day precision and accuracy (percent relative standard deviation and percent error) were ≤2% over three days. During the stability investigation, percent initial concentration of lorazepam from room and refrigerated syringes remained above 90% for the duration of the study. Conclusion: The stability-indicating HPLC-UV method was successfully applied to the investigation of lorazepam oral solution stability when stored in syringes at room and refrigerated temperatures. The emergent need for use of lorazepam concentrate for inpatients and the restrictions of how the medication is supplied necessitated a need for the evaluation of repackaging into unit dose syringes for immediate availability from automated dispensing cabinets. Lorazepam oral solution stored in clear plastic syringes maintained greater than 90% initial concentration at both room and refrigerated temperatures for 60 days.
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  • 文章类型: Journal Article
    沙特阿拉伯住院精神卫生保健护士的短缺是一个重要的卫生保健挑战。
    这项研究的目的是阐明在精神科住院环境中受雇的精神科心理健康护士对其就业经历的看法。
    本研究采用了使用主题内容分析的探索性定性方法。十名具有精神病住院护理经验的专业护士参加了由护理硕士学生组成的两个焦点小组。
    出现了四个主要主题:精神病精神保健实践的专业技能和知识不足,公众对精神病/心理健康护士的负面态度,对人身安全的担忧,和替代品和优势。这项研究的结果表明,护士对精神科工作缺乏兴趣不仅是个人的,也是社会和组织的。
    研究结果可能会鼓励管理者和当局制定措施,吸引更多的心理健康护士到精神科工作。这些策略可能包括修改护士的技能,培训,和专业知识,合议监督,指导,以及工作条件和环境。
    UNASSIGNED: The shortage of inpatient psychiatric mental health care nurses in Saudi Arabia represents an important health care challenge.
    UNASSIGNED: The aim of this study was to illuminate perspectives of psychiatric mental health nurses employed in psychiatric inpatient settings about their employment experiences.
    UNASSIGNED: This study adopted an exploratory qualitative approach using thematic content analysis. Ten professional nurses with psychiatric inpatient caring experience participated in two focus groups composed of Master of Nursing students.
    UNASSIGNED: Four main themes emerged: inadequate professional skills and knowledge for psychiatric mental health care practice, negative public attitudes toward psychiatric/mental health nurses, concerns for personal safety, and alternatives and advantages. The findings of this study suggest that nurses\' lack of interest in working in psychiatric units is not merely personal but also social and organizational.
    UNASSIGNED: The study findings may encourage managers and authorities to develop measures to attract more mental health nurses to work in psychiatric units. Such strategies may include modification of nurses\' skills, training, and professional knowledge, collegial supervision, mentoring, and working conditions and environment.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    COVID-19大流行导致痴呆症患者的行为恶化。新加坡一家三级精神病医院的专门痴呆症病房住院人数增加,床位不足,导致痴呆症患者被安置在高依赖性精神病部门(HDPCU)。在HDPCU创建痴呆症友好环境的定制包括:(1)环境修改,以促进方向和性别熟悉;(2)以人为本的护理,以促进依恋,inclusion,身份,职业,和舒适度;(3)谵妄的风险管理;(4)培训核心能力。这种实用的解决方案也可以在其他地方实施,以帮助克服资源限制和重新调整服务,以适应越来越多的痴呆症患者。
    The COVID-19 pandemic led to behavioral exacerbations in people with dementia. Increased hospitalizations and lack of bed availability in specialized dementia wards at a tertiary psychiatric hospital in Singapore resulted in lodging people with dementia in the High Dependency Psychiatric Unit (HDPCU). Customizations to create a dementia-friendly environment at the HDPCU included: (1) environmental modifications to facilitate orientation and engender familiarity; (2) person-centered care to promote attachment, inclusion, identity, occupation, and comfort; (3) risk management for delirium; and (4) training core competencies. Such practical solutions can also be implemented elsewhere to help overcome resource constraints and repurpose services to accommodate increasing populations of people living with dementia.
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  • 文章类型: Journal Article
    目的:在美国退伍军人的全国代表性样本中,研究阻塞性呼吸系统疾病的精神和身体健康负担。
    方法:次要数据分析使用2019-2020年国家退伍军人健康和复原力研究的数据进行。调查了美国退伍军人的全国代表性样本。参与者自我报告健康专业诊断的阻塞性呼吸系统疾病(即,哮喘,慢性支气管炎或慢性阻塞性肺疾病)。将报告阻塞性呼吸系统疾病的退伍军人(n=502)与没有这种疾病但至少有一种或多种其他医疗条件的退伍军人进行比较(n=3169)在社会人口统计学指标上,创伤,精神病学,和身体健康的特点。多变量回归分析检查了阻塞性呼吸系统疾病与精神疾病和身体特征之间的独立关联。
    结果:总共12.5%的样本报告诊断为阻塞性呼吸系统疾病。与对照组相比,患有阻塞性呼吸系统疾病的退伍军人更有可能是女性,未婚/伴侣,收入较低,居住在中西部,接受VA医疗保健,一生和童年的创伤负担更大。在调整后的分析中,患有呼吸系统疾病的退伍军人对当前的创伤后压力筛查呈阳性的可能性增加了47-91%,重度抑郁,和广泛性焦虑症,目前自杀想法的几率要高出48%。他们也更可能患有终生尼古丁使用障碍,并且有更多的医学合并症和更严重的躯体症状。
    结论:阻塞性呼吸系统疾病在美国退伍军人中普遍存在,并与重大的身心健康负担有关。结果突出表明,需要及时筛查和治疗该人群中与阻塞性呼吸系统疾病高度合并症的精神病和医疗状况。
    OBJECTIVE: To examine the psychiatric and physical health burden of obstructive respiratory disease in a nationally representative sample of U.S. Veterans.
    METHODS: Secondary data analyses were conducted using data from the 2019-2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of U.S. Veterans. Participants self-reported health professional-diagnosed obstructive respiratory disease (i.e., asthma, chronic bronchitis or chronic obstructive pulmonary disease). Veterans who reported obstructive respiratory disease (n = 502) were compared to veterans without this disease but with at least one or more other medical conditions-controls (n = 3169) on measures of sociodemographic, trauma, psychiatric, and physical health characteristics. Multivariable regression analyses examined independent associations between obstructive respiratory disease and psychiatric conditions and physical characteristics.
    RESULTS: A total 12.5% of the sample reported a diagnosis of obstructive respiratory disease. Compared to controls, veterans with obstructive respiratory disease were more likely to be female, unmarried/partnered, lower income, residing in the Midwest, receiving VA healthcare, and had greater lifetime and childhood trauma burden. In adjusted analyses, veterans with respiratory disease had 47-91% greater odds of screening positive for current posttraumatic stress, major depressive, and generalized anxiety disorders, and had 48% greater odds of current suicide ideation. They were also more likely to have lifetime nicotine use disorder and had more medical comorbidities and more severe somatic symptoms.
    CONCLUSIONS: Obstructive respiratory disease is prevalent among U.S. veterans and associated with significant mental and physical health burden. Results highlight the need for timely screening and treatment for psychiatric and medical conditions that are highly comorbid with obstructive respiratory disease in this population.
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