目的   识别经皮冠状动脉介入治疗（PCI）后恐动症患者抑郁、焦虑和压力的影响因素。方法   采用横断面研究，纳入780例行PCI术后恐动症患者。应用系列量表评估恐动症患者的不良心理健康状况、生活质量、自我感受负担、社会支持和运动自我效能，并通过问卷收集了患者的社会人口学数据。线性回归和Logistic回归用于识别抑郁、焦虑和压力等不良心理状态的影响因素，应用中介分析探索潜在的中介机制。结果  271例（34.7%）、304例（39.0%）和153例（19.6%）恐动症患者存在不同程度的抑郁、焦虑和压力。恐动症患者的抑郁、焦虑和压力水平呈正相关。线性回归和Logistic分析结果表明，较高的家庭月收入与较高的抑郁水平相关（线性回归：β为0.908和1.937；Logistic：OR为2.05和5.47），社会支持程度与抑郁水平呈负相关（线性回归：β=-0.079；Logistic：OR=0.93）。单身/离异/寡居患者的焦虑水平显著高于已婚患者（线性回归：β=1.613；Logistic：OR=2.28）。与家庭月收入低于5 000元者相比，家庭月收入为5 000~10 000元之间的患者的压力水平较高（线性回归：β=1.065；Logistic：OR=3.14）。此外，自我感受负担较重的患者具有更高的压力水平（线性回归：β=0.077；Logistic：OR=1.05）。中介分析结果表明，焦虑和压力是社会支持/自我感受负担与抑郁之间关联的潜在中介因子。结论  PCI术后恐动症患者广泛存在心理健康问题，其家庭月收入、年龄、婚姻状况、生活方式和病史等因素对患者的不良心理健康状态具有显著影响。医务人员应关注这些患者的心理健康状况及影响因素，制定综合管理策略以改善其预后。

       Objective  To identify the risk factors associated with depression，anxiety  and  stress in  patients with kinesiophobia after percutaneous coronary intervention（PCI）．Methods  In this cross-sectional study，780 patients who developed kinesiophobia after undergoing PCI were enrolled．A series of scales were used to assess the psychological health status，quality of life，self-perceived burden，social support，and exercise self-efficacy of patients with kinesiophobia，and socio-demographic data of the patients were collected through a questionnaire．Linear regression analyses and Logistic regression analyses were used to identify risk factors of adverse psychological outcomes，including depression，anxiety，and stress．Furthermore，mediation analysis was employed to explore the potential mediating mechanisms．Results  Among the 780 patients with kinesiophobia，271（34.7%），304（39.0%）and 153（19.6%）were found to have varying degrees of depression，anxiety，and stress，respectively．The levels of depression，anxiety and stress in patients with kinesiophobia were positively correlated with each other．The results of both linear regression and Logistic regression analyses indicated that higher levels of family monthly income were associated with higher levels of depression（linear：β=0.908 and 1.937；Logistic：OR=2.05 and 5.47），while the degree of social support was negatively correlated with depression levels（linear：β=-0.079；Logistic：OR=0.93）．For patients who were single，divorced or widowed，their levels of anxiety were significantly higher than those of married patients（linear：β=1.613；Logistic：OR=2.28）．Compared to patients with a monthly household income of less than 5 000 yuan，those with a monthly income between 5 000 and 10 000 yuan reported higher levels of stress（linear：β=1.065；Logistic：OR=3.14）．Additionally，patients who perceived a higher personal burden also experienced greater stress（linear：β=0.077；Logistic：OR=1.05）．Mediation analysis indicated that anxiety and stress were potential mediating factors in the relationship between social support/self-perceived burden and depression．Conclusions  This study  reported the widespread psychological health issues among patients with kinesiophobia after PCI and the interactions between these issues．Factors such as monthly household income，age，marital status，lifestyle and medical  history were found to  be significantly associated with these negative psychological outcomes．Clinicians and nurses should focus on the psychological health and influencing factors of these patients and develop comprehensive management strategies to improve their prognosis．

目的 探讨大一护理系学生（护生）心理健康素养、心理健康与心理弹性的现状以及三者之间的关系。方法 采用方便抽样法选取大一护生202人作为研究对象,采用一般资料问卷、青少年心理健康素养评定量表（AMHLAQ）、心理健康量表（K10）,心理弹性量表（CD-RISC）进行调查。结果 （1）城市大一护生心理健康素养（t=-2.832,P<0.01）、心理健康水平（t=3.052,P<0.001）和心理弹性水平（t=-2.521,P<0.05）高于农村大一护生;独生子女的心理健康素养（t=2.098,P<0.05）和心理健康水平（t=-2.684,P<0.01）高于非独生;父亲学历为高中及以上的心理健康素养（t=-2.543,P<0.05）和心理健康水平（t=3.082,P<0.01）高于父亲学历为初中及以下;母亲学历为高中及以上的心理健康素养（t=-2.052,P<0.05）和心理健康水平（t=2.595,P<0.01）高于父亲学历为初中及以下;（2）心理健康得分越高,心理问题越严重,心理健康素养与心理弹性呈正相关（r=0.340,P<0.01）,心理健康得分与心理健康素养、心理弹性呈负相关（r=-0.651,-0.384,P<0.01）。（3）心理弹性在心理健康素养与心理健康中存在部分中介效应,中介效应值为-0.190,中介效应占比15.68%。结论 山西医科大学汾阳学院大一护生心理健康存在一定问题,要多注重农村地区、非独生子女以及父母学历较低的人群心理健康和心理健康素养的培养,大一护生心理健康素养越高,心理弹性水平越高,心理健康得分越低,心理健康水平越高。心理弹性在心理健康素养与心理健康中起中介作用,可以提升大一护生的心理弹性水平,培养其坚韧性、自强性和乐观性,从而降低心理健康得分,提高心理健康水平。

Objective To explore the current status of mental health literacy,mental health,and psychological resilience among first-year nursing students,as well as the relationship among the three．Methods A total of 202 freshmen were selected as the research subjects using convenience sampling method．The survey was conducted using a general information questionnaire,the Adolescent Mental Health Literacy Assessment Scale（AMHLAQ）,the Mental Health Scale（K10）,and the Psychological Resilience Scale（CD-RISC）．Results （1）The mental health literacy（t=-2.832,P<0.01）,mental health level（t=3.052,P<0.001）,and psychological resilience level（t=-2.521,P<0.05）of urban freshmen were significantly higher than those of rural freshmen．The mental health literacy（t=2.098,P<0.05）and mental health level（t=-2.684,P<0.01）of only-child were higher than those of non-only-child．The mental health literacy（t=-2.543,P<0.05）and mental health level（t=3.082,P<0.01）of the father with a high school education or above were higher than those of the father with a middle school education or below．The mental health literacy（t=-2.052,P<0.05）and mental health level（t=2.595,P<0.01）of the mother with a high school education or above were higher than those of the father with a middle school education or below．（2）The higher the mental health score,the more serious the psychological problem．There was a significant positive correlation between mental health literacy and psychological resilience（r=0.340,P<0.01）,while there was a significant negative correlation among mental health score and mental health literacy and psychological resilience（r=-0.651,-0.384,P<0.01）．（3）Psychological resilience had a partial mediating effect between mental health literacy and mental health,with a mediating effect value of -0.190,accounting for 15.68% of the total．Conclusions There are certain problems with the mental health of freshmen nursing students in Shanxi Medical University．It is necessary to pay more attention to the cultivation of mental health and mental health literacy in rural areas,non-only-child,and those whose parents with lower educational level．The higher the mental health literacy and resilience level of freshmen nursing students,the lower their mental health scores,and the higher their mental health level．Psychological resilience plays a mediating role in the relationship between mental health literacy and mental health．It can cultivate the level of psychological resilience,resilience,self-improvement and optimism of first-year nursing students,thereby reducing their mental health scores and improving their mental health level．

目的 了解医务人员临床工作中血源性职业暴露的情况、暴露后的心理健康状况及其影响因素,采取干预措施,保障医务人员身心健康。方法 对医院2013年1月—2017年12月上报的79例血源性职业暴露者,在1个月内进行现状调查,同时采用自填式问卷症状自评量表(SCL-90)对调查对象进行调查,对其暴露后的心理影响程度进行评估。结果 医务人员在发生血源性职业暴露后其中躯体化因子、人际关系敏感因子、抑郁因子、焦虑因子在职业暴露前后的比较及与未发生职业暴露的医务人员相比较,均有不同程度的提高,差异均有统计学意义(P<0.001)。单因素分析显示影响血源性职业暴露后医务人员的心理健康状况的因素有年龄、职业、工龄、既往发生职业暴露史和患者患传染病种类(P<0.05)。其中年龄在21~25岁年龄的医务人员的得分较高,职业为医生和陪护工人的得分较高,工龄在1~5年的得分较高,既往发生过职业暴露的医务人员得分较高,患者患传染病类型为梅毒及暴露源不明的得分较高。结论 医务人员在发生血源性职业暴露后,其心理健康状态可受到较大影响;工龄、既往发生职业暴露史和患者患传染病种类是医务人员发生血源性职业暴露后心理状况健康的独立影响因素。医院管理者在重视预防及减少职业暴露的同时,更应关注血源性职业暴露后的心理变化,及时提供心理支持和医疗帮助。

目的 了解社区医护人员的心理健康状况,评估心理干预措施效果,找到提高社区医护人员心理健康状况的有效措施。方法 采用《症状自评量表 SCL-90》对社区医护人员的心理健康状况进行基线调查,在干预3、6、9个月时分别进行SCL-90复测,以评估心理干预措施效果;根据《医护人员工作压力测试量表》的调查结果制定有针对性的心理干预措施并适时调整。结果 社区医护人员SCL-90测评总分和躯体化、强迫、人际敏感、焦虑、敌对、恐怖、偏执7个因子得分均高于全国常模水平(P<0.05);经过综合干预,随访期间SCL-90测评总分呈逐步下降趋势,干预6个月时,除人际敏感因子外,SCL-90测评总分及各因子分已趋于正常水平,与全国常模比较差异没有统计学意义(P<0.05)。至9个月时,人际敏感因子得分也恢复至正常水平。结论 社区医护人员心理健康状况低于全国常模水平,进行针对性的综合干预可提高其心理健康水平,实验显示干预时长应不低于6个月。

Objective To understand the mental health status of community health care workers, assess the effect of psychological intervention measures, and find effective measures to improve the mental health status of community health care workers.Methods With the help of Symptom Checklist SCL-90, we firstly carried out baseline survey on community medical staff mental health; then retested that at 3, 6 and 9 months later. Thus, we could assess the effect of psychological intervention. According to the results of the medical staff working pressure test questionnaire, we could develop targeted psychological intervention measures and adopt prompt adjustment.Results Community health care personnel SCL-90 evaluation score and 7 factors scores(physical,forced,interpersonal sensitivity,anxiety,hostility,terror,and paranoia) were higher than the national norm(P<0.05);after comprehensive intervention in the 9 months follow-up,the SCL-90 evaluation score was decreasing gradually.After intervention for 6 months,except for the interpersonal sensitivity factor,SCL-90 total scores and the other factor scores tend to normal levels, to compare the national norm, there was no statistical significance in differences (P<0.05). 9 months later, the scores of interpersonal sensitivity also return to normal levels.Conclusion The mental health status of community health care workers was lower than the national norm,the comprehensive intervention may improve their mental health level, and the experiment showed that the intervention should be no less than 6 months.

目的 探讨心理健康干预对复治肺结核患者在整个治疗过程中生活质量影响,为加强结核病的宣教奠定坚实的基础。方法 选取广州市结核病防治所在治的复治肺结核病人72例,随机分成宣教组和普通组,选取2名有丰富经验的主管护师,经专业心理师培训指导,护长考核,负责宣教组的工作,而普通组则由轮班护士进行,无作特别要求。对比两组心理健康干预前后的变化。结果 两组症状自评量表(SCL-90)测评相比较,宣教组优于普通组,差异有统计学意义(P<0.05)。宣教组的生理健康总评及精神健康总评比对照组好,差异均有统计学意义(P<0.05)。结论 通过对门诊复治结核病患者进行心理健康干预,能有效改变复治病人的心理和生理健康,提高生活质量。