【摘要】目的：探讨HEART五步沟通模式对突发性耳聋（SSHL）患者心理状态及恢复情况的影响。方法：将2024年3月~2025年9月就诊于本院的110例SSHL患者作为研究对象，经抛币法将入组患者随机列为常规组、试验组，55例为一组。常规组实施常规临床护理，试验组在常规组的护理基础上联合实施HEART五步沟通模式，比较两组患者的心理状态，治疗依从性，护理结束后开展为期3个月短期随访，比较两组患者的听力改善情况及生活质量。结果：护理后，试验组的医院焦虑抑郁量表（HADS）、疾病不确定感（MUIS）评分分别为（8.25±1.39）分、（20.34±5.49）分，均低于常规组[（10.28±2.46）分、（25.52±6.67）分]（t=5.328，4.447；P＜0.05）。护理后，试验组的用药依从性、康复依从性、随访依从性均高于常规组（x2=9.429，11.733，11.282；P＜0.05）。试验组随访1个月、随访3个月时气导1kHz下平均听阈（PTA）及2kHz下PTA分别为（25.62±5.41）dB HL、（18.35±3.69）dB HL、（28.52±5.44）dB HL、（20.18±5.24）dB HL，均低于常规组[（30.67±6.35）dB HL、（21.33±4.25）dB HL、（33.69±6.37）dB HL、（25.49±6.33）dB HL]（t=4.490，3.927，4.577，4.792；P＜0.05）。截至随访结束时，试验组的成人听力障碍量表（HHIA）中社交维度、情绪维度、躯体维度评分均低于常规组（t=3.787，5.562，12.132；P＜0.05）。结论：HEART五步沟通模式可改善SSHL患者的不良心理状态并提升治疗依从性，对促进患者听力水平恢复及生活质量提升均有积极影响

[Abstract]Objective:To explore the impact of the HEART five step communication model on the psychological state and recovery of patients with sudden sensorineural hearing loss (SSHL).Methods:110 patients with SSHL who visited our hospital from March 2024 to September 2025 were selected as the research subjects. The enrolled patients were randomly divided into a control group and an experimental group using a coin toss method, with 55 patients in each group. The routine group received routine clinical nursing care, while the experimental group received the HEART five step communication model in addition to the routine nursing care. The psychological status and treatment compliance of the two groups of patients were compared. After the nursing was completed, a 3-month short-term follow-up was conducted to compare the hearing improvement and quality of life of the two groups of patients.Results:After nursing, the HADS and MUIS scores of the experimental group were (8.25 ± 1.39) points and (20.34 ± 5.49) points, respectively, which were lower than those of the control group [(10.28 ± 2.46) points and (25.52 ± 6.67) points] (t=5.328，4.447; P<0.05). After nursing, the medication compliance, rehabilitation compliance, and follow-up compliance of the experimental group were higher than those of the conventional group (x2=9.429，11.733，11.282; P<0.05). The PTA of the experimental group at 1kHz and 2kHz were (25.62 ± 5.41) dB HL, (18.35 ± 3.69) dB HL, (28.52 ± 5.44) dB HL, and (20.18 ± 5.24) dB HL, respectively, during a 1-month and 3-month follow-up, which were lower than those of the control group [(30.67 ± 6.35) dB HL, (21.33 ± 4.25) dB HL, (33.69 ± 6.37) dB HL, and (25.49 ± 6.33) dB HL] (t=4.490，3.927，4.577，4.792; P<0.05). As of the end of the follow-up, the scores of social, emotional, and physical dimensions in the HHIA of the experimental group were lower than those of the control group (t=3.787，5.562，12.132; P<0.05).Conclusion:The HEART five step communication model can improve the adverse psychological state of SSHL patients and enhance treatment compliance, which has a positive impact on promoting the recovery of patients' hearing level and improving their quality of life.

目的 分析团体认知行为干预联合揿针全程护理对胃癌晚期癌痛患者心理状态的影响。方法 选取我院115例胃癌晚期癌痛患者(2018年3月—2021年1月),依照干预方案不同分为3组。对照1组(37例)接受团体认知行为干预,对照2组(38例)接受揿针全程护理干预,观察组(40例)接受团体认知行为干预联合揿针全程护理干预,比较3组干预效果。结果 疼痛爆发时疼痛缓解情况:观察组疼痛爆发时疼痛缓解率均较对照1组、对照2组高(P＜0.05);心理状态:干预1个月后,3组心理状态均得到改善,且观察组汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评分均较对照1组、对照2组低(P＜0.05);护理满意度:与对照1组、对照2组对比,观察组护理满意度较高(P＜0.05)。结论 团体认知行为干预联合揿针全程护理应用于胃癌晚期癌痛患者,能有效缓解疼痛,改善心理状态,且护理满意度高。

Objective To analyze the effect of group cognitive behavior intervention combined with whole-process nursing of pressing needle on the psychological state of patients with advanced gastric cancer pain. Methods A total of 115 patients with advanced gastric cancer pain in our hospital (from March 2018 to January 2021) were selected and divided into 3 groups according to different intervention methods. Control group 1 (37 cases) received group cognitive behavioral intervention, control group 2 (38 cases) received whole-course nursing intervention of pressing needle, and observation group (40 cases) received whole-process nursing intervention of group cognitive behavioral intervention combined with pressing needle. The intervention effects of the three groups were compared. Results Pain relief when pain burst: the pain relief rate of observation group was higher than control group 1 and control group 2 (P<0.05). Mental state: after 1 month of intervention, the mental state of the 3 groups was improved, and the scores of Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) in the observation group were lower than those in control group 1 and control group 2 (P<0.05). Nursing satisfaction: compared with control group 1 and control group 2, nursing satisfaction of observation group was higher (P<0.05). Conclusions Group cognitive behavior intervention combined with whole-process nursing of pressing needle applied to patients with advanced gastric cancer pain could effectively relieve pain, improve psychological state, and nursing satisfaction.

目的 对颞下颌关节紊乱病患者的心理健康状况进行分类别的评估分析。方法 随机选择口腔科门诊就诊的颞下颌关节紊乱病患者88例为病例组,健康正常人92例为对照组,心理科抑郁患者92例及焦虑患者90例为心理疾病组,采用症状自评量表(SCL-90)量表、焦虑自评量表(SAS)、抑郁自评量表(SDS)、艾森克人格问卷(EPQ)进行问卷调查,将量表调查结果分别归类整理后,使用统计软件SPSS13.0进行统计学分析。结果 TMD患者与正常对照组相比,在SCL-90、SAS、SDS评分中多项有统计学意义,在病例组中,多次患病和初次患病相比、高学历与低学历患者相比,在焦虑和抑郁上有统计学意义。颞下颌关节紊乱病患者与心理疾病患者相比,心理疾病患者在焦虑和抑郁上得分高于颞下颌关节紊乱病患者。结论 颞下颌关节紊乱病患者存在着不同程度的心理障碍,但远未达到心理疾病的程度,且颞下颌关节紊乱病患者中的不同群体心理状况也有所不同,这对于TMD患者心理上的疏导提供了一定的依据。

Objective To explore the research and analysis of temporomandibular disorder(TMD)patients' psychological states. Methods People diagnosed in the dental clinic were identified as target population.Totally, 88 patients with TMD were recruited as case control,whereas 92 normal people,92 patients with mental depression and 90 patients with dysphoria disorders were collected as control group.Questionnaire survey was carried out based on Symptom Checklist(SCL-90),Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS)and Eysenck Personality Questionnaire(EPQ). Correlations between TMD and psychological factors were assessed using the statistical methods. Results Compared with normal people,patients with TMD showed statistically significant diversity in SCL-90,SAS and SDS.In subgroup analysis of patients with TMD,patients with repeated disease history or advanced education degree presented significant variation in terms of depression and anxiety when compared with those with first diagnosed or lower education degree.Compared with patients with mental illnesses,patients with TMD showed significant lower score in depression and anxiety. Conclusion In TMD treatment we should not only adapt traditional physical therapy,medical therapy,corrective therapy and surgical treatment but also pay attention to psychological treatment to correct the patients' negative emotions,which may improve the symptoms and actively terminate disease process.

       目的   探讨女性医务人员月经改变的影响因素及与心理状态的相关性。方法   对深圳市3家医院女性医护人员进行随机抽样得到869份问卷调查样本，均为知情自愿参与本项调查研究。统计女性医务人员出现女性月经改变的比率和月经改变的基本特征，并采用单因素和多因素分析的方法分析影响月经改变因素。并以抑郁症筛查量表（PHQ-9）评估女性医护人员的心理状态，分析女性医务人员月经改变与心理状态评分间相关性。结果  869名女性医护人员中有293例发生月经改变，改变率为33.72%，其中月经周期改变94例、经期时间改变86例、月经量改变68例、痛经改变45例。将869例女性医护人员分为月经正常组和月经改变组，经单因素分析，两组间的年龄、职业、值夜班频率、既往病史、新冠感染等比较差异无统计学意义（P＞0.05）。月经改变组的护士占58.36%高于月经正常的24.48%，月经改变组的新冠一线抗疫人员占64.51%高于月经正常的27.08%，月经改变组合并妇科疾病史的占比20.82%（61例）高于月经正常组的占比11.98%（69例）。而月经改变组的护士、新冠一线抗疫人员、合并妇科疾病史、新冠感染的比较差异有统计学意义（P＜0.05）。多因素分析显示，职业为护士、合并妇科疾病史、新冠一线抗疫人员的P值分别为0.001、0.004、＜0.001，故而职业为护士、合并妇科疾病史、新冠一线抗疫人员是女性医务人员月经改变的危险因素。月经改变组PHQ-9评分为9.10±2.57，月经正常组PHQ-9评分为5.98±1.06，月经改变组PHQ-9评分高于月经正常组（P＜0.001）。两组受试者PHQ-9评分比较差异具有统计学意义，月经改变组PHQ-9评分中0～4分受试者为26.3%，月经正常组为47.2%，月经改变组PHQ-9评分中0～4分者比例小于月经正常组，差异具有统计学意义（P＜0.05）。结论   女性医务人员中职业为护士、合并妇科疾病史、新冠一线抗疫人员是月经改变的主要危险因素，且月经改变与心理状态有密切的相关性，需引起医疗机构的关注。

      Objective  To analyze the influencing factors of menstruation changes of female medical staff and the correlation with their psychological status．Methods  The female medical staff in three hospitals of Shenzhen were  randomly sampled to get 869 questionnaires，with informed and willing to participate in this research．The rate of female menstruation changes and the basic characteristics of menstruation changes in female medical staff were calculated，and the influencing factors of menstruation changes were analyzed by single factor and multi factor analysis．And the psychological status of female medical staff was using the Depression Screening Scale （PHQ-9），and the correlation between menstrual changes and psychological status scores of female medical staff were analyzed．Results  Among 869 female medical staff，293 had hemorrhagic menstrual disease，with a change rate of 33.72%．Among them，94 had changes in menstrual cycle，86 had changes in menstrual period days，68 had changes in menstrual volume，and 45 had changes in dysmenorrhea．These 869 female medical staff were divided into normal menstruation group and menstrual change group．Through single factor analysis，there was no statistical difference between the two groups in terms of age，careers，night shift frequency，previous medical history，COVID-19 infection （P＞0.05）．The percentage of nurses in the menstrual change group was 58.36%，higher than that of 24.48% in the normal menstruation group．The percentage of frontline medical staff combating COVID-19 in the menstrual change group was 64.51%，higher than that of 27.08% in the normal menstruation group．And the percentage of menstrual change group with a history of combined gynecological diseases was 20.82% （61 cases），higher than that of the normal menstruation group was 11.98% （69 cases）．And the difference was statistically significant when comparing the ratio of nurses，the frontline medical staff combating COVID-19，the history of gynecological diseases，and COVID-19 infection in the menstrual change group （P＜0.05）．Multivariate analysis showed that the occupation of nurses，frontline medical staffs combating COVID-19，and history of gynecological diseases were the risk factors for menstrual changes．The PHQ-9  score of the menstrual change group was higher than that of the normal menstrual group，and the difference was statistically significant．Conclusions  The main risk factors for menstrual changes are nurses，frontline anti-epidemic staff，and women with gynecological disease history．Menstrual changes are closely related to mental status，attention from healthcare organizations．