目的 探讨肺癌根治术后患者康复期的症状体验与心理感受, 为完善症状管理和制定个性化康复干预方案提供依据。方法 采用现象学研究法,对15例肺癌根治术后康复期患者进行半结构式访谈, 运用Colaizzi 7步分析法进行归纳和提炼主题。结果 归纳出5个主题, 12个亚主题：多重躯体症状负担持续存在（术后疼痛综合征、顽固性刺激性咳嗽、劳力性呼吸困难、持续性疲劳感）; 负性心理情绪困扰（病耻感、疾病不确定感与复发恐惧）; 心理调适过程（诊断冲击与认知失调、角色适应与主动应对）; 创伤后成长与健康行为转变（生命意义感提升、健康促进行为强化）; 强烈的康复信息支持需求（自我保健知识需求、结构化康复锻炼指导需求）。结论 医护人员应关注肺癌根治术后患者康复期的症状体验, 动态评估患者的身心状况, 制定精准、有效的个性化干预方案, 帮助患者树立康复信心, 改善术后康复体验和提高生活质量。

       Objective  To explore the symptom experience and psychological feelings of patients during the rehabilitation period after radical resection of lung cancer, aiming to provide a basis for improving symptom management and formulating personalized rehabilitation interventions．Methods The phenomenological research method was used to conduct semi-structured interviews with 15 patients in the rehabilitation period after radical surgery for lung cancer．Colaizzi's 7-step analysis method was used to summarize and extract themes．Results Five themes and 12 sub-themes were summarized：Persistent burden of multiple physical symptoms（postoperative pain syndrome, refractory irritative cough, exertional dyspnea, persistent fatigue）; negative emotional experiences（stigma of illness, illness uncertainty and fear of recurrence）; psychological adjustment processes（diagnostic shock and denial, role acceptance and active coping）; post-traumatic growth and health behavior transformation（enhanced sense of meaning in life, strengthened health-promoting behaviors）; strong demand for rehabilitation information support（self-care knowledge, rehabilitation exercise knowledge）．Conclusions Medical staff should pay attention to the symptom experience of patients during the recovery period after radical lung cancer surgery, dynamically assess their physical and mental conditions, develop precise and effective personalized intervention plans, help patients build confidence in recovery, and thereby improve their postoperative rehabilitation experience and quality of life．

       目的   探究认知行为疗法联合治疗性沟通在对内镜黏膜下剥离（ESD）术患者心理及治疗依从性的效果。方法   前瞻性选取2023年3月至2025年3月鹰潭市一八四医院收治的122例行ESD术的患者作为研究对象，采用随机数字表法将患者分为A、B组，B组56例患者采取治疗性沟通干预，A组66例患者采用认知行为疗法联合治疗性沟通干预，两组均连续干预2个月。比较两组患者干预前后焦虑自评量表（SAS）、抑郁自评量表（SDS）评分、心理弹性量表（CD-RISC）评分、Herth希望指数量表（HHI）评分差异，对比两组干预依从性。结果   干预后，两组SAS、SDS评分均下降且A组低于B组（t分别为12.096、10.326，P＜0.05）；干预后，两组CD-RISC量表各项评分均提高且A组高于B组（t分别为18.483、12.060、13.622，P＜0.05）；干预后，两组HHI量表各项评分均上升且A组高于B组（t分别为1.289、11.568、12.527、13.794，P＜0.05）；A组患者总依从率96.97%（64/66）高于B组80.36%（45/56）（χ ² =8.782，P＜0.05）。结论   认知行为疗法联合治疗性沟通在ESD术患者中干预效果理想，能够明显改善患者负性情绪，提高心理弹性及对疾病康复的希望水平，有效提升依从性。

       Objective  To explore the effect of cognitive behavioral therapy combined with therapeutic communication on psychological  health and therapy compliance of patients undergoing endoscopic submucosal dissection（ESD）．Methods  Prospectively，122 patients who underwent ESD at Yingtan 184 Hospital from March 2023 to March 2025 were selected as the research subjects．These patients were randomly divided into Group A and Group B using the random number table method，and 56 patients in group B were treated with therapeutic communication，66 patients in group A were treated with cognitive behavioral therapy combined with therapeutic communication，and both groups were continuously intervened for 2 months．The  scores of Self-Rating Anxiety Scale（SAS），Self-Rating Depression Scale（SDS），Connor-Davidson Resilience Scale（CD-RISC）and Herth Hope Index（HHI）were compared between the two groups before and after treatment．Therapy compliance between the two groups was compared．Results  After treatment，the SAS and SDS scores of the two groups were decreased，and the scores of group A was lower than that of group B（t=12.096，10.326，P＜0.05）after the intervention，the scores of the CD-RISC scale of the two groups were improved，and the score of group A was higher than that of group B（t=18.483，12.060，13.622，P＜0.05）．After intervention，the scores of HHI scale in both groups increased and score of group A was higher than that ofgroup B（t=11.289，11.568，12.527，13.794，P＜0.05）．The total compliance rate of patients in group A was 96.97%（64/66），which was significantly higher than 80.36%（45/56）in group B（χ ² =8.782，P＜0.05）．Conclusions  Cognitive-behavioral therapy combined with therapeutic communication has an ideal effect in ESD patients，which can significantly improve patients’ negative emotions，psychological resilience and hope for disease recovery，and also therapy compliance．

       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   探讨肺癌伴癌性疼痛患者心理僵化现状及其影响因素，为临床制定改善患者心理僵化的针对性干预措施以及提升患者生活质量提供参考依据。方法   采用便利抽样法，选取2023年10月—12月期间焦作市某三级甲等医院收治的肺癌伴癌性疼痛患者为研究对象，采用一般资料调查问卷、疼痛心理僵化量表（PIPS）、简易疾病感知问卷（BIPQ）、家庭功能问卷（APGAR）进行调查，采用Pearson相关性分析肺癌伴癌性疼痛患者心理僵化与疾病感知、家庭功能的关系。采用多元线性回归分析肺癌伴癌性疼痛患者心理僵化的影响因素。结果   本次研究共发放问卷152份，回收有效问卷150份，有效回收率为98.68%。150例肺癌伴癌性疼痛患者心理僵化量表总分为（61.66±2.85）分，回避型经验维度得分为（45.52±1.97）分，认知融合维度得分为（19.74±1.59）分。不同文化程度、家庭人均月收入、疼痛程度的肺癌伴癌性疼痛患者心理僵化得分比较，差异有统计学意义（P＜0.05）。Pearson相关性分析结果显示：肺癌伴癌性疼痛患者心理僵化总分、经验性回避维度得分、认知融合维度得分与疾病感知得分均呈正相关关系（P＜0.001），与家庭功能得分均呈负相关关系（P＜0.001）。多元线性回归结果显示：文化程度、家庭人均月收入、疾病感知、家庭功能是肺癌伴癌性疼痛患者心理僵化的影响因素（P＜0.05），可解释肺癌伴癌性疼痛患者心理僵化43.9%的变异度。结论   肺癌伴癌性疼痛患者心理僵化处于较高水平，且受到文化程度、家庭人均月收入、疾病感知和家庭功能的影响，临床医护人员可从疾病感知、家庭支持等角度出发，采用认知干预、同伴支持等方法，加强对患者的健康教育，以缓解其对疾病的负性认知，从而缓解心理僵化，促进身心健康恢复。

       Objective  To explore the status and influencing factors of psychological  rigidity in patients with lung cancer and cancer pain，and to provide reference for clinical development of targeted interventions to improve patients’psychological rigidity andquality of life．Methods  The convenience sampling method was used to select patients with lung cancer and cancer pain who were admitted to a tertiary hospital in Jiaozuo City from October to December 2023 as the research object．The general data questionnaire，Psychological Inflexibility in Pain Scale（PIPS），Brief Illness Perception Questionnaire（BIPQ），and family function questionnaire（APGAR）were used to investigate．Pearson correlation analysis was used to analyze the relationship between psychological rigidity and disease perception and family function in patients with lung cancer and cancer pain．Multivariate linear regression was used to analyze the influencing factors of psychological rigidity in patients with lung cancer and cancer pain．Results  A total of 152 questionnaires were distributed in this study，and 150 valid questionnaires were recovered，with an effective recovery rate of 98.68 %．The total score of PIPS of 150 patients with lung cancer and cancer pain was（61.66±2.85），the score of avoidance experience dimension was（45.52±1.97），and the score of cognitive fusion dimension was（19.74±1.59）．There were statistically significant differences in the scores of psychological rigidity among lung cancer patients with cancer pain with different educational levels，family per capita monthly income，and pain degree（P＜0.05）．The  results of Pearson correlation analysis showed that the total score of PIPS，the score of empirical avoidance dimension and the score of cognitive fusion dimension were positively correlated with the score of disease perception（P＜0.001），and negatively correlated with the score of family function（P＜0.001）．The results of multiple linear regression showed that education level，family per capita monthly income，disease perception and family function were the influencing factors of psychological rigidity in patients with lung cancer and cancer pain（P＜0.05 ），which could explain 43.9 % of the variation of psychological rigidity in patients with lung cancer and cancer pain．Conclusions  The psychological rigidity of lung cancer patients with cancer pain is at a high level，and is affected by education level，family per capita monthly income，disease perception and family function．Clinical medical staff can use cognitive intervention and peer support from the perspective of disease perception and family support to strengthen the health education of patients，so as to alleviate their negative cognition of the disease，to alleviate the psychological rigidity and promote the recovery of physical and mental health．

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 探讨院外延续性护理联合院内心理指导对重症烧伤患者创伤应激的影响。方法 选取2020年6月—2022年6月南开大学附属医院（天津市第四医院）重症烧伤科收治的86例重度烧伤患者为研究对象,应用随机数字表法将患者分为观察组与对照组,每组各43例。对照组采取常规护理,观察组在常规护理基础上增加院外延续性护理联合院内心理指导,评估患者的创伤应激指标[血清肿瘤坏死因子α（TNF-α）、白细胞介素6（IL-6）、β-内啡肽（β-ep）]、心理韧性程度、应对行为、创伤后成长水平,并分析患者创伤应激与心理韧性的相关性。结果 干预前,两组的TNF-α、IL-6、β-ep水平比较差异无统计学意义（P>0.05）;干预后,两组创伤应激相关指标水平均下降,且观察组降低幅度更大（P<0.05）。干预后,两组患者乐观性、力量性、坚韧性相关中文版创伤后成长评定量表（C-PTGI）评分均升高,且观察组更高（P<0.05）;Pearson相关性分析显示,TNF-α、IL-6、β-ep等创伤应激指标水平与心理韧性水平呈负相关（P<0.05）;干预后,两组患者积极应对特质应对方式问卷（TCSQ）评分均升高,观察组高于对照组,人消极应对评分均降低,观察组低于对照组（P<0.05）;干预后,两组患者人际关系、精神变化、生活欣赏、个人力量、新的可能相关C-PTGI评分分量表得分均升高,观察组高于对照组（P<0.05）。结论 对重度烧伤患者采取院外延续性护理联合院内心理指导能够降低患者的创伤后应激水平、消极应对评分,提升患者心理韧性程度、创伤后成长水平以及积极应对评分,且创伤后应激水平与心理韧性水平呈负相关。

Objective To explore the effect of out-hospital continuous nursing combined with in-hospital psychological guidance on traumatic stress in severe burn patients．Methods A total of 86 patients with severe burn treated in the Affiliated Hospital of Nankai University（Tianjin Fourth Hospital）from June 2020 to June 2022 were selected as the research objects．The patients were divided into observation group and control group by random number table method,with 43 cases in each group．The control group received routine care,and the observation group was supplemented with out-hospital continuous nursing and in-hospital psychological guidance on the basis of routine care．The traumatic stress indexes [serum tumor necrosis factor-α（TNF-α）,interleukin-6（IL-6）,β-endorphin（β-ep）],psychological toughness,coping behavior and post-traumatic growth level of the patients were evaluated．The correlation between traumatic stress and mental toughness was analyzed．Results Before intervention,the levels of TNF-α,IL-6 and β-ep were not significantly different between the two groups（P>0.05）．After intervention,the levels of traumatic stress-related indicators were decreased between the two groups,and the reduction was greater in the observation group（P<0.05）．After intervention,C-PTGI scores related to optimism,strength and fortitude were increased in both groups,which were higher in observation group（P<0.05）．Pearson correlation analysis showed that the levels of TNF-α,IL-6,β-ep and other traumatic stress indexes were significantly negatively correlated with the levels of mental toughness（P<0.05）．After intervention,the positive coping TCSQ scores of both groups were increased,the observation group was higher,and the negative coping scores were decreased,while the observation group was lower（P<0.05）．After the intervention,the scores of interpersonal relationships,mental changes,life appreciation,personal strength,and new possibly relevant C-PTGI score subscale were increased in both groups,and higher in the observation group（P<0.05）．Conclusions The combination of out-hospital continuous nursing and in-hospital psychological guidance for severe burn patients can reduce the level of post-traumatic stress and negative response score of patients,and improve the level of mental toughness,post-traumatic growth and positive score of patients,and the level of post-traumatic stress is significantly negatively correlated with the level of mental toughness．

目的 探讨在分化型甲状腺癌（DTC）患者的治疗中,采用早期积极心理进行干预,对患者负性情绪和癌因性疲乏的影响。方法 抽取2021年6月—2023年1月平煤神马医疗集团总医院收治的160例DTC癌患者,随机分为对照组（常规护理）和研究组（常规护理+早期积极心理干预）,每组各80例,评估患者干预前后的心理状态、癌因性疲乏、生活质量、护理工作满意度。结果 护理干预1~4周后,两组患者汉密尔顿抑郁量表（HAMD）评分、汉密尔顿焦虑量表（HAMA）评分均降低,并且研究组患者评分更低（P<0.05）;干预后,两组患者的癌因性疲乏评分均升高,但是研究组患者的以上指标升高幅度小于对照组（P<0.05）;此外,两组患者的护士观察量表（NOSIE）评分均明显改善,并且研究组变化幅度大于对照组（P<0.05）;研究组患者的护理满意度高于对照组（95.00% vs 82.50%,P<0.05）。结论 对DTC患者开展早期积极心理干预,能够帮助患者改善负性情绪,减轻癌因性疲乏,提高患者的生活质量和护理满意度。

Objective To investigate the effect of early positive psychological intervention on negative emotions and cancer-related fatigue in the treatment of differentiated thyroid cancer（DTC） patients．Methods From June 2021 to January 2023,160 patients with DTC admitted to General Hospital of Pingmei Shenma Group were randomly divided into the control group（routine nursing）and the research group（routine nursing + early positive psychological intervention）,with 80 patients in each group．The psychological state,cancer-related fatigue,quality of life and nursing satisfaction of patients before and after intervention were evaluated．Results After 1~4 weeks of intervention,the scores of Hamilton Depression Scale（HAMD）and Hamilton Anxiety Scale（HAMA）were decreased in both groups,and the scores of research group were lower（P<0.05）．After intervention,the cancer-related fatigue scores of both groups were increased,but the increase of research group were less than that of control group（P<0.05）．Moreover,NOSIE scores of both groups were significantly improved,and the change range of research group was greater than that of control group（P<0.05）．The nursing satisfaction of research group was higher than that of control group（95.00% vs 82.50%,P<0.05）．Conclusions Early positive psychological intervention for patients with DTC can effectively improve negative emotions,reduce cancer-related fatigue,and improve nursing satisfaction of patients．

目的 探讨心理因素对儿童功能性腹泻的影响。方法 选取贵州省人民医院儿科2018年1月—2023年1月收治的200例功能性腹泻患儿,依照患儿年龄进行分组,将3~9岁患儿纳入儿童期观察组（n=116）、将10~14岁纳入青少年期观察组（n=84）,另选取同期体检的200名健康儿童志愿者作为对照组,将3~9岁儿童纳入儿童期对照组（n=110）、10~14岁纳入青少年期对照组（n=90）。对所有3~9岁儿童采用幼儿心理健康评定量表（CMHA-80）评价心理健康水平。对所有10~14岁儿童采用青少年版中国心理健康量表（MSSMHS）评价心理健康水平。心理因素与儿童功能性腹泻的相关性采用Spearman相关性分析,采用Logistic回归分析分析儿童功能性腹泻的影响因素。结果 儿童期观察组与对照组儿童人际关系、意志力、认知、注意力相关CMHA-80评分对比差异无统计学意义（P>0.05）,观察组儿童适应性、社会行为、性格、自我意识、情绪情感、其他相关CMHA-80评分明显低于对照组儿童（P<0.05）;青少年期观察组与对照组儿童环境适应、人际交往相关MSSMHS评分对比差异无统计学意义（P>0.05）,青少年期观察组儿童自我认识、情绪体验、认知效能相关MSSMHS评分低于对照组儿童（P<0.05）。儿童期儿童适应性、社会行为、性格、自我意识、情绪情感与功能性腹泻呈负相关（P<0.05）,青少年期自我认识、情绪体验、认知效能与功能性腹泻负正相关（P<0.05）。Logistic回归分析结果表明,性格、情绪情感、其他为儿童期功能性腹泻的影响因素（P<0.05）,情绪体验、认知效能为青少年期功能性腹泻的影响因素（P<0.05）。结论 心理因素对于儿童功能性腹泻具有较大影响。对于儿童期儿童来说,性格、情绪情感、其他不良习惯、抽动、睡眠、饮食等均是引发功能性腹泻的影响因素,对于青少年期来说,情绪体验、认知效能为引功能性腹泻的影响因素。

Objective To explore the influence of psychological factors on functional diarrhea in children．Methods A total of 200 children with functional diarrhea admitted to Pediatric Department of Guizhou Provincial People's Hospital from January 2018 to January 2023 were selected．They were grouped according to their age．Children aged 3-9 were included in the preschool observation group（n=116）,while those aged 10-14 were included in the adolescent observation group（n=84）．Additionally,200 healthy children volunteers who underwent physical examinations during the same period were selected as the control group．Children aged 3-9 were included in the preschool control group（n=110）,and those aged 10-14 were included in the adolescent control group（n=90）．Use the CMHA-80 Preschool Mental Health Assessment Scale to evaluate the level of mental health for all children aged 3-9．Evaluate the mental health level of all children aged 10-14 using the MSSMHS．The correlation between psychological factors and functional diarrhea in children was analyzed using Spearman correlation analysis,and the influencing factors of functional diarrhea in children were analyzed using logistic regression analysis．Results The results showed that there was no statistically significant difference in the CMHA-80 scores of interpersonal relationships,willpower,cognition and attention between the preschool observation group and control group（P>0.05）．The CMHA-80 scores of adaptability,social behavior,personality,self-awareness,emotions and other factors in the observation group in childhood were significantly lower than those in the control group（P<0.05）．There was no statistically significant difference in the MSSMHS scores of environmental adaptation and interpersonal communication between the adolescent observation group and control group（P>0.05）．The MSSMHS scores of self-awareness,emotional experience and cognitive efficacy in the adolescent observation group were lower than those in the adolescent control group（P<0.05）．There was a negative correlation（P<0.05）between adaptability,social behavior,personality,self-awareness,emotions and functional diarrhea in preschool children．Adolescent self-awareness,emotional experience,cognitive efficacy,and functional diarrhea were negatively and positively correlated（P<0.05）．The results of Logistic regression analysis showed that personality,emotions and other factors were the influencing factors of functional diarrhea in preschool childhood（P<0.05）．Emotional experience and cognitive efficacy were influencing factors for adolescent functional diarrhea（P<0.05）．Conclusions Psychological factors have a significant impact on functional diarrhea in children．For preschool children,personality,emotions,other bad habits,tics,sleep,diet are all factors that can cause functional diarrhea．For adolescents,emotional experience and cognitive efficacy are factors that can cause functional diarrhea．

目的 分析基于叙事护理理论的心理干预在突发创伤下肢骨折患者中的应用价值。方法 选择南方医科大学深圳医院2023年4月—2023年10月收治的100例突发创伤下肢骨折患者,根据随机数字表法将患者分为研究组和对照组,各50例。对照组提供常规心理护理和健康教育,研究组在对照组的基础上增加基于叙事护理理论的心理干预。对比两情绪压力量表和创伤后成长情况、康复依从性。结果 研究组的情绪压力评分维度中抑郁和焦虑及压力评分明显低于对照组（P<0.05）;研究组的创伤相关评分维度中与他人的关系、新的可能性和个人力量、生活的欣赏和精神变化评分高于对照组,康复依从性高于对照组（P<0.05）。结论 基于叙事护理理论的心理干预,可缓解突发创伤下肢骨折患者的心理压力,提高康复依从性,促进早日康复。

Objective To analyze the application value of psychological intervention based on narrative nursing theory in patients with sudden traumatic lower extremity fracture．Methods A total of 100 patients with sudden traumatic lower extremity fracture admitted to Shenzhen Hospital of Southern Medical University from April 2023 to October 2023 were selected and divided into study group and control group with 50 cases in each group by random number table method．The control group received routine psychological nursing and health education,and the study group was added psychological intervention based on narrative nursing theory．The two emotional stress scales were compared with post-traumatic growth and rehabilitation compliance．Results The scores of depression,anxiety and stress in the study group were significantly lower than those in the control group（P<0.05）．The trauma-related scores of the study group were significantly higher than those of the control group in relation to others,new possibilities and personal strength,appreciation of life and spiritual changes,and the rehabilitation compliance was significantly higher than that of the control group（P<0.05）．Conclusions Psychological intervention based on narrative nursing theory can relieve psychological pressure of patients with sudden traumatic lower extremity fracture,improve rehabilitation compliance,and promote early recovery．

目的 探讨与观察思维导图教育模式对肠造口患者生活质量与心理情绪的影响。方法 选择2021年5月—2022年4月本院胃肠外科收治的低位直肠癌术后患者80例为研究对象,按入院顺序随机编号,对应随机数字为偶数的分到思维导图组（n=40）,奇数的分到传统组（n=40）。传统组给予常规健康教育干预,思维导图组在传统组护理的基础上给予思维导图教育模式干预,思维导图组与传统组护理观察时间为3个月。结果 思维导图组护理期间的造口感染、坏死、水肿、出血、旁疝等并发症发生率与传统组相比都降低（P<0.05）。思维导图组与传统组护理后的焦虑与抑郁评分与护理前相比降低（P<0.05）,护理后思维导图组评分与传统组相比降低（P<0.05）。思维导图组的术后住院时间、术后排气时间、术后下床活动时间与传统组相比均减少（P<0.05）。思维导图组护理后的副作用、共性症状、尿路症状、特异躯体症状、特异心理、性功能、尿袋问题等生活质量评分与传统组相比都减少（P<0.05）。结论 思维导图教育模式在肠造口患者的应用能促进缓解心理负面情绪,促进患者康复,提高患者的生活质量,减少术后造口并发症的发生。

Objective To explore and observe the effects of mind map education mode on the quality of life and psychological emotions of patients with enterostomy．Methods From May 2021 to April 2022, 80 cases of patients with postoperative low rectal cancer who were admitted to the Gastrointestinal Surgery Department of our hospital were selected as the research subjects, and all the cases were numbered according to the random admission sequence, and those with even random numbers were assigned to the mind map group（n=40）, and odd numbers were assigned to the traditional group（n=40）．The traditional group was given routine health education intervention, the mind map group was given mind map education mode intervention additionally, and the nursing observation time of both groups was 3 months．Results The incidences of complications such as stoma bleeding, parastomal hernia, stoma necrosis, stoma edema and stoma infection during nursing in the mind map group were lower than that in the traditional group（P<0.05）．The anxiety and depression scores in both groups after nursing were significantly lower than those before nursing（P<0.05）, and the scores in the mind map group after nursing were also significantly lower than those in the traditional group（P<0.05）．The postoperative hospital stay, postoperative exhaust time, and postoperative ambulation time of the mind map group were significantly shorter than those of the traditional group（P<0.05）．The quality of life scores of common symptoms, side effects, urinary tract symptoms, specific somatic symptoms, specific psychology, urine bag problems and sexual function in the mind map group after nursing were significantly lower than those in the traditional group（P<0.05）．Conclusions The application of mind map education model in patients with enterostomy can promote the relief of psychological negative emotions, promote the recovery of patients, reduce the occurrence of postoperative complications, and improve the quality of life of patients．