Analysis on the status and influencing factors of anticipatory grief among primary caregivers of families with advanced Alzheimer′s disease / 中华健康管理学杂志

Objective:To investigate the status of anticipatory grief among primary caregivers of families with advanced Alzheimer′s disease (AD) and analyze the influencing factors.Methods:A total of 160 primary caregivers in the families of AD patients in the middle and late stage who were treated in Shaoxing Seventh People′s hospital from August 2018 to September 2019 were selected as research subjects to investigate caregivers′ gender, age, education level, relationship with patients, reasons for taking care of patients, and the patients′ time of illness, combined diseases, and self-care ability. Anticipatory Grief Scale was used to compare the anticipatory grief level (AGL) of caregivers with different characteristics, and Pearson correlation analysis was used to analyze the correlation between the anticipatory grief and burden of caregivers, with a further exploration of the factors affecting caregivers′ anticipatory grief.Results:The anticipatory grief score of primary caregivers of families with AD patients in the middle and late stage was (83.88±17.21). Single factor analysis showed the following facts: the AGL of female caregivers was higher than that of males ( t =12.337, P<0.05); the AGL of spouses was higher than that of children and other family members ( F=10.940); the AGL showed in caretaking based on willingness was lower than that based on responsibility and obligation, and the reason was because other people were available ( F=4.501); the AGL of caregivers of patients with 5-10 years of illness was higher than that of those with 2-4 years of illness ( F=6.014); the AGL of caregivers of patients with more than 3 kinds of other diseases was higher than that of those with less than 1 and 2 kinds of other diseases; the AGL of caregivers of patients with no self-care ability was higher than that of those of patients who lost partial or most self-care ability ( F=5.712). The burden score of primary caregivers of patients in the middle and late stages of AD was (50.19±12.61). Pearson correlation analysis indicated that the anticipatory grief of caregivers was positively correlated with their burden of care ( r=0.581, P<0.001), and multiple regression analysis showed that the caregivers′ gender and relationship with patients, patients′ time of illness, and capacity of self-care, and the caregivers′ burden are the main factors influencing the anticipatory grief of caregivers in families of patients in the middle and late stages of AD (all P<0.05). Conclusion:There exists serious anticipatory grief among primary caregivers in families of patients in the middle and late stages of AD. The main influencing factors include caregivers′ gender, burden of care, relationship with patients, patients′ time of illness, and self-care capacity. Health management should be enhanced to improve the quality of life of the primary caregivers of patients in the middle and late stages of AD.

Adverse Reactions Induced by Non-ionic Iodinated Contrast Agent in 20,418 Patients receiving CT Examination / 中国医学影像学杂志

Purpose Medicine information and features of adverse reactions induced by non-ionic iodinated contrast agent injection for CT examination are analyzed and discussed,offering empirical evidence and reference for medication choice and patient information for clinical CT examination and targeted adverse reactions disposal.Materials and Methods General material,medicine type and name,adverse reactions occurrence time,symptoms and other information of the 20,418 patients receiving CT examination with non-ionic iodinated contrast agent at X-ray Department in Gansu Provincial Hospital from July 2013 to September 2016 were retrospectively analyzed.Results For observation objects in this group,11,679 were male and 8,739 female,aging from 3 to 93 and the average age was (52.1 ± 13.2) years.Various adverse reactions occurrence rate of non-ionic iodinated contrast agent was 0.4％ and adverse reactions occurrence rate of secondary hypertonic contrast and isotonic contrast agent was 0.47％ and 0.27％,respectively.Among the 81 adverse reactions,91.3％ were acute,among which 88.9％ occurred within 15 min after injection.8.7％ were delayed,97.6％ mild and moderate,and 2.4％ severe.Secondary hypertonic contrast and isotonic contrast agent occupied 74.0％ and 26.0％,respectively for the cause of adverse reactions.Delayed adverse reactions were mainly caused by isotonic contrast agent,representing as mild and moderate.Representation frequency of adverse reactions symptoms in turn was skin,digestive tract,central nervous system,respiratory system and circulatory system.Conclusion Adverse reactions caused by iodinated contrast agent were mainly acute and mild and moderate.The patients or their family members shall be fully notified before examinations.Severe adverse reactions caused by iodinated contrast agent developed very quickly and multi-systems would be damaged.Efficient on-site treatment is very important.Delayed reactions caused by isotonic contrast agent shall be paid more attention.

Absence of Humanities in the Closed Management of Psychiatric Ward and Countermeasures / 中国医学伦理学

This paper analyzes the absence of humanities in the closed management of psychiatric ward,and proposes relevant countermeasures: strengthening absorbing knowledge in humanities,applying humanistic nursing care,promoting the cultural construction of humanities in psychiatric ward,and strengthening the mental health support for nurses in psychiatric ward.