Drinking behavior among government employees in Changsha and its influencing factors / 中南大学学报(医学版)

OBJECTIVES@#To analyze the prevalence and influencing factors for drinking behavior and heavy drinking among government employees in Changsha and provide a basis for carrying out interventions for drinking behaviors and formulating public health promotion plans for government employees.@*METHODS@#Government employees were recruited consecutively from the Health Management Center of a general hospital in Changsha between December 2017 and December 2018. Information on sociodemograpic characteristics, drinking behaviors, life events, and psychosocial characteristics was collected using a standard set of questionnaire. Drinking behavior was defined as drinking once or more per week for the past 12 months. The differences in drinking rates and excessive drinking rates among groups with different characteristics were compared. Multivariate analysis was performed to analyze the associated factors of drinking behaviors and heavy drinking for government employees.@*RESULTS@#A total of 6 190 people completed this investigation. The overall drinking rate of government employees in Changsha was 21.9%, and the rate of drinking was higher in males than that in females (44.7% vs 4.0%, @*CONCLUSIONS@#The drinking and heavy drinking rates of government employees are high in Changsha. Marital status, physical exercise, and frequency of social intercourse are the common influencing factors of male drinking behavior and female drinking behavior. The life events stimulation is the influencing factor of heavy drinking.

Reliability and validity for Chinese version of the 9-item Shared Decision Making Questionnaire / 中南大学学报(医学版)

To translate the English version of the 9-item Shared Decision Making Questionnaire (SDM-Q-9) into Chinese, and to test its reliability and validity in Chinese version.
 Methods: A total of 720 inpatients were recruited randomly from 6 hospitals in Changsha and were investigated using the Chinese version of SDM-Q-9. SPSS 23.0 and AMOS 23.0 were used to test the reliability and validity.
 Results: There were 660 participants completed and returned valid questionnaires (valid return rate was 91.7%). An analysis of internal consistency yielded a Cronbach's α at 0.945 and the correlation of test-retest reliability was 0.319 for whole instrument. The correlations between the items and total scale ranged from 0.790 to 0.879 (P<0.001). A single factor was extracted by exploratory factor analysis and it could explain 69.824% of the total variance. The confirmatory factor analysis revealed a good model fit. The goodness-of-fit index (GFI), adjusted goodness-of-fit index (AGFI), comparative fit index (CFI), normal fit index (NFI), and root mean square residual (RMR) were 0.870, 0.784, 0.926, 0.921, and 0.054, respectively.
 Conclusion: The Chinese version of SDM-Q-9 is proved to be reliable and eligible except the correlation of test-retest reliability is relatively low. It can be used to assess the patient's perspective in the process of shared decision making in clinical situation.

Several issues in individual-oriented suicide prevention in clinical settings / 中华行为医学与脑科学杂志

Suicide is a global public health concern.Clinical practitioners are also frequently involved in providing treatment for patients at suicide risk.This paper analyzes problems of current studies on the causes of suicide,suggests that causes of suicide ideation,attempted suicide and committed suicide may different and need further research.After that,the paper discusses problems in the clinical evaluation of suicide risk,propose a systematic clinical evaluation of suicide risk,which should integrate suicide ideation,individual features of the person,and the sociocultural context.Finally,the author provides advices on five aspects of clinical treatment targeted to high suicide risk individuals.

A case-control study on dating violence among gay men in Guangzhou / 中国心理卫生杂志

Objective: To understand the prevalence of dating violence experienced by gay men in Guangzhou. Methods: A self-report surveys were collected and analyzed from 510 gay men and 510 heterosexual males. Respondents were assessed with the self-made social demographic information questionnaire, Dating Violence Questionnaire (DVQ). DVQ included three parts which were five types of violence (controlling, emotional, security threatening, physical and sexual violence), whether they were threatened of disclosure of their sexual orientation to the public ("outing") and whether they had seek for help from other individuals or organizations after the violence as stated above. Results: The rate of reported at least one type of dating violence in gay men was 34.5％. Controlling for age, education, place of household registration etc., in logistic regression models, gay men were 5.08 times (95％ CI: 3.54——7.29) more likely to report any type of dating violence comparing to male heterosexual males. And 12.6％ gay men experienced the threat of being outed. Among those gay men who experienced dating violence, 85.2％ of them did not seek any help from anyone or any organization. Conclusion: Overall, the prevalence of dating violence among gay men is higher than that of heterosexual males. It is necessary to have targeted interventions for dating violence among gay men.

Health and life satisfaction for Chinese gay men in Guangzhou, China / 中南大学学报(医学版)

Objective:To understand Chinese gay men's health and life satisfaction in Guanzhou,and to analyze the main factors for life satisfaction.Methods:Male gay participants were recruited through respondent-driven sampling and faceto-face investigations with self-administered questionnaires,including a general demographic questionnaire,a suicide questionnaire,the Depression-Anxiety Stress Scale,the Self-Stigma Scale,the Perceived Social Support Scale,the Rosenberg Self-Esteem Scale,and the Satisfaction with Life Scale.Results:Surveys were successfully conducted for 420 gay men.High levels of depression,anxiety,and stress were observed among the respondents.A total of 29.3％ had suicidal tendency in the past year,36.5％ experienced dating violence,39.2％ had homosexual sex without protection in the past 6 months,and 14.0％ were infected with at least one type of infection of sexually transmitted diseases.Multiple linear regression analysis showed that gay men who felt highly satisfied with life exhibited low levels of self-stigma,high self-esteem,and low levels of depression.Moreover,they did not suffer dating violence and playing passive sex roles.Conclusion:The survey confirmed that gay men in Guangzhou,China,have poor health and lower life satisfaction levels.Self-stigma,self-esteem,sex roles,depression,and dating violence are the main factors that influence the life satisfaction of them.

Association between loneliness and risks of depressive episode among rural older people / 中南大学学报(医学版)

Objective:To investigate association between loneliness and depressive episode among rural older people.Methods:A total of 839 rural adults (aged over 60 years) from Liuyang in Hunan were enrolled by using multi-stage cluster sampling method.The Short-form of the UCLA Loneliness Scale,the Social Support Rating Scale,the Life Events Scale for the Elderly,Quality of Life Scale,and the Activity of Daily Living Scale were used to assess loneliness,the social support condition,the stimulating quantity of negative life events,the quality of life,and the abilities of daily life activities,respectively.The Structured Clinical Interview for DSM-Ⅳ-TR Axis I Disorders questionnaire survey was performed by a face-to-face interview.Results:The prevalence rate of depressive episode among the rural older people was 6.8％.Multivariable analysis showed that the elderly who were with stronger loneliness were the risk factor of depression (OR=1.126,95％CI 1.038 to 1.221).Conclusion:Loneliness is positively associated with an increased risk of depressive episode.

Emotional problems among newly diagnosed HIV-positive men with homosexual sex behaviors / 中国心理卫生杂志

Objective:To know about the prevalence of depression,anxiety,and suicidal behaviors among newly diagnosed HIV-positive men who have sex with men.Methods:A cross-sectional study with a consecutive sample was conducted in the HIV/AIDS Voluntary Counseling and Testing Clinic of the Center for Disease Control and Prevention.A standard set of questionnaires,namely,the Patient Health Questionnaire Depression Scale (PHQ9),Generalized Anxiety Disorder Scale (GAD-7),and a self-designed suicidal behavior questionnaire were used to assess the subjects'emotional problems.Results:Among 321 newly diagnosed HIV-positive men who had sex with men,the positive rate of depression and anxiety were 41.1％ (132/321) and 31.5％ (101/321),respectively.The rate suicidal ideation after HIV diagnosis was 27.7％ (89/321).Individuals who were living with others,had HIV related clinical symptoms,higher HIV/AIDS related stress,and lower social support were more likely to have positive depressive symptoms.Individuals who were unmarried,had lower HIV/AIDS related stress,and lower social support were more likely to have positive anxiety.The prevalence of suicidal ideation after HIV diagnosis was higher among individuals who were unwilling to join in HIV/AIDS support groups,had HIV related clinical symptoms,higher HIV/AIDS related stress,lower social support,and both positive depression and anxiety symptoms.Conclusion:The prevalence of emotional problems is high among newly diagnosed HIV-positive men who have sex with men.It is warranted to promote mental health service for this vulnerable group.

Strategies for measuring medication adherence in patients with schizophrenia / 中南大学学报(医学版)

Long-term therapy should be administrated for patients with schizophrenia and the medication adherence is very important for the prognosis and outcome in these patients. In this study, we screened the literatures from various databases in accordance with our search criteria. A total of 11 literatures with the results of reliability and validity regarding the measurement of schizophrenia medication adherence were enrolled in our analysis. Based on the measurements, they were classified into subjective methods and objective ones. The objective methods include blood plasma and urine concentrations, pharmacy records, pill counts and Medication Event Monitoring System. The subjective methods include Drug Attitude Inventory, Rating of Medication Influences Scale, Brief Evaluation of Medication Influences and Beliefs, the Brief Adherence Rating Scale, Medication Adherence Rating Scale, and Morisky scales. In general, single method for measuring medication adherence in patients with schizophrenia is limited. We recommend researchers to use 2 or more methods when measuring the medication adherence in patients with schizophrenia.

Relationship between the ischemic ST-T changes in ECG and the coronary artery diseases / 中南大学学报(医学版)

OBJECTIVE@#To analyze the relationship between the ischemic ST-T changes in electrocardiogram (ECG) and the coronary artery diseases based on the perspective of diagnostics.
@*METHODS@#A total of 341 patients, who underwent coronary angiography in Department of Cardiology of Xiangya Hospital, Central South University from June 2013 to April 2014, were enrolled for this study. The internationally recognized diagnostic criteria for ischemic ST-T changes in ECG and the Judkins diagnostic criteria for coronary angiography were applied, respectively. The sensitivity and specificity of ECG were analyzed.
@*RESULTS@#There were more ischemic ST-T changes in women than that in men (P0.05). For ischemic diagnostic tests by ECG ST-T, the total sensitivity and specificity was 83.6% and 54.4%, respectively. The sensitivity and specificity was 82.3% and 68.0% or 85.0% and 28.2% in the male or female group, respectively. 
@*CONCLUSION@#Ischemic ST-T changes in ECG possess important value in the diagnosis of the coronary artery diseases. The sensitivity of ECG in the diagnosis of myocardial ischemia in women was higher than that in men, whereas the specificity of ECG in the diagnosis of myocardial ischemia in men was higher than that in women.

Emotional problems and related factors in patients with HIV/AIDS / 中南大学学报(医学版)

OBJECTIVE@#To investigate the prevalence and related factors of emotional problems of newly identified patients with HIV/AIDS in Changsha, Hunan Province, and to provide scientific evidence for the mental health intervention in this special population.@*METHODS@#A total of 370 patients with HIV/AIDS who were newly identified by the Center for Disease Prevention and Control in Changsha City from March 1, 2013 to February 28, 2014 were investigated. Self-designed questionnaire, Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), HIV/AIDS Stress Scale and Social Support Rating Scale (SSRS) were performed to assess the prevalence of depression, the anxiety symptoms, the HIV related stress and the status of social support.@*RESULTS@#The prevalence of depression and anxiety were 40.3% (PHQ-9 ≥ 10 points) and 30.5% (GAD-7 ≥ 10 points), respectively. Severe depressive symptoms (PHQ-9≥20 points) and severe anxiety (GAD-7 ≥ 15 points) accounted for 8.1% and 14.3%, respectively. Hierarchical regression analysis showed that the status of employment (b=-3.407, P<0.001; b=-2.799, P=0.001), the sexual orientation (b=1.903, P=0.008; b=1.314, P=0.034), the resident status (b=-1.995, P=0.012; b=-2.167, P=0.002), the emergence of HIV-related symptoms(b=4.578, P<0.001; b=3.652, P<0.001) and the HIV related stress (b=0.081, P<0.001; b=0.090, P<0.001) were the predictors for both depressive and anxious emotional problems whereas the social support (b=-0.046, P=0.044) was the predictor for depressive emotional problems. Both anxiety (ΔR2=54.7%, P<0.001) and depression (ΔR2=55.8%, P<0.001) were strong predictors for patients with HIV/AIDS.@*CONCLUSION@#Depression and anxiety are prevalent among the newly identified patients with HIV/ AIDS. Psychosocial support and basic mental health services should be integrated into the current HIV/AIDS care system.

Epidemiological characteristics of burn workers in Hunan Province / 中南大学学报(医学版)

OBJECTIVE@#To understand the epidemiological characteristics of workers who are burn patients, and to provide basis for prevention and treatment of burn at work.@*METHODS@#We investigated 4 078 burn workers in 9 cities in Hunan provincial enterprises, and different trades managed by municipal government from January 1st, 2005 to December 31st, 2010.@*RESULTS@#The incidence rate of employment injury was 94.84 per 10 thousand workers each year in Hunan. That of the enterprises directly managed by Hunan Medical Insurance Bureau was 93.71 per 10 thousand workers each year, and that of the enterprises managed by Medical Insurance Bureaus of cities or districts was 95.02 per 10 thousand workers each year. The burn incidence accounted for 2.00% of the total work injury in Hunan Province (7.35% in the enterprises directly managed by Hunan Medical Insurance Bureau and 1.39% in districts and industries). There were 4 078 burn patients from the sorted units [1 823 out-patients and 2 255 in-patients; 3 498 males (85.78%) and 580 females (14.22%) with age of (38.64±11.56) years]. The ratio between males and females was 6.03:1. Among the 4 078 patients, 2 979 were from the rural area (71.78%), with 1 100 out-patients and 1 379 in-patients. The burn was mostly mild and moderate (64.66%), and mainly occurred on the face, head, arms, and legs (61.55%). The main causes of burn were heating power (74.1%), chemical stuff (14.37%), and electric power (10.78%). The death rate was 1.42%. The burn accidents often happened between July and September. The average time from being burned to be in the hospital for treatment was 3.91 hours.@*CONCLUSION@#Burn accidents, especially mild and moderate burn, occur mainly in young, married and poorly educated males from rural areas. Heating power, chemical stuff, and electric power are the key causes for burn. Work injury prevention measures should be improved in high risk enterprises.

Analysis of epidemiological characteristics of advanced schistosomiasis in Hu-nan Province,2012 / 中国血吸虫病防治杂志

Objective To understand the epidemiological characteristics of patients with advanced schistosomiasis in Hunan Province,so as to provide the evidence for formulating the advanced schistosomiasis prevention strategies and measures. Meth-ods The data of advanced schistosomiasis patients were collected and analyzed retrospectively with the cross section research method and description method in Hunan Province,2012. Results There were 5 722 advanced schistosomiasis patients in Hu-nan Province,and among them,4 112 patients were male(71.86%),and 1 610 were female(28.14%). Totally 5 311 patients came from the schistosomiasis endemic areas(92.82%)and 411 patients from non-schistosomiasis endemic areas(7.18%). The prevalence rate of advanced schistosomiasis was 8.46/10 000. The mean age of advanced schistosomiasis patients was 60.30 ± 11.63 years,and the youngest was 17 years old and the oldest 92 years old. In the age composition of advanced schistosomiasis pa-tients,the greatest number of cases was in the 60-70 years age group (32.72%). There were 3 595 cases of ascites type (62.83%),2107 cases of splenomegaly type(36.82%),11 cases of dwarf type(0.16%),and 11 cases of colon proliferation type (0.35%). Conclusion The prevalence rate of advanced schistosomiasis is relatively stable in Hunan Province,and the age of the patients showed an old aging trend. The salvation of advanced schistosomiasis patients in non-endemic areas should be strength-ened.

Analysis on depression of patients with advanced schistosomiasis and its influ-encing factors / 中国血吸虫病防治杂志

Objective To explore the status of depression in patients with advanced schistosomiasis and its influencing fac-tors,so as to provide the evidence for improving psychological interventions. Methods A total of 206 patients with advanced schistosomiasis were investigated with the self-designed general information questionnaire,the Self-Rating Depression Scale,and WHOQOL-BREF Form. Results Among the 206 cases,the incidence of depression was 69.4%,and depression was negatively related to the quality of life(P = 0.000). The multiple logistic regression analysis showed that the times of hospitalization(β=0.442,P=0.007)was a risk factor for depression,while the high education levels(β=-0.583,P=0.011)and the history of por-tal hypertension operation(β=-0.917,P=0.000)were the protective factors. Conclusion The incidence of depression in ad-vanced schistosomiasis patients is high,and it is influenced by various factors. Therefore,we should take corresponding interven-tions to reduce its occurrence.

The cost-effectiveness of early rehabilitation of burns patients / 中华物理医学与康复杂志

Objective To compare the cost-effectiveness of intervention protocols with or without rehabilitation approaches for burn patients.To explore the pros and cons of the two treatment programs,especially in terms of efficacy.Methods Data on 164 burn patients hospitalized in four hospitals in Hunan Province were collected and compared in terms of the therapeutic interventions employed,the direct medical costs and the effects obtained at the end of the first two months of hospitalization.The patients were divided into an early rehabilitation therapy group and a control group,based on the interventions they received.Results The average total direct medical cost of the early rehabilitation group was significantly lower than that of the control group [((￥)59 380.80 ±196.87) versus ((￥)67 471.62 ±217.23)].The average Vancouver scar scale (VSS) results in the early rehabilitation group were significantly better than those of the controls,but their Zung's Self-rating Anxiety Scale and Barthel index scores were not.The average cost-effectiveness ratio (C/E) of the early rehabilitation group as judged by these scores was lower than that of the control group.Conclusion Early rehabilitation can improve the therapy of burns patients and reduce subsequent expenditures.It is a cost-effective approach to treating burns patients.

Cost-effect analysis of 2 therapeutic regimens for deep II burn patients / 中南大学学报(医学版)

OBJECTIVE@#To compare the cost-effect of 2 therapeutic regimens and to find out a better therapeutic regimen with reasonable price and better effect, hoping to improve the quality of burn patients and reduce the waste of medical resources.@*METHODS@#We collected 1017 burn patients from Hunan and Sichuan, and divided them into a research group (the moist exposed burn therapy group) and a control group (the escharectomy and grafting group). We analyzed the cost and effect of the 2 groups from general condition, direct medical cost during treatment and curative effect.@*RESULTS@#The average total cost of the research group [93633.71 (82260.79, 107576.34) yuan] was significantly lower than the control group [175077.93 (131433.23, 228918.83) yuan] (P<0.05). The total effective rate of the research group was higher (97.28%) than that in the control group (92.89%) (P<0.05). The cost-effect of the research group (962.52) was better than that of the control group (1884.79).@*CONCLUSION@#Cost-effect analysis is objective and direct in the evaluation of different treatments. The moist exposed burn therapy is a better and cheaper therapeutic regimen.

Performance of 3 diabetes screening questionnaires for a rural sample in China / 中南大学学报(医学版)

OBJECTIVE@#To evaluate 3 published questionnaires for screening diabetes for rural samples in China.@*METHODS@#Three screening questionnaires (Finnish Diabetes Risk Score, Danish Diabetes Risk Score, and Chinese Diabetes Risk Score) were selected through literature review, and were employed in a rural community sample in Wangcheng, Changsha.@*RESULTS@#Sensitivity of these risk scores was 63.72%, 56.64% and 82.30%; the specificity was 79.75%, 62.64% and 46.90%. The area under the receiver operating characteristic curve (AUC) was 0.78 (95% CI: 0.73-0.83), 0.65 (95% CI: 0.60-0.70) and 0.68 (95% CI: 0.63-0.73).@*CONCLUSION@#The 3 screening questionnaires show a lower validity than originally described when applied to rural samples in the study. Difference in population characteristics is a possible reason. F-DRS is better than the other two, suggesting that F-DRS is more suitable for diabetes screening in China rural areas.

Evaluation of sexual risk behaviors and its characteristics among drug users / 中南大学学报(医学版)

OBJECTIVE@#To explore the characteristics of sexual risk behaviors and related factors of drug users in two enforced detoxification institutions in Changsha, China.@*METHODS@#A total of 309 drug users from two compulsory detoxifications in Hunan Province were investigated using self-designed questionnaire, which included background information, drug use and sexual risk behaviors, STD/HIV related knowledge and permissiveness of sexual behaviors.@*RESULTS@#Among 309 drug users, 279 (90.3%) had regular sexual relationships, and 85 (27.5%) of them had more than 1 regular partner. The prevalence of casual sexual behaviors, commercial sexual behaviors and multi-partner sexual behaviors was 38.2% (118/309), 25.9% (80/309), and 62.8% (194/309), respectively. And 74 (23.9%) had sex with both commercial and noncommercial partners. The major factors related to sexual risk behaviors were gender, marital status, the age of sexual debut, drug injection, the history of STD and sexual permissiveness.@*CONCLUSION@#Sexually risk behaviors are relatively common in drug users. To modify the sexual risk behaviors in this group is very important to prevent and control HIV transmission to general population.

Reliability and validity of ULS-8 loneliness scale in elderly samples in a rural community / 中南大学学报(医学版)

OBJECTIVE@#To explore the reliability and validity of the short-form of the UCLA loneliness scale (ULS-8) among Chinese rural community-dwelling elderly.@*METHODS@#ULS-8 was used for 839 Chinese rural community-dwelling elderly during face-to-face interviews.@*RESULTS@#After deleting item-3 (I am an outgoing person) and item-6 (I can find companionship when I want it), the exploratory factor analysis showed that the construction of the new scale (ULS-6) fit the original construction of ULS-8, a single-factor resolution. Cronbach's α coefficient of ULS-6 was 0.831. Test-retest reliability was 0.715. All item-total correlations reached statistical significance. The total score of ULS-6 was correlated to quality of life, social support, suicidal ideation, and current major depression episode.@*CONCLUSION@#ULS-6 shows satisfactory reliability and validity and meets the needs of psychometric properties, and can be used for the evaluation of loneliness among Chinese rural elderly.

Selection of assessment indicators for mental health service / 中南大学学报(医学版)

Assessment of mental health service refers to the process of using the indicator system and methods to reflect the quality or performance of mental health. Mental health evaluation can effectively promote the development of mental health system and service quality. Scientific and comprehensive indicator system is key to assessment. After long-term practice and exploration, there have been many successful assessment schemes in foreign countries, which may be used in establishing the assessment system and screening indicators in China.

Antipsychotics combined use pattern among schizophrenic inpatients in Tangshan region / 中华行为医学与脑科学杂志

Objective To investigate rates and clinical associates of combined antipsychotic therapy in hospitalized patients with schizophrenia during 1986 ～ 2006. Methods Hospital charts of schizophrenic inpatients who discharged from six psychiatric hospitals in Tangshan in 1986,1996,2001, and 2006 were reviewed. Demographic and clinical character and prescription information at time of discharged of patients' was coded by trained investigators with a special designed form. Results The rates of combination antipsychotic therapy in the four years mentioned above were 13.2%, 18. 1% ,32.7%, and 28.9% ,respectively and the difference was statistically significant( x2 = 76.431, P ＜ 0.01; linear by linear x2 = 25. 542, P ＜ 0.01 ). Combined antipsychotic therapy in schizophrenic inpatients in Tangshan region show a increasing trend. There is significant difference of rate of combined antipsychotic therapy between hospitals. Combined antipsychotic therapy were associated with duration of illness,numbers of prior psychiatric hospital admission,hospital from which patients discharged,and discharged year.