BACKGROUND & AIMS: :Ninety women with recently diagnosed stage I or stage II breast cancer who had been admitted to the NIH Clinical Center and were participating in a randomized trial were entered onto this behavioral immunology protocol. Patients were immunologically and psychosocially assessed at baseline (approximately 5 days after surgery) and again at 3 and 15 months post surgery. All of the patients were followed up for a minimum of 5 years, and 60% of the patients were followed for 7 years or longer. Twenty-nine women in the study group reported disease recurrences over the entire follow-up period. Causal path modeling statistical techniques showed that natural killer (NK) cell activity was a strong predictor of disease outcome when the outcome variable was defined as recurrence v nonrecurrence of disease (chi 2 = 6.9, p less than .001). Higher NK cell activity at follow-up predicted disease-free survival over the follow-up period. When the disease outcome variable was operationally defined as time to recurrent disease, the psychosocial factors were more strongly predictive of the rate of disease progression for those who had a recurrence (chi 2 = -4.1, p less than .01), but NK cell activity was seemingly less relevant in this latter case. Overall, these findings suggest that including mood and potentially relevant immunological variables, along with important biological prognostic variables, in multivariate and prospective models such as those examined in this study, potentially contributes more to the explanation of greater outcome variance of early-stage breast cancer than has been believed in the past.

背景与目标： : 90名最近被诊断为I期或II期乳腺癌的妇女已进入NIH临床中心并参加了一项随机试验，并进入了该行为免疫学方案。在基线 (手术后约5天) 和术后3和15个月再次对患者进行免疫和心理评估。所有患者均随访至少5年，60% 患者随访7年或更长时间。研究组中有29名妇女报告了整个随访期间的疾病复发。因果路径建模统计技术表明，当结果变量被定义为疾病的复发v不复发 (chi 2 = 6.9，p小于.001) 时，自然杀伤 (NK) 细胞活性是疾病结果的强预测因子。随访时较高的NK细胞活性可预测随访期间的无病生存期。当将疾病结果变量操作性地定义为复发疾病的时间时，社会心理因素对复发患者的疾病进展速率的预测能力更强 (chi 2 = -4.1，p小于.01)，但在后一种情况下，NK细胞活性似乎不太相关。总体而言，这些发现表明，在多变量和前瞻性模型 (例如本研究中检查的模型) 中，包括情绪和潜在相关的免疫学变量以及重要的生物学预后变量，可能有助于解释早期乳腺癌的更大结果差异比过去认为的要多。

BACKGROUND & AIMS: :The aim of this study is to investigate psychosocial factors related to the diagnosis and treatment of patients with restless legs syndrome. Fifteen patients were interviewed at the Neuro-Sono Outpatient Clinic, Universidade Federal de São Paulo. The results were submitted to a qualitative analysis. We identified four content categories: illness description, illness history, illness experience, and relationships. Lack of control over the body and lack of recognition by professionals produce stigma and lead patients to suffering. The research underscores the relevance of psychosocial factors to the diagnosis and treatment of patients with restless legs syndrome and the importance of having interdisciplinary teams when attending patients with restless legs syndrome.

背景与目标： : 本研究的目的是调查与不宁腿综合征患者的诊断和治疗有关的社会心理因素。在圣保罗联邦大学Neuro-Sono门诊接受了15名患者的采访。结果提交给定性分析。我们确定了四个内容类别: 疾病描述，病史，疾病经历和关系。缺乏对身体的控制和缺乏专业人员的认可会产生污名，并导致患者痛苦。该研究强调了社会心理因素与不宁腿综合征患者的诊断和治疗的相关性，以及在治疗不宁腿综合征患者时建立跨学科团队的重要性。

BACKGROUND & AIMS: :We studied 10 boys, and 15 girls, all below the age of 16, who had been referred to the National Hospital in Norway for evaluation for transplantation of either the heart, or the heart and lungs. These represent the complete cohort of patients being considered for transplantation between 1990 and 1997. Of the 25 children and their families, 24 sets underwent a comprehensive psychosocial assessment, including interviews with both parents and their children. The parents completed the Child Behavior Checklist and the General Health Questionnaire. We had accepted 15 children for transplantation and placed them on the waiting list. The others were rejected for medical reasons, and 3 died whilst waiting for an organ. One was reconsidered for conventional surgery and removed from the list. Transplantation was performed in 11 children, whilst one of the patients we had rejected underwent transplantation abroad, and was included in the study. This left 12 patients in the final sample, with a mean age of 8 years, and with a range from 11 months to 13.9 years. We reassessed their psychosocial and physical functioning two years after transplantation. Of those undergoing transplantation of the heart and lungs, two were severely affected by progressive obliterative bronchiolitis. The others were in good general physical condition. At the assessment prior to transplantation, three already fulfilled the criterions for diagnosis of an overanxious disorder. Two others had symptoms of anxiety and depression, but without fulfilling the accepted criterions. At follow- up, two patients retained this psychiatric diagnosis. Increased levels of stress were uncovered in the parents prior to surgery, but these had normalised at follow-up. The study shows that, in general, physical and psychological conditions improve in children undergoing transplantation, but they and their parents live in a stressful environment, and are in need of psychosocial support both before and after transplantation.

背景与目标： : 我们研究了10个男孩和15个女孩，年龄都在16岁以下，他们被转诊到挪威国家医院进行心脏或心脏和肺部移植的评估。这些代表正在考虑进行移植1990年和1997的患者的完整队列。在25名儿童及其家庭中，有24套接受了全面的社会心理评估，包括对父母及其子女的访谈。父母完成了儿童行为清单和一般健康问卷。我们接受了15名儿童进行移植，并将他们列入了等待名单。其他人因医疗原因被拒绝，其中3人在等待器官时死亡。其中一个被重新考虑进行常规手术，并从列表中删除。在11名儿童中进行了移植，而我们拒绝的其中一名患者在国外进行了移植，并被纳入了研究。最终样本中剩下12名患者，平均年龄为8岁，范围为11个月至13.9岁。移植后两年，我们重新评估了他们的心理和身体功能。在接受心脏和肺部移植的患者中，有两例受到进行性闭塞性细支气管炎的严重影响。其他人的身体状况良好。在移植前的评估中，三个已经满足了过度焦虑障碍的诊断标准。另外两个人有焦虑和抑郁的症状，但没有达到公认的标准。在随访中，两名患者保留了这种精神病诊断。手术前父母发现压力水平增加，但随访时压力已恢复正常。研究表明，总体而言，接受移植的儿童的身体和心理状况有所改善，但他们及其父母生活在压力大的环境中，并且在移植前后都需要社会心理支持。

BACKGROUND & AIMS: :Use of opioid analgesics for management of chronic nonmalignant pain has become common, yet there are presently no well-validated predictors of optimal opioid analgesic efficacy. We examined whether psychosocial factors (eg, depressive symptoms) predicted changes in spontaneous low back pain after administration of opioid analgesics, and whether endogenous opioid (EO) function mediated these relationships. Participants with chronic low back pain but who were not chronic opioid users (N = 89) underwent assessment of low back pain intensity pre- and post-drug in 3 (counterbalanced) conditions: (1) placebo, (2) intravenous naloxone, and (3) intravenous morphine. Comparison of placebo condition changes in back pain intensity to those under naloxone and morphine provided indexes of EO function and opioid analgesic responses, respectively. Results showed that (1) most psychosocial variables were related significantly and positively to morphine analgesic responses for low back pain, (2) depressive symptoms, trait anxiety, pain catastrophizing, and pain disability were related negatively to EO function, and (3) EO function was related negatively to morphine analgesic responses for low back pain. Bootstrapped mediation analyses showed that links between morphine analgesic responses and depressive symptoms, trait anxiety, pain catastrophizing, and perceived disability were partially mediated by EO function. Results suggest that psychosocial factors predict elevated analgesic responses to opioid-based medications, and may serve as markers to identify individuals who benefit most from opioid therapy. Results also suggest that people with greater depressive symptoms, trait anxiety, pain catastrophizing, and perceived disability may have deficits in EO function, which may predict enhanced response to opioid analgesics.

背景与目标： : 使用阿片类镇痛药治疗慢性非恶性疼痛已变得很普遍，但目前尚无有效的最佳阿片类镇痛药疗效预测指标。我们检查了心理社会因素 (例如，抑郁症状) 是否预测了阿片类镇痛药给药后自发性腰痛的变化，以及内源性阿片类药物 (EO) 功能是否介导了这些关系。患有慢性腰痛但不是慢性阿片类药物使用者 (N = 89) 的参与者在3种 (平衡) 条件下接受了药物前后腰痛强度的评估 :( 1) 安慰剂，(2) 静脉注射纳洛酮和 (3) 静脉注射吗啡。与纳洛酮和吗啡下的安慰剂状态背痛强度变化的比较分别提供了EO功能和阿片类镇痛药反应的指标。结果表明 :( 1) 大多数心理社会变量与吗啡对下腰痛的镇痛反应显着正相关，(2) 抑郁症状，特质焦虑，疼痛灾难性和疼痛残疾与EO功能负相关。(3) EO功能与下腰痛的吗啡镇痛反应呈负相关。引导中介分析表明，吗啡镇痛反应与抑郁症状，特质焦虑，疼痛灾难性和感知残疾之间的联系部分由EO功能介导。结果表明，社会心理因素可预测对阿片类药物的镇痛反应升高，并可作为识别从阿片类药物治疗中受益最大的个体的标志物。结果还表明，具有更大的抑郁症状，特质焦虑，疼痛灾难性和感知残疾的人可能具有EO功能缺陷，这可能预示着对阿片类镇痛药的反应增强。

BACKGROUND & AIMS: PURPOSE:We identified and treated young adults with type 1 diabetes who had been lost to follow-up during their transfer from pediatric to adult care, comparing their clinical, psychosocial, and health care utilization outcomes to participants receiving continuous care (CC) throughout the transition to adult care. METHODS:Individuals in their last year of pediatric care (CC group, n = 51) and individuals lost to follow-up in the transfer to adult care ("lapsed care" [LC] group, n = 24) were followed prospectively for 12 months. All participants were provided developmentally tailored diabetes education, case management, and clinical care through a structured transition program. RESULTS:At baseline, LC participants reported lapses in care of 11.6 months. Compared with CC participants, they had higher hemoglobin A1C (A1C; p = .005), depressive symptoms (p = .05), incidence of severe hypoglycemia (p = .005), and emergency department visits (p = .004). At 12-month follow-up, CC and LC participants did not differ on the number of diabetes care visits (p = .23), severe hypoglycemia (no events), or emergency department visits (p = .22). Both groups' A1C improved during the study period (CC: p = .03; LC: p = .02). LC participants' depressive symptoms remained elevated (p = .10), and they reported a decline in life satisfaction (p = .007). There was greater loss to follow-up in the LC group (p = .04). CONCLUSIONS:Our study suggests that, for young adults with a history of lapses in care, a structured transition program is effective in lowering A1C, reducing severe hypoglycemia and emergency department utilization, and improving uptake of routine diabetes care. Loss to follow-up and psychosocial concerns remain significant challenges in this population.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:The prevalence of mental health problems in women is 1:3 and such problems tend to be persistent. There is evidence from a range of studies to suggest that a number of factors relating to maternal psychosocial health can have a significant effect on the mother-infant relationship, and that this can have consequences for the psychological health of the child. It is now thought that parenting programmes may have an important role to play in the improvement of maternal psychosocial health. OBJECTIVES:The objective of this review is to address whether group-based parenting programmes are effective in improving maternal psychosocial health including anxiety, depression and self-esteem. SEARCH STRATEGY:A range of biomedical, social science, educational and general reference electronic databases were searched including MEDLINE, EMBASE CINAHL, PsychLIT, ERIC, ASSIA, Sociofile and the Social Science Citation Index. Other sources of information included the Cochrane Library (SPECTR, CENTRAL), and the National Research Register (NRR). SELECTION CRITERIA:Only randomised controlled trials were included in which participants had been randomly allocated to an experimental and a control group, the latter being either a waiting-list, no-treatment or a placebo control group. Studies had to include at least one group-based parenting programme, and one standardised instrument measuring maternal psychosocial health. DATA COLLECTION AND ANALYSIS:A systematic critical appraisal of all included studies was undertaken using the Journal of the American Medical Association (JAMA) published criteria. The data were summarised using effect sizes but were not combined in a meta-analysis due to the small number of studies within each group and the presence of significant heterogeneity. MAIN RESULTS:A total of 22 studies were included in the review but only 17 provided sufficient data to calculate effect sizes. These 17 studies reported on a total of 59 outcomes including depression, anxiety, stress, self-esteem, social competence, social support, guilt, mood, automatic thoughts, dyadic adjustment, psychiatric morbidity, irrationality, anger and aggression, mood, attitude, personality, and beliefs. Approximately 22% of the outcomes measured suggested significant differences favouring the intervention group. A further 40% showed differences favouring the intervention group but which failed to achieve conventional levels of statistical significance, in some cases due to the small numbers that were used. Approximately 38% of outcomes suggested no evidence of effectiveness. REVIEWER'S CONCLUSIONS:It is suggested that parenting programmes can make a significant contribution to the improvement of psychosocial health in mothers. While the critical appraisal suggests some variability in the quality of the included studies, it is concluded that there is sufficient evidence to support their use with diverse groups of parents. However, it is also suggested that some caution should be exercised before the results are generalised to parents irrespective of the level of pathology present, and that further research is still required.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:The purpose of this study is to examine psychological health of left-behind children (LBC), social support and rearing behavior towards LBC as well as their correlations in the city of Shaoxing, China. METHODS:By stratified sampling, 401 LBC and 527 non-left-behind children (NLBC) had completed the questionnaires in 2014. Spearman's correlation was performed to clarify the relationship between psychological health, social support and rearing behavior in LBC. Multiple linear regression analytical methods were used to identify the variables that were associated with psychological health. RESULTS:Compared to NLBC, LBC got lower scores in psychological health, general social support, subjective support and emotional warmth, but higher in rejection. Psychological health was positively correlated with social support, and negatively with rearing behavior (rejection, overprotection) in LBC. It was also closely connected with the subjective support, rejection and general health status. CONCLUSION:These data show that LBC suffer significant impairment on psychological health, and receive less social support and worse rearing behavior than NLBC. Psychological health may be affected by subjective support, rejection, and general health status. Urgent government assessment and support from the community, school, mental health systems are warranted.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Mental health problems (MHP) are the leading cause of disability worldwide. The inverse association between socioeconomic position (SEP) and MHP has been well documented. There is prospective evidence that factors from the work environment, including adverse psychosocial work factors, could contribute to the development of MHP including psychological distress. However, the contribution of psychosocial work factors to social inequalities in MHP remains unclear. This study evaluates the contribution of psychosocial work factors from two highly supported models, the Demand-Control-Support (DCS) and the Effort-Reward Imbalance (ERI) models to SEP inequalities of psychological distress in men and women from a population-based sample of Quebec workers. METHODS:Data were collected during a survey on working conditions, health and safety at work. SEP was evaluated using education, occupation and household income. Psychosocial work factors and psychological distress were assessed using validated instruments. Mean differences (MD) in the score of psychological distress were estimated separately for men and women. RESULTS:Low education level and low household income were associated with psychological distress among men (MD, 0.56 (95% CI 0.06; 1.05) and 1.26 (95% CI 0.79; 1.73) respectively). In men, the contribution of psychosocial work factors from the DCS and the ERI models to the association between household income and psychological distress ranged from 9% to 24%. No clear inequalities were observed among women. CONCLUSIONS:These results suggest that psychosocial work factors from the DCS and the ERI models contribute to explain a part of social inequalities in psychological distress among men. Psychosocial factors at work are frequent and modifiable. The present study supports the relevance of targeting these factors for the primary prevention of MHP and for health policies aiming to reduce social inequalities in mental health.

背景与目标：

BACKGROUND & AIMS: :Social desirability has long been viewed as a potential source of error variance in self-report measures. We suggest that social desirability (whether in the form of impression management or self-deception) has the capacity to mask relations between psychosocial variables and sport-related outcome or criterion measures that are not measured by selfreport. To illustrate what can occur, we present data from a longitudinal study in which life stress and psychological coping skills were studied as predictors of behaviorally-defined athletic injuries. When data from the entire sample of 352 athletes were analyzed, virtually no injury variance was accounted for by life stress, psychological coping skills, or their interaction. In contrast, deletion from the sample of athletes with high social desirability response set scores resulted in significant predictive relations involving both life stress and coping skills, as well as a significant moderator effect for coping skills. We propose that social desirability masking effects can significantly increase the likelihood of Type II errors in sports medicine research that involves self-report measures, and that social desirability responding needs to be controlled or minimized.

背景与目标： : 社会可取性长期以来一直被视为自我报告措施中误差差异的潜在来源。我们建议，社会可取性 (无论是印象管理还是自我欺骗的形式) 都有能力掩盖社会心理变量与运动相关的结果或标准措施之间的关系，而这些关系无法通过自我报告来衡量。为了说明可能发生的情况，我们提供了一项纵向研究的数据，其中研究了生活压力和心理应对技能作为行为定义的运动伤害的预测指标。当分析来自352名运动员的整个样本的数据时，几乎没有因生活压力，心理应对技能或他们的相互作用而造成的伤害差异。相反，从具有较高社会期望响应集得分的运动员样本中删除会导致涉及生活压力和应对技能的显着预测关系，以及应对技能的显着调节作用。我们建议，社会期望掩盖效应可以显着增加运动医学研究中涉及自我报告措施的II型错误的可能性，并且需要控制或最小化社会期望响应。

BACKGROUND & AIMS: BACKGROUND:In Ontario, Canada, patients admitted to inpatient rehabilitation hospitals post-stroke are classified into rehabilitation patient groups based on age and functional level. Clinical practice guidelines, called quality-based procedures, recommend a target length of stay (LOS) for each group. OBJECTIVES:The study objective was to evaluate the extent to which patients post-stroke at an inpatient rehabilitation hospital are meeting LOS targets and to identify patient characteristics that predict exceeding target LOS. METHODS:A quantitative, longitudinal study from an inpatient rehabilitation hospital was conducted. Participants included adult patients (≥18 years) with stroke, admitted to an inpatient rehabilitation hospital between 2014 and 2015. The percentage of patients exceeding the recommended target LOS was determined. Logistic regression was performed to identify clinical and psychosocial patient characteristics associated with exceeding target LOS after adjusting for stroke severity. RESULTS:Of 165 patients, 38.8% exceeded their target LOS. Presence of ataxia, recurrent stroke, living alone, absence of a caregiver at admission, and acquiring a caregiver during hospital LOS was each associated with significantly higher odds of exceeding target LOS in comparison to patients without these characteristics after adjusting for stroke severity (p < 0.05). CONCLUSIONS:Findings suggest that social and stroke-specific factors may be helpful to adjust LOS expectations and promote efficient resource allocation. This exploratory study was limited to findings from one inpatient rehabilitation hospital. Cross-validation of results using data-sets from multiple rehabilitation hospitals across Ontario is recommended.

背景与目标：

BACKGROUND & AIMS: PURPOSE:Community-based cancer organizations provide telephone-based information and support services to assist people diagnosed with cancer and their family/friends. We investigated the demographic characteristics and psychosocial support needs of family/friends who contacted Australian Cancer Council 13 11 20 information and support helplines. METHODS:Data collected on 42,892 family/friends who contacted a 13 11 20 service across Australia from January 2010 to December 2012 were analyzed. Chi-square analysis was used to examine associations between caller groups and reasons for calling, logistic regression to examine age and gender interaction effects. RESULTS:The majority of calls received were from women (81%) of middle- (40%) and high-socio-economic backgrounds (41%), aged 40-59 years (46%); 52% phoned for information on cancer diagnosis (including early detection, risk factors), 22% on treatment/disease management, and 26% phoned seeking psychological/emotional support. Information on a diagnosis was significantly more often the reason older males called, compared to female callers of any age. Overall, 32% found out about the service through Cancer Council resources or events, 20% from the media, 18% from the internet; 11% from health professionals. CONCLUSIONS:Family/friends of persons diagnosed with cancer have specific information and support needs. This study identifies groups of family/friends to whom the promotion of this service could be targeted. Within Australia and internationally, clinicians and oncology nurses as well as allied health professionals can provide an important role in increasing access to cancer telephone support services to ensure the needs of the family and friends of people affected by cancer are being met.

背景与目标：

BACKGROUND & AIMS: OBJECTIVES:Bariatric surgery is an evidence-based treatment for severe obesity; however, the unique developmental and psychosocial needs of young adults often complicate care and, as yet, are not well understood. We sought to identify themes in young adult patients undergoing bariatric surgery regarding: 1) the psychosocial experiences of obese young adults (18 to 24) seeking bariatric surgery; 2) the experiences during the preoperative bariatric surgery process and 3) the postoperative experiences of young adult patients. METHODS:In-depth, semistructured individual interviews were conducted with 13 young adult bariatric patients who were seeking or had undergone bariatric surgery within the past 5 years. Interviews were analyzed using a qualitative methodology. RESULTS:We found the following themes in our analyses: 1) the impact of relationships (with families and healthcare providers) on the bariatric healthcare experience; 2) preoperative experiences by young adults prior to undergoing surgery and 3) postoperative reflections and challenges experienced by young adult patients. CONCLUSIONS:Results revealed that patients' experiences appear to encompass impact on familial relationships, needs sought to be fulfilled by healthcare providers, and various preoperative and postoperative psychosocial concerns. By understanding the experiences of young adults, healthcare providers might be able to provide better care for these patients.

背景与目标：

BACKGROUND & AIMS: :The purpose of this study was to examine the impact of participation in different sport modalities on quality of life (QOL) and perceived social competence (PSC) in young people with physical disability. Ninety participants (33 females and 57 males) were monitored across four conditions: competitive separate physical activity (COSPA), recreational separate physical activity (RESPA), reverse-integrated basketball activity (RIBA), and no physical activity (NOPA). QOL and PSC questionnaires were administered at the beginning and the end of the study's duration of six months. ANCOVA corrected for functional independence and gender revealed significant group effects for pre to post change values of QOL and PSC, with greater positive change in the RIBA compared to all other groups. In addition, one-way ANOVA on pre to post change values with LSD post hoc revealed significant differences. RIBA change values for QOL with 8.77%, and for PSC with 9.98% change were significantly higher (p<.001) than in all other groups (ranges -0.18 through 1.36% for QOL, and -2.31 through 2.34% for PSC). These outcomes demonstrate a favorable outcome of the RIBA on participants. Low functional ability did not constrain the effects of sport participation.

背景与目标： : 这项研究的目的是研究参加不同运动方式对身体残疾的年轻人的生活质量 (QOL) 和感知的社会能力 (PSC) 的影响。在四个条件下对90名参与者 (33名女性和57名男性) 进行了监测: 竞争性单独体育活动 (COSPA)，娱乐性单独体育活动 (RESPA)，反向综合篮球活动 (RIBA) 和无体育活动 (NOPA)。QOL和PSC问卷在研究持续六个月的开始和结束时进行。校正了功能独立性和性别的ANCOVA显示，QOL和PSC的前后变化值具有显着的组效应，与所有其他组相比，RIBA的正变化更大。此外，LSD post hoc对前后变化值的单向方差分析显示出显着差异。具有8.77% 的QOL和具有9.98% 变化的PSC的RIBA变化值显着高于所有其他组 (范围-0.18到1.36% 的QOL，以及-2.31到2.34% 的PSC) (p<.001)。这些结果表明RIBA对参与者有良好的结果。功能能力低下并没有限制运动参与的效果。

BACKGROUND & AIMS: :In the last twenty years, psychosocial risks have become crucial in Occupational Health. Particularly, there is an increasing interest about psychological and physical violence at the workplaces. Psychological violence (mobbing or workplace bullying) is described as a situation in which the person has been the victim of negative acts directed to the person and work, with offences, discriminations and isolation. Physical violence at work, still underestimated in many parts of the world, is becoming a topical subject both for its frequency and its pathogenic potential and consist of violence among workers (internal violence) and between workers and external persons (external violence). Examples of external violence are bank robberies, which are prevalent in many European countries, particulary in Italy. The costs of psychological and physical workplace violence are very high at all levels; individual, for the implication of violence for health and quality of life as well as organizational, for the increase of absenteeism, turnover and health care demands and claims. The Medical Centre for Occupational Stress and Harassment (CDL) of the "Clinica de Lavoro Luigi Devoto" was set up in 1996 with a day-hospital service for the diagnosis, rehabilitation and prevention of work related psychological diseases. From its opening, about 5000 patients have been examined.

背景与目标： : 在过去的20年里，社会心理风险在职业健康中变得至关重要。特别是，人们对工作场所的心理和身体暴力越来越感兴趣。心理暴力 (围攻或工作场所欺凌) 被描述为一种情况，在这种情况下，该人一直是针对该人和工作的负面行为的受害者，具有犯罪，歧视和隔离。在世界许多地方仍然被低估的工作中的人身暴力，由于其频率和致病潜力而成为热门话题，包括工人之间的暴力 (内部暴力) 以及工人与外部人之间的暴力 (外部暴力)。外部暴力的例子是银行抢劫，这在许多欧洲国家，特别是在意大利很普遍。在各个层面，心理和身体上的工作场所暴力的代价都很高; 个人，因为暴力对健康和生活质量以及组织的影响，旷工，更替和医疗保健需求和索赔的增加。“拉沃罗·路易吉·德沃托临床” 职业压力和骚扰医学中心 (CDL) 成立于1996年，提供日间医院服务，以诊断，康复和预防与工作有关的心理疾病。从其开口开始，已经检查了大约5000名患者。

BACKGROUND & AIMS: Psychosocial outcome at one year post-injury was examined prospectively in 466 hospitalized head-injured subjects, 124 trauma controls, and 88 friend controls. The results indicate that head injury is associated with persistent psychosocial limitations. However, the presence and extent of limitations are related to the demographics of the population injured, to other system injuries sustained in the same accident, and particularly to the severity of the head injury. More severe head injuries are associated with limitations implying greater dependence on others including poorer Glasgow Outcome Scale (GOS) ratings, dependent living, unemployment, low income, and reliance on family and social subsidy systems. Head injury severity is more closely related to more objective indices of psychosocial outcome (e.g., employment) than to self-perceived psychosocial limitations, such as measured by the Sickness Impact Profile (SIP).

背景与目标： 在466名住院的头部受伤受试者，124名创伤对照者和88名朋友对照者中，前瞻性地检查了受伤后一年的社会心理结果。结果表明，头部受伤与持续的心理社会局限性有关。但是，限制的存在和程度与受伤人口的人口统计，同一事故中遭受的其他系统伤害有关，尤其是与头部受伤的严重程度有关。更严重的头部受伤与局限性相关，这意味着对其他人的依赖性更大，包括较差的格拉斯哥结果量表 (GOS) 评分，受抚养人的生活，失业，低收入以及对家庭和社会补贴制度的依赖。与自我感知的心理社会局限性 (例如，通过疾病影响概况 (SIP) 衡量) 相比，头部受伤的严重程度与更客观的心理社会结果指标 (例如，就业) 更密切相关。