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【单选题】

Factors for Stress and Anxiety

At some point in their lives virtually everyone will experience stressful s or situations that overwhelm their natural coping mechanisms. In one poll, 89% of respondents indicated that they had experienced serious stress in their lives. Some people are simply biologically prone to stress. Factors leading to stress and anxiety mainly are as follows:
Risk Factors
Conditions that are most likely to be associated with stress and negative physical effects include the following:
* An accumulation of persistent stressful situations, particularly those that a person cannot easily control (for example, high-pressured work plus an unhappy relationship).
* Persistent stress following a severe acute response to a stabbing (such as an automobile accident).
* Acute stress accompanying serious illness, such as heart disease.
People respond to stress differently, depending on different factors:
* Early nurturing: Abusive behavior towards children may cause long-term abnormalities (反常) in the hypothalamus-pituitary system, which regulates stress.
* Personality traits: Certain people have personality traits that cause them to over-respond to stressful s.
* Genetic factors: Some people have genetic factors that affect stress, such as having a more or less efficient relaxation response. One study found a genetic abnormality in serotonin (血清素) regulation that was connected with a heightened reaction of heart rates and blood pressure in response to stress. (Serotonin is a brain chemical involved with feelings of well-being.)
* Immune-regulated diseases: Certain diseases that are associated with immune abnormalities such as rheumatoid arthritis (类风湿性关节炎) may actually weaken a response to stress.
* The length and quality of stressors: Naturally, the longer the duration and the more intense the stressors, the more harmful the effects.
Childhood Factors
Children are frequent victims of stress because they are often unable to communicate their feelings accurately. They also have trouble communicating their responses to s over which they have no control. Certain physical symptoms, notably repeated abdominal pain without a known cause, may be indicators of stress in children. Various conditions can affect their susceptibility to stress.
Parental stress, especially in mothers, is a particularly powerful source of stress in children, even more important than poverty or overcrowding. Young children of mothers who are highly stressed (particularly if they were depressed) tend to be at high risk for developing stress-related problems. This may be especially true if the mothers were stressed during both the child’s infancy and early years. Some evidence even supports the old idea that stress during pregnancy can have adverse effects on the infant’s mood and behavior. Older children with stressed mothers may become aggressive and anti-social. Another study suggested that stress-reduction techniques in parents may improve their children’s behavior.
Adolescent boys and girls experience equal amounts of stress, but the source and effects may differ. Girls tend to become stressed from interpersonal situations, and stress is more likely to lead to depression in girls than in boys. For boys, however, specific s, such as changing schools or getting poor grades, appear to be the major sources of stress.
Work and Stress
In a study of 46,000 workers, health care costs were 147% higher in workers who were stressed or depressed than in others who were not. Furthermore, according to one survey, 40% of American workers describe their jobs as very stressful, job-related stress an important and prable health hazard.
Several studies are now suggesting that job-related stress is as great a threat to health as smoking or not exercising. Stress impairs concentration, causes sleeplessness, and increases the risk for illness, back problems, accidents, and lost time from work. Work stress can lead to harassment or even violence while on the job. At its most extreme, chronic stress places a burden on the heart and circulation that in some cases may be fatal. The Japanese even have a word for sudden death due to overwork, karoushi.
Many institutions within the current culture, while paying lip service to stress reduction, put intense pressure on individuals to behave in ways that increase tension. Yet, there are numerous effective management tools and techniques available to reduce stress. Furthermore, treatment for work-related stress has proven benefits for both the employee and employer. In one study, at the end of 2 years, a company that instituted a stress management program saved nearly $150,000 in workers compensations costs (the cost of the program was only $6,000). Other studies have reported specific health benefits resulting from workplace stress-management programs. In one of the studies, workers with hypertension experienced reduced blood pressure after even a brief (16-hour) program that helped them manage stress behaviorally.
In general, however, few workplaces offer stress management programs, and it is usually up to the employees to find their own ways to reduce stress. Here are some suggestions:
* Seek out someone in the Human Resources department or a sympathetic manager and communicate concerns about job stress. Work with them in a non-confrontational way to improve working conditions, letting them know that productivity can be improved if some of the pressure is off.
* Establish or reinforce a network of friends at work and at home.
* Restructure priorities and eliminate unnecessary tasks.
* Learn to focus on positive outcomes.
* If the job is unendurable, plan and execute a career change. Send out resumes or work on getting a transfer within the company.
* If this isn’t possible, be sure to schedule daily pleasant activities and physical exercise during free time.
It may be helpful to keep in mind that bosses are also victimized by the same stressful conditions they are imposing. For example, in one study of male managers in three Swedish companies, those who worked in a bureaucracy had greater stress-related heart risks than those who worked in companies with social supports.
Caregiving
Studies show that caregivers of physically or mentally disabled family members are at risk for chronic stress. One study reported that overall mortality rates were over 60% higher in caregivers who were under constant stress. Spouses caring for a disabled partner are particularly vulnerable to a range of stress-related health threats, including influenza, depression, heart disease, and even poorer survival rates. Caring for a spouse with even minor disabilities can induce severe stress.
Intervention programs that are aimed at helping the caregiver approach the situation positively can reduce stress, and help the caregiver maintain a positive attitude. A 2002 program also demonstrated that moderate-intensity exercise was very helpful in reducing stress and improving sleep in caregivers.
Caregiving among the health professionals is also a high risk factor for stress. One study, for example, found that registered nurses with low job control, high job demands, and low work-related social support experienced very dramatic health declines, both physically and emotionally.
Anxiety Disorders
People who are less emotionally stable or have high anxiety levels tend to experience specific s as more stressful than others. Some doctors describe an exaggerated negative response to stress as treating the as a catastrophe. Nevertheless, a 2003 study of patients with anxiety disorder did not find any differences in actual physical response to stress (heart rate, blood pressure, release of stress hormones) compared to people without anxiety.
Lacking a Social Network
The lack of an established network of family and friends predisposes (使预先有倾向) one to stress disorders and stress-related health problems, including heart disease and infections. A study, meanwhile, reported that older people who maintain active relationships with their children are buffered against the adverse health effects of chronic stress-inducing situations, such as low-income or lower-social class. Another study suggested this may be because people who live alone are unable to discuss negative feelings as a means to relieve their stress.
Studies of people who remain happy and healthy despite many life stresses conclude that most have very good networks of social support. One study indicated that support even from strangers reduced blood pressure surges in people undergoing a stressful . Many studies suggest that having a pet helps reduce medical problems aggravated by stress, including heart disease and high blood pressure.
Factors for Stress and AnxietyRisk FactorsChildhood FactorsWork and StressCaregivingAnxiety DisordersLacking a Social NetworkWhich one is the most serious effect of chronic work stress according to the passage

A.
Harassment.
B.
Violence.
C.
Heart burden.
D.
Karoushi.
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举一反三

【单选题】指间关节类风湿性关节炎表现不包括()

A.
多见于远侧指间关节
B.
多见于近侧指间关节
C.
血沉快、类风湿因子阳性
D.
远侧指骨基部背侧常见两个隆起
E.
受累关节常有轻度屈曲畸形,有摩擦感

【多选题】风湿性关节炎的主要临床特点是()

A.
侵犯大关节
B.
红、肿、热、痛
C.
呈游走性
D.
约持续1~2个月
E.
最终留有关节畸形

【单选题】在为预防类风湿性关节炎患者发生晨僵而采取的护理措施中,不正确的是

A.
鼓励多卧床休息
B.
睡眠时使用弹力手套保暖
C.
晨起后用温水泡僵硬的关节15分钟
D.
遵医嘱服用抗炎药
E.
避免关节长时间不活动

【单选题】类风湿性关节炎

A.
属Ⅰ型超敏反应性疾病
B.
属Ⅱ型超敏反应性疾病
C.
属Ⅲ型超敏反应性疾病
D.
属Ⅳ型超敏反应性疾病
E.
不属于超敏反应性疾病

【单选题】类风湿性关节炎患者

A.
无全身症状
B.
无关节畸形
C.
有多系统脏器损害
D.
有关节畸形
E.
有乏力、发热、体重减轻

【多选题】类风湿性关节炎的描述,对的是( )

A.
女性多发
B.
小关节对称多发
C.
关节滑膜的非特异性炎症
D.
常有骨质增生硬化