慢性肾功能衰竭患者饮食依从性调查分析及护理对策

目的探讨循证护理在改善糖尿病痛性神经病变中的应用价值.方法将86例糖尿病痛性神经病变患者随机分为干预组和对照组各43例.干预组应用循证护理的理论,针对患者具体情况,提出循证问题,寻求最佳护理行为并实施干预,为期1个月;对照组进行常规护理.结果护理干预后干预组疼痛分值明显下降,神经传导速度及踝-肱指数均有不同程度的改善,与对照组比较有显著性差异(P＜0.05).结论循证护理能有效缓解糖尿病痛性神经病变患者的疼痛症状,减轻患者痛苦,提高患者生活质量.     

循证护理在糖尿病痛性神经病变中的应用

目的：探讨循证护理在改善糖尿病痛性神经病变中的应用价值。方法：将86例糖尿病痛性神经病变患者随机分为干预组和对照组各43例。干预组应用循证护理的理论，针对患者具体情况，提出循证问题，寻求最佳护理行为并实施干预，为期1个月；对照组进行常规护理。结果：护理干预后干预组疼痛分值明显下降，神经传导速度及踝一肱指数均有不同程度的改善，与对照组比较有显著性差异（P〈0．05）。结论：循证护理能有效缓解糖尿病痛性神经病变患者的疼痛症状，减轻患者痛苦，提高患者生活质量。     

循证护理和自我效能评价在糖尿病周围神经炎病人中的应用

目的:探讨将循证护理和自我效能评价应用于糖尿病周围神经炎病人中的效果,以提高病人生命质量。方法:将86例糖尿病周围神经炎病人随机分为护理干预组和对照组各43例。对照组按常规健康宣教,护理干预组应用循证护理,同时将自我效能运用其中。结果:护理干预组病人住院时间明显短于对照组(P<0.05);各项自我效能分值和护理满意度明显高于对照组(P<0.05)。结论:通过循证护理及自我效能的联合护理干预,缩短了糖尿病周围神经炎病人住院时间,提高了病人护理满意度及生命质量。     

循证护理和自我效能评价在糖尿病周围神经病变患者中的应用效果

目的：探讨循证护理和自我效能干预对糖尿病周围神经病变患者的应用价值。方法按照随机数字表法将150例糖尿病周围神经病变患者分为观察组和对照组各75例。对照组实施常规护理措施,观察组在对照组的基础上给予循证护理及自我效能干预理念进行护理干预。比较两组患者对护理服务质量的满意度,空腹血糖水平及住院治疗时间和自我效能得分。结果护理干预后,观察组患者对疾病知识、膳食指导、运动指导、心理指导及用药指导等的满意度均高于对照组,差异有统计学意义（P＜0．05）;观察组患者护理干预后空腹血糖水平及住院治疗时间均低于对照组,差异有统计学意义（P＜0．05）;观察组自我效能评价评分均高于对照组,差异有统计学意义（ P＜0．05）。结论循证护理及自我效能干预指导能提高糖尿病周围神经病变患者对医疗服务满意度及自我效能评价得分,可有效控制血糖水平,缩短住院治疗时间,具有较好的实际应用价值。     

中药穴位敷贴联合红外线照射治疗糖尿病痛性神经病变

目的:探讨中药穴位敷贴联合红外线照射对糖尿病痛性神经病变的效果。方法:选取我院内分泌科进行糖尿病痛性神经病变治疗的80例患者作为研究对象,随机将其等分为对照组与观察组,对照组患者予以常规护理模式护理;观察组给予中药穴位敷贴联合红外线照射干预,疗程2周。比较两组患者不同干预后神经传导速度的变化、疼痛程度及临床疗效。结果:观察组患者正中神经和腓总神经的运动传导速度及感觉传导速度均优于对照组,差异具有统计学意义(P0.05);观察组患者疼痛程度明显低于对照组,差异具有统计学意义(P0.05);观察组患者的疗效高于对照组,差异具有统计学意义(P0.05)。结论:中药穴位敷贴联合红外线照射治疗糖尿病痛性神经病变,能有效缓解患者疼痛,提高运动神经和感觉神经的传导速度。     

糖尿病痛性神经病变合并抑郁症患者的社区护理干预

目的 探讨社区干预对糖尿病痛性神经病变合并抑郁症患者的影响.方法 将100例糖尿病痛性神经病变合并抑郁症患者,随机分为干预组50例和对照组50例.干预组除给予常规的治疗和护理外,按照系统化护理模式给予充分的心理支持,指导情绪调节,争取社会支持;对照组给予常规治疗和护理.干预前后,比较两组患者的认知情况、生化指标、情绪状态、遵医行为及社会支持等.结果 干预后,干预组空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbAlc)、血压低于对照组,而治疗依从性、认知行为高于对照组(P＜0.05).干预后,干预组糖尿病、抑郁症知识得分提高,汉密顿抑郁量表(HAMD-17)和疼痛得分降低(P＜0.05).结论 社区干预有利于改善糖尿病痛性神经病变患者的抑郁情绪,控制血糖,减轻疼痛,对提高患者生活质量有重要意义.     

α-硫辛酸联合加巴喷丁治疗糖尿病痛性神经病变的临床研究

目的:观察α-硫辛酸联合加巴喷丁对糖尿病痛性神经病变的疗效。方法:随机将52例糖尿病痛性神经病变的患者分为两组,治疗组27例应用α-硫辛酸联合加巴喷丁观察疼痛缓解情况;对照组25例进行常规治疗。两组疗效进行比较。结果:α-硫辛酸联合加巴喷丁组有效率显著高于对照组(P<0.05)。结论:α-硫辛酸联合加巴喷丁可明显改善糖尿病痛性神经病变。     

基于Barthel指数和疾病自我效能联合评估的主动式护理在2型糖尿病住院患者中的应用

目的 探讨基于Barthel指数和疾病管理自我效能联合评估的主动式护理在2型糖尿病住院患者中的应用价值.方法 该院自2016年4月起开始实施基于Barthel指数和疾病管理自我效能联合评估的主动式护理模式,选择实施前(2016年1~3月)和实施后(2016年4~5月)于该院接受住院治疗的2型糖尿病患者各66例作为研究对象,实施前后病例组分别设为对照组和实验组,比较两组干预后各相关观察指标的差异性.结果 实施后糖尿病住院病例组干预后的自护能力评分、治疗总有效率和医护患三方护理满意度评分均显著高于对照组,差异有统计学意义(P<0.05).结论 采用基于Barthel指数和疾病管理自我效能联合评估的主动式护理对2型糖尿病住院患者实施干预,可显著提高其糖尿病自护能力,获得积极的疾病控制效果,提高医护患三方护理满意度.     

延续性护理联合知信行理论对宫颈癌术后化疗患者自我效能及希望水平的影响

目的 探讨延续性护理联合知信行(KAP)理论对宫颈癌术后化疗患者自我效能及希望水平的影响.方法 选取2018年10月—2019年10月来我院诊断为宫颈癌的患者60例作为研究对象,采用数字随机法分为研究组(n=30)与对照组(n=30).对照组采取常规护理及延续性护理,研究组在对照组基础上联合KAP理论进行护理.统计两组干预前后自我效能(GSES)及希望水平(与他人保持亲密关系、采取积极行动和对现实及未来态度)评分、护理工作满意度,并进行对比.结果 干预后两组GSES分值较干预前增高,且研究组高于对照组(P<0.05);干预后两组与他人保持亲密关系、采取积极行动和对现实及未来态度分值较干预前增高,且研究组高于对照组(P<0.05);研究组护理工作满意度(93.33％)高于对照组(73.33％)(P<0.05).结论 宫颈癌术后化疗患者采取延续性护理联合KAP理论干预,可有效提升患者希望水平,改善其自我效能感,且可提高护理工作满意度.     

LERANS模式在糖尿病视网膜病变患者健康教育中的应用

目的:探讨LERANS模式在糖尿病视网膜病变患者健康教育中的应用效果。方法:将2017年9月至2018年4月在广东省中医院住院治疗的124例糖尿病视网膜病变患者按照入院时间顺序进行分组,其中2017年9至12月接受治疗的62例患者设为对照组,采用基础治疗联合常规健康教育模式;将2018年1至4月接受治疗的62例患者设为观察组,采用基础治疗联合LERANS模式健康宣教。比较两组干预前后自我护理能力、自我效能、生存质量及治疗效果情况。结果:干预前两组自我护理能力、自我效能和生存质量的对比差异均无统计学意义,干预后观察组自我护理能力各维度评分、自我效能感评分均明显高于对照组(P0.05),生存质量各维度评分及总分均明显低于对照组(P0.05);观察组治疗效果明显优于对照组(P0.05)。结论:通过LEARNS模式开展健康教育可有效提升糖尿病视网膜病变患者的自我护理能力和自我效能感,改善患者的生存质量和治疗效果,在临床值得进一步推广。     

A Randomized Controlled Pilot Study of a Cognitive-Behavioral Therapy Approach for Painful Diabetic Peripheral Neuropathy

The purpose of the present pilot study was to assess the efficacy of cognitive-behavioral therapy (CBT) for painful diabetic peripheral neuropathy. This was a randomized, treatment as usual (TAU), controlled, nonblinded intervention pilot study with a 4-month follow-up conducted in a VA medical center. It was hypothesized that participants who received CBT, as compared to those who received TAU, would report significant decreases on self-report measures of pain severity, interference, and depressive symptoms from pretreatment to 4-month follow-up. Participants meeting inclusion criteria were randomly assigned to 1 of the study conditions. Of the 20 eligible participants, 12 were randomized to CBT and 8 were randomized to TAU. Participants randomized to CBT showed significant decreases on measures of pain severity (B = ?.54) and pain interference (B = ?.77) from pretreatment to 4-month follow-up. There were no significant changes in the TAU participants' scores on measures of pain severity (B = .00) or pain interference (B = ?.09). Neither CBT nor TAU participants showed significant changes in their levels of depressive symptoms from pretreatment to 4-month follow-up. CBT may be an effective treatment approach for reducing pain severity and interference associated with painful diabetic peripheral neuropathy.PerspectiveThe results of this study suggest that engaging patients in CBT for painful diabetic peripheral neuropathy may provide them the skills to become more active and experience less pain.     

Antiepileptic drugs in treatment of pain caused by diabetic neuropathy

Pain is frequent in diabetic neuropathy and is very hard to manage. Antiepileptic drugs have been used in treating pain for several decades. Their effectiveness has been described in different types of neuropathic pain, but when used as analgesics in painful diabetic neuropathy it still remains controversial. To clarify this effectiveness, a meta-analysis was performed to determine which antiepileptic drug had the best analgesic potential for managing pain in patients suffering from painful diabetic neuropathy. The search covered the Cochrane, MEDLINE, EMBASE, and LILACS databases, between January 1966 and September 2005. The following information was obtained from each article: criteria for diagnosing diabetic neuropathy, patients' age average, antiepileptic drug received and dose, sample size, duration of the disease and treatment follow-up, outcome measurement, evaluation of pain, and rescue medication. A combined 2.33 relative risk (95% confidence interval [CI] 1.88-2.88) was obtained; this result indicated that the antiepileptic drugs studied were effective for controlling pain in diabetic neuropathy. The corresponding necessary number to treat (NNT) values were established for evaluating which antiepileptic drug was most effective as an analgesic, according to our interests; pregabalin was shown to be the antiepileptic drug having the lowest NNT (NNT=3.24 and 95% CI 2.12-6.81) for achieving greater than 50% analgesia in patients suffering from painful diabetic neuropathy. Antiepileptic drugs are frequently used in the specific case of diabetic neuropathy; the combined result of this meta-analysis has demonstrated their analgesic benefit.     

循证护理对鼻咽癌放疗患者疼痛程度及皮肤反应程度的影响

目的 探讨循证护理对鼻咽癌放疗患者躯体疼痛感知程度及皮肤反应程度的影响,为该类特殊群体的优质诊疗服务积累循证经验.方法 选取该院耳鼻喉科于2013年9月~2016年3月收治的84例鼻咽癌患者为研究对象,按随机数字表法分为研究组和对照组各42例.其中,对照组行常规护理,而研究组则在对照组基础上引入循证护理模式.两组患者均于干预前及干预后第7天接受视觉模拟疼痛程度评分调查,并均于干预后第4周末接受皮肤反应程度测评.结果 两组患者在干预前的视觉模拟疼痛程度评分差异无统计学意义(P>0.05);干预后,研究组患者的视觉模拟疼痛程度评分低于对照组,差异有统计学意义(P<0.05).研究组患者干预后的皮肤反应程度要轻于对照组,差异有统计学意义(P<0.05).结论 引入循证护理模式,有助于减轻鼻咽癌放疗患者的躯体痛感,且能降低皮肤反应程度,临床疗效显著.     

糖尿病患者介入治疗中的舒适护理

目的探讨护理干预对糖尿病介入治疗患者心理状况及术后舒适度的影响。方法将49例择期行介入治疗的糖尿病患者随机分为实验组25例和对照组24例,对照组实施传统的常规护理,实验组在此基础上给予系统的舒适护理干预。比较2组患者手术前后焦虑情况变化及术后并发症的发生率。进行t检验和χ^2检验。结果实验组患者术后焦虑改善情况明显优于对照组,术后腰背疼痛、排尿困难、导尿、下肢麻木、心烦失眠的发生率较对照组显著降低。结论实施系统的护理干预措施可改善糖尿病介入治疗患者心理状况及术后舒适度。     

Gabapentin vs. amitriptyline in painful diabetic neuropathy: an open-label pilot study

The objective of this study was to compare the efficacy and tolerability of gabapentin and amitriptyline monotherapy in painful diabetic neuropathy. This was a 12-week, open-label, prospective, randomized trial. Twenty-five type-II diabetic patients with pain attributed to diabetic neuropathy and a minimum score of 2 on a pain intensity scale ranging from 0 (no pain) to 4 (excruciating pain) were randomized to receive either gabapentin, titrated from 1,200 mg/day to a maximum of 2,400 mg/day, or amitriptyline, titrated from 30 mg/day to a maximum of 90 mg/day. Both drugs were titrated over a 4-week period and maintained at the maximum tolerated dose for 8 weeks. The main outcome measures were weekly pain intensity and paresthesia intensity, measured on two categorical scales. Thirteen patients received gabapentin and 12 received amitriptyline. All 25 patients completed the trial. Gabapentin produced greater pain reductions than amitriptyline (mean final scores were 1.9 vs. 1.3 points below baseline scores; P = 0.026). Decreases in paresthesia scores also were in favor of gabapentin (1.8 vs. 0.9 points; P = 0. 004). Adverse events were more frequent in the amitriptyline group than in the gabapentin group: they were reported by 11/12 (92%) and 4/13 (31%) of patients, respectively (P = 0.003). Side effects were the main limiting factor preventing dose escalation. Gabapentin produced greater improvements than amitriptyline in pain and paresthesia associated with diabetic neuropathy. Additionally, gabapentin was better tolerated than amitriptyline. Further controlled trials are needed to confirm these preliminary results.     

循证护理在癌症疼痛病人中的应用

目的:探讨循证护理在癌症疼痛病人护理中的应用效果。方法:将100例癌症疼痛病人随机分为试验组和对照组,试验组48例,对照组52例。两组病人都接受肿瘤科疾病常规治疗和护理,试验组在此基础上增加循证护理措施,评价两组病人入院15 d后的生活质量。结果:两组病人生活质量评分均升高,但试验组升高程度要优于对照组,两组比较有统计学意义(均P<0.05)。结论:循证护理可以作为癌症疼痛病人护理的理论依据,对临床护理工作具有很大的指导意义。     

糖尿病患者介入治疗中的舒适护理

目的 探讨护理干预对糖尿病介入治疗患者心理状况及术后舒适度的影响.方法 将49例择期行介入治疗的糖尿病患者随机分为实验组25例和对照组24例,对照组实施传统的常规护理,实验组在此基础上给予系统的舒适护理干预.比较2组患者手术前后焦虑情况变化及术后并发症的发生率.进行t检验和χ2检验.结果 实验组患者术后焦虑改善情况明显优于对照组,术后腰背疼痛、排尿困难、导尿、下肢麻木、心烦失眠的发生率较对照组显著降低.结论 实施系统的护理干预措施可改善糖尿病介入治疗患者心理状况及术后舒适度.     

循证理念用于胆囊结石患者腹腔镜术后护理中的效果

目的分析循证理念用于胆囊结石患者腹腔镜术后护理中的效果。方法选取2017年1月至2019年1月我院接收并诊治100例的胆囊结石患者为研究对象,采用随机数字法将其分为参照组和循证理念组,各50例。两组患者均采用腹腔镜手术进行治疗,参照组给予常规护理干预,循证理念组给予基于循证理念的护理干预。分析两组患者护理前、护理1周后情绪量表(emotional scale,ES)、功能状态(karnofsky performance status,KPS)量表、遵医Frankl依从量表、生活质量调查量表SF-36评分。结果护理1周后,两组ES评分明显降低,且循证理念组低于参照组,差异具有统计学意义(P<0.05)。护理1周后,两组KPS、Frankl、SF-36评分均明显升高,且循证理念组明显高于参照组,差异具有统计学意义(P<0.05)。结论循证理念用于胆囊结石患者腹腔镜术后护理中的效果显著,可缓解患者的疼痛,促进患者康复,提高生活质量,值得临床推广应用。