AI聊天机器人在骨质疏松骨折术后患者延续护理中的应用

目的 探讨AI聊天机器人在骨质疏松骨折术后患者院外延续护理中的应用效果。方法 将300例骨质疏松骨折术后患者按照时间分为常规组和干预组，每组150例。常规组实施常规院外延续护理，干预组在常规组的基础上由AI聊天机器人辅助完成院外延续护理。比较两组干预后骨质疏松健康信念水平、健康自我管理能力、疼痛评分、关节功能及二次骨折发生率。结果 出院1个月、3个月、6个月、12个月干预组骨质疏松健康信念水平、健康自我管理能力评分显著高于常规组，二次骨折发生率显著低于常规组（均P<0.05）；两组干预前及干预后各时间点疼痛及Harris髋关节功能评分比较，差异无统计学意义（均P>0.05）。结论 AI聊天机器人用于骨质疏松骨折术后患者院外延续护理，可有效提高患者骨质疏松健康信念及健康自我管理能力，降低二次骨折发生率。     

疼痛全程管理对癌痛患者服药依从性及爆发痛的影响

目的降低癌痛患者爆发痛发生率。方法将200例癌痛患者根据入院时间分组,2014年1~12月收治的癌痛患者100例分为对照组,2015年1~12月收治的癌痛患者100例分为干预组,两组均按癌痛规范化治疗,对照组行常规护理及健康指导,干预组实施疼痛全程管理模式干预,比较两组服药依从性及爆发痛发生率。结果干预后干预组服药依从性显著高于对照组(P0.01),而爆发痛发生率显著低于对照组(P0.01)。结论全程护理管理模式是一种全程化、专业化、人性化的护理模式,用于癌症晚期患者的疼痛管理,能有效提高患者服药依从性,减少癌性爆发痛的发生,提高癌痛患者生活质量。     

癌痛规范化管理结合微信平台宣教对肿瘤患者镇痛的影响

目的探讨癌痛规范化管理结合微信平台宣教对晚期肿瘤患者镇痛和治疗依从性的影响。方法将肿瘤科收治的癌症并伴有癌痛的患者136例随机分为两组各68例。对照组采取癌痛规范化管理,观察组在进行癌痛规范化管理的同时结合微信平台宣教。出院3周比较两组患者癌痛程度、治疗依从性及满意度。结果观察组患者疼痛程度、服药依从性及满意度显著优于对照组(均P<0.01)。结论在癌痛规范化管理的同时配合微信平台宣教能够有效缓解癌痛患者的疼痛程度,调动患者治疗的依从性,提高其满意度。     

医护药一体化管理在癌痛患者中的应用

目的探讨医护药一体化管理在癌痛患者中的应用效果。方法按时间段将91例恶性肿瘤疼痛患者分为对照组44例、观察者47例;对照组行常规癌痛管理,观察组成立医护药一体化癌痛管理小组实施协同管理。结果观察组镇痛药服药依从性显著高于对照组,疼痛评分显著低于对照组(P 0. 05,P 0. 01)。结论对癌痛患者实施医护药一体化管理,可有效提高患者镇痛药服药依从性,从而有效缓解疼痛。     

膝关节镜术后院外功能康复训练指导效果观察

目的 探讨对膝关节镜术后患者实施院外功能康复训练指导的效果.方法 将60例膝关节镜术后患者随机分为观察组与对照组各30例,两组住院期间予以常规健康教育、康复指导;出院后对照组不作任何干预,观察组出院后给予功能康复训练指导,1个月内每周1次,以后每个月1次.结果 观察组术后3个月、6个月膝关节HSS评分显著高于对照组(P＜0.05).结论 对膝关节镜术后患者进行院外功能康复训练指导,能使患者获得延续的护理,提高手术治疗的效果.     

赋能教育在癌痛患者中的应用

目的探讨赋能教育对癌痛患者疼痛控制的影响。方法将80例癌痛患者随机分为干预组与对照组各40例,对照组给予常规癌痛知识教育,干预组在此基础上结合赋能教育进行干预。观察两组癌痛患者在出院后4周服药依从性、癌性爆发痛发生率、癌痛控制障碍得分及疼痛应对策略得分情况。结果出院后4周干预组服药依从性及疼痛应对策略评分显著高于对照组,爆发痛发生率及癌痛控制障碍得分显著低于对照组(P 0. 05,P 0. 01)。结论对癌痛患者实施赋能教育能提高患者的服药依从性,减少癌性爆发痛发生率,减轻患者癌痛控制障碍,有利于患者采取积极的应对策略,从而更好地控制癌痛。     

膝关节镜术后院外功能康复训练指导效果观察

目的探讨对膝关节镜术后患者实施院外功能康复训练指导的效果。方法将60例膝关节镜术后患者随机分为观察组与对照组各30例，两组住院期间予以常规健康教育、康复指导；出院后对照组不作任何干预，观察组出院后给予功能康复训练指导，1个月内每周1次，以后每个月1次。结果观察组术后3个月、6个月膝关节HSS评分显著高于对照组（P〈0．05）。结论对膝关节镜术后患者进行院外功能康复训练指导，能使患者获得延续的护理，提高手术治疗的效果。     

癌症患者癌痛自我管理体验的质性研究

目的 了解癌症患者癌痛自我管理的真实体验,为改善患者癌痛程度和癌痛规范化管理提供参考.方法 采用现象学研究方法对23例癌痛患者进行半结构式深度访谈,并采用Nvivo11.0软件和Colaizzi七步分析法对访谈资料进行编码、分析、提炼主题.结果 患者癌痛自我管理体验可归纳5个方面主题:用药管理、癌痛认知与应对管理、心理管理、生活管理、人际交往管理.结论 癌症患者有复杂的癌痛自我管理体验,医护人员应根据患者病情、癌痛程度与个体差异实施针对性干预,以提高患者癌痛自我管理能力,减轻身心痛苦.     

居家癌痛管理APP软件的研制及应用评价

目的探讨护患APP在居家癌性疼痛患者中的应用效果。方法将80例出院癌痛患者随机分为对照组和观察组各40例,对照组实施常规出院后电话随访,观察组通过护患APP进行居家癌痛管理,出院3周后比较两组患者服药依从性、镇痛效果、满意度及疼痛评分。结果观察组患者服药依从性、镇痛效果、满意度显著高于对照组,疼痛评分显著低于对照组(P0.05,P0.01)。结论通过护患APP进行居家患者癌痛管理,可提高患者的遵医行为及镇痛满意度。     

基于5G网络的复合型糖尿病AI管理平台的设计与应用

目的 构建基于5G网络的复合型糖尿病AI管理平台,观察在糖尿病患者管理及基层医护培训中的应用效果。方法 选取2型糖尿病出院患者340例,采用随机数字表法分为观察组和对照组各170例。对照组接受常规糖尿病院外管理,观察组基于5G网络的复合型糖尿病AI管理平台实施院外管理,于干预前和干预3个月后观察患者血糖控制相关指标和患者自我管理行为的变化。另在基层医院内选取护理人员60名,通过平台进行培训。比较干预前和干预6个月后基层护士综合能力评分。结果 干预3个月后,观察组患者空腹血糖、餐后2 h血糖及糖化血红蛋白显著低于对照组,自我管理行为评分显著高于对照组(均P<0.05)。项目开展6个月后,护理人员理论知识、实践操作及护理团队建设评分显著高于开展前(均P<0.05)。结论 基于5G网络的数字医疗平台的应用可改善糖尿病患者的血糖,提高患者的自我管理能力,且促进基层护士的能力提升,有利于区域内护理质量持续改进。     

Discogenic pain in acute nonspecific low-back pain

Acute nonspecific low-back pain is characterized by the sudden onset and severe unendurable low-back pain without radicular pain or neurological deficit in the lower extremities. The study was carried out using 55 patients who visited our hospital for acute nonspecific low-back pain, who exhibited degeneration on T2-weighted MR images, and underwent intradiscal injection of local anesthetics,steroid and contrast medium. Intervertebral disc sites with an obvious enhanced region in the posterior annulus of the disc on enhanced T1-weghted MR images was selected for intradiscal injection. When no enhaced region was detected, the most severely degenerated disc on T2-weighted MR images was selected. Acute nonspecific low-back pain with an improvement rate of 70% or higher 5min after injection was judged to be discogenic. The clinical characteristics and pathogenesis of discogenic acute nonspecific low-back pain were investigated. Forty of the 55 patients (73%) had discogenic acute nonspecific low-back pain. As for the characteristics of patients, the mean age was 37 years, and onset occurred upon casual daily movements in 18 patients (45%). Nineteen patients (48%) had bilateral low-back pain, and 29 patients (73%) had no tenderness in the paravertebral muscles. On plain X-ray radiograms, degeneration of the disc was normal or mild in 36 patients(91%). On the discograms, a radial tear extending to the posterior annulus was noted in all patients, but epidural leakage was seen only in six patients (15%). The degree of disc degeneration on T2-weighted MR images (Gibsons classification) was grade 3 in 30 patients (75%). Gadolinium-DTPA enhanced T1-weighted MR images showed an obvious enhanced region in the posterior annulus of the intervertebral disc in 19 patients (48%). As for the clinical characteristics of discogenic acute nonspecific low-back pain, the relatively young adult patients had no tenderness in the paravertebral muscles, and showed moderately degererated intervertebral discs. The pathogenesis of discogenic acute nonspecific low-back pain is mostly considered to be a re-rupture in an asymptomatic ruputured region in the posterior annulus, repaired by granulation tissue, in a moderately degenerated intervertebral disc with a radial tear.     

Characteristics of pain and pain management in the elderly

A COMMON SYMPTOM: Pain is a common and underestimated problem in older people who are likely to suffer from many acute and chronic conditions. DIFFICULT ASSESSMENT: Clinical assessment of pain often depends on the patient's ability to communicate his or her experience. If self-assessment of pain is not possible, behavioral hetero-evaluation instruments have been built for easy pain assessment by caregivers. ADJUSTED PAIN MANAGEMENT: As for younger patients, the most common strategy for pain management is the use of analgesic drugs. Special care should be taken however when such drugs are initiated in the elderly because increased sensitivity, prolonged drug half-life and adverse effects and drug interactions are more likely.     

Myofascial pain in patients with postthoracotomy pain syndrome

OBJECTIVE: Postthoracotomy pain syndrome is generally considered to be neuropathic pain due to intercostal nerve injury. However, nonneuropathic pain can also occur following thoracic surgery. We present a series of cases with postthoracotomy pain syndrome in which myofascial pain was thought to be a causative component of postthoracotomy pain syndrome. CASE REPORT: Twenty-seven patients (17 men and 10 women) were treated with trigger point injections, intercostal nerve blocks, and/or epidural blocks. Clinical criteria were used to diagnose the myofascial pain. A visual analogue scale was used, and sensory disturbances were recorded before and after treatment. A trigger point in a taut muscular band within the scapular region, which we diagnosed as myofascial pain, was observed in 67% of the patients. The existence of this trigger point significantly increased the rate of success for the treatments. CONCLUSIONS: Postthoracotomy pain may result, at least in part, from a nonneuropathic origin (myofascial pain). It is recommended that each patient be examined in detail to determine whether there is a trigger point in a taut muscular band within the scapular region. If found, this point is suggested as a good area for anesthetic injection.     

Repeatability of pain drawings in a low back pain population

STUDY DESIGN: This is a prospective test-retest repeatability study. OBJECTIVE: The primary purpose of this study was to determine the test-retest repeatability, using a variety of scoring methods, of pain drawings in a group of chronic low back pain patients. The intraevaluator repeatability for the methods requiring subjective interpretation was also evaluated. SUMMARY OF BACKGROUND DATA: Pain drawings have been used in a variety of applications, including documentation of symptom location, as a tool for diagnosis and as a psychological screening tool. Accordingly, there have been several methods described for interpreting the drawings and several groups have investigated evaluators' abilities to replicate their interpretation. However, there has been less investigation of patients' consistency in completing the drawings. METHODS: The intraevaluator repeatability was determined for the two scoring methods requiring subjective interpretation by the evaluator rescoring the drawings 2 weeks after the initial scoring. To determine repeatability, drawings were completed on two occasions by 75 patients. Patients who indicated on a questionnaire that there had been no change in their pain location since their first clinic visit (the day the first drawing was completed) were included in the study. This subgroup consisted of 45 patients who completed pain drawings on two occasions separated by a mean of 244.2 days (range, 26-1197 days). Repeatability was assessed for several scoring methods described in the literature: penalty point system, overall visual inspection, body regions, and a grid method. RESULTS: Patients were consistent in completing the drawings, assessed by the various scoring methods. The worst repeatability values were for some of the sensation types. DISCUSSION: As reported by others, the intraevaluator repeatability was high. The results of this study, finding acceptable repeatability for most scoring methods for pain drawing completed on occasions separated by a relatively long period of time, support that the pain drawing is a stable instrument for use in chronic back pain patients.     

Role of pain injection procedures in the management of chronic pain

The paper offers an overview of pain intervention procedures which are just one facet of a holistic approach to managing pain. They can have a therapeutic and/or diagnostic focus, at times being useful in terms of guiding the clinician to useful pointers to the source of pain, and at others allowing windows of opportunity of pain relief to allow the patient to engage with other modes of pain management such as physiotherapy or occupational therapy with a common goal of improving level of function. The paper explores the importance of managing patient expectations, providing clear patient information and acquiring appropriate patient consent. It provides a brief overview of different procedures, drugs and other modalities as well as imaging used in their delivery.