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1.
目的 了解2型糖尿病患者自我血糖监测情况及其影响因素,为糖尿病教育工作提供参考依据.方法 随机选择在广州市5家医院就诊的349例2型糖尿病患者.对其血糖监测情况及有关糖尿病知识、健康信念和自我效能等进行问卷调查.采用Logistic回归法分析患者家庭血糖监测的影响因素.结果 本次调查中能按要求进行家庭监测血糖者占65.6%.患者的血糖自我监测水平与其血糖监测等技能掌握得分、健康信念(P<0.01)呈正相关.城市患者的家庭监测状况优于乡镇患者(P<0.05);患者到医院就诊和监测病情(包括监测血糖)的间隔时间,56.2%的患者间隔1~2个月,32.0%的患者间隔较长时间才复查或监测血糖,8.6%的患者是在感觉身体不适时才就诊,3.2%的患者确诊后从未再就诊.结论 应强化患者血糖监测的意识,提高其自测血糖技能;扩大教育途径范围,重视对乡镇患者进行教育引导;倡导患者家庭成员教育,争取获得其家庭支持,以解决目前糖尿病监测管理薄弱环节.  相似文献   

2.
【】目的 了解社区2型糖尿病患者自我血糖监测情况及其影响因素,为社区糖尿病教育和预防工作提供参考依据。方法 随机选取南京西路社区在册管理的339例2型糖尿病患者,对其血糖监测情况及有关糖尿病知识、健康信念和自我效能等进行问卷调查。采用Logistic回归法分析社区糖尿病患者家庭血糖监测的影响因素。结果 本次调查中能按要求进行家庭监测血糖者占37.2%。患者就诊和监测血糖的间隔时间,57.2%的患者间隔l~2个月,32.7%的患者间隔较长时间才复查或监测血糖,8.3%的患者是在感觉身体不适时才就诊,1.8%的患者确诊后从未再就诊。患者的血糖自我监测水平与经济收入、血糖监测等技能掌握得分、健康信念呈正相关(p<0.01)。结论 应强化患者自我血糖监测的意识,扩大教育途径范围,提高自测血糖技能,倡导患者家庭成员教育和同伴支持教育,以解决目前糖尿病监测管理薄弱环节,提高社区糖尿病患者管理工作的效率。  相似文献   

3.
目的探讨糖尿病患者自我血糖监测现状及教育效果。方法采用自行设计的问卷调查表,对200例门诊糖尿病患者进行自我血糖监测意识及知识、技能掌握情况调查,并进行相关健康教育,6个月后评价教育效果。结果大部分糖尿病患者对自我血糖监测的重要性认识不足,对自我血糖监测的知识、技能掌握不够,对其进行教育干预后,患者自我血糖监测状况明显好转,差异有统计学意义(P〈0.05或P〈0.01)。结论糖尿病患者自我血糖监测现状不容乐观,应加强对糖尿病患者自我血糖监测的健康教育,提高糖尿病患者自我血糖监测的认知水平和依从性。  相似文献   

4.
目的探讨行为转变理论(TTM)对2型糖尿病患者建立自我血糖监测行为中的影响。方法选择60例2型糖尿病患者,随机分为干预组(n=30)和对照组(n=30)。对照组接受单纯的糖尿病血糖监测知识教育,干预组接TTM干预方法,干预6个月后比较两组患者自我血糖监测行为变化。结果干预后1个月两组患者自我血糖监测行为的得分比较差异无统计学意义(P〉0.05);干预2,6个月干预组自我血糖监测行为得分为(17.89±2.67),(23.76±3.74)分,均高于对照组得分(15.27±2.35),(12.36±2.03)分,差异均有统计学意义(t分别为4.792,8.863;P〈0.01);干预3,4,5个月两组患者自我血糖监测行为比较差异均有统计学意义(P〈0.01);两组患者干预1~6个月自我血糖监测行为比较差异均有统计学意义(F分别为67.031,26.573;P〈0.01)。干预前两组患者血脂代谢指标的比较差异均无统计学意义(P〉0.05);干预后干预组FBG、P2hBG分别为(5.83±1.45),(10.29±4.42)mmol/L,均低于对照组(7.63±1.64),(12.95±4.78)mmol/L,差异均有统计学意义(t分别为1.972,2.036;P〈0.05);其他血脂指标两组比较差异均有统计学意义(P〈0.05)。结论TTM对帮助2型糖尿病患者建立自我血糖监测行为有促进作用,建立良好的自我血糖监测行为能有效改善2型糖尿病的血脂代谢指标。  相似文献   

5.
目的了解四川省糖尿病患者自我血糖监测现状,分析影响自我血糖监测的因素,为采取相应措施提高2型糖尿病患者自我血糖监测水平提供依据。方法采用方便抽样的方法,抽取四川省7个地市州17所医院和社区卫生服务中心确诊2型糖尿病1年以上的患者410例,通过问卷调查形式调查糖尿病患者的自我血糖监测情况。结果410例被调查患者中,其平均每月自我监测血糖7.3次,其中268例(65.4%)每月血糖监测不足4次,94例(22.9%)为4~15次,29例(7.1%)为16~29次,19例(4.6%)为30次以上;仅234例(57.1%)患者最近6个月监测过糖化血红蛋白。自我监测血糖频率与空腹血糖、餐后2小时血糖和糖化血红蛋白水平呈负相关。影响血糖自我监测的主要因素有:是否进行胰岛素治疗和是否接受过关于自我血糖监测的健康教育。结论四川省2型糖尿病患者自我血糖监测的水平较低,有待通过进行自我血糖监测的健康教育来提高患者的血糖监测依从性。  相似文献   

6.
2型糖尿病病人服药治疗依从性研究   总被引:4,自引:0,他引:4  
[目的]了解2型糖尿病病人服药治疗依从性以及影响因素,为有效开展糖尿病教育提供依据。[方法]选择在广州市5家医院就诊的335例2型糖尿病病人,对服药治疗依从性、糖尿病知识、健康信念、自我效能以及服药一般情况等进行问卷调查,用线性逐步回归分析法分析各种因素对服药依从性的影响。[结果]病人服药依从性均分与总分比为0.83;能完全按医嘱长期坚持服药者仅占67.0%。病人服药依从性与糖尿病知识掌握程度、健康信念、自我效能、购药方式、有无药物副反应、是否工作忙或事情多和就医的便利性相关(P〈0.01或P〈0.05)。[结论]医院应强化糖尿病健康教育,确保病人长期坚持服药;重点关注工作忙、记忆力减退、经济困难等因素产生的影响;调动家庭支持力量;政府部门应制定相应治疗优惠政策,合理配置医疗资源。  相似文献   

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[目的]了解2型糖尿病病人足部护理情况及其影响因素,为针对性开展足部护理教育提供依据。[方法]选择广州市5家医院就诊的349例2型糖尿病病人,对足部护理依从性及有关糖尿病知识、健康信念和自我效能等进行问卷调查,采用线性逐步回归分析法筛选病人足部护理依从性的影响因素:[结果]病人足部护理各项措施执行情况不理想;病人足部护理依从性与其年龄、经济条件、糖尿病知识、健康信念均呈正相关(P〈0.01、P〈0.05);生活方式呈负相关(P〈0.05).与家人同住的病人容易忽视足部护理:[结论]应强化病人对糖尿病足危害的认识,提高足部护理技能;注意对非老年病人、经济条件差的病人进行教育引导;重视对病人家庭成员教育,争取获得家庭支持,以确保病人有效执行足部护理。  相似文献   

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目的探讨加强健康管理对老年糖尿病患者血糖监测依从性的影响。方法选取老年糖尿病患者85例,随机分为实验组(42例)和对照组(43例)。两组患者均给予普通的常规管理,内容包括血糖监测的知识和操作;实验组在此基础上加强健康管理。记录和比较加强健康管理前后两组患者的血糖监测及得分情况;加强健康管理前和加强健康管理后12个月发放健康调查简表评价患者血糖的监测依从性。结果加强健康管理后患者的自我血糖监测依从性及血糖监测记录依从性实验组明显优于对照组(P〈0.05),血糖监测知识的掌握状况明显好于对照组(P〈0.05),患者自我管理的依从性明显好于对照组(P〈0.05)。结论加强健康管理较常规管理方法相比患者血糖监测和记录的依从性显著得到了提高,同时还使老年糖尿病患者的血糖监测知识及技能得到了提高,并提高了老年糖尿病患者的自我管理能力。  相似文献   

9.
2型糖尿病患者眼部检查依从性影响因素的调查   总被引:4,自引:2,他引:2  
目的探讨2型糖尿病患者眼部检查依从性的影响因素,为糖尿病教育工作提供参考依据。方法问卷调查在广州市5所医院就诊的349例2型糖尿病患者,包括眼部检查情况以及有关糖尿病知识、健康信念和自我效能等,用Logistic回归法筛选眼部检查依从惟的影响因素。结果眼部检查依从性良好者仅21.4%;单因素分析结果发现,年龄、居住地(城市或乡镇)、文化程度、从事医疗或接触医疗、医疗支付方式(公费或医疗保险、自费)、病程、糖尿病知识、健康信念和自我效能等因素对检查依从性有着影响作用;多测素分析显示,仅患者年龄(OR=1.46,95%C.I、=1.07~1.99,P<0、05)、糖尿病知识(OR=1.13,9,5%C.I=1.07~1.19,P<O.01)有统计学意义。结论应重视糖尿病眼病早期防治教育,关注非老年患者的眼部检查依从性。政府应强化健康教育促进职责,利用媒体增加乡镇、偏远地区健康信息的可获得性,并提高医疗检查的便利性。  相似文献   

10.
目的探讨家庭健康教育对2型糖尿病慢性并发症患者家庭负担的影响。方法采用目的抽样法于2011年5~7月从两个社区的2型糖尿病慢性并发症患者家庭中选取123例研究对象,根据社区分为研究组(60例)和对照组(63例)。由专人通过家庭访视的方式对研究组进行为期3个月的健康教育(每个月访视2次,每次45min至1h),对照组接受医院和社区常规的健康教育,比较两组研究对象干预3个月后的家庭负担量表(familyburdenscaleofdiseases,FBS)得分及患者的血糖控制水平。结果干预前,两组研究对象FBS总分及各维度得分差异均无统计学意义(P〉0.05);干预后3个月,研究组除经济负担外,FBS总分及其他各维度得分均低于对照组,差异有统计学意义(P〈0.05或P〈0.01);研究组患者干预后的空腹血糖及餐后2h血糖均低于干预前,差异有统计学意义(P〈0.05)。结论家庭健康教育能显著减轻2型糖尿病慢性并发症患者的家庭负担,有助于患者控制病情。  相似文献   

11.
Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.  相似文献   

12.
Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.  相似文献   

13.
Ranganath C  Heller AS  Wilding EL 《NeuroImage》2007,35(4):1663-1673
Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.  相似文献   

14.
ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.  相似文献   

15.
This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.  相似文献   

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目的 探讨手转胎头术失败的原因与分娩结局.方法 选择2008年1月至2010年12月于我院住院分娩的持续性枕横位、枕后位产妇198例,根据行手转胎头术后结果分为成功组126例、失败组72例.比较两组分娩结局,对比分析失败原因.结果 失败组胎儿体质量≥3500 g的发生率[76.4%(55/72)]明显高于成功组[31.7%(40/126)],差异有统计学意义(x2=30.177,P=0.001)、失败组宫缩乏力发生率[58.3%(42/72)]高于成功组[38.1% (48/126)],差异有统计学意义(x2=7.569,P=0.006)、失败组骨盆临界或轻度狭窄发生率[38.9% (28/72)]高于成功组[23.8%(30/126)],差异有统计学意义(x2 =5.030,P=0.002)、失败组手转胎头时机不当(宫口开大<6 cm、胎头位于坐骨棘上及宫口开大8~10 cm、胎头位于坐骨棘下≥2 cm)发生率[61.1%(44/72)]高于成功组[38.9%(49/126)],差异有统计学意义(x2=9.084,P=0.003).失败组母儿并发症(产后出血、产褥病率、胎儿窘迫、新生儿窒息)发生率高于成功组(x2 =9.586,P=0.002、x2=9.334,P=0.002、x2=5.910,P=0.015、x2=5.240,P=0.022)、失败组剖宫产发生率[72.2%(52/72)]明显高于成功组[34.1 %(43/126),x2=26.641,P=0.001)].结论 手转胎头术能使难产变顺产,降低剖宫产率,减少母儿并发症,但须积极预防、处理导致手转胎头术失败的原因,对矫正失败后继续矫正及试产应慎重.  相似文献   

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The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.  相似文献   

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