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1.
目的 探讨综合干预对降低住院老年患者跌倒发生率的影响.方法 将392例住院老年患者,随机分成干预组与对照组,对干预组200例住院老年患者采取综合干预:包括防跌倒认知行为干预、环境干预、药物治疗干预、心理干预和运动训练,帮助老年患者掌握跌倒的高风险因素及预防措施.对照组接受其中前3种防跌倒因素的干预,并比较2组防跌倒相关知识掌握程度及跌倒发生率.结果 干预组98.50%的患者不同程度的掌握了跌倒的风险因素以及预防措施的知识,与对照组71.88%的掌握率比较差异有统计学意义(P<0.01);干预组跌倒发生率为0,对照组跌倒发生率2.60%,2组比较差异有统计学意义(P<0.05).结论 综合干预可有效地减少住院老年患者跌倒发生率,提高老年患者生活质量.  相似文献   

2.
目的:对老年患者进行跌倒的风险评估并实施行为干预。方法应用Morse 评分量表对患者评估后对高危人群分为对照组和干预组。对干预组的高危人群采取行为干预,帮助老年患者掌握跌倒的相关因素及预防措施。对照组不采用行为干预,分析比较两组跌倒发生率及对护理工作的满意度。结果87.3%住院患者不同程度地掌握了跌倒的相关危险因素及预防措施知识。住院期间无跌到发生。与对照组0.72%跌倒发生率相比差异有统计学意义(P<0.01)。结论对住院老年患者预防跌倒进行评估并实施行为干预,可有效地预防跌倒,对提高老年人生活质量有重要意义。  相似文献   

3.
目的 探讨安全实例宣教在对眼科住院老年患者跌倒宣教中的作用及影响。方法将200例眼科住院老年患者,按入院时间分成干预组与对照组,前100名患者为对照组,后100名患者为干预组,对干预组100例住院老年患者采取安全实例宣教,帮助老年患者掌握跌倒的高风险因素及预防措施,并做好相关护理措施。对照组做普通防跌倒知识宣教及其他护理措施,并比较2组防跌倒相关知识掌握程度及跌倒发生率。结果观察组对防跌倒相关知识了解程度及依从性明显高于对照组(均P<0.01);干预组跌倒发生率为0,对照组跌倒发生率1%,2组比较差异有统计学意义(P<0.05)。结论 跌倒实例宣教可有效地提高患者对防跌倒知识的了解程度和依从性,减少眼科住院老年患者跌倒发生率,提高老年患者生活质量。  相似文献   

4.
【】目的 探讨神经内科老年患者跌倒的危险因素及护理对策。方法对我院神经内科986例老年患者采取防跌倒知识的宣教等干预并对其效果进行分析及总结。结果患者及家属不同程度掌握了跌倒相关危险因素及预防措施的知识,住院期间跌倒明显减少。结论 护理干预能有效地预防神经内科老年患者跌倒。  相似文献   

5.
住院期间健康教育对老年患者出院后跌倒的预防作用   总被引:1,自引:0,他引:1  
何雁  王琳 《解放军护理杂志》2009,26(4):10-11,29
目的了解引起老年人跌倒的主要危险因素,探讨防跌倒宣教的作用,为预防老年人跌倒提供科学依据。方法对376例住院老年患者及家属进行防跌倒知识的普及;对发生过跌倒的患者进行病因分析,并作相应的处理;高危患者实行重点追踪和随访。结果376名患者在入院前1年发生跌倒53名,跌例发生率为14.1%;经宣教后1年内发生跌倒的人数为14名,跌倒发生率为3.7%,出院后跌倒的发生率明显下降。结论住院期间防跌倒宣教对于防止老年人跌倒有重要意义,建议列为住院老年患者的护理常规。  相似文献   

6.
目的了解自制跌倒危险因素评估量表在住院老年患者安全管理中的应用效果。方法采用跌倒危险因素评估量表对338例(干预组)住院老年患者进行跌倒危险因素评估及针对性的防跌倒干预,并与同期应用传统防跌倒措施干预的患者(对照组)进行效果比较。结果干预组应用跌倒危险因素评估表进行评估≥4分者289例,干预期间发生跌倒1例,跌倒发生率为0.3%;对照组评估总分≥4分者305例,跌倒9例,跌倒发生率为3.0%,两组跌倒发生率比较差异有统计学意义(字2=4.611, P<0.05)。结论应用自制的跌倒危险因素评估量表在住院老年患者安全管理中的效果较为明显,能减少跌倒的发生,今后可望在老年住院患者中推广使用。  相似文献   

7.
目的:探讨老年患者跌倒因素及预防措施。方法:对68例老年住院患者进行问卷调查,分析跌倒原因并制定相应的护理措施。结果:对住院老年患者实施防跌倒教育,有效预防了患者的跌倒。结论:探讨老年患者跌倒的相关因素及预防措施,对避免纠纷、提高老年患者生活质量具有重要意义。  相似文献   

8.
目的 对精神科住院患者实施防跌倒护理风险管理,探讨其防跌倒康复效果。方法随机对二个病区120例住院精神障碍患者实施防跌倒护理风险管理(研究组),并与另二个病区120例仅实施常规安全护理管理(对照组)作对照,比较两组干预前和干预半年后简明精神病量表(BPRS)总分、跌倒发生的相关因素、跌倒发生率的差异。结果与对照组比较,研究组经实施防跌倒护理风险措施干预后BPRS评分下降更显著(P〈0.01);意外跌倒的发生率对照组为11.7%,研究组为4.2%,两组比较有显著性差异(P〈0.05);特别是互相戏耍打架而意外跌倒的发生率两组比较有显著性差异(P〈0.05)。结论对精神科住院患者实施防跌倒护理风险管理,与一般常规安全护理相比,对预防意外跌倒有较好的效果。  相似文献   

9.
目的:研究影响老年人跌倒相关的风险因素,并建立精准个性化的老年人跌倒风险预测系统,为老年人跌倒干预提供决策支持。方法:收集南京医科大学附属脑科医院2017年6月至2018年6月收治的419例老年患者,利用Logistics 回归方法建立风险预测模型,并用Nomogram可视化该预测模型。结果:患者年龄、经济来源、患者对鞋子与跌倒关系的认知、关节痛和/或畸形与跌倒关系的认知、认知功能与跌倒关系的认知、血管扩张药与跌倒关系的认知、降糖药与跌倒关系的认知七个因素为老年人跌倒的影响因素;新建立的老年人跌倒风险预测模型具有较高的预测精度(ROC曲线下面积:0.8051,95%CI: 0.7702-0.8401,P < 0.001),模型的Nomogram可以个性化的预测每个老年人跌倒风险。结论:本研究建立了一个老年患者跌倒风险预测系统,且该系统具有很好的预测效果。Nomogram提供了一个个性化的可视化老年人患者跌倒风险预测方法。  相似文献   

10.
跌倒危险度评分表在老年病房的应用研究   总被引:2,自引:2,他引:0  
目的对老年住院患者跌倒危险性进行评估,根据评估结果制定个性化的防跌倒方案,指导护士对有跌倒危险老年患者的护理,有效预防住院老年患者跌倒的发生。方法将332例老年患者随机分为实验组166例和对照组166例,其中实验组用跌倒危险度评分表进行评估,并采取相应预防措施,对照组按常规护理。结果332例病例中,实验组老年人跌倒发生1例,对照组老年人跌倒发生6例。结论跌倒危险度评分表已在国外研究中取得良好效果,也可以为我国在跌倒的评估和预防中提供参考和借鉴。  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.
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   

14.
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   

15.
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   

16.
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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18.
目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高<20%视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P<0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P<0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P<0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.  相似文献   

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20.
ZusammenfassungFragestellung Es wurde geprüft, wie sich der Differenziertheitsgrad zweier Schmerzmessmethoden auf Angaben zur Ausgedehntheit klinischer Schmerzen auswirkt. Zugleich wurde der Referenzzeitraum variiert, über den die Patienten berichten sollten.Methode Erfasst wurde der Einfluss zu Lasten der Befragungsdifferenziertheit durch den Vergleich zweier Körperschema-Bildvorlagen. Drei Referenzzeiträume (Schmerz aktuell, letzte Woche, letztes halbes Jahr) wurden vorgegeben.Ergebnisse Patienten mit ausgedehnten Schmerzen gaben bei differenzierter Befragung um so mehr Schmerzen an, je weiter die Schmerzen zurück lagen und je größer der Berichtszeitraum war. Patienten mit gelenknahen Schmerzen gaben bei hoch differenzierter Befragung weniger ausgedehnte Schmerzen in der Vergangenheit an als bei globaler Einschätzung. Patienten mit Rückenschmerzen berichteten bei differenzierter Befragung zum aktuellen Schmerz über weniger ausgedehnte Schmerzen als bei globaler Befragung.Schlussfolgerung Die Angaben zur Schmerzausdehnung variieren vor allem bei Patienten mit ausgedehnten Schmerzen in Abhängigkeit von der Differenziertheit der Befragung. In diesen Fällen ist die Wahrscheinlichkeit erhöht, dass sich die Beschwerdesymptomatik zumindest teilweise erst in der Reaktion auf die situativen Befragungsbedingungen konstituiert und daher nicht auf andere Befragungsbedingungen generalisiert werden kann.  相似文献   

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