协同护理模式对帕金森病患者自护能力及生存质量的影响

目的分析协同护理模式对帕金森病患者自护能力及生存质量的影响。方法选取69例于该院进行治疗的帕金森病患者作为研究对象,采用随机数字表法分为两组,其中对照组(34例)采用常规护理模式,研究组(35例)采用协同护理模式。采用自护能力测量量表和生存质量测定量表简表分别于入院时与出院时对两组患者的自护能力及生存质量进行测定和比较。结果刚入院时,两组患者的自护能力比较差异无统计学意义(P0.05),而出院时,研究组在自我责任感、自我概念、自护技能、健康知识水平4个维度上显著优于对照组,差异均有统计学差异(P0.05);入院时两组患者的生存质量比较差异无统计学意义(P0.05),而出院时,研究组在生理、环境、健康状况及生存质量维度上优于对照组(P0.05),而在心理和社会维度上比较差异无统计学意义(P0.05)。结论对帕金森病患者运用协同护理模式能显著提升患者的自护能力,并积极改善患者生存质量,对疾病的康复和预后有重要意义,临床值得推广运用。     

粉防己甲素联合氟桂利嗪胶囊治疗偏头痛的临床观察

目的观察粉防己甲素联合氟桂利嗪胶囊对偏头痛患者治疗效果及安全性。方法 70例偏头痛患者随机分为对照组36例(氟桂利嗪胶囊)和治疗组34例(粉防己甲素片联合氟桂利嗪胶囊)。观察两组患者视觉模拟量表(VAS)评分、口述疼痛分级法(VRS)评分与生存质量评分(SF-36)变化。结果两组患者年龄、病程、治疗前VAS、VRS积分及SF-36评分差异无统计学意义(P0.05)。两组治疗后VAS、VRS积分均显著降低,治疗组优于对照组(P0.05)。治疗组患者生活质量各维度评分较治疗前均有显著提高,差异有统计学意义(P0.05)。对照组患者生理功能、生理职能、躯体疼痛、总体健康、精力及社会功能较治疗前比较有明显提高(P0.05)。治疗后两组比较,治疗组各维度评分均高于对照组,其中生理职能、躯体疼痛及总体健康评分差异均有统计学意义(P0.05)。结论粉防己甲素片能显著提高氟桂利嗪胶囊治疗偏头痛的临床效果,改善患者的生活质量,其作用机制有待进一步深入研究。     

循证护理对轻度颅脑损伤患者疗效及生存质量的影响

目的研究循证护理对轻度颅脑损伤患者疗效及生存质量的影响。方法将轻度颅脑损伤患者根据护理方法分为循证护理组(Evidence-based nursing group,EBN组)和常规护理组(Control group,CON组),比较两组患者住院时间、满意率、并发症发生率、死亡率及治疗前和治疗后生存质量的差异。结果 EBN组轻度颅脑损伤患者住院时间、并发症发生率及死亡率均显著低于CON组轻度颅脑损伤患者(均P0.05),而满意率显著高于CON组轻度颅脑损伤患者(P0.05)。EBN组和CON组轻度颅脑损伤患者治疗前生理功能、生理职能、躯体疼痛、总体健康、精力、社会功能、情感职能和精神健康评分的差异均无统计学意义(均P0.05),EBN组患者治疗后生理功能、生理职能、躯体疼痛、总体健康、精力、社会功能、情感职能和精神健康评分均显著高于CON组(均P0.05)。结论循证护理可显著提高轻度颅脑损伤患者疗效及生存质量,值得在临床中广泛推广。     

延续性护理对PCI患者生活质量的影响

目的评估电话延续性护理对PCI患者出院后生活质量的影响。方法研究对象选自2016年11月～2017年11月在武汉大学人民医院心内科三病区住院接受PCI治疗的稳定性心绞痛患者。将患者按入院先后顺序分为干预组和对照组。对照组患者只进行出院宣教,不实施延续护理;干预组患者出院后应用电话随访式延续护理模式进行干预。在术后3个月采用SF-36健康简表评估两组患者的生活质量。结果干预3个月后,与对照组相比,干预组在生理机能(PF)、生理职能(RP)、一般健康状况(GH)、精力(VT)、精神健康(MH)和总分数维度上分数较高,差异具有统计学意义(P 0.01)。结论延续性护理能明显改善PCI患者出院后的生活质量,可作为慢性心血管疾病二级预防的重要组成部分。     

偏瘫患者在家庭康复中采用强制性患肢使用的效果分析

目的观察偏瘫患者在家庭康复中采用强制性使用运动疗法提高患侧上肢功能及日常生活能力的效果。方法将42例经传统康复治疗后出院但上肢功能并未完全恢复正常的脑卒中后偏瘫患者随机分为两组,研究组和对照组各21例,对照组出院后给予常规的康复指导和健康教育,研究组在对照组基础上出院前1周给予强制性使用运动疗法指导,指导其在家庭康复时对患侧上肢进行强制性使用,并采用Wolf运动功能评价量表(WMFT)评定患者的上肢运动功能及改良的Barthel指数(MBI)评定日常生活活动能力。对两组患者治疗后的疗效进行评价。结果对照组患者出院时和出院后1个月WMFT和MBI评分比较差异无统计学意义(P0.05),出院时与出院后3个月WMFT和MBI评分比较差异有统计学意义(P0.05);研究组患者出院时和出院后1个月WMFT和MBI评分比较差异无统计学意义(P0.05),出院时和出院后3个月比较WMFT和MBI评分差异有统计学意义(P0.05)。比较两组出院后3个月WMFT和MBI评分差异有统计学意义(P0.05)。结论在家庭康复中恰当地采用强制性使用运动疗法对于缓解脑卒中患者上肢功能障碍有着重要的作用,但患者需要一定的适应过程,这种方法操作简单,灵活性强,偏瘫患者在家庭康复中的远期效果明显。     

循证护理在高血糖患者中的应用效果及对患者血糖和生存质量的影响

目的探讨循证护理对高血糖患者血糖水平及生存质量的影响。方法将该院自2016年1月至2019年1月收治的95例高血糖患者(空腹血糖水平在12～20mmol/L)作为研究对象,根据入院顺序,将所有患者分为研究组(49例)和对照组(46例)。对照组给予常规控制血糖治疗和常规护理干预,研究组在常规控制血糖治疗的基础上给予循证护理干预。观察两组患者血糖水平改善情况和生存质量。结果经治疗和护理后,两组患者空腹血糖水平均显著降低,差异有统计学意义(P0.05),且与对照组比较,研究组患者空腹血糖水平、血糖降至正常水平所需时间及胰岛素使用量显著降低,而血糖降至正常水平患者数量显著增加,差异均有统计学意义(P0.05);护理后两组患者生理维度、心理维度、社会维度、治疗维度评分及总评分均明显降低,差异有统计学意义(P0.05),且与对照组干预后相比,研究组患者干预后生存质量相关指标评分及总评分均显著降低,差异有统计学意义(P0.05)。与对照组相比,研究组患者的护理满意度显著增加,差异有统计学意义(P0.05)。结论对高血糖患者在常规治疗的基础上实施循证护理能够明显提高患者的治疗效果,降低血糖水平,提高生存质量和护理满意度,效果显著,可推广使用。     

延续护理干预对高血压患者治疗依从性与生存质量的影响

目的:探讨延续护理干预对高血压患者出院后治疗依从性与生存质量的影响.方法:将出院的80例高血压患者采用随机数字表法分为两组,各40例.对照组给予常规出院指导,研究组予以延续护理干预,观察6个月.采用健康状况问卷评定两组患者的生存质量,比较两组的治疗依从率.结果:除生理职能因子分外,研究组健康状况问卷各因子评分均显著高于对照组(P＜0.05或0.01),治疗依从率显著高于对照组(P＜0.01).结论:对高血压患者出院后实施延续护理干预能显著提高患者的治疗依从性与生存质量.     

药物治疗联合综合护理干预对胃肠外科术后患者的影响

目的探讨药物治疗联合综合护理干预对胃肠外科术后患者胃肠功能恢复及早期炎性肠梗阻的影响。方法选取我院2014年10月至2017年11月行胃肠手术的患者240例为研究对象,随机等分为对照组和研究组,对照组给予常规药物治疗联合一般护理,研究组给予常规药物治疗联合综合护理干预,比较两组患者胃肠功能恢复及术后炎性肠梗阻发生情况。结果研究组早期炎性肠梗阻发生情况低于对照组,差异有统计学义(P0.05);研究组肠鸣音恢复时间、排气时间、恢复排便时间及下床活动时间均短于对照组,差异有统计学意义(P0.05);研究组情感职能、生理职能、躯体疼痛、活力、社会功能、健康状况、生理功能、精神健康等评分均高于对照组,差异有统计学意义(P0.05)。结论胃肠外科术后给予患者药物治疗联合综合护理干预可促进术后胃肠功能恢复,降低早期炎性肠梗阻的发生概率,提高患者生存质量。     

综合护理干预对行射频消融术心房颤动患者生活质量的影响研究

选取2014年1月~2015年6月在我院住院行射频消融治疗的房颤患者。按住院时间先后进行随机分配。将单号为试验组,双号为对照组,试验组和对照组各100例。两组患者住院期间按常规进行健康教育,出院后遵医嘱维持治疗。对照组采取常规护理,观察组在常规护理基础上进行综合护理干预。结果显示,两组干预后生理功能(PF)、生理职能(RP)、情感职能(RE)、社会功能(SF)、精神状态(MH)、活力(VT)、健康总体评价(GH)均较干预前明显改善(P0.05),两组治疗后组间比较差异具有统计学意义(P0.05)。射频消融术AF患者通过护理干预可以改善患者的生活质量。为提高患者健康水平,提高其生活质量等提供依据。     

个体化延续护理在改善老年高血压患者生活质量及满意度中的效果分析

目的分析个体化延续护理对老年高血压患者生活质量及满意度的改善效果。方法将124例患有高血压的老年患者随机均分为观察组和对照组,观察组实施个体化延续护理,对照组实施常规护理,分析2组患者出院时及出院后6个月的生活质量及满意度。结果观察组出院后和复诊时的舒张压(SBP)、收缩压(DBP)与对照组比较,差异有统计学意义(P0.05);6个月后进行指标测试,观察组患者的生理职能、基本健康情况、情感职能、精力、精神健康和躯体疼痛6项生活质量指标均高于对照组,差异有统计学意义(P0.05);观察组患者对护理的满意度达88.7%,显著高于对照组的77.4%(P0.05)。结论个体化延续护理能够明显改善老年高血压患者的生活质量,提高护理质量。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

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.     

Interprofessional approaches to creating safe,high quality health care

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.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

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.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Clinical Trial Updates and Hotline Sessions presented at the European Society of Cardiology Congress 2007

This article provides information and commentaries on trials which were presented at the Hotline and Clinical Trial Update Sessions at the European Society of Cardiology Congress 2007 in Vienna. The key presentations were performed by leading experts in the field with relevant positions in the trials or registries. It is important to note that unpublished reports should be considered as preliminary data, as the analysis may change in the final publications. The comprehensive summaries have been generated from the oral presentation and the webcasts of the European Society of Cardiology and should provide the readers with the most comprehensive information of relevant publications.     

Balance and Boundaries in Grief Counseling: An Intervention Framework for Volunteer Training

Volunteers or paraprofessional counselors are commonly used to provide supportive care to the bereaved. These counselors generally are trained in basic listening skills, providing a generic, nonspecific approach to intervention that remains to be proven effective. The present paper outlines a framework that provides paraprofessionals with a broader model for intervention with the bereaved. Attention to boundaries as a helper and balance in the grief recovery are central to the model. Interventions are described that provide the paraprofessional counselor with more options for tailoring their counseling strategy to the individual. These include techniques that are presumed to be more specific to the enhancement of grief recovery.     

Prospects for the control of neglected tropical diseases by mass drug administration

The prospects for the control of neglected tropical diseases, including soil-transmitted helminthiasis, shistosomiasis, lymphatic filariasis, onchocerciasis and trachoma, through mass drug administration, are exemplified by the elimination of the trachoma as a public-health problem in Morocco. In spite of this and other striking successes, mass drug administration programs are faced with major challenges resulting from suboptimal coverage and lack of efficacy. At current suboptimal coverage rates, programs may need prolongation for an extended period, increasing costs and undermining sustainability. Community participation through health education and information appears to be crucial to improve coverage and to achieve sustainability. Implementation of complementary measures, such as vector control, improved hygiene and environmental sanitation, are important to further control transmission and to prevent re-emergence of the infection and, again, may only be achieved effectively through community-based initiatives. To reduce costs and to relieve pressure on the health system, combining neglected tropical disease programs in areas where diseases coexist and integration with existing control programs for malaria, tuberculosis and HIV/AIDS is advocated. The risk of developing drug resistance is of particular concern in view of the lack of alternative drugs, and reduced treatment efficacy due to emerging resistance is evident for the soil-transmitted helminths and onchocerciasis. Given the risk for the development of drug resistance and the need for a high degree of participation, close attention should be paid to the monitoring of the coverage and efficacy of the different program components.     

A new method for the simultaneous analysis of unmodified and modified urinary nucleosides and nucleobases by high performance liquid chromatography

Details are given of a new, rapid and simple pre-fractionation method and an isocratic high performance liquid chromatography system suitable for parallel analysis of nucleosides and nucleobases from urine and other biological fluids. The quantitative recovery and excellent reproducibility of the method is demonstrated by analysis of representative standard RNA catabolites. The advantage of this new method for application to biological samples is discussed.     

Adsorption of Charged Non-albumin Bound Drugs by Amorphous Silica

We investigated the in vitro drug adsorption of PQ 10150 sodium silicate gel (AIS, Santa Clara, CA) with particle size of 230 um and surface area of 400 nr/g. We observed 99% to 88% adsorption of gentamicin; a mean 91 % of disopyramide; a mean 89% of quinidine at low concentration, falling to 75% at higher concentration. Insulin was 88% adsorbed at low concentrations but less so (65%) at higher concentrations. We observed a mean 83 % adsorption of procainamide, a mean 84% of N-acetyl procainamide, 74% oflidocaine, 73% of amitriptyline; and 44% of desipramine. We found an average 14% reduction of total digoxin concentration when serum containing digoxin (2 to 33 ng/mL) was exposed to sodium silicate, while the reduction in free digoxin concentration was 16%. Five percent ethosuximide was also removed. The adsorption of theophylline, phenobarbital, acetaminophen, phenytoin, ethylene glycol, methotrexate, salicylate, thiocyanate and diazepam was minimal and not significant. We conclude that significant amounts of charged, non-albumin bound drugs can be removed by PQ 10150 sodium silicate gel.