耳鼻喉科用药知识宣教中的问题及对策

目的 在对耳鼻喉科病人进行用药知识教育的过程中,发现一些问题并制定出相应的措施,为更好地对住院病人进行用药知识教育提供了参考.方法 根据临床所遇问题自行设计问卷,问卷包括对用药知识内容是否满意、宣教时机是否合适、宣教方法是否得当,以及病人对药品知识的掌握情况等.对耳鼻喉科300名患者实行不记名填写方式进行调查.发放300份,回收300份,回收率100%,有效问卷300份,正确率100%.结果 人们的法律意识、自我保护意识和维权意识不断增强,但医护人员在这方面的意识却明显滞后,临床工作中还是以医疗行为为主导,存在宣教时机不当、方式呆板、效果不佳、内容不能因人而异、病人对宣教人员信任度偏低等问题.结论 用药知识教育是健康教育的一个重要方面,是病人康复中不可缺少的,因此,我们应因人而异、选择合适的时机、采用多样的方式、加强护士自身素质的培养、增加交流,从而提高宣教效果.     

耳鼻喉科用药知识宣教中的问题及对策

目的在对耳鼻喉科病人进行用药知识教育的过程中，发现一些问题并制定出相应的措施，为更好地对住院病人进行用药知识教育提供了参考。方法根据临床所遇问题自行设计问卷，问卷包括对用药知识内容是否满意、宣教时机是否合适、宣教方法是否得当，以及病人对药品知识的掌握情况等。对耳鼻喉科300名患者实行不记名填写方式进行调查。发放300份，回收300份，回收率100％，有效问卷300份，正确率100％。结果人们的法律意识、自我保护意识和维权意识不断增强，但医护人员在这方面的意识却明显滞后，临床工作中还是以医疗行为为主导，存在宣教时机不当、方式呆板、效果不佳、内容不能因人而异、病人对宣教人员信任度偏低等问题。结论用药知识教育是健康教育的一个重要方面，是病人康复中不可缺少的，因此，我们应因人而异、选择合适的时机、采用多样的方式、加强护士自身素质的培养、增加交流，从而提高宣教效果。     

健康教育内容及方法的调查分析

[目的]选择合适的健康教育内容、方式和时机,以提高健康教育水平.[方法]采用自行设计问卷的形式对住院的586例病人进行调查分析.[结果]有效问卷568份,病人在健康教育内容方面对饮食知识、药物注意事项有较高的需求;在健康教育方式上有85.56%的病人认为采取个别交谈的方式好;认为病情稳定后和环境安静时进行健康教育较合适.[结论]选择合适的健康教育内容、方法及时机有利于提高健康教育水平及病人疾病的康复.     

PICC病人健康教育效果评价及需求调查

[目的]对经外周静脉穿刺置入中心静脉导管(PICC)病人健康教育效果进行评价,了解PICC置管病人的健康教育需求,为制定有效的PICC置管肿瘤病人的健康教育措施提供参考依据。[方法]应用自行设计的PICC知识技能掌握调查问卷评估健康教育效果。[结果]调查对象对导管的风险认识不足,对维护知识掌握不全面,宣教知识来源较单一。[结论]对导管的风险及并发症内容宣教不够全面,并且宣教方式单一,没有形成系统的宣教体系。针对调查结果,制定改善措施:制定PICC健康宣教临床路径和宣教规范内容,采用多样化的健康教育途径提高宣教质量和病人学习的兴趣。     

开腹术后病人自控镇痛泵应用的常见问题及护理对策

[目的]探讨开腹术后病人使用自控镇痛泵(PCA)过程中常见问题的原因分析及护理对策,给健康教育提供依据.[方法]自设访谈问卷,使用访谈法收集50例开腹术后使用PCA病人的临床资料,问卷内容包括病人一般资料、使用PCA期间出现的问题及病人对PCA的宣教内容、时间、方式等的需求.[结果]在使用过程中最常出现的问题是恶心、呕吐,100%的病人认为应向其宣教有关PCA的使用方法和注意事项,86%的病人选择术前进行宣教,52%的病人选择口头宣教.[结论]常规宣教尚不能满足开腹术后病人需要,应在宣教内容、时间和方式上进行完善,同时护理人员也应不断加强有关PCA知识的再培训,避免由于PCA使用不当所致问题的发生.     

初治肺结核病人对健康教育需求的调查分析

目的:了解初治肺结核病人对健康教育知识的需求,探讨有效的宣教方式与内容。方法:采用自行设计的调查问卷,对98例门诊结核病人就结核病的一般知识、化疗知识、临床检查知识及知识需求途径四部分的16个问题进行调查分析,并针对存在的问题,提出相应的护理干预措施。结果:化疗及临床检查方面的知识需求最为迫切,占调查人数的90%以上。宣教方式主要是要求医护人员讲解及发放健康手册,占70%以上。结论:必须针对病人对疾病相关知识的需求,制定可行的健康教育计划,及时为病人提供有效的健康教育信息。     

采用问卷考核法强化宣教在临床护理路径中应用效果

目的探讨采用问卷考核法强化宣教在临床护理路径中的应用效果。方法选择进入临床护理路径的乳癌病人160例,分为对照组和实验组各80例。对照组常规由责任护士依照护理教育路径表进行护理宣教,实验组在此基础上对病人进行宣教知识考核并强化指导。出院前对两组病人进行效果评价及满意度调查。结果实验组健康教育内容知晓率及护理满意度明显高于对照组,差异有统计学意义（t=6.39～10.26,uc=2.98,P〈0.05）。结论采用问卷考核法强化宣教能显著提高病人对健康教育内容的知晓率及对护理质量满意度,利于临床护理路径开展和病人康复。     

产科病室健康教育缺陷原因分析及防范

“以人为本,以病人为中心”的医学模式,强调对人的生理、心理、精神、文化的统一整体犤1犦,强调病人从入院到出院的整体护理过程。产科又具有其特殊性,产妇的心理需求会随产程进展而变化。所以,关注孕产妇的心理变化,提供必要的心理咨询和指导,满足不同个性的心理需求,减轻其心理压力,消除焦虑、恐惧情绪,从而减少因心理障碍而引起的产科并发症,提高围产保健质量。1对象与方法1.1对象2004年6～12月份的产科住院产妇中随机抽取248人,为调查对象。1.2方法采用自行设计问卷调查表,产妇入住产科后由责任护士发放问卷调查表,并详细介绍问卷内容后,请产妇填写。不能填写者,由产妇口述家属代笔。收回问卷后进行统计、分析。共发放问卷248份、收回241份,有效问卷241份,有效率100%。2结果宣教时机不当占49.6%,宣教内容不详细占21.5%,宣教呆板、缺乏语言艺术占25.3%,宣教时不文明体语占15.4%,不因人施教、方法单一占13.4%。3分析3.1宣教时机不当病人刚入院时心情未稳定,对环境的变化和角色的转变未适应,这时接待护士急于给予入院宣教,且内容单一,多以入院规定、住院期间注意事项、产妇如何自我保护等知识为主,未结合产妇...     

临床医生对病人安全的认知现状调查与分析

目的调查临床医生对病人安全的认识现状及重视度,分析存在的问题,推测可能的原因,为开展病人安全教育提供可靠依据。方法随机抽取以四川大学华西医院为主的四川省三甲医院的临床医生进行问卷调查。以匿名问卷,采取调查员指导下,被调查者自填调查表的方式收集资料。结果发放调查问卷300份,收回有效问卷258份,回收率86％。调查结果显示,临床医生对病人安全知识的理解度较低,但门诊部医生理解度优于住院部医生。95．00％以上的医生愿意主动学习病人安全知识。结论针对临床医生对病人安全认知度偏低但愿意主动学习相关知识的趋向,有必要对临床医生和医学生开展病人安全知识教育。     

应用临床护理路径对青光眼病人进行健康教育

目的:探讨对青光眼病人进行健康教育的最佳方式和效果。方法:将近三年来就诊的163例青光眼病人随机分为观察组82例和对照组81例。观察组给予临床护理路径进行健康教育,对照组采用一般健康教育宣教方式,然后自行设计问卷进行青光眼疾病知识、用药知识和自我保健等方面的测试,并比较两组病人的再次发病率和视力情况。结果:应用临床护理教育路径进行健康教育组的知识测试成绩明显较对照组的知识测试成绩好,差异有显著意义(P<0.01);观察组病人的再次发病率降低,差异有显著意义(P<0.05)。结论:开展临床护理路径进行健康教育效果明显优于一般健康教育方式。     

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.     

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.     

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.     

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.     

Bacterial meningitis: an update of new treatment options

The outcome of bacterial meningitis critically depends on the rapid initiation of bactericidal antibiotic therapy and adequate management of septic shock. In community-acquired meningitis, the choice of an optimum initial empirical antibiotic regimen depends on the regional resistance patterns. Pathogens resistant to antibacterials prevail in nosocomial bacterial meningitis. Dexamethasone is recommended as adjunctive therapy for community-acquired meningitis in developed countries. In comatose patients, aggressive measures to lower intracranial pressure <20 mmHg (in particular, external ventriculostomy, osmotherapy and temporary hyperventilation) were effective in a case–control study. Although many experimental approaches were protective in animal models, none of them has been proven effective in patients. Antibiotics, which are bactericidal but do not lyse bacteria, and inhibitors of matrix metalloproteinases or complement factor C5 appear the most promising therapeutic options. At present, vaccination is the most efficient method to reduce disease burden. Palmitoylethanolamide appears promising to enhance the resistance of the brain to infections.