围手术期病人健康信息需求的调查分析

为了进一步探讨外科病人围手术期健康教育的需求,解决在围手术期影响治疗和康复的诸多心理危机,对１０４例外科住院病人进行了调查分析,从而找出病人的需求和方法。并根据病人的需求,采用正确的护理干预手段,通过三期（手术前、手术中、手术后）健康教育,从中制定各种疾病的适合个体化的健康教育计划、提供不同层次病人健康教育与咨询服务,有效地通过病人的满意度,促进病人术后康复,使整体护理更加完善。     

前列腺增生患者围手术期健康教育需求调查分析

目的探讨前列腺增生症患者围手术期健康教育需求。方法采用自制调查表对200例前列腺增生症患者围手术期进行健康教育相关知识需求调查，进行针对性健康教育。结果患者在围手术期对健康教育的需求程度达70％；对疾病、手术、预防并发症及保健知识相关知识需求达85％。结论围手术期对患者进行针对性的健康教育，能提高患者对健康教育的认识及改变不良生活方式和行为。     

痔疮患者围手术期护理需求调查与分析

目的了解痔疮患者围手术期对护理及健康知识需求的特点，以便更好地满足患者的需要，提高护理服务质量。方法采用自行设计的问卷，调查102例痔疮患者围手术期的护理需求。结果围手术期患者认为与疾病相关知识最为重要，其次为心理需求、术前常识、术后处置等方面。结论护理人员可依据痔疮患者围手术期不同阶段的需求实施健康教育，满足患者的需求，促进其早日康复。     

整形美容求美者围手术期护理心理需求调查

目的：了解整形美容求美者围手术期对心理护理及健康知识需求的特点,以便更好提高护理服务质量。方法：调查本科室978名求美者围手术期的心理护理的需求。结果：围手术期求美者心理恐惧、焦虑、知识得分45%属于中等,就医前与医护沟通处以较好水平,整形美容求美者学历大专以上占75%,处于较高知识层面。结论：护理人员可依据整形美容求美者围手术期不同阶段的心理需求实施健康教育,满足美容求美者的需求,促进其早日康复。     

脊柱侧凸患儿与家属围手术期健康教育需求研究

目的提高脊柱侧凸矫形围手术期健康教育的针对性。方法发放自行设计的调查表，内容包括患儿与家属的个人情况，围手术期健康教育内容与方法需求情况，调查了拟行矫形手术患儿与家属各63例，采用访谈式调查。结果63例患儿及其家属对教育方式的选择具有多样性。与医护人员个别交谈是两首选的教育方法：两对手术相关知识很想了解的人数比例在50％以上，家属的需求欲望明显强于患儿。结论63例患儿与家属围手术期健康教育需求很高，在临床健康教育过程中必须考虑到患儿的年龄特点。把患儿与家属同时作为健康教育的对象，在评估需求的基础上，针对手术治疗的不同阶段，实施多样化教育，提高临床健康教育效果。     

胃肠道疾病围手术期病人健康教育需求的调查

目的 通过对胃肠道疾病围手术期病人健康教育需求的调查,为提高健康教育质量提供依据.方法 采用自行设计的调查问卷对50例胃肠道围手术期病人进行调查.结果 入院宣教中,92%病人最需要了解主管医生、责任护士情况及自身疾病现状和预后;术前宣教中78%以上病人需求手术适应性训练的知识;术后宣教中,96%以上病人强烈需求配合治疗、减轻痛苦的康复知识.75%高中以上文化程度病人有心理卫生需求.结论 根据病人健康教育需求的特点,应采取全程分期的健康教育模式,因人施教,从而提高健康教育质量,增强胃肠道疾病围手术期病人的手术适应能力,促进病人早日康复.     

胃肠道疾病围手术期病人健康教育需求的调查

目的 通过对胃肠道疾病围手术期病人健康教育需求的调查,为提高健康教育质量提供依据.方法 采用自行设计的调查问卷对50例胃肠道围手术期病人进行调查.结果 入院宣教中,92%病人最需要了解主管医生、责任护士情况及自身疾病现状和预后;术前宣教中78%以上病人需求手术适应性训练的知识;术后宣教中,96%以上病人强烈需求配合治疗、减轻痛苦的康复知识.75%高中以上文化程度病人有心理卫生需求.结论 根据病人健康教育需求的特点,应采取全程分期的健康教育模式,因人施教,从而提高健康教育质量,增强胃肠道疾病围手术期病人的手术适应能力,促进病人早日康复.     

普外科围手术期病人健康教育需求调查分析

为探讨普外科手术病人的健康教育需求，解决围手术期影响手术治疗和康复的诸多因素，对116例手术病人进行调查分析，从而了解病人健康教育的需求，提高健康教育质量。     

胆道疾病围手术期患者健康信息需求调查分析

目的:探讨胆道疾病围手术期患者的健康教育需求的特点,为患者实施个性化、全程、优质的健康教育提供理论依据。方法:对98例胆道系统疾病患者采用自制健康信息需求调查表进行调查。结果:胆道疾病围手术期患者在住院各阶段健康教育需求程度均较高。术前,患者比较关注与手术成功密切相关的信息;术后,则关注手术是否成功及术后注意事项,并希望医务人员给予健康指导。不同年龄、不同文化程度患者,其术前、术后健康教育需求不同。结论:对胆道疾病围手术期患者需求采取形式多样的健康教育方式,开展阶段性、个性化的健康教育。     

脊柱侧凸围手术期健康教育效果调查与分析

目的　针对脊柱侧凸患者的特点 ,探讨围手术期健康教育面临问题与提高健康教育效果的对策。方法　通过自行设计的认知与需求调查表 ,分别调查 6 8例已行矫形手术的康复期患者对手术治疗的认知及 6 3例拟行矫形手术的住院期患者与家属对手术治疗的认知及两者对围手术期健康教育内容与方式的需求状况。结果　接受常规健康教育的康复期患者及拟行手术治疗的患者及家属对手术认知偏低 ;拟行手术的患者与家属对手术相关知识迫切希望掌握人数比例超过 5 0 % ,且家属的需求欲望明显强于患者 ;与医护人员个别交流是两者首选的教育方式。结论　建议在评估认知与需求基础上 ,开展患者与家属兼顾的围手术期健康教育     

重性精神病患者封闭式住院治疗期间心理需求分析

目的了解封闭式管理重性精神病患者住院治疗期间心理需求。方法采用便利抽样法,2017年3月—2018年3月选取四川省精神卫生中心封闭式管理的81例重性精神病患者为研究对象,采用自行设计的重症精神病患者心理需求调查问卷进行调查,调查患者自知力、住院治疗自我归因、希望解决的问题等心理需求状况,分析患者心理需求的影响因素。结果81例患者中33.33%(27/81)的患者认为自己患病,对于本次住院治疗39.51%(32/81)的患者归因于自己性格原因,归因于情感问题占17.28%(14/81);心理需求中,希望有家人的陪伴和探视占79.01%(64/81),有心理治疗需求占62.96%(51/81);最想解决的问题中,35.80%(29/81)的患者希望治好疾病,需要提高自信心的患者只占4.94%(4/81)。不同疾病诊断的患者在希望家人陪伴和探视的需求中差异有统计学意义(P<0.05)。不同性别患者在自身疾病相关知识的需求中差异有统计学意义(P<0.05)。不同文化程度的患者对提升压力应对能力需求的差异有统计学意义(P<0.05)。结论封闭式管理重性精神病患者住院治疗期间有较多心理需求,不同性别、文化程度、疾病诊断患者的需求不同,要有针对性地提供心理干预及护理,促进患者尽快康复。     

Identifying elective orthopedic surgical patients transfused with amounts of blood in excess of need: the transfusion trigger revisited

The discharge hematocrit has been analyzed as a clinical indicator of the transfusion trigger by which to identify patients undergoing elective orthopedic surgery who were transfused with blood in excess of need. The volume of red cells lost by each patient during surgical hospitalization was compared to the volume of red cells transfused. Three clinical indicator levels were considered. Red cell losses of 10, 20, and 30 percent of each patient's baseline red cell volume at admission were considered to be appropriate before subsequent blood transfusion replacement, representing generous, intermediate, or strict clinical indicator levels, respectively. With Level I as a generous clinical indicator, 110 (25%) of 525 patients were transfused in excess of blood needs; by Level II (intermediate) and Level III (strict) criteria, 221 (42%) and 314 (60%) of 525 patients, respectively, were transfused in excess of blood needs. Significant differences were found for transfused patients analyzed by gender (26% of women vs. 13% of men; Level I, p less than 0.001) and preoperative autologous blood donation (25% of autologous blood donors vs. 11% of those who did not donate autologous blood; Level I, p less than 0.001). It can be concluded that the discharge hematocrit and amount of blood lost during hospitalization can be used as clinical indicators with which to identify patients receiving transfusions in excess of needs in the elective surgical setting. With this method, it was found that the transfusion trigger is different for women and for men as well as for autologous blood donors and those who did not donate autologous blood undergoing elective orthopedic surgery [corrected].     

Physical activity during hospitalization: Activities and preferences of adults versus older adults

ABSTRACT

Objective: Inactivity during hospitalization leads to a functional decline and an increased risk of complications. To date, studies focused on older adults. This study aims to compare the physical activities performed by older adult and adult hospitalized patients. Methods: Patients hospitalized for >3 days at a university hospital completed a questionnaire regarding their physical activities (% of days on which an activity was performed divided by the length of stay) and physical activity needs during hospitalization. Crude and adjusted comparisons of older adult (>60 years) and adult (≤60 years) patients were performed using parametric testing and regression analyses. Results: Of 524 patients, 336 (64%) completed the questionnaire, including 166 (49%) older adult patients. On average, the patients were physically active on 35% or less of the days during their hospitalization. Linear regression analysis showed no significant associations between being an older adult and performing physical activities after adjusting for gender, length of stay, surgical intervention, and meeting physical activity recommendations prior to hospitalization. Most patients were well informed regarding physical activity during hospitalization; however, the older adult patients reported a need for information regarding physical activities after hospitalization more frequently (odds ratios, 2.47) after adjusting for educational level, gender, and physical therapy during hospitalization. Conclusions: Both older adult and adult patients are physically inactive during hospitalization, and older adult patients express a greater need for additional information regarding physical activity after hospitalization than adult patients. Therefore, personalized strategies that inform and motivate patients to resume physical activities during hospitalization are needed regardless of age.     

外科ICU患者精神障碍危险因素分析与人性化护理干预

目的:研究外科ICU危重患者精神障碍发生率、出现精神障碍的危险因素,采用人性化护理干预对ICU危重病人精神障碍的影响。方法:对113例外科ICU危重病人采用简明精神状态检查量表与意识障碍评估方法进行评估,获取52例出现精神障碍患者,将52例患者采用人性化护理干预,比较干预前后MMSE和CAM的评分。结果:外科ICU危重患者精神障碍发生率24.7%,且随年龄增大发病率明显增加;住院天数、环境改变、使用镇静药物等是发生精神障碍的危险因素;人性化护理干预后的MMSE和CAM的评分差别具有统计学意义(P<0.05)。结论:重视外科ICU危重病人发生精神障碍的危险因素,积极采用人性化护理干预,促进患者早日康复。     

Patient outcomes beyond hospitalization: carotid endarterectomy surgical patient outcomes after a rapid recovery program

Improved surgical techniques for carotid endarterectomy (CEA) surgical patients have resulted in improved postoperative hemodynamic stability of patients and reduced lengths of hospitalization. The purpose of this pilot project was to determine CEA patient outcomes after a rapid recovery hospitalization program. Thirty-nine patients were enrolled in the study and contacted at 1 month after CEA surgery to examine carotid occlusive disease clinical symptoms, functional status, atherosclerotic disease risk-factor reduction, and patient satisfaction. Findings of the pilot study demonstrated that CEA surgical patients were able to resume physical and psychosocial functioning by 1 month after surgery at levels comparable to preoperative functioning. Subjects reported relief of carotid artery occlusive disease symptoms and reported high levels of independent functioning and satisfaction with CEA surgery. Men in the study had significantly higher levels of reported independence in functioning compared with the women, using a "0" to "10" scale to rate level of functioning independence. Findings from the pilot study will be used to develop an early recovery and atherosclerotic disease risk-factor modification program for CEA surgical patients.     

Privacy in hospital

Privacy during hospitalization can be jeopardized as caring situations are often intimate. The aims of the current study were to explore patients' and nurses' attitudes towards privacy and to study whether nurses' perceptions of patients' privacy needs corresponded with the patients' own reported needs. Two questionnaires were used for the data collection, which included 120 consecutive patients and 42 nurses responsible for the participating patients' individual care. The main findings indicated that patients and nurses agree in the ratings of the major components of privacy in general, but privacy in hospital was estimated more highly by the nurses than by the patients themselves. Being allowed to talk to the physician in private was given the highest preference. Patients in long-term care had higher privacy preferences than those in acute care. An explanatory approach is needed to study the need for privacy in different caring situations and how privacy needs could be recognized and met by nurses.     

Clinical characteristics of hospitalized diabetic patients

In an inpatient diabetes control unit established to fulfill the special needs of hospitalized diabetic patients, 29% of the admissions were for control of diabetes. In 71% the metabolic abnormalities of diabetes were incidental to the cause of admission. Of the first 232 patients, 162 had type II diabetes. The degree of hyperglycemia in the type II patients was virtually identical to that in the type I patients, as measured by hemoglobin A1C levels at admission and by mean blood glucose values in the hospital. The mean hemoglobin A1C level at admission was 9.1% in both groups (normal 3.2 to 6.1). During hospitalization the patients admitted for medical and surgical problems achieved average blood glucose levels similar to levels in those who were admitted strictly for diabetes control. Regardless of the reason for admission, hospitalization of a diabetic patient is an opportunity for improvement in metabolic control and for patient education.     

华西心晴指数对老年手术患者住院时间、住院费用及满意度的评估价值

  目的  探讨华西心晴指数(Huaxi emotional-distress index, HEI)对老年手术患者住院时间、住院费用及满意度的评估价值。  方法  回顾性收集并分析四川大学华西医院麻醉科老年患者数据库2015年10月至2018年6月间患者的临床资料, 包括性别、年龄、文化程度、美国麻醉医师协会(American Society of Anesthesiologists, ASA)分级、是否为恶性肿瘤、手术科室、术前简易智力状态评估量表Mini-cog评分、Katz指数、HEI分级(1~4级)及不良情绪等观察指标, 分析HEI与住院时间、住院费用、患者满意度的相关性。  结果  共入选565例符合纳入和排除标准的老年患者, 性别、年龄、文化程度、ASA分级、是否为恶性肿瘤、手术科室、Mini-cog评分等在HEI不同分级之间及有/无不良情绪两组间的差异均无统计学意义(P均>0.05)。不良情绪组患者的住院时间更长(P=0.003)、日均住院费用更高(P=0.001), 且HEI分级越高住院时间越长(P=0.000)。HEI分级和有/无不良情绪均与术后第7 d患者满意度相关(P均 < 0.05), 有不良情绪组术后7 d满意度更低。  结论  HEI可较好预测老年手术患者的住院时间、日均住院费用及患者满意度。