自我管理教育对下肢深静脉血栓形成患者的影响研究

目的 探讨自我管理教育在下肢深静脉血栓(DVT)患者中的应用效果.方法 将本科60例DVT患者分为观察组和对照组,两组治疗方法相同,对照组采用常规健康教育,观察组采用自我管理教育,比较两组患者的自我管理行为以及治疗效果.结果 观察组在纠正不良饮食习惯、坚持运动、心理调整等自我管理行为方面的评分均显著高于对照组(P＜0.05).观察组的治愈率及护理满意度评分均显著高于对照组(P＜0.05).结论 自我管理教育能够显著促进DVT患者掌握健康知识,提高自我管理能力和治疗效果.     

多囊卵巢综合征患者自我管理法研究临床效果评价

目的:评价多囊卵巢综合征(PCOS)患者自我管理法研究临床效果.方法:按照随机对照试验研究设计,将150例自愿参加该实验的PCOS患者,随机分为干预组75例和对照组75例.对照组接受常规健康教育课程,干预组接受自我管理课程.比较干预组和对照组患者在实施6个月后自我管理行为、自我效能和体重指数改变情况.结果:在实验组与对照组各变量差值比较中,4项运动管理指标具有统计学意义(P＜0.05);1项饮食管理指标具有统计学意义(P＜0.05);所有依从行为具有统计学意义(P＜0.05);2项自我效能指标具有统计学意义(P＜0.05).体重指数、胰岛素和雄激素的下降幅度明显优于对照组,具有统计学意义(P＜0.05).结论:自我管理法实施6个月后可改善患者的自我管理行为、自我效能及代谢指标,PCOS自我管理法具有较强的实用性,它的实施与推广具有一定的社会意义.     

How to Measure Self-management Abilities in Older People by Self-report. The Development of the SMAS-30

This paper presents the results of two studies carried out in order to design and test a self-report instrument to measure Self-Management Ability (the SMAS-30) in aging individuals. SMA refers to the core behavioral and cognitive abilities which presumably contribute to sustainable well-being in later life. Robust findings of the studies (n=275 and n=1338) showed that SMA could be measured reliably as a composite concept of abilities systematically linked to dimensions of well-being in adults aged 65 and over, with the different sub-scales revealing a profile of inter-related abilities. A sub-sample of participants in Study 2 (n=86) showed that the SMAS-30 had high reproducibility over a period of 16 weeks. The validity of the SMAS-30 was supported by meaningful associations with other constructs in both studies. As expected, the older and frailer the people, and the poorer their perceived health, the lower their SMA. Moreover, SMA was positively related to several dimensions of subjective well-being and the related concepts of general self-efficacy and mastery.     

How to understand and improve older people’s self-management of wellbeing

This paper addresses the question of how older people can be supported to actively self-manage their own process of ageing such that overall wellbeing is achieved and maintained for as long as possible. Starting from a resource-based approach, a new theory of self-management of wellbeing (SMW theory) is proposed, and it is shown how it can be used as a basis for the design of self-management interventions for ageing successfully. The main aspects of the theory, i.e. six key self-management abilities and the core dimensions of wellbeing, are presented as well as the theory-based ‘blueprint’ for the design of interventions. Empirical results of two intervention studies are briefly presented and show that the SMW theory may be a useful tool for the design and evaluation of interventions for successful ageing.

Psychopathology and illness beliefs influence COPD self-management

OBJECTIVE: To explore the influence of psychological characteristics in Chronic Obstructive Pulmonary Disease (COPD) self-management. METHODS: Patients admitted with an exacerbation of COPD were interviewed for psychiatric symptoms, illness beliefs and self-management behaviour using a new COPD Self-Management Interview (COPD-SMI). This comprised three scenarios to mimic a future evolving exacerbation. Responses were scored for knowledge and actions (adherence) for each scenario. RESULTS: Of 47 people approached, 39 participated; 41% had panic attacks, 33% general anxiety, 35% a depression history, 31% an anxiety history and 21% an alcohol dependence history. Twenty-six (67%) had a self-management plan. When hypothetically "well" lower (poorer) COPD-SMI Knowledge Scores were associated with an alcohol dependence history (P=.025), no panic (P=.021) and males (P=.028). Those perceiving less influence over COPD had lower Action Scores during this scenario (P=.01) and the "early exacerbation" scenario (P=.05). Lower Knowledge Scores for the "early exacerbation" were associated with no panic (P=.01) and no self-management plans (P=.03). For the "severe exacerbation", lower Action Scores were associated with depression history (P=.004), panic (P=.002), higher FEV(1)% and no self-management plans (P=.005). Higher PaCO(2) was associated with lower confidence in symptom recognition, self-management ability and medical care influencing COPD. CONCLUSION: Anxiety, depression, alcohol use and illness beliefs may differentially influence self-management. Depression, previous alcohol dependence and perceived less influence over COPD inhibited self-management. Those with panic demonstrated more self-management knowledge when "well" but performed poorly on actions during the "severe exacerbation". Those with self-management plans had better knowledge and actions.     

护理干预对持续非卧床性腹膜透析患者自我管理能力的影响

目的:探讨护理干预对持续非卧床性腹膜透析(CAPD)患者自我管理能力的影响.方法:选择2008年5月～2009年2月在我院腹膜透析中心行CAPD治疗的53例门诊患者,采用自行设计的问卷,于干预前、干预后3个月进行调查.结果:护理干预后患者对腹膜透析相关知识及自我管理能力比较差异有统计学意义(P＜0.05).结论:护理干预可以改善患者的自我管理能力,提高腹膜透析治疗质量及患者生存质量.     

自我管理教育对康复期精神分裂症患者的影响

目的 探讨自我管理教育对康复期精神分裂症患者治疗依从性等是否有积极的影响。方法 选取2018年7月至2019年7月无锡市精神卫生中心诊治的康复期精神分裂症患者120例为观察对象，依据护理方式不同分为研究组和对照组，每组各60例。对照组给予常规护理；研究组在常规护理基础上再给予自我管理教育护理。比较干预后两组患者的生活质量（SQLS）评分、用药依从性、疾病复发率、简明精神病评定量表（BPRS）评分、社会功能缺陷筛选量表（SDSS）评分以及自我护理能力评分。结果 研究组患者SQLS量表中心理社会、动力和精力、症状和副作用3个分量表的评分均低于对照组，治疗后用药依从性高于对照组，疾病复发率低于对照组，护理前，两组BPRS、SDSS评分比较不存在显著差异性（P＞0.05），护理后一周研究组BPRS、SDSS评分明显低于对照组，差异均有统计学意义（均P＜0.05）。结论 对康复期精神分裂症患者应用自我管理教育，对患者用药依从性等产生积极影响，有助减少疾病复发率，进而改善生活质量。     

The case for stepped care for weight management after bariatric surgery

Among carefully screened patients, bariatric surgery has proven safe and efficacious in the management of clinically severe obesity and poorly controlled type 2 diabetes. Nonetheless, individual outcomes vary, suggesting the need for interventions to maximize and sustain the health benefits of surgery. In this short review, we synthesize findings from the extant research literature to suggest the potential utility of a stepped care approach to optimize the postsurgery weight trajectory, which requires further research using adaptive designs. Starting with low-intensity, cost-effective interventions, such as self-weighing and self-monitoring, interventions that increase in intensity, such as counseling, meal replacements, or weight loss medications, could be added strategically according to predetermined decision rules based on patient weight change. Interventions could subsequently be withdrawn if no longer indicated, or reinstituted when appropriate, allowing for efficient allocation of resources in a personalized approach to postsurgery weight management over time.