不同病情程度下类风湿关节炎患者自我管理能力比较

目的:比较不同病情程度下类风湿关节炎患者自我管理能力.方法:选取2014年6月至2015年6月我院收治的类风湿关节炎患者80例,依据病情程度分为重度组、中度组、轻度组,比较三组患者的自我管理知识评分、能力评分及达标率.结果:重度组、中度组、轻度组患者的自我管理知识评分、能力评分均依次升高,达标率分别为54.17％、64.29％、78.57％,以上差异均具有统计学意义(P＜0.05).结论:类风湿关节炎病情越严重患者自我管理能力越低,医护人员应加强健康教育,提高患者自我管理能力.     

多元化护理在精神分裂症患者自我管理中的应用探讨

目的 探讨精神分裂症患者应用多元化护理干预对治疗效果及自我管理行为的影响. 方法 整群选择该院于2013 年8月—2015 年3月期间收治的84例精神分裂症患者作为研究对象,随机分为对照组(42例)和观察组(42例).两组患者均在该院接受抗精神病药物治疗,期间两组按常规护理,观察组增加多元化护理干预,比较两组患者的自我管理能力及治疗效果. 结果 干预后,观察组PANSS评分显著低于对照组,组间差异有统计学意义(P<0.05). 自我管理能力评分比较:干预后,在日常生活自理、医嘱行为遵守、心理自我调节、社会生活能力方面,观察组评分均显著高于对照组,组间差异有统计学意义(P<0.05).SDSS评分:干预后,观察组(12.36±3.95)分,对照组(24.48±5.74)分,组间差异有统计学意义(P<0.05). 结论 精神分裂症患者应用多元化护理干预,可有效提升患者自我管理能力,有助于改善患者预后.     

探究授权教育在改善冠心病病人自我管理效能的护理价值

目的：探究授权教育在改善冠心病病人自我管理效能的护理价值。方法整群选取该院2014年2月—2015年8月收治的冠心病行支架植入术治疗的患者88例依据随机平均原则划分为对照组和观察组,两组患者均接受常规护理干预,对照组44例患者在此基础上采取传统教育,观察组44例患者采取授权教育。对两组患者干预前后自我管理效能情况的变化进行记录与比较。结果观察组教育后CSMS评分(93.2±2.4)分较教育前(81.7±1.9)分显著提升, t=6.47,P=0.002<0.01;对照组教育后CSMS评分(86.2±2.9)分较教育前(81.6±1.4)分显著提升,t=4.28,P=0.009<0.01;观察组教育后CSMS评分(93.2±2.4)分显著优于对照组(86.2±2.9)分,t=3.94,P=0.012<0.05。结论对行支架植入术治疗的冠心病患者在常规护理干预的基础上实行授权教育,对于改善患者的自我管理效能有重要作用,可提升患者的自我管理水平,值得临床推广与应用。     

Self-management support programs for persons with Parkinson’s disease: An integrative review

ObjectiveTo identify the characteristics of self-management programs for persons with Parkinson’s disease and the evidence for their effectiveness.MethodsAn integrative literature review was conducted. Studies describing the provision or outcomes of self-management interventions for persons with Parkinson’s disease and published in English were included. Two reviewers independently screened and evaluated articles. Interventions were described and compared, and evidence was presented using The Traffic Lighting system.ResultsEighteen interventions were identified, representing a variety of group- and individual-based interventions that differed in structure, components, and outcomes. Notably, 89% were designed specifically for persons with Parkinson’s disease and 39% combined self-management support with other therapies. Evidence to support specific self-management programs for persons with Parkinson’s disease was limited. However, a moderate quality systematic review and a good quality RCT supported self-management for improving specific domains of quality of life.ConclusionsA variety of interventions have been designed to support self-management by persons with Parkinson’s disease. More research is needed to identify key active ingredients and determine which programs are most effective.Practice implicationsSelf-management programs embedded within rehabilitation are promising. Clinicians should ensure programs include goal setting and problem solving and consider the inclusion of caregivers and peer support.     

社区糖尿病患者自我管理的现状及护理对策

目的:调查分析基层社区糖尿病患者自我管理的现状,探讨有效的护理对策。方法:对2 215名中老年人体检筛查出180例糖尿病患者,采用调查问卷的方式,对糖尿病的认知程度、情绪调控能力、健康饮食方法、自我管理能力、自我责任感、遵医用药情况、控制交叉感染的方法、以及不良生活行为方式等内容进行问卷调查。结果:发现基层社区患者存在对疾病认识不足,糖尿病患者病情的反复与过度劳累、不合理饮食、情绪异常波动等都有关系,严重影响疾病的治疗和康复。结论:护理干预对强化糖尿病自我管理,保持病情的相对稳定,减缓病情的发展有重要意义。     

跨理论模型的健康教育对慢性阻塞性肺疾病患者自我管理的影响

目的探讨跨理论模型的健康教育对漫性阻塞性肺疾病（c（）PD）患者自我管理的影响。方法将100例COPD患者随机分成干预组和对照组各50例，干预组采用跨理论模型的健康教育方式，对照组采用常规健康教育。在出院后4，12，24周采用自我管理量表对患者进行评价。结果干预后4，12，24周干预组自我管理得分改变均高于对照组，差异有统计学意义。结论依据跨理论模型的健康教育可以提高COPD患者的自我管理能力。     

Self-management support at the end of life: Patients’, carers’ and professionals’ perspectives on managing medicines

BackgroundPain is a frequently reported symptom by patients approaching the end of life and well-established that patients and carers hold fears relating to opioids, and experience side effects related to their use. The management of medicines is intrinsic to achieving effective pain relief. The concept of self-management support whilst well characterised in the context of chronic illness has not been elaborated with respect to end of life care.AimTo identify patient, carer and professional views on the concept of self-management support at end of life, specifically in relation to analgesia and related medicines (for side-effect management) in order to describe, characterise and explain self-management support in this context.Methodology & methodsQualitative design, data collection methods involved focus groups and interviews. Topics included the meaning of self-management support in this context, roles and behaviours adopted to manage pain-related medicines, and factors that influence these. A largely deductive approach was used, involving verification and validation of key frameworks from the literature, but with capacity for new findings to emerge.SettingParticipants were drawn from two different localities in England, one North, the other South. Interviews with patients and carers took place in their own homes and focus groups with healthcare professionals were held at local hospices.Participants38 individuals participated. 15 patients, in the last year of life, and 4 carers under the care of community-based specialist palliative care services and 19 specialist palliative care health professionals (predominantly community palliative care nurses).FindingsThe concept of self-management support had salience for patients, carers and specialist nurses alongside some unique features, specific to the end of life context. Specifically self-management was identified as an ever-changing process enacted along a continuum of behaviours fluctuating from full to no engagement. Disease progression, frequent changes in symptoms and side-effects, led to a complex web of roles and behaviours, varying day by day, if not hour by hour. Data confirmed previously proposed professional roles were enacted to support self-management. Furthermore, as patients, carers and clinical nurse specialists worked together to achieve effective pain management, they enacted and inter-acted in the roles of advocate, educator, facilitator, problem solver, communicator, goal setter, monitor and reporter.ConclusionsThe study has demonstrated what self-management support at end of life entails and how it is enacted in practice.     

护理延伸服务对泌尿系结石患者自我管理的作用

目的评价护理延伸服务对泌尿系结石患者自我管理能力的作用。方法将116例泌尿系结石患者随机分成观察组和对照组各58例,住院期间均予以常规护理和健康宣教,观察组出院后分阶段、持续进行护理延伸服务(定期电话回访、家庭访视、群体教育、患者交流会),对患者自我管理能力进行干预;随访2年后观察两组在掌握疾病相关知识情况、自我管理能力、结石复发率方面的差异。结果观察组患者掌握疾病相关知识情况、自我管理能力等方面均优于对照组,结石复发率明显低于对照组,两组比较有显著性差异(P<0.01)。结论护理延伸服务可以提高患者自我管理能力,在一定程度上避免结石的反复发作。     

综合干预对社区糖尿病患者自我管理能力的影响

目的：探讨综合干预措施对社区糖尿病患者自我管理能力的影响。方法：对42例某社区糖尿病患者进行综合干预，包括疾病知识的教育、饮食指导、运动指导、药物指导、心理指导。采用自制自我管理问卷分别在干预前和干预后6个月进行测试，比较干预前、后患者的自我管理能力。结果：42例社区糖尿病患者给予综合干预措施后自我管理能力得分在合理饮食、服药、血糖监测、合理运动、低血糖的预防及处理、健康知识的获取及总得分方面均高于干预前，差异具有统计学差异（P〈0．05）。结论：在社区开展科学、合理的综合干预措施对提高糖尿病患者自我管理能力，预防严重并发症，改善生活质量具有不可忽视的作用。