糖尿病教育对提高社区病人遵医行为效果的研究

目的评价社区糖尿病健康教育对提高糖尿病病人遵医行为的效果。方法以社区糖尿病病友联谊会的活动形式,对社区糖尿病病人进行系统的糖尿病教育和生活干预。一年半后,使用问卷调查、收集96例完整的社区糖尿病病人资料,调查分析病人接受教育前后对糖尿病基本知识、糖尿病饮食知识的认知变化,血糖的控制情况,生活干预后的遵医行为,结果经SPSS软件处理,进行比较。结果本组病人接受教育后,对糖尿病的认知水平显著提高(P<0.05),遵医嘱用药、控制饮食、自我监测血糖、定期复诊等方面的遵医率高于接受教育前(P<0.05)。血糖控制达标及尚好率>50%,远高于教育前统计资料25.4%(P<0.01)。结论社区医疗卫生服务机构以“病人联谊会活动”形式开展社区糖尿病病人教育,对提高病人遵医意识和行为是切实可行的,能提高糖尿病血糖良好控制达标率,达到糖尿病的二级防治的目的,是社区医疗的方向之一。     

健康教育对支气管哮喘患者用药依从性的影响

目的分析健康教育对哮喘患者用药依从性的影响;探讨健康教育在哮喘病情控制和哮喘治疗中的疗效。方法将60例成人支气管哮喘住院患者根据入院先后顺序随机分为两组,每组30例,对入院前6个月回顾调查、出院后6个月电话和上门随访跟踪调查。结果出院时研究组的哮喘知识和住院天数与对照组比较差异有统计学意义(P<0.05);出院后6个月的用药依从性比较差异有统计学意义(P<0.05)。结论对哮喘患者进行有关哮喘管理和治疗的教育,是哮喘管理各个方面成功的关键。     

调任通督治疗失眠症实施护理干预的临床观察

目的 探讨调任通督治疗并实施护理干预对失眠患者睡眠的影响.方法 将57例失眠患者随机分为对照组28例和干预组29例,对照组给予调任通督针剌治疗,干预组在调任通督治疗基础上实施护理干预,观察两组心理健康状况、睡眠质量、临床疗效及治疗依从性,并进行比较.结果 干预组治愈率明显高于对照组,心理健康状况、睡眠质量指标及对治疗的依从性亦明显优于对照组.结论 调任通督针刺并实施护理干预是治疗失眠症的有效方法.     

量化健康教育应用于1020例高血压患者的自我护理效果研究

目的：分析并评价量化健康教育应用于高血压患者的自我护理效果。方法将本院心内科自2011年2月～2013年1月期间收治的2040例患者，按照随机数字表法，随机分为观察组与对照组，各为1020例。对照组患者给予常规的健康宣教，观察组给予健康教育计划，并实施个体量化健康宣教。对比两组患者的自我护理行为的依从性。结果观察组在测定血压、规律服药、合理运动、合理饮食、按时检查及保持体重方面的自我护理依从性均优于对照组，两组相比差异显著，具有统计学意义（P均＜0.05）。结论个体量化健康宣教能够增强高血压患者自我护理依从性，对患者的病情康复发挥积极的作用。     

Influence of measurement uncertainty on the world health organization recommended regulation for mainstream cigarette smoke constituents

The World Health Organization Study Group on Tobacco Product Regulation (WHO TobReg) proposed mandated ceilings on 9 prioritized mainstream cigarette smoke constituents determined from the market-specific median of nicotine-normalized yield distributions. Considering the requirements for assessing and reporting of compliance with ceilings, it is of great importance to estimate the measurement uncertainty. To have a better understanding of influence of measurement uncertainty on the WHO recommended regulation for cigarette smoke constituents, in the present study, the measurement uncertainties were evaluated systematically based on series of collaborative studies reported by three different authorities over the years from 2012 to 2016, according to the approaches guided in ISO/TS 21748. Furthermore, the compliance assessment of 20 representative cigarette samples with proposed ceilings was conducted by taking measurement uncertainty into account. This work demonstrated that measurement uncertainty had great influence on the implementation of the regulated mandated lowering of toxic smoke constituents, both on the setting of ceilings and the compliance assessment as well.     

Evaluating provider communication in pediatric chronic kidney disease care using a global coding system

ObjectiveAmong adolescents and young adults (AYAs) with chronic illness, effective provider communication is essential for patient-centered care during a sensitive developmental period. However, communication in chronic illness care for AYAs is not well studied. Our objectives were to describe the provider communication skills in pediatric chronic kidney disease (CKD) care visits; and determine if communication skills differ by AYA characteristics.MethodsWe adapted a global consultation rating system for pediatric subspecialty care using audiotaped clinic encounters of 18 pediatric nephrologists with 99 AYAs (age M(SD) = 14.9(2.6)) with CKD stages 1–5 and 96 caregivers. We hypothesized that provider communication skills would differ by AYA characteristics (age, gender, and race).ResultsThe strongest provider skills included initiating the session and developing rapport; lowest rated skills were asking patient’s perspective and checking understanding. Communication scores did not consistently differ by AYA age or race, but were rated higher with female AYAs in several domains (ps<0.05).ConclusionsPediatric providers generally had adequate or good communication scores with AYAs, but improvement in certain skills, particularly with male AYAs, may further support patient-centered care.Practice implicationsTo achieve consistent, patient-centered communication with AYAs, an observation-based global assessment may identify areas for provider improvement.     

Vascular Structure and Function in Cancer Survivors after Hematopoietic Stem Cell Transplantation

This study examined the effects of hematopoietic cell transplantation (HCT) and associated preparative regimens on vascular structure and function. Measures of carotid artery stiffness and brachial artery endothelial-dependent dilation were obtained in patients who had survived ≥ 2 years after HCT for hematologic malignancy and were diagnosed at ≤21 years. HCT survivors (n?=?108) were examined: 66 received total body irradiation (TBI) alone or with a low-dose cranial radiation boost (TBI±LD-CRT), 19 received TBI plus high-dose cranial radiation (TBI+HD-CRT), and 23 received a chemotherapy-only preparative regimen (CHEMO). Siblings (n?=?83) were invited to participate as control subjects. Although endothelial-dependent dilation did not differ between siblings and HCT survivors, carotid cross-sectional compliance, cross-sectional distensibility, diameter compliance, and diameter distensibility were greater in siblings than HCT survivors. Comparing the HCT preparative regimens, carotid cross-sectional compliance, cross-sectional distensibility, diameter compliance, diameter distensibility, and incremental elastic modulus were significantly lower in the TBI+HD-CRT group compared with siblings or with TBI±LD-CRT and CHEMO treatment groups. Cross-sectional distensibility and diameter compliance were significantly lower in the TBI±LD-CRT group compared with siblings. TBI±LD-CRT and CHEMO groups did not differ from each other in these vascular measures. HCT preparative regimens containing TBI+HD-CRT resulted in greater arterial decrements, indicating increased risk for cardiovascular disease.     

Postoperative pain assessment in hospitalised patients: National survey and secondary data analysis

BackgroundMeasuring pain is important for the adequate pain management of postoperative patients. The actual compliance with pain assessment in postoperative patients after implementation of a national safety program is unknown.ObjectivesThe aim of this study is to examine the compliance with pain assessment in postoperative patients after implementation of a national safety program, according to the national quality indicators for pain assessment in postoperative patients. Furthermore, organisational factors associated with this compliance were determined.Study designIn this study, two data sources were used: 1) data from an evaluation study of the Dutch Hospital Patient Safety Program; and 2) data from a questionnaire survey.MethodsThe compliance with two different pain process indicators was determined: 1) 3 pain measurements a day, all three full days after surgery; and 2) ≥1 pain measurement a day, all three full days after surgery. Multilevel logistic regression analysis was used to investigate the association between organisational factors in hospitals and compliance with pain process indicators.ResultsData of 3895 patient records from 16 hospitals was included in this study. In 12% of the postoperative patients, pain was measured 3 times a day, all three full days after surgery. In 53% of the postoperative patients, pain was measured ≥1 time a day, all three full days after surgery. Compliance was highest in general hospitals compared to tertiary teaching and academic hospitals, and was statistically significantly higher at the surgery and surgical oncology department compared to the other departments.ConclusionsLow compliance was shown with pain assessment in postoperative patients, according to the process indicator pain after surgery in Dutch hospitals. This suggests that the implementation of measuring pain in hospitals is still insufficient.