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31.
Measurement of health-related quality of life was integrated into a randomized trial (NMSG 4/90) comparing melphalan/prednisone to melphalan/prednisone + interferon α-2b in newly diagnosed multiple myeloma. One of the aims of the study was to assess the prognostic significance of quality-of-life scores, using the EORTC QLQ-C30 questionnaire. Univariate analysis showed a highly significant association with survival from the start of therapy for physical functioning as well as role and cognitive functioning, global quality of life, fatigue and pain. In multivariate analysis, physical functioning and W.H.O. performance status were independent prognostic factors ( P values=0.001 for both) when analysed in a Cox regression model with the somatic variables β-2 microglobulin, skeletal disease and age. The best prediction for survival from the start of therapy was obtained by combining the β-2 microglobulin and physical functioning scores in a variable consisting of three risk factor levels with an estimated median survival of 17, 29 and 49 months, respectively. At a 12 months landmark analysis, the relative risk for patients with physical functioning score 0–20 v 80–100 was 5.63 (99% CI 2.76–11.49), whereas the relative risk for patients without an objective response to chemotherapy compared to those with at least a minor response was 2.32 (99% CI 1.44–3.74). Quality-of-life assessment may be an independent and valuable addition to the known prognostic factors in multiple myeloma.  相似文献   
32.
护理工作中院内感染相关问题与对策   总被引:5,自引:2,他引:3  
目的 :提出护理工作与院内感染相关问题与对策。方法 :通过监测 ,找出护理工作引起院内感染存在的问题及薄弱环节 ,并制定相应对策。结果 :建立严格的控制感染的管理制度 ,层层落实把关 ,主动和独立地判断出行之有效的预防措施。结论 :在感染管理工作中严格认真执行消毒、灭菌、无菌操作 ,最大限度地避免因护理工作失误而引起的医院内感染  相似文献   
33.
OBJECTIVE: To obtain consensus among a panel of experts on performance measures useful for evaluating the quality of hospital-based domestic violence (DV) programs. METHODS: The Delphi process of consensus development was used with a panel of 18 experts including DV researchers, program planners, and advocates. Three rounds were conducted over a period of six months, with each round involving the completion of a written questionnaire. Panelists were instructed to concentrate on structure and process measures of DV program performance. Health outcome measures were not considered. During each round, panelists rated (scale of 1-5) their level of agreement with each measure, in terms of the measure's usefulness for evaluating hospital-based DV programs. Data were entered into SPSS on a personal computer and frequency distributions, measures of central tendency, and variance were computed for each measure. Consensus development was defined as a reduction in the item-specific variance from one round to the next. RESULTS: A total of 37 performance measures were agreed upon. These measures fell within nine different domains of DV program activities, including: Policies and Procedures, Hospital Physical Environment, Hospital Cultural Environment, Training of Providers, Screening and Safety Assessment, Documentation, Intervention Services, Evaluation Activities, and Collaboration. CONCLUSIONS: A number of measures have been identified as useful for evaluating hospital-based DV programs. Use of these measures should assist researchers, program planners, and administrators in assessing the quality of hospital-based DV programs.  相似文献   
34.
This paper reports the proceedings of the discussion panel assigned to look at clinical aspects of quality in emergency medicine. One of the seven stated objectives of the Academic Emergency Medicine consensus conference on quality in emergency medicine was to educate emergency physicians regarding quality measures and quality improvement as essential aspects of the practice of emergency medicine. Another topic of interest was a discussion of the value of information technology in facilitating quality care in the clinical practice of emergency medicine. It is important to note that this is not intended to be a comprehensive review of this extensive topic, but instead is designed to report the discussion that occurred at this session of the consensus conference.  相似文献   
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目的 探讨中药大陷胸汤高位保留灌肠对流行性出血热(EHF)急性肾衰的治疗作用。方法 将60例EHF急性肾衰患者随机分为对照组与治疗组各30例,对照组予以常规治疗,治疗组在常规治疗的基础上加用大陷胸汤高位保留灌肠,观察两组患者治疗前后的疗效。结果 治疗组治愈23例,好转6例,无效1例,总有效率96.7%;对照组治愈17例,好转7例,无效6例,总有效率80.0%;两组疗效比较,有显著差异性p〈0.05(x^2=4.630)。结论 大陷胸汤高位保留灌肠治疗EHF急性肾衰疗效显著,且简便、安全、经济、病人乐于接受等优点。  相似文献   
38.
研究大学生心理素质与思想品德发展的关系,目的在于分析、发现个体在接受教育过程中的心理运动规律,从而提高思想教育的实效性。本文从马克思主义认识论和实践论的观点出发,依据教育心理学的原理,探讨了心理健康教育与思想品德教育的内在联系和相互作用,提出良好的心理素质是大学生思想品德发展的基础的观点。认为品德的形成与人的心理活动息息相关,个体如果没有良好的品德,将影响其心理素质的完善;同样,没有健全的心理素质,思想品德也不能得到很好的发展。只有思想品德教育与心理健康教育协调发展,共同作用,才能收到良好的教育效果。  相似文献   
39.
PICC使用过程中的异常问题及护理   总被引:1,自引:0,他引:1  
目的 探讨PICC使用过程中的异常问题及护理措施,提高外周静脉置入中心静脉导管的成功率,减少术后并发症.方法 回顾性分析2007年6月~2008年11月在我科放置PICC导管的62例患者的病历资料.结果 成功置管61例,1例送管未成功.其中贵腰静脉55例,正中静脉6例,头静脉1例.发生静脉炎4 例,置入颈内静脉1例,导管部分脱出1例,导管堵塞2例.62例患者除2例危重患者非导管原因死亡外,均顺利出院或完成化疗周期,正常拔管.结论 针对PICC常见异常问题,进行预防及处理,可提高PICC的成功率,减少术后并发症.  相似文献   
40.
Damage to the genetic component of spermatozoa seems to play the main role in a majority of cases where current approaches fail to reveal the specific cause of male infertility. In this study, we compared semen quality in men assigned to two defined groups: men from couples with unexplained infertility – idiopathic infertility (A) and young men with no experiences of infertility (B). All samples were examined by standard ejaculate analysis and sperm chromatin structure assay (SCSA). Sperm chromatin damage was significantly higher in men from group A than in those from group B. Similar results were obtained by comparison of men from group A (all men were normozoospermic) with normozoospermic men from group B. According to these results, we can suppose that chromatin disorders may be the causal factor of subfertility or infertility in some of these men. No evidence for a strong association between chromatin disorders and standard parameters of ejaculates was found. We failed to confirm a relationship between smoking and sperm quality in men from any of the investigated groups. SCSA is a method that facilitates the identification of infertile men who otherwise show normal semen variables.  相似文献   
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