早期康复在老年股骨颈骨折合并偏瘫患者中的效果观察

目的探讨全髋关节置换术后早期康复在股骨颈骨折合并偏瘫患者中的应用效果。方法选取2017年2月-2019年2月本院老年偏瘫侧股骨颈骨折患者68例。分为研究组和对照组,对照组采用常规偏瘫康复,研究组则采用术后早期康复,对比两组患者各项结果。结果术后康复训练3个月和6个月,研究组Harris髋关节评分均高于对照组(P<0.05);研究组Brunnstrom偏瘫运动功能5期以上人数多于对照组(P<0.05);研究组并发症发生率低于对照组(P<0.05),且训练后3个月和6个月,两组均未发生假体移位、松动和下沉的情况。研究组生活质量高于对照组(P<0.05)。结论全髋关节置换术后早期康复有利于提高老年股骨颈骨折合并偏瘫患者的康复,提高生活质量。     

DHS和PFNA固定治疗老年股骨粗隆间骨折的疗效

目的对比动力髋螺钉(dynamic hip screw,DHS)治疗和股骨近端抗旋髓内钉(proximal femoral nail anti-rotation,PFNA)固定治疗老年股骨粗隆间骨折疗效。方法纳入本院收治的45例采用PFNA固定治疗的老年股骨粗隆间骨折患者作为研究组,研究时间为2017年11月-2018年11月;回顾性分析2016年11月-2017年11月在我院采用DHS治疗的45例老年股骨粗隆间骨折患者的临床资料,作为对照组。记录两组的相关手术指标,观察手术并发症情况。结果研究组的手术时间和骨折愈合时间均短于对照组,术中出血量明显少于对照组,术后疼痛VAS评分均明显低于对照组(P<0.05)。对照组的并发症发生率高于研究组(P<0.05)。结论PFNA固定治疗比DHS治疗老年股骨粗隆间骨折更加安全有效,值得临床借鉴和应用。     

甘肃省养老机构老年人健康服务需求及影响因素分析

目的探讨甘肃省养老机构老年人健康服务需求现状及主要影响因素,为健全和完善机构养老服务提供理论依据。方法选取甘肃省兰州市、张掖市和平凉市养老机构的360名老年人作为调查对象,采用自设问卷对其进行调查。结果养老机构老年人健康服务需求总分为28.48±5.78分,地区、家庭类型、文化程度为影响健康服务需求的独立影响因素。欠发达地区,不完整的家庭及文化程度较低的老人对健康服务需求更高。结论应根据不同特征老年人的需求有针对性地提供相关养老服务项目。养老机构应该定期采集老年人的意见,鼓励子女探望,大力开展健康知识宣教,并完善养老与医疗服务机构间的合作机制。     

老年失禁相关性皮炎护理研究进展

对国内外老年失禁相关性皮炎的概念、流行病学、影响因素、评估及最新护理研究进行综述,旨在为临床老年失禁导致失禁性皮炎护理提供帮助。     

南京市时间银行发展现状及影响因素分析

[目的]调查南京市中老年人对时间银行的知晓状况及参与意愿,分析时间银行发展现状及影响因素。[方法]采用文献研究、实地考察、问卷调查、个案访谈对南京市5个社区的中老年人81人进行调查。[结果]子女数量、养老打算、是否愿意让陌生人照护对中老年人成为时间银行志愿者有影响(均P<0.05)。[结论]南京市中老年人参与时间银行意愿度总体较高,但时间银行发展过程中还存在很多问题,需要政府的干预实现时间银行的可持续发展。     

益气养精法对老年肺癌患者肿瘤标志物、生存期影响研究

目的探究益气养精法对老年肺癌患者肿瘤标志物、生存期影响。方法研究纳入60例老年肺癌患者,均由本院2016年1月-2017年1月收治,采取随机数字表法将患者分为两组,对照组患者(30例)常规化疗治疗,观察组患者(30例)在化疗基础上联合益气养精法治疗,比较两组患者治疗效果、治疗前后癌胚抗原(carcino-embryonic antigen,CEA)及血清癌抗原125(serum oncoantigen 125,CA 125)肿瘤标志物水平、不良反应情况及患者2年生存率。结果观察组患治疗有效率高于对照组,P<0.05;治疗前,两组患者CEA及CA 125水平相当,P>0.05,治疗后均改善,观察组优于对照组,P<0.05;观察组患者不良反应与对照组相当,均较低,P>0.05;观察组患者2年生存率高于对照组,P<0.05。结论益气养精法治疗老年肺癌患者效果患者,患者症状改善,不良反应少,安全可靠,且患者2年生存率较高。     

Challenges and Growth as a Mental Health Professional from Volunteering Experiences in the Community Gambling Awareness Campaign

As the demand for high-quality mental health services increases, producing expert nurses with the skills and expertise to deal with various complex mental health situations involving diverse subjects is critical. Nursing programs should be prepared to provide education that can improve mental health professional competence. Using a qualitative study and focus group interviews, we focused on the experiences of nursing students who voluntarily participated in campaign activities to prevent gambling problems. The respondents were 23 nursing students who participated in the campaign for more than four months. Data were analyzed using Downe-Wamboldt’s eight steps of content analysis. The experiences of the participants were integrated into the theme of challenge and growth for a mental health professional with five sub-themes: challenging for an active nursing student, committing to gambling awareness campaign club activity, promoting interpersonal relationships, improving problem-solving skills, and developing a mental health professional identity. Planning and implementing various volunteer activities, in addition to the existing regular curriculum in nursing education, will provide a foundation for nursing students to become good nurses and ultimately help produce competent mental health professionals.     

Diabetes treatment and hypoglycaemic episodes in elderly patients at nursing homes in Uppsala County

Aim: The aim of this study was to examine the situation for elderly patients with diabetes living in nursing homes with regard to diabetes treatment, clinical variables, and vascular complications associated with diabetes. A second aim was to evaluate if the patients were at risk of hypoglycaemia.

Methods: This was a cross-sectional study including diabetes patients from all 30 nursing homes in Uppsala County, Sweden. Current antidiabetic medications, HbA_1c, hypoglycaemic events, and diabetes complications were registered from the medical records. The patients were stratified into a general group and divided into three groups according to HbA_1c (<52, 52–73, and >73?mmol/mol).

Results: Of 1,350 individuals, 218 patients were identified with diabetes mellitus. The diabetes duration was 11.2?±?9.4 years and their serum HbA_1c concentration 56.0?±?1.2?mmol/mol. Hypoglycaemic events were reported in 24% of the diabetic individuals, and 43.1% of them had HbA_1c <52?mmol/mol (mean value 44.0?±?1.1?mmol/mol). Of these, 36% were taking antidiabetic drugs. Another 35.8% of the patients had HbA_1c values between 52–73?mmol/mol (mean value 60.0?±?1.1?mmol/mol), and 82% of these patients were taking antidiabetic drugs. Almost 80% of the diabetic patients had either micro- or macrovascular complications, with diabetes duration as an association for both micro- or macrovascular complications and hypoglycaemic events.

Conclusions: A reduction of the use of antidiabetic drugs with follow-up of HbA_1c level should be considered, especially for multimorbid elderly patients with low HbA_1c and hypoglycaemia.