会所康复模式在女性精神分裂症恢复期病人中的应用

目的:探讨会所康复模式在女性精神分裂症恢复期病人中的应用效果。方法:选取2019年2月—2020年3月精神科收治的100例女性精神分裂恢复期病人作为研究对象,按随机数字表法分为对照组、观察组各50例,对照组采取常规康复治疗,观察组在常规康复治疗基础上应用会所多维度康复治疗模式。采用阳性和阴性症状量表(PANSS)、疾病家庭负担量表(FBS)、日常生活能力量表(ADL)、生活满意度指数B量表(LSIB)评价两组病人干预前、干预3个月、干预6个月精神症状、家庭负担、日常生活能力、生活自理能力。结果:两组病人干预3个月、干预6个月PANSS、FBS、ADL及LSIB评分比较差异有统计学意义(P<0.05);两组组内干预前后PANSS、FBS、ADL及LSIB评分比较差异有统计学意义(P<0.05)。结论:女性精神分裂症病人在恢复阶段应用会所康复模式进行干预可改善其精神症状,缓解其家庭负担,调节其日常生活能力和生活自理能力,提升其生活满意度。     

Effects of anteriorly-loaded treadmill walking on dynamic gait stability in young adults

BackgroundAnteriorly-loaded walking is common in many occupations and may increase fall risk. Dynamic gait stability, defined by the Feasible Stability Region (FSR) theory, quantifies the kinematic relationship between the body’s center of mass (COM) and base of support (BOS). FSR-based dynamic gait stability has been used to evaluate the fall risk.Research questionHow does front load carriage affect dynamic gait stability, step length, and trunk angle among young adults during treadmill walking?MethodsIn this between-subject design study, 30 healthy young adults were evenly randomized into three load groups (0%, 10%, or 20% of body weight). Participants carried their assigned load while walking on a treadmill at a speed of 1.2 m/s. Body kinematics were collected during treadmill walking. Dynamic gait stability (the primary variable) was calculated for two gait events: touchdown and liftoff. Step length and trunk angle were measured as secondary variables. One-way analysis of variance was conducted to detect any group-related differences for all variables. Post-hoc analysis with Bonferroni correction was performed when main group differences were found.ResultsNo significant differences but medium to large effect sizes were found between groups for dynamic gait stability at touchdown (p = 0.194, η² = 0.114) and liftoff (p = 0.122, η² = 0.139). Trunk angle significantly increased (indicating backward lean) with the front load at touchdown (p < 0.001, η² = 0.648) and liftoff (p < 0.001, η² = 0.543). No significant between-group difference was found related to the step length (p = 0.344, η² = 0.076).SignificanceCarrying a front load during walking significantly alters the trunk orientation and may change the COM-BOS kinematic relationship and, therefore, fall risk. The findings could inform the design of future studies focusing on the impact of anterior load carriage on fall risk during different locomotion.     

U-turn speed is a valid and reliable smartphone-based measure of multiple sclerosis-related gait and balance impairment

BackgroundPeople living with multiple sclerosis (MS) experience impairments in gait and mobility, that are not fully captured with manually timed walking tests or rating scales administered during periodic clinical visits. We have developed a smartphone-based assessment of ambulation performance, the 5 U-Turn Test (5UTT), a quantitative self-administered test of U-turn ability while walking, for people with MS (PwMS).Research questionWhat is the test-retest reliability and concurrent validity of U-turn speed, an unsupervised self-assessment of gait and balance impairment, measured using a body-worn smartphone during the 5UTT?Methods76 PwMS and 25 healthy controls (HCs) participated in a cross-sectional non-randomised interventional feasibility study. The 5UTT was self-administered daily and the median U-turn speed, measured during a 14-day session, was compared against existing validated in-clinic measures of MS-related disability.ResultsU-turn speed, measured during a 14-day session from the 5UTT, demonstrated good-to-excellent test-retest reliability in PwMS alone and combined with HCs (intraclass correlation coefficient [ICC] = 0.87 [95 % CI: 0.80–0.92]) and moderate-to-excellent reliability in HCs alone (ICC = 0.88 [95 % CI: 0.69–0.96]). U-turn speed was significantly correlated with in-clinic measures of walking speed, physical fatigue, ambulation impairment, overall MS-related disability and patients’ self-perception of quality of life, at baseline, Week 12 and Week 24. The minimal detectable change of the U-turn speed from the 5UTT was low (19.42 %) in PwMS and indicates a good precision of this measurement tool when compared with conventional in-clinic measures of walking performance.SignificanceThe frequent self-assessment of turn speed, as an outcome measure from a smartphone-based U-turn test, may represent an ecologically valid digital solution to remotely and reliably monitor gait and balance impairment in a home environment during MS clinical trials and practice.     

基于ADOPT问题解决模式下的个体化护理对口腔正畸患者自我 护理能力的影响

目的 探讨ADOPT问题解决模式下的个体化护理对口腔正畸患者自我护理能力的影响。方法 选 取2021年1月-12月我院正畸科收诊的80例正畸患者作为观察对象，采用自拟抽签法随机分为对照组与观察 组，各40例。对照组采用常规护理，观察组采用ADOPT问题解决模式下的个体化护理，比较两组干预前后 自我管理能力、生活质量以及社会心理适应能力。结果 两组干预后1个月生活质量以及自我管理能力评分 高于干预前，且观察组高于对照组，差异有统计学意义（P＜0.05）。观察组接受水平、持续担忧、积极 面对评分高于对照组，差异有统计学意义（P＜0.05）。结论 ADOPT问题解决模式下的个体化护理有助于 提升口腔正畸患者自我管理能力及社会心理适应能力，进而提高患者生活质量。     

Inspiratory muscle training improves performance of a repeated sprints ability test in professional soccer players

BackgroundInspiratory muscle training (IMT) is an important method of attenuating both respiratory and peripheral effort perceptions, consequently improving neuromuscular performance and resulting in greater improvements in exercise capacity than exercise training alone.ObjectiveThe aim of this study was to investigate the effects of IMT on exercise tolerance, repeated sprint ability (RSA) performance, maximal inspiratory pressure (MIP), and peak inspiratory flow (PIF) in a cohort of professional male soccer players.MethodsTwenty-two healthy male professional soccer players (18.3 ± 1.4 years; 174.5 ± 6.1 cm; 70.5 kg ± 4.6 kg; body fat 10.1 ± 4.2%) from a club in the Brazilian first division soccer league participated in this study. IMT consisted of 15 and 30 self-paced inspiratory breaths (each to 50% maximal static inspiratory pressure [P₀]) in the 1-and 2-week intervention period, respectively. IMT was performed prior to soccer training (1 sets.d⁻¹; 6 d.wk⁻¹) with repeated sprint ability (RSA) assessed pre- and post- the 2-week period of IMT.ResultsStatistical analyses identified a significant (p < 0.001) decrease in sprint time post-IMT. Additionally, RSA_best, RSA_mean, total sprint time and percentage of RSA performance decrement (RSA _{% dec}) also showed significant decreases (p < 0.0001) post-IMT. Additional measures including MIP and PIF were also significantly elevated (p < 0.0002) following the 2-week period of IMT.ConclusionIn conclusion, our results raise two important issues. Firstly, IMT demonstrated enhanced inspiratory muscle strength in professional soccer players. Secondly, this increase in inspiratory muscle efficiency led to a decrease in sprint time and improved exercise tolerance. We recommend that a standard training protocol be developed and tested in an experimental and control group with a large representative sample.     

Effects of the frequency of ostomy management reinforcement education on self-care knowledge,self-efficacy,and ability of stoma appliance change among Korean hospitalised ostomates

Patients who undergo stoma surgery experience difficulties in adapting physically and psychologically. The priority is to support them in learning self-care for successful rehabilitation and psychosocial adaption to a new life. In order to do this, it is important to provide ostomates with repetitive reinforcement education on self-care in a continuous and individual manner, not just to increase knowledge or perform related skills. This study aims to evaluate the effects of ostomy management reinforcement education (OMRE) in ostomates and to identify the optimal frequency of reinforcement education using an equivalent control group post-test design. Participants were 60 ostomates admitted to a university hospital after ostomy formation surgery, and they were randomly assigned to a control and two experimental groups of this study. The OMRE was given to the control group (n = 20), experimental group 1 (n = 20), and experimental group 2 (n = 20) once, twice, and three times, respectively. Participants' self-care knowledge, self-efficacy, and ability of stoma appliance change were evaluated before and after the OMRE. Major results of this study were as follows: the self-care knowledge score of post-test was higher than the pretest in the control, experimental 1, and experimental two groups (P < 0.001). The self-efficacy score of post-test was higher than the pretest in the control, experimental 1, and experimental 2 groups (P < 0.001). The self-care knowledge score according to the frequency of OMRE did not differ among the control, experimental 1, and experimental 2 groups (F = 1.921, P = 0.156). The self-efficacy score according to the frequency of OMRE was significantly different between the control and experimental groups (F = 8.616, P = 0.001), but there was no difference between the experimental 1 and experimental 2 groups (Scheffe's post-hoc analysis: a < b, c). The ability of stoma appliance change score according to the frequency of OMRE was significantly different between the control and experimental groups (F = 49.546, P < 0.001), but there was no difference between the experimental 1 and experimental 2 groups (Scheffe's post-hoc analysis: a < b, c). Results of this study suggested that the OMRE was effective for promoting hospitalised ostomates' self-care knowledge, self-efficacy, and ability of stoma appliance change, and two sessions of the OMRE was the most effective. Findings of this study may be useful in planning education programmes designed to improve self-care ability for hospitalised ostomates.     

临床护士情绪智力对护士领导力的影响

目的 探讨临床护士情绪智力对护士领导力的影响,为提高护士领导力提供参考。方法 在郑州市5所医院便利抽取925名 临床护士,采用一般资料调查表、护士领导力问卷、情绪智力量表对其进行调查分析。结果 临床护士领导力总均分为4.04± 0.56,解决问题能力得分最高,其次是护理专业能力,得分最低的是评判性思维能力和自护能力;情绪智力得分为55.54±10.33, 情绪智力总分及4个维度均与护士领导力及7个维度呈正相关(均P<0.01)。多元回归分析结果显示,情绪的运用和情绪的调 节为护士领导力的主要影响因素(均P<0.01)。结论 临床护士领导力及情绪智力处于中等偏上水平,两者呈正相关关系,情绪 的运用和情绪的调节是护士领导力的主要影响因素,护理管理者应予以重视并进行针对性干预,以提升临床护士情绪智力,进而 提升护士领导力。     

急性心肌梗死心源性休克患者渐进式早期康复训练

目的探讨急性心肌梗死心源性休克患者实施渐进式早期康复训练的效果。方法选取65例机械通气的急性心肌梗死心源性休克患者,根据入院时间顺序分为对照组32例和干预组33例,两组均常规应用综合药物治疗和给予系统的集束化护理,干预组在此基础上实施渐进式早期康复训练,比较两组的干预效果。结果干预后干预组患者Barthel指数评分、握力及一次脱机成功率显著高于对照组,机械通气时间显著短于对照组(P0.05,P0.01)。结论渐进式早期康复训练可缩短急性心肌梗死心源性休克患者机械辅助通气时间,提高一次脱机成功率;加速患者的肌力和日常生活能力恢复,降低患者ICU谵妄发生率。