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目的 构建家庭正向行为支持(positive behavior support,PBS)方案,并探讨其在学龄前恶性肿瘤患儿情绪行为影响中的应用效果。方法 以家庭系统理论为框架构建家庭PBS方案,选取2019年3月—2020年2月于重庆市某三级甲等儿童医院就诊的100例学龄前恶性肿瘤患儿为研究对象,采用随机数字表法分为试验组(n=50)和对照组(n=50)。试验组在常规护理基础上接受为期3个月的家庭PBS方案,对照组实施常规护理。比较两组干预前后家庭亲密度与适应性量表得分、养育心理灵活性问卷得分及长处与困难问卷得分。结果 两组干预后长处与困难问卷得分低于干预前(均P<0.001),家庭亲密度与适应性量表得分高于干预前(均P<0.001);试验组干预后养育心理灵活性问卷得分高于干预前(P<0.001);干预后试验组长处与困难问卷得分低于对照组(P<0.001),家庭亲密度与适应性量表得分和养育心理灵活性问卷得分高于对照组(均P<0.05)。结论 应用家庭PBS方案可减少学龄前恶性肿瘤患儿情绪行为问题的发生,改善家庭亲密度与适应性,提高父母养育心理灵活性。  相似文献   
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《Vaccine》2020,38(18):3501-3507
BackgroundNo national vaccination program against herpes zoster (HZ) is currently in place in Norway. We aimed to quantify the burden of medically attended HZ to assess the need for a vaccination program.MethodsWe linked data from several health registries to identify medically attended HZ cases during 2008–2014 and HZ-associated deaths during1996–2012 in the entire population of Norway. We calculated HZ incidences for primary and hospital care by age, sex, type of health encounter, vaccination status, and co-morbidities among hospital patients. We also estimated HZ-associated mortality and case-fatality.ResultsThe study included 82,064 HZ patients, of whom none were reported as vaccinated against HZ. The crude annual incidence of HZ was 227.1 cases per 100,000 in primary healthcare and 24.8 cases per 100,000 in hospitals. Incidence rates were higher in adults aged ≥50 years (461 per 100,000 in primary care and 57 per 100,000 in hospitals), and women than in men both in primary healthcare (267 vs 188 per 100,000), and hospitals (28 vs 22 per 100,000). Among hospital patients, 47% had complicated zoster and 25% had comorbidities, according to the Charlson comorbidity index. The duration of hospital stay (median 4 days) increased with the severity of comorbidities. The estimated mortality rate was 0.18 per 100,000; and in-hospital case-fatality rate was 1.04%.ConclusionsMedically attended HZ poses a substantial burden in the Norwegian healthcare sector. The majority of the zoster cases occurred among adults aged ≥50 years – the group eligible for zoster vaccination – and increased use of zoster vaccination may be warranted, especially among persons with co-morbidities.  相似文献   
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This study used the National Survey of Ambulatory Surgery (NSAS) database to measure the incidence of and risk factors for symptoms in the ambulatory surgery center and problems within 24 h after isolated carpal tunnel release (CTR). The NSAS contained records on 400,000 adult patients with carpal tunnel syndrome who were treated with CTR in 2006, based on ICD-9 codes. The type of anesthesia used and factors associated with symptoms and problems were sought in bivariate and multivariable statistical analyses. The mean duration of the procedure was 16 ± 8.8 min. Only 5 % were performed under local anesthesia without sedation, 45 % with IV sedation, 28 % regional anesthesia, and 19 % general anesthesia. Symptoms in the ambulatory surgery center or a problem within 24 h after discharge were recorded in 10 % of patients, all of them minor and transient, including difficulties with pain and its treatment. The strongest risk factors were male sex, age of 45 years and older, and participation of an anesthesiologist. Local anesthesia and regional anesthesia were associated with more perioperative symptoms and postoperative problems. Most CTR are performed with some sedation in the United States. CTR is a safe procedure: one in 10 patients will experience a minor issue in the perioperative or immediate postoperative period.  相似文献   
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