循证护理对提高流动肺结核患者治疗依从性的临床观察

目的 探讨循证护理对提高流动肺结核患者治疗依从性的效果.方法 选择200例流动结核患者为研究对象,随机分为试验组和对照组,对照组给予常规护理,试验组给予循证护理.结果 试验组治疗异型性显著优于对照组(P<0.01),痊愈率也显著大于对照组(P<0.05).结论 循证护理可以提高治疗依从性和临床效果,但仍需要相关部门给予更多的关注和支持.     

广州市海珠区流动人口结核病患者结核病防治知识知晓情况调查

目的了解广州市海珠区流动人口中结核病患者对于结核病防治知识的知晓情况,为制订完善有针对性的健康教育方法提供依据。方法对广州市胸科医院第二门诊部2010—10-01～2010—12—30初诊为结核病患者中的流动人口进行结核病防治知识知晓情况调查。结果调查对象对结核病防治核心信息的总知晓率为59．75％;对肺结核病的传染性、传播途径以及治愈情况知晓率较高,而对肺结核病主要可疑症状及免费政策知晓率较低。年龄≥40岁者（Z=-2．016,P=0．044）及初中及以下文化程度者（Z=-2．604,P=0．009）综合知识得分低;多因素非条件Logistic回归分析显示,知晓程度与年龄呈负相关（OR^^=0．306,P=0．027）。结论广州市海珠区流动人口结核病患者的结核病防治知识掌握情况不容乐观,为实现《全国结核病防治规划（2001—2010年）》的目标,加大力度开展结核病防治知识健康教育尤为重要和迫切。     

广州市海珠区流动人口结核病患者结核病防治知识知晓情况调查

目的 了解广州市海珠区流动人口中结核病患者对于结核病防治知识的知晓情况,为制订完善有针对性的健康教育方法提供依据.方法 对广州市胸科医院第二门诊部2010-10-01~2010-12-30初诊为结核病患者中的流动人口进行结核病防治知识知晓情况调查.结果 调查对象对结核病防治核心信息的总知晓率为59.75%;对肺结核病的传染性、传播途径以及治愈情况知晓率较高,而对肺结核病主要可疑症状及免费政策知晓率较低.年龄≥40岁者(Z=-2.016,P=0.044)及初中及以下文化程度者(Z=-2.604,P=0.009)综合知识得分低;多因素非条件Logistic回归分析显示,知晓程度与年龄呈负相关(OR =0.306,P=0.027).结论 广州市海珠区流动人口结核病患者的结核病防治知识掌握情况不容乐观,为实现<全国结核病防治规划(2001-2010年)>的目标,加大力度开展结核病防治知识健康教育尤为重要和迫切.     

对4例外籍肺结核病人的多元文化护理体会

多元文化护理是指对世界上不同文化的民族,重点研究其不同传统照料方式,对健康与疾病的认识、人民的信念和价值观念,并运用这些知识为不同民族的人民进行共性各异的护理。我科与2002年1月～2005年1月共收治了4例外籍肺结核病人,采用多元文化护理,使之能正确对待疾病,积极主动地配合治疗、护理,现将体会介绍如下。1临床资料对4例外籍病人实施多元文化护理过程。本组4例均为男性,年龄25～42岁,均使用英语,1例来自尼日利亚,2例来自几内亚,1例来自菲律宾。肺结核2例,肺结核并咯血1例,肺结核并胸腔积液、结核性腹膜炎、HIV1例。治疗后好转出院3…     

对社区流动人口结核病管理的循证评价

目的调查分析社区流动人口结核病管理和治疗措施,并对其进行系统评价,考察结核病控制管理的效果,为专门针对流动人口制定科学可行的干预方案,亦为进一步探索和更新流动人口结核病管治策略提供可靠依据。方法计算机检索中同医院数字图书馆、万方医学网及中国知网等数据库和手工检索有关医学期刊、专著;纳入1998—2010年发表的关于流动人门结核病治疗、管理、护理干预的文献;同时采用非慨率目的性抽样方法,在获得访谈对象知情同意后进行现场访谈。结果共检索到符合纳入标准的已发表文献137篇,通过查看全文,最后评价为1级证据9篇,2,3级15篇。从纳入评价的文献及访谈结果显示：运用各种有效的管理措施包括健康促进、提供激励机制、跨区域转诊追踪、对病人实行DOTS管理等,均取得一定的效果;但流动人口对结核病相关知识和免费治疗政策了解有限,看法不一,结核病防治的意识较差,居住不稳定,缺乏有效的联系方式,致使对流动人口的追踪督导刚难,流动结核病人的管理亟待加强。结论有必要对流动病人扩大免费治疗及相应的费用补贴,丌展全方化、多形式的社区防痨知识及旧家对结核病控制政策的宣传,加强社区结核病督导的力度．开展个体化循环且动式的健康教育,提高结核病人遵医的依从性。     

对社区流动人口结核病管理的循证评价

Objective To investigate management and treatment to tuberculosis(TB)of floating population in the community,and evaluate systematically,study the effect of TB control management,in order to provide reliable basis for developing the scientific and practical intervention programs specifically for the floating population,and also to further explore and update the governance strategy of the floating population of TB.Hethods The databases of CHKD,WANFANG MED ONLING and CNKI Etc,were searched and analyzed by computer,and related medical journals and monographs were studied by manual searching,getting the issued literature on the treatment,management,nursing intervention of floating population tuberculosis from 1998 to 2010.At the same time we used non-probability purposive sampling method and had on-site interviews after obtaining the interviewee informed of consent.Besults We retrieyed 137 documents that have been published meeting the inclusion criteria,by viewing the full text,9 docunents had been evaluated for the 1 evidence and 15 documents had been evaluated for the 2～3 finally.From the literature with the evaluation and interviews.it showed that:to use a variety ofeffective management measures include health promotion,providing incentives,cross-regional referral tracking,DOTS nanagemerit of patient,had achieved certain effects.But the floating population understood limitedly TB-related knowledge and free treatment policy and had mixed views,that the awareness of TB control is poor,residential instability,lack of effective contact,resulted in difficuhing in supervision and tracking of the floating population.The TB management to floating population patients should be strengthened.Condusion It is necessary to expand the free flow of patient treatment and the corresponding cost of subsidies,to carry out comprehensive and multi-fornKq of community knowledge on TB and the publicity on national TB control policy,to make efforts to improve community supervision OfTB,and carry out individual recycling interactive health education for improving the compliance of TB patient.     

41例结核性脑膜炎死亡原因分析及护理对策

目的探讨重症结核性脑膜炎患者的护理方法。方法回顾分析41例结核性脑膜炎患者的死亡原因和护理经过。结果 41例患者死于脑疝20例(48.78%),感染14例(34.15%),上消化道出血6例(14.63%),心跳骤停1例(2.44%)。结论积极做好基础、饮食、心理和用药护理,消除脑疝的诱发因素、有效地控制颅内压、预防医院感染及消化道大出血可以降低结核性脑膜炎的死亡率。     

激励模式用于护理管理中的效应分析

目的:探讨激励模式用于护理管理中的效果。方法:在2009年7月～2010年6月采用激励模式用于科室护理管理中,每季度进行一次综合评价,评价包括患者满意度、技术操作水平、差错发生次数、服务态度,以及护士对自身工作综合满意度评分。并与2008年7月～2009年6月这些评价结果进行统计学处理,对比分析有无明显差异。结果:应用激励模式在护理管理后,患者的满意度增加,技术操作优秀率提高,差错发生次数减少,综合管理质量分数提高,与实施激励模式前相比,有明显差异,P<0.05,差异有统计学意义。对比实施激励模式后护士的自我满意度评分,实施后有明显降低,P<0.05,差异有统计学意义。结论:在临床护理管理中,采用激励模式,能很好地提高护士的自身能力、科室的管理水平,护士对自身工作综合满意度有明显的提高。     

健全护理安全路径对防范住院患者跌倒的意义

目的健全护理安全路径,降低护理风险系数,防范住院患者跌倒的发生。方法从2010年1月起健全并对住院病人全面实施＂跌倒危机评估-防跌倒预见性护理-住院安全知情同意书应用-建立非惩罚性差错事故上报系统＂的护理安全路径。结果进行对患者跌倒风险的评估,能及时发现潜在的危险因素,及时实施预见性护理,进行必要的预防和处理,有效减少患者跌倒的发生。结论防范住院患者跌倒的发生,健全护理安全路径是基础;提高护理人员风险防范意识及对风险因素评估能力是关键,患者及家属的理解和配合是保证。     

对社区流动人口结核病管理的循证评价

Objective To investigate management and treatment to tuberculosis(TB)of floating population in the community,and evaluate systematically,study the effect of TB control management,in order to provide reliable basis for developing the scientific and practical intervention programs specifically for the floating population,and also to further explore and update the governance strategy of the floating population of TB.Hethods The databases of CHKD,WANFANG MED ONLING and CNKI Etc,were searched and analyzed by computer,and related medical journals and monographs were studied by manual searching,getting the issued literature on the treatment,management,nursing intervention of floating population tuberculosis from 1998 to 2010.At the same time we used non-probability purposive sampling method and had on-site interviews after obtaining the interviewee informed of consent.Besults We retrieyed 137 documents that have been published meeting the inclusion criteria,by viewing the full text,9 docunents had been evaluated for the 1 evidence and 15 documents had been evaluated for the 2～3 finally.From the literature with the evaluation and interviews.it showed that:to use a variety ofeffective management measures include health promotion,providing incentives,cross-regional referral tracking,DOTS nanagemerit of patient,had achieved certain effects.But the floating population understood limitedly TB-related knowledge and free treatment policy and had mixed views,that the awareness of TB control is poor,residential instability,lack of effective contact,resulted in difficuhing in supervision and tracking of the floating population.The TB management to floating population patients should be strengthened.Condusion It is necessary to expand the free flow of patient treatment and the corresponding cost of subsidies,to carry out comprehensive and multi-fornKq of community knowledge on TB and the publicity on national TB control policy,to make efforts to improve community supervision OfTB,and carry out individual recycling interactive health education for improving the compliance of TB patient.