延续性护理对居家癌痛患者疼痛及生命质量的影响

目的：探讨延续性护理对居家癌痛患者疼痛及生命质量的影响。方法：选取93例居家癌痛患者,采用家庭访视、电话随访、远程网络干预、心理专科咨询门诊干预等护理手段进行干预,3个月后,观察患者的疼痛程度及生命质量的改善情况。结果：干预后患者疼痛程度较干预前减轻,差异有统计学意义（P＜0.001）,五维健康量表EQ-5D总体得分低于干预前, 差异有统计学意义（P＜0.05）。 结论：延续性护理能减轻居家癌痛患者疼痛程度, 改善患者的生命质量。     

基于APP平台的健康教育在居家癌性疼痛患者延续护理中的应用研究

目的探讨以APP平台为基础的健康教育在居家癌痛患者中的应用及效果评价。方法选取140例首次使用阿片类镇痛药物的居家癌痛患者为对照组,140例为干预组。对照组沿用常规方法进行健康教育,干预组在此基础对患者或家属采用APP进行延续性健康教育护理,连续干预3个月。研究结束后,比较两组患者出院时、出院3个月后生活质量、焦虑、抑郁程度。结果出院3个月后,干预组居家癌痛患者生活质量高于对照组,焦虑和抑郁评分低于对照组,差异均有统计学意义。结论基于APP平台的延续性健康教育有效改善了患者的症状,提高了生活质量,改善了焦虑、抑郁状况,对居家癌痛患者进行延续护理应用效果较好,值得临床推广和借鉴。     

延续性护理干预对癌痛患者满意度及服药依从性的影响

目的探讨延续性护理干预对于癌痛患者护理满意度及用药依从性的影响。方法选取2018年5月至2019年5月我科治疗的癌痛患者120例作为研究对象,随机将其等分为对照组和观察组,对照组给予常规护理干预,观察组给予延续性护理干预,比较两组患者护理满意度和用药依从性。结果观察组护理满意度和用药依从性明显高于对照组(P 0. 05)。结论采用延续性护理干预,对提高癌痛患者用药依从性和护理满意度具有积极作用,可予以推广应用。     

社区卫生服务中心护理人员对疼痛护理认知的现况调查

目的了解社区卫生服务中心护理人员对疼痛护理认知情况,以构建"南京市玄武区三级医疗服务机构癌痛规范化护理体系"。方法采用江苏省肿瘤防治研究所设计的癌痛规范化诊疗护理评估体系问卷调查表,对南京市新街口社区卫生服务中心78名临床护理人员进行疼痛知识问卷调查。结果临床护士对疼痛知识知晓率低,问卷调查平均正确率为21.3%;护士对疼痛的认知情况不受年龄、工作年限、学历、职称、工作场所、有无疼痛管理规定、接受继续教育状况等因素的影响。结论社区临床护理人员疼痛认知缺乏,需进行规范化癌痛知识培训,尽快提高对癌痛的认知和实践水平,更好地为居家癌痛患者开展延续性护理。     

癌痛病人居家护理研究进展北大核心

主要对癌痛病人的居家护理研究进行综述,包括癌痛病人居家护理的内涵、相关现状、模式,重点阐述了目前学者对癌性疼痛病人出院后进行居家护理的一般模式,指出可建立专业的居家护理团队进行整体护理,根据癌痛病人及家属状况建立康复档案,定期进行康复指导和团队随访,对居家护理进行全面评估,为我国建立完善的居家护理体系提供帮助,以降低医疗成本,提高居家护理满意度。     

延续性护理干预对提高癌痛患者镇痛效果的临床研究

目的 探讨在癌痛示范病区延续性护理干预对提高癌痛患者镇痛效果的临床研究.方法 选取笔者所在工作单位的三甲医院肿瘤内科86例晚期住院癌痛患者作为研究对象,采用单纯随机抽样法将其分为对照组与实验组,每组43人.前者予以癌痛示范病区实施癌痛规范化管理,后者在癌痛规范化管理的基础上借助微信平台对出院患者实施延续性用药指导及人文关怀,出院后2～3周随访两组患者对疼痛知识的知晓率、疼痛评估准确率、爆发痛的发生率、治疗依从性及生活质量评分.结果 结合研究数据分析实验组癌痛患者对疼痛知识的知晓率、疼痛评估正确率、治疗依从性及生活质量评分均优于对照组,爆发痛的发生率显著低于对照组,均有统计学意义(P<0.05).结论 在癌痛示范病区实施延续性护理干预对提高癌痛患者的镇痛效果显著,对改善晚期癌痛患者的生活质量有研究意义和临床应用价值,愿广大医护同仁鉴定,采纳.     

老年脑梗死患者居家延续性护理需求的质性研究

目的:调查老年脑梗死患者出院后对居家延续性护理的需求情况,给予患者有效的居家延续性护理。方法:于2017年8月～10月目的性抽取11例老年脑梗死患者,对其进行半结构式访谈,资料收集及分析采用现象学分析法。结果:老年脑梗死患者居家延续性护理需求主题主要为脑梗死健康教育、经济支持、心理改善和卫生服务资源需求4个方面。结论:老年脑梗死患者居家延续性护理需求迫切,应该与医院联合改善现有的居家延续性护理质量。     

延续护理对癌痛患者居家自我管理的效果观察

目的探讨延续护理对癌痛患者居家自我管理的应用效果。方法选取我科收治的服用阿片类药物的癌痛患者212例,按入院时间顺序分组,2015年7—9月纳入106例患者为对照组,2015年10—12月纳入106例患者为观察组。对照组给予常规出院指导,观察组在常规出院指导基础上给予延续护理。评估2组癌痛患者居家自我管理能力和对护理服务满意度。结果观察组情绪管理、不良反应管理、疼痛监测、工作与休息管理、治疗依从性、饮食管理得分及自我管理能力总分均高于对照组(P0.05);观察组癌痛患者对护理服务满意度高于对照组(P0.05)。结论延续护理对癌痛患者居家服用阿片类药物,可提高患者自我管理能力及对护理服务满意度,值得临床借鉴使用。     

微信平台在癌痛出院患者延续性护理中的应用

目的探讨微信平台在癌痛出院患者中的应用效果。方法将240例中重度癌痛患者随机分为实验组和对照组各120例。出院后,对照组每周给予常规电话随访,实验组由研究者借助微信平台进行延续性护理。干预时间为3周。结果干预后,实验组疼痛知识掌握、镇痛效果、服药依从性、生活质量、心理状态及满意度均优于对照组。结论运用微信对癌痛出院患者进行延续性护理效果较好,值得推广。     

癌痛护理专业小组运用CDSMP模式对居家癌症伴疼痛患者护理干预的效果研究

目的为了提高居家癌症伴疼痛患者出院后的生活质量和自我健康教育的效果,使患者疼痛及治疗过程中出现的问题及时得到解决,降低患者焦虑、抑郁等不良情绪的发生率。方法癌痛护理专业小组对本院出院的59例服用吗啡缓释片止痛的癌痛患者运用CDSMP模式(观察组)进行护理干预与未运用CDSMP模式进行护理干预的59例患者(对照组)比较护理效果及抑郁、焦虑情况。结果观察组对癌痛相关知识的掌握度、满意度及疼痛缓解率高于对照组,药物依赖性、焦虑抑郁发生率、焦虑抑郁评分低于对照组,差异均有统计学意义(均P0.05)。结论运用CDSMP模式对居家癌症疼痛患者进行护理干预,使患者疼痛评分均控制在3分以内,提高了居家癌痛患者对癌痛相关知识的掌握程度、降低了患者焦虑和抑郁等不良情绪的发生率、降低了患者药物的依赖性,提高了患者的满意度。     

From hospital to home care: a randomized controlled trial of a Pain Education Programme for cancer patients with chronic pain

AIM OF THE STUDY: To investigate the role of district nurses in the care of cancer patients with chronic pain at home, as well as the effects of a Pain Education Programme for patients and their district nurses. The Pain Education Programme consisted of a tailored multi-method approach in which they were educated about pain, instructed how to report pain, and how to contact health care providers. BACKGROUND: No educational programs for patients in pain have been studied in outpatients nor integrated with the home care provided. DESIGN AND METHODS: One hundred and four patients and their 115 district nurses were enrolled in a prospective, longitudinal, randomized controlled study. The primary outcome of interest was type of care provided by district nurses, satisfaction with the pain treatment, and agreement in estimating patients' pain intensity. RESULTS: Results showed that continuity of care was poor as only 36% of the district nurses were informed about patients' pain by hospital nurses. Pain was rarely the reason for referring the patient to district nursing after discharge. Although pain control was not a main reason for district nurses to visit a patient, pain was a subject for discussion in 76% of visits. Besides discussing the pain problem with patients, district nurses provided only a few pain-relieving interventions. District nurses randomized to the intervention group significantly better estimated patients' pain intensity, and were more satisfied about patients' pain treatment, but no differences were found in their assessment of patients' pain relief. CONCLUSIONS: These findings suggest a significant but moderate effect of the Pain Education Programme, with district nurses only playing a minor role in the treatment of cancer pain.     

Analyses of nursing home residents in hospice care using the minimum data set

OBJECTIVE: To present comprehensive profiles of residents in hospice care at admission to the nursing home using the Minimum Data Set (MDS). DESIGN AND SETTING: We analysed 40,622 MDS admission assessments for nursing home residents in hospice care. The MDS contains resident-focused data on pain, cognitive patterns, physical function, disease diagnoses, medications, nutrition, and specific treatments received. RESULTS: About four in five recently admitted hospice residents had 'do not resuscitate' orders and only 27% had a living will. Over 70% of recently admitted hospice residents experienced pain, with almost one half experiencing daily pain. Over one half of those hospice residents in pain experienced moderate pain and almost one third experienced horrible or excruciating pain. About 57% of recently admitted hospice patients had cancer, 21 % had congestive heart failure, 20% had emphysema/chronic obstructive pulmonary disease, and 18% had depression. About one in two recently admitted hospice residents exhibited at least moderate impairment in cognitive function. CONCLUSIONS: There is a need to improve pain management, advanced directives, and mental health services for residents dying in nursing homes.     

三主线贯标流程管理在晚期恶性肿瘤病人疼痛控制中的应用效果

[目的]分析三主线贯标流程管理在晚期恶性肿瘤病人疼痛控制中的应用效果。[方法]2016年1月—2016年6月入选病例45例设为对照组,2016年7月—2016年12月入选病例45例设为试验组,均于我科诊断为恶性肿瘤处于晚期且伴疼痛的住院病人,对照组接受常规癌痛护理,试验组接受三主线贯标流程癌痛控制管理,比较该模式实施前后各相关指标的差异性。[结果]试验组干预后疼痛症状控制评分显著低于对照组,该模式实施后护患满意度评分显著高于实施前(P0.05)。[结论]采取三主线贯标流程模式对晚期恶性肿瘤病人实施疼痛控制工护理,可显著提高该类病人癌痛症状控制效果和护患满意度。     

The emerging role of advanced nursing practice in acute pain management throughout Canada

The purpose of this study was to describe the role qualifications and responsibilities related to advanced nursing practice in acute pain management across Canada. The Canadian Nurses Association national framework on advanced nursing practice was used as a guide to identify role components for nurses within this specialty. A self-administered questionnaire of fixed choice and open-ended questions was mailed to nurses in acute pain management throughout Canada. Respondents identified their primary role responsibilities as clinical, educational, and administrative. Role challenges included lack of administrative/colleague support, complexity of pain problems, role definition, and acceptance. Key areas of positive outcomes involved the patient as well as interdisciplinary and nursing teams. Nurses described the ability to provide continuity of care, patient and staff education, and leadership in pain management as important and rewarding. The role of advanced nursing practice in acute pain management throughout Canada is evolving. The affect of this role promises to enhance the quality of pain management for healthcare professionals and their patients.     

综合护理干预对中晚期癌症化疗患者生活质量的影响

目的:探讨综合护理干预对中晚期癌症化疗患者生活质量的影响。方法:对住院接受前3次化疗的78例中晚期癌症患者在第1次化疗中给予常规护理,第1次化疗结束后开始采取心理护理、癌性疼痛护理及预防压疮、院内感染、药物外渗、消化道不良反应等综合护理,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、数字疼痛程度分级法(NPIS)评定其化疗前和3个疗程化疗结束后心理、疼痛改善情况,评估综合护理前后压疮、院内感染、消化道反应等改善情况。结果:给予综合护理干预后,78例患者的SAS、SDS评分和NPIS级数明显下降(P<0.05);第3次化疗时发生压疮、院内感染、药物外渗、消化道反应情况与第1次时比较差异有统计学意义(P<0.05)。结论:对中晚期癌症化疗患者给予综合护理干预、个体化护理,能提高患者的生活质量。     

以互联网为依托的居家安宁疗护联合疼痛管理对老年晚期肝癌患者生存质量和家庭压力的影响

摘要：目的：观察以互联网为依托的居家安宁疗护联合疼痛管理对老年晚期肝癌患者生存质量和家庭压力的影响。方法：选择2020年6月-2021年5月和2021年6月-2022年5月在廊下及吕巷接受居家安宁疗护的肝癌晚期患者61例和77例分别为常规疗护组、互联网疗护组，分别予以常规居家安宁疗护联合疼痛管理，和互联网为依托的居家安宁疗护联合疼痛管理护理。在干预前、干预后3个月比较两组患者生存质量、负面情绪、睡眠、疼痛以及家庭压力。结果：干预3个月后，互联网疗护组QOL-LC量表中躯体功能、心理功能、症状/副作用、社会功能评分、SAS和SDS评分、PSQI评分、疼痛VAS评分、FDI评分均低于常规疗护组，舒适度量表中生理舒适、精神心理舒适、环境舒适三个维度各条目平均分高于常规疗护组。结论：以互联网为依托的安宁居家疗护联合疼痛管理，提高老年晚期肝癌患者生存质量、缓解患者家庭压力的重要作用。     

Analyses of nursing home residents with cancer at admission

The objective of the study was to profile nursing home residents with cancer at admission to the nursing facility. We used all admission assessments in the Minimum Data Set recorded throughout the United States during 2002 to identify 61,890 residents with cancer, or 11.3% of all admissions. Nursing home residents with cancer were significantly older and more likely to be male than other residents at admission. Large proportions of nursing home residents with cancer were activities of daily living dependent and about 55% used a wheelchair as their primary mode of locomotion. More than 37% of residents with cancer experienced at least moderate daily pain at admission and almost 26% had a diagnosis of depression. At admission, more than half of residents with cancer had an unstable health condition, 21% were judged to be in their final 6 months of life, and 19% received hospice care. More than 40% of residents with cancer had no advance directives recorded at admission. Compared to other residents at admission, larger proportions of residents with cancer require heavy care. Staff at nursing facilities need to address depression, pain management, and the implementation of advance directives to improve the quality of life for residents with cancer.     

我国肿瘤患者居家护理研究文献的计量分析

目的 对我国居家肿瘤患者的护理状况进行文献回顾和分析,了解其研究现状和存在的问题,为我国居家护理实践和护理科研提供参考。方法 分别以“居家”、“肿瘤”、“护理”为关键词或主题词”对中国知网、万方、维普、中国生物医学文献数据库公开发表的我国肿瘤患者居家护理的相关文献进行检索分析,检索时限为建库至2020年4月。对题名、发表年份、期刊、著者数、第一作者(地域、机构、机构属性)、通讯作者、基金情况、文献类型、研究内容,关键词、资料收集方法等进行统计分析。结果 共获得201篇期刊文献,发文量随年份变化呈递增趋势,纳入期刊发表文献种类众多,共发表在108种期刊上,文献第一作者所属省份地区差异大,以江苏,上海等地居多。有基金支持的文献占比37%,研究类型以类试验性研究为主,研究内容集中于癌痛、PICC、用药和居家宁养等方面。结论 我国肿瘤患者居家护理相关的实验性研究质量相对较差,有待提高,且发文量地域差异大,居家护理实践需借助互联网的独特优势,突破地域限制。同时居家肿瘤患者重点护理问题突出,我国护理管理者应进一步规范相关护理技术规范,保证居家护理的规范性、安全性。     

Stoma care nursing: what the community nurse needs to know

The transition from hospital to home can be a worrying period of time for a patient with a newly formed stoma. It is well documented that community care is important, however this transition has been seen as a weak link in the care for a patient with a stoma (Allison 1996). In most cases following discharge from hospital, the nurse specialist in stoma care will visit the patient at home as a means of maintaining continuity of care. It is also important that the patient's GP, district nurse and other relevant community services are introduced to ensure a cohesive approach to the patients care at home (Taylor, 2003). This article therefore aims to offer the community nurse an overview of stoma care nursing in order to provide the continuity of care much needed by this group of patients.     

家居护理路径对晚期癌症谵妄患者睡眠质量的影响研究

目的：探讨家居护理路径对晚期癌症谵妄患者睡眠质量的影响.方法：选取2012年10月～2013年6月晚期癌症谵妄患者130例,将其随机分为对照组（常规护理干预组）和观察组（家居护理路径组）各65例,将两组患者分别于干预后第2周采用睡眠质量测定量表进行评估,并将两组患者干预后2周的评估结果进行比较.结果：观察组干预后2周的睡眠质量测定量表评分均明显低于对照组.结论：家居护理路径可有效改善晚期癌症谵妄患者的睡眠质量,对于此类患者发挥着积极的作用.