健康信念模式对PICC患者出院后遵医行为的影响

目的探讨健康信念模式对经外周静脉置入中心静脉导管(peripherally inserted central catheter,PICC)患者出院后遵医行为的影响。方法按入院时间先后次序,将75例行PICC患者分为对照组36例,观察组39例,对照组患者住院时接受常规健康教育和出院后定期门诊复诊,观察组在此基础上应用健康信念模式为理论基础对患者进行干预。采用自行设计的遵医行为调查问卷对患者进行调查。结果出院后观察组患者遵医行为优于对照组,两组比较,P0.05,差异有统计学意义。结论应用健康信念模式为理论基础对PICC患者进行干预,可提高患者遵医行为。     

Writing behavioural objectives: an evaluation of a simple, inexpensive method

This study demonstrated experimental control of nurse compliance with writing behavioural objectives in a National Health Service adult training unit for mentally handicapped adults. At the baseline, low rates of compliance in writing complete behavioural objectives (i.e. an objective referring to a resident, an action, a prompt and a target) were identified. A simple environmental manipulation, namely redesigning the activity charts, led to an increase in writing complete behavioural objectives. Experimental control was demonstrated using a multiple baseline design across two groups of staff. Nurse compliance with writing adequate prompts and targets was less than compliance with writing names and behaviours. Greater degrees of compliance may require alternative methods of staff management such as feedback procedures.     

健康信念模式对改善再住院糖尿病患者治疗依从性的效果研究

目的:探讨健康信念模式教育对提高再住院糖尿病患者治疗依从性的影响。方法:筛选在我院接受治疗的再住院糖尿病患者78例,随机分为两组,分别采取应用健康信念模式和常规健康教育方法进行健康教育,分别于教育前、教育后进行依从性评价并对比治疗效果,进行统计学分析。结果:经过健康教育干预后,两组患者的治疗依从性有统计学意义(P<0.05)。结论:健康信念模式理论指导健康教育,能促进再住院糖尿病患者主动配合治疗,提高其治疗依从性,改善其生活质量。     

音乐节拍按摩法对听神经瘤术后面神经麻痹患者康复治疗依从性的影响

目的探讨音乐节拍按摩法对听神经瘤术后面神经麻痹患者康复治疗依从性的影响,为听神经瘤术后面神经麻痹患者提供简便易学、便于操作的手法按摩方法,提高患者训练的依从性。方法采用前瞻性随机对照的方法,将行乙状窦后入路听神经瘤切除术的92例患者分为观察组45例和对照组47例,两组患者均从术后24h开始进行手法按摩,每日3次,每次15min。对照组仅采用手法按摩,观察组在采用手法按摩时配以音乐节拍。两组患者于术后24h及术后1个月均采用House—Braekmann面神经功能评定法进行面神经麻痹等级评定,采用治疗依从性量表于术后1个月进行依从性评分。结果观察组治疗依从性好者18例,部分依从者22例,依从性差者5例;对照组依从性好者11例;部分依从者20例,依从性差者16例,观察组康复治疗依从性明显高于对照组,两组比较,差异具有统计学意义（x^2=7．5069,P〈0．05）。在面神经麻痹康复治疗效果方面,观察组痊愈12例,显效23例,好转7例,无效3例;对照组痊愈9例,显效14例,好转16例,无效8例,经等级资料两样本比较,观察组疗效优于对照组,差异具有统计学意义（U=2．372,P〈0．05）。结论音乐节拍按摩法可以规范按摩手法,在音乐节拍的引导下使康复训练定时、定量、定位,提高患者治疗的依从性、准确性,确保康复训练效果。     

A review of the evidence for suboptimal compliance of healthcare practitioners to standard/universal infection control precautions

Aims. The review examines from international research: the extent to which practitioners comply with infection control precautions; the pertinent issues that are considered influential in compliance; what strategies have been evaluated to instigate positive behaviour changes amongst practitioners and the effect of these interventions. Background. Internationally, standard/universal precautions (UP) are regarded as fundamental in the prevention and control of infection, and effective in protecting practitioners and patients. However, adherence has been problematic and the practice of standard/UPs is globally suboptimal. Design and methods. Literature review where relevant evidence was identified using several electronic databases, from 1994 to 2006, with number of key terms utilized. Data were extracted by using key headings, which facilitated analysis. Results. Thirty‐seven studies were appraised. Twenty‐four related to measuring practitioner compliance and 13 studies that evaluated the effect of a research intervention on compliance. In addition, other studies were included which examined the specific reasons for suboptimal compliance, or discussed infection control precautions generally. Conclusions. Compliance to infection control precautions is internationally suboptimal. The evidence confirms that compliance to specific aspects of standard/UPs varies, and practitioners are selective in their application of recommended practice. Compliance does improve following a structured intervention; however, research fails to indicate for how long the intervention affects practitioner compliance, or whether compliance after a period of time returns to the norm. Several reasons for non‐compliance are discussed, and recommendations for future research are suggested. Relevance to clinical practice. Suboptimal compliance has significant implications for staff safety, patient protection and the care environment. Infection control teams and researchers need to consider the reasons for non‐compliance and provide a supportive environment that is conducive to the routine, long‐term application of standard precautions.     

心理支持对异基因干细胞移植患者的影响

目的研究心理支持在白血病患者异基因干细胞移植(allo-PBSCT)过程中的影响,以求提高治疗效果和护理水平。方法30例行allo-PBSCT患者随机分为对照组(n=15)和支持组(n=15),对照组按移植术护理常规进行护理,支持组除按移植术护理常规进行护理外,于患者进入全环境保护的无菌层流室前起至入室后的预处理期、移植治疗期、康复缓解期同时施行心理支持护理,比较2组患者在allo-PBSCT中依从性和并发症发生率以及需要住无菌层流室行保护隔离时间的差异。结果支持组的依从性显著高于对照(P<0.01),并发症发生率显著低于对照组(P<0.05),需住无菌层流室隔离时间显著低于对照组(P<0.01)。结论心理支持护理能显著提高allo-PBSCT患者的依从性,减少并发症的发生,缩短在无菌层流室隔离的时间,提高治疗效果。     

药学服务对服用中成药治疗感冒的影响调查

目的:了解药学服务对服用中成药治疗感冒的影响,为临床药师对服用中成药治疗感冒合理干预提供依据。方法:我院自行设计调查问卷,采取随机抽样调查方法分成干预组和对照组进行调查,在南昌市行政区域内随机选取1个社区、1所学校和1个社区中心医院总共调查320例。内容包括受访者基本资料、感冒和中成药认知、中成药治疗感冒方案、依从性4部分。结果:干预14个月后,中成药治疗感冒方案良好者干预组和对照组分别为95%和53%,感冒和中成药认知良好者干预组和对照组分别为97%和57%,依从性良好者干预组和对照组分别为99%和52%。结论:社区居民使用中成药治疗感冒基本合理,药师的药学服务对社区居民帮助佷大,解决了社区居民在感冒和中成药认知、中成药治疗感冒方案和依从性等方面存在的问题,而持续的干预对社区居民服用中成药治疗感冒是必须的。     

医院-社区-家庭延续护理模式在老年骨质疏松患者中的应用

目的：探讨医院-社区-家庭延续护理模式在老年骨质疏松患者中的应用效果。方法：采用便利抽样的方法,选取2016年1月至6月于天津医科大学总医院保健医疗部住院或门诊治疗的老年骨质疏松患者113例,随机分为观察组57例,对照组56例。对照组采取常规护理方法,观察组在常规护理基础上实施医院-社区-家庭延续护理模式,3个月后比较两组骨质疏松知识得分、健康信念、自我效能、服药依从性水平。结果：干预后观察组骨质疏松症知识得分,健康信念量表得分及自我效能得分与对照组比较差异有统计学意义 (P＜0.05);观察组干预前后服药依从性差异有统计学意义（P＜0.05）;对照组干预前后服药依从性差异无统计学意义（P＞0.05）。结论：老年骨质疏松患者医院-社区-家庭延续护理干预可有效提高老年骨质疏松症患者的知识水平,健康信念,自我效能及其服药依从性。     

冠心病患者疾病感知和健康行为依从性相关性研究

目的：了解西安市冠心病患者疾病感知及健康行为依从性现状,探讨疾病感知和健康行为依从性的相关性,为临床开展冠心病患者健康行为管理干预提供参考依据。方法：方便抽取西安市4家医院进行常规复查的冠心病患者进行调查;采用一般资料调查表、简易疾病感知问卷（B-IPQ）、Godin休闲时间运动问卷、Morisky药物依从性量表、饮食吸烟咨询表评估患者的疾病感知信念以及健康行为依从性现状;评估疾病感知和健康行为依从性的相关性及预测价值。结果：回收有效问卷248份（有效应答率为95.4%）,冠心病患者对疾病了解程度水平较高,相信能够通过自己和（或）适当的治疗控制病情。感知的主要病因与肥胖、高脂饮食、久坐生活方式等危险因素有关。调整后回归分析显示,个人控制（β=2.66,95%CI:1.25-4.04）、病程（β=1.85,95%CI:0.80-2.88）和疾病了解度（β=2.12,95%CI:0.35-3.90）为运动依从性的一个有力的预测感知。药物依从性由个人控制、治疗控制、疾病关注度感知预测。低脂饮食依从性通过疾病了解度感（OR=1.20,95%CI:1.04-1.33）进行预测。当前吸烟者更易认为他们的病情会持续很长时间,并对他们的生活产生诸多影响。结论：通过对冠心病患者疾病感知与健康行为依从性相关性探讨,对冠心病患者实施健康教育时,应重点强调这些尚未被患者认知的危险因素,用科学的理论方法进行有效干预, 增强其自我保健意识,自觉采取有利于健康的行为方式,增强其遵医行为,提高冠心病患者的生活质量, 防止心血管事件的发生。     

The effect of education and written material on compliance of pediatric clients

One hundred and fifty babies and their mothers, presenting to the Well Baby Clinic of the Pediatric Outpatient Department were studied for compliance. They were divided randomly into three groups, one serving as a control (n = 55) and two as experimental groups (n = 48 and 47). The latter were exposed to two different intervention methods; teaching and written material respectively, in addition to the routine care given to the control group. The three groups were compared in terms of compliance and improvement in knowledge. The results showed that reinforcement of the doctor's advice by a nurse, or written instructions to the patients, did not improve knowledge or compliance. Possible explanations for such results are given and suggestions for other modes of intervention are made.     

Standard parameters of diabetic control: are they reliable?

To evaluate the reliability of the tradional methods to assess short-term control of diabetes, 25 children with insulin-dependent diabetes were studied with a 24-h glucose profile in addition to the traditional assessment techniques. Patient compliance was elminated as much as possible from the experimental design. The correlation of the routine methods with the 24-h glucose profile was excellent, and a scoring system for control was empirically derived. The single method of assessment that correlated best with the overall control score was the traditional daily urine test. In 6 of the 25 subjects studied, relative hypoglycemia was observed, occurring asymptomatically at night, and was followed by a hyperglycemic rebound. Traditional assessment techniques did not detect this event. Five additional patients had symptomatic daytime hypoglycemia. We conclude that the traditional daily urine tests are adquate indicators of day-to-day control in most diabetic patients, given adquate compliance. Our data also suggest that asymptomatic nocturnal hypoglycemia occurs frequently in children with diabetes, although clinical proof is difficult in the absence of a 24-h glucose profile.     

思维导图在脑卒中患者健康教育及健康行为依从性中的应用

目的：评价思维导图在脑卒中患者健康教育及行为依从性中的应用效果。方法：将80例脑卒中患者按随机数字表法分为观察组和对照组各40例。观察组运用思维导图进行健康教育,对照组应用常规宣教方式进行健康教育,比较两组患者的健康教育效果。结果：观察组患者脑卒中知识掌握度高于对照组（P=0.007）,健康行为中在饮食遵循（P=0.009）、控烟戒酒（P=0.013）、康复训练（P=0.000）和自我监测（P=0.000）方面依从性均优于对照组。结论：将思维导图应用于脑卒中患者的健康教育,能够提高患者的知识掌握度,提高患者的健康行为依从性,有益于养成健康的行为和生活方式。     

对农村老年糖尿病患者实施饮食管理的方法与效果

目的探讨农村老年糖尿病患者饮食管理的有效方法。方法选择100例农村老年糖尿病患者按随机数字表法分为对照组和观察组,各50例。对照组给予常规护理及健康教育,观察组在此基础上实施个性化饮食管理,包括分层次健康教育及“一对一”的饮食指导,设计并实施饮食治疗卡,同时强化家庭成员的支持、出院后随访等。结果经过6个月的观察,观察组的血糖控制指标和饮食治疗依从性明显优于对照组（P〈0．01）。结论个性化饮食管理能控制患者的血糖、提高饮食治疗依从性。     

磁共振评价不同年龄主动脉顺应性的研究

目的：评价MRI在观察主动脉顺应性改变中的作用。方法：对63例正常志愿者按年龄分组进行升主动脉MR相位对比电影法扫描，生成时间-面积曲线，用直径法和面积法计算主动脉顺应分数。结果：随年龄增长，主动脉顺应性逐渐减低，顺应分数升高；并且，MR面积法所得主动脉顺应分数与年龄相关性大（r=-0.6972）。MR测量方法可重复性高（r=0.91）。结论：MRI可作为观测主动脉顺应性较好的手段。     

自编韵律操对肩关节手法松解术后患者肩关节活动恢复的影响

目的探讨自编韵律操对肩关节手法松解术后患者肩关节活动恢复的影响。方法 2012年7月至2013年9月,将确诊肩周炎并施行肩关节手法松解术的60例患者按随机数字表法分为对照组(n=30)和观察组(n=30),对照组采用常规锻炼方法,观察组采用韵律操方式锻炼。分别于术后1、2、4、8周比较两组患者的肩关节功能及功能锻炼依从性。结果术后1、2、4、8周,观察组患者的肩关节功能评分均高于对照组,功能锻炼依从性好的比例也高于对照组,差异均有统计学意义(均P0.01)。结论行肩关节松解术患者应用自编韵律操进行锻炼可促进肩关节功能的恢复,且能提高患者功能锻炼的依从性。     

护理干预对断指再植患者抗凝治疗依从性的研究

目的:探讨护理干预对断指再植患者术后抗凝治疗依从性的影响。方法:将90例使用抗凝治疗的断指再植术后患者,按病例就诊顺序随机分成实验组和对照组各45例。对照组采用常规护理,实验组除常规护理外对患者实施全程健康教育护理干预。结果:护理干预前,2组患者治疗依从性比较差异无统计学意义;护理干预后,实验组断指再植治疗相关知识评分与对照组比较有显著性差异(P0.01),实验组断指再植抗凝治疗依从性与对照组比较有显著性差异(P0.05)。结论:健康教育方式应多样性,方式因人而异;对患者家庭成员进行心理教育;满足患者对治疗信息渴望,加强与患者信息交流。积极的护理干预可提高患者的健康教育知识水平,增强抗凝治疗的依从性。     

Facilities assessment/surveillance for infection control in ambulatory care

A thorough facility assessment that engages personnel from multiple departments is crucial to infection control. Surveillance of both the outcomes and the processes used for cleaning, disinfection, and sterilization are critical, especially for high-volume, high-risk procedures. Written definitions, along with simple and reasonable data collection methods, allow for greater compliance to policies.     

精神障碍合并糖尿病患者的服药依从性和血糖控制情况现状研究

目的：探讨精神障碍合并糖尿病患者的服药依从性和血糖控制情况现状，为提高精神障碍合并糖尿病患者行为干预及血糖控制提供临床依据。方法：选取2021年1月~2022年6月我院收治的精神障碍合并糖尿病患者148例为研究对象，所有患者临床资料完整。以8条目Morisky用药依从性量表(MMAS-8)调查所有患者服药依从性并分组，MMAS-8评分<6分的患者依从性差组，MMAS-8评分6~8分的患者依从性好组；通过抽取静脉血检测患者FBG、PBG、HbA1c，比较两组患者血糖控制状况及血糖控制达标率。结果：在纳入研究的148例研究对象中，依从性较差组患者61例（41.22%），依从性较好组患者87例（58.78%），依从性较好组MMAS-8评分明显高于依从性较差组，P＜0.05，差异具有统计学意义；依从性较好组患者FBG、PBG、HbA1c水平显著低于依从性较差组，且依从较好组血糖控制达标率（74.71%）明显高于依从性较差组（37.70%），P＜0.05，差异具有统计学意义。单因素logistic回归分析显示服药依从性（OR=0.638，95%Cl（0.422~0.915））是影响精神障碍合并糖尿病患者血糖控制达标率的独立危险因素。结论：精神障碍合并糖尿病患者服药依从性有待提高，服药依从性与患者血糖控制达标率密切相关，应该采取针对性措施让患者规律用药，延缓患者糖尿病病情进展。     

OSHA's final bloodborne pathogens standard. Part I.

The Bloodborne Pathogens Standard is the first standard promulgated by OSHA that addresses a biological hazard in the workplace. This Standard applies to all workers with occupational exposure to blood or other potentially infectious materials. To achieve compliance, the employer must determine and document exposure. Also, a written exposure control plan must be available that stipulates the use of appropriate methods of compliance such as engineering controls, work practice controls, and the use of personal protective equipment.     

单病种护理质量标准对老年冠心病患者治疗依从性、自我管理能力的影响

目的 探讨单病种护理质量标准对老年冠心病患者治疗依从性、自我管理能力的影响.方法 随机选择2016年7月至2018年11月收治的222例老年冠心病患者作为研究对象,根据入院时间将其分为对照组(2016年7月至2017年7月)和观察组(2017年8月至2018年11月),各111例.对照组给予常规护理,观察组在对照组基础...