探视对不同住院时间精神病患者的影响

目的了解家属在不同阶段探视住院精神病患者对其病情的影响。方法将149例精神病患者按病程分为入院初期组42例,病情稳定组51例,康复组56例,采用护士用简明精神病量表对患者在家属探视前后进行测量,观察3组患者和各类疾病患者探视前后该量表得分并进行比较。结果对入院初期的精神分裂症、情感性障碍、复发性躁狂患者进行探视,患者的总体病情变化和敌对激惹因子有显著性差异(P<0.01或P<0.05),而在病情稳定期除情感性障碍有变化外,对其他疾病以及康复期的患者探视没有质的变化。结论在患者入院初期不宜探视,在病情稳定期和康复期的探视也有必要限制。     

亲属探视护理干预对首次住院精神分裂症病人病情的影响

[目的]观察亲属探视护理干预对首次住院精神分裂症病人病情的影响。[方法]将101例首次住院的精神分裂症病人随机分为两组,对照组50例采取随意探视,观察组51例进行亲属探视的护理干预。采用护士用住院病人观测量表(NOSIE)和简明精神病量表(BPRS)进行效果评定病人的精神症状。[结果]观察组病人入院2周、8周BPRS评分低于对照组(P<0.05);观察组病人NOSIE评分中激惹、抑郁及精神症状因子分低于对照组(P<0.05)。[结论]亲属探视护理干预对首次住院精神分裂症病人的病情有一定影响,适当选择探视时机探视,对改善病情有明显的辅助效果。     

亲属探视护理干预对首次住院精神分裂症病人病情的影响

[目的]观察亲属探视护理干预对首次住院精神分裂症病人病情的影响.[方法]将101例首次住院的精神分裂症病人随机分为两组,对照组50例采取随意探视,观察组51例进行亲属探视的护理干预.采用护士用住院病人观测量表(NOSIE)和简明精神病量表(BPRS)进行效果评定病人的精神症状.[结果]观察组病人入院2周、8周BPRS评分低于对照组(P＜0.05);观察组病人NOSIE评分中激惹、抑郁及精神症状因子分低于对照组(P＜0.05).[结论]亲属探视护理干预对首次住院精神分裂症病人的病情有一定影响,适当选择探视时机探视,对改善病情有明显的辅助效果.     

住院精神病患者首次被探视后的观察及护理

目的 探讨住院精神病患者首次被探视后的病情变化及护理方法。方法 随机观察160例住院精神病患者首次被探视后的病情变化，分析其临床特征，并根据具体情况进行护理。结果 首次被探视后72例（45％）出现病情反复，针对性地护理能有效减少意外事件的发生。结论 加强对住院精神病患者首次被探视后的观察和护理具有重要意义。     

探视后精神病患者发生意外事件的护理干预

通过对21例住院精神病患被探视后发生意外事件的原因分析,认为不适宜的探视可加重病情或致疾病反复,甚至发生意外事件。做好对探视的宣教,及时对患采取适时的护理,是防止意外事件发生．促进疾病康复的重要措施。     

护理风险管理在CCU病人“边缘时间”的应用

护理风险是指医院内病人在护理过程中有可能发生的一切不安全事件,广义地讲就是在护理工作中对病人、医院工作人员、探视者造成损害或被投诉事件[1]。冠心病重症监护病房(CCU)病人病情重、变化快以及疾病发展的不可预知性,使医疗护理风险更加明显。在监护室病人治疗期间,CCU医护人员对存在的风险有足够的认识,但当病人需外出检查或病情相对平     

家属远程弹性探视对急诊重症监护室病人家属疾病不确定感的影响

目的:探讨家属远程弹性探视对急诊重症监护室(EICU)病人家属疾病不确定感的影响。方法:便利抽取2021年1月—2021年12月郑州市某三级甲等医院首次入住EICU且入住时间在24 h以上病人的家属为研究对象,根据探视模式的不同,采用非同期对照的方法进行对比研究,将2021年1月—2021年6月入住EICU的234名病人的家属纳入对照组,实行限制性探视制度,将2021年7月—2021年12月入住EICU的218名病人的家属纳入观察组,实施家属远程弹性探视制度,比较两组病人家属的疾病不确定感评分。结果:两组病人家属在病人入住EICU未探视时,对照组疾病不确定感得分为(89.77±5.23)分,观察组疾病不确定感得分为(89.05±7.31)分,均处于较高水平,但差异无统计学意义(P>0.05);病人出科时,对照组家属疾病不确定感得分为(88.53±7.38)分,观察组家属为(72.77±2.71)分,两组病人家属疾病不确定感得分均有所降低,且观察组病人家属疾病不确定感得分明显低于对照组,差异均具有统计学意义(P<0.05)。结论:家属远程弹性探视较限制探视能够更加有效地降低E...     

如何护理甲状腺机能亢进病人？

护理要点有：(1)病情观察：注意精神状态及生命体征的改变，观察治疗反应，警惕甲状腺危象的发生。(2)一般护理：①加强心理护理，使病人了解病情及转归，树立战胜疾病的信心，以减少紧张不安情绪或发怒；②保持安静的休养环境，使病友、亲属及探视人员了解病人的病情及需要，减少对病人的各种刺激；③指导病人增加营养，给予高热量、高蛋白、高维生素饮食；④指导用药，     

住院精神病人家属探视情况及对病人的影响

目的 了解住院精神病病人家属探视频率对病人的影响.方法 自制问卷,对160例病人和160位家属进行探视状况调查.结果 35.2%北京病人及42.86%的外地病人在住院期间处于极少探视或无探视状态.48.75%的病人在无探视时出现负性情绪,76.25%的病人探视后心情愉快.53.75%的家属没有意识到病人心理需求的重要性.结论 住院精神病病人家属探视率低,医护人员需对家属进行心理辅导,转变家属对病人和对探视的态度,良好的家庭支持和关怀有利于病人疾病的治疗和康复.     

住院精神病人家属探视情况及对病人的影响

目的了解住院精神病病人家属探视频率对病人的影响。方法自制问卷,对160例病人和160位家属进行探视状况调查。结果35．2％北京病人及42．86％的外地病人在住院期间处于极少探视或无探视状态。48．75％的病人在无探视时出现负性情绪,76．25％的病人探视后心情愉快。53．75％的家属没有意识到病人心理需求的重要性。结论住院精神病病人家属探视率低,医护人员需对家属进行心理辅导,转变家属对病人和对探视的态度,良好的家庭支持和关怀有利于病人疾病的治疗和康复。     

Sexual changes in hemiparetic patients

Eighty-six patients, each with hemiparesis caused by a single stroke, were studied to assess the changes in sexual life experienced after the onset of the illness. Clinical data were collected, and a questionnaire concerning both sexual behavior and feelings about sexuality was administered to the patients and their spouses. Twenty-four couples were eliminated from further analysis because of a discrepancy between husband and wife in the answers concerning sexual behavior after stroke. A marked decline in sexual activity after stroke was found in both genders; other aspects of sexual behavior underwent fewer changes. The feeling of an overall change in sexual life was reported more frequently by male patients. Most patients' spouses reported the feeling of an overall psychological change in their partners and the feeling of an overall change in sexual life after the onset of the illness. No significant associations were found between clinical features and changes in sexual life. This study confirms that cerebrovascular accidents are generally followed by some important alterations in sexual life. Clinical factors do not seem to play a crucial role in determining these changes, which may be better explained in terms of maladjustment attributable to psychologic and interpersonal factors.     

Illness concerns and recovery from a URI

Fifty ambulatory upper respiratory tract infection patients were studied to evaluate the nature of their illness concerns and explore the relationship between these concerns and subsequent recovery. Thirty-four patients still had URI-related symptoms 1 week after their medical visit, whereas 16 were asymptomatic. In general, asymptomatic patients could not be distinguished from symptomatic patients in terms of demographic variables, symptom type or duration, initial level of health concerns, physician findings, culture results, or therapy. Further, both groups exhibited surprisingly high levels of initial concern. Asymptomatic patients had a significantly greater reduction in these concerns shortly after their visit than the symptomatic group (P less than 0.01). Asymptomatic patients also reported more benefit from discussion of their concerns (P less than 0.01) and more satisfaction with this aspect of their care than the symptomatic group (P less than 0.001). The notion of illness concerns appears to be a concept worthy of clinical consideration and further investigation.     

专职术前访视在外科ICU的作用探讨

目的探讨专职术前访视在外科ICU的作用。方法选取2007年10月-2008年6月进入普外科IEU且均已行专职术前访视的术后病人320例为观察组,选取2005年10月～2007年9月进入普外科ICU且均未行专职术前访视的术后病人300例为对照组。比较两组病人术后急性认知功能障碍发生率、护士对病人相关病情知晓率及病人对护理工作的满意度。结果两组病人术后急性认知功能障碍发生率、护士对病人相关病情知晓率及病人对护理工作满意度比较,差异均有统计学意义（均P〈0．01）。其中观察组病人术后急性认知功能障碍的发生率低于对照组,而在护士对病人相关病情知晓率和病人对护理工作满意度方面则高于对照组。结论专职术前访视可降低老年病人术后急性认知功能障碍的发生率,提高护士对病人相关病情知晓率和病人对护理工作的满意度。     

慢性病病人团体访问的模式、效果和面临的挑战

团体访问是由医务工作者以团体访问的形式为病人提供广泛的健康教育、相互的支持等,从而促进病人健康的行为方式,提高其自我照顾的能力。它是慢性病管理的一种新的模式。本文对目前团体访问的模式、效果以及面临的挑战进行了综述。     

Patient exposition and physician explanation in initial medical interviews and outcomes of clinic visits

To replicate an earlier study and explore associations between verbal behaviors in patient-physician interactions and outcomes of care, 102 visits to a medicine walk-in clinic were tape-recorded, transcribed, and coded according to the Verbal Response Mode (VRM) system. Questionnaires given before and after the clinic visit and telephone interviews 1 week and 4 weeks after the visit were used to measure patient satisfaction, compliance, and change in symptoms. Data were collected on patients' sociodemographic characteristics, illness characteristics, and health beliefs. Two verbal exchanges were examined: in the medical history, the Patient Exposition exchange, which was measured as the frequency with which patients make statements about their illnesses in their own words; and in the conclusion, the Physician Explanation exchange, which was measured as the percentage of physician statements that are factual. These verbal indexes showed correlations with patient satisfaction, thus replicating the earlier study, but no significant correlations with compliance. Analysis of variance showed that the association between verbal exchanges and patient satisfaction remained after controlling for physician differences and for patient age, education, and belief in the controllability of the illness.     

Adrenal insufficiency in prolonged critical illness

Introduction  

Adrenal insufficiency is common in critically ill patients and affects their prognosis, but little is known about how adrenal function changes during prolonged critical illness. This study was conducted to investigate dynamic changes in cortisol levels in patients with critical illness who do not improve after treatment.     

Beyond the walls: a review of ICU clinics and their impact on patient outcomes after leaving hospital.

INTRODUCTION: Patients often experience physical disability, neurocognitive and/or psychological impairment after surviving ICU. The burden arising from critical illness on patients, their families and health services may be substantial. Follow-up of these patients is important and ICU clinics have been introduced for this purpose. AIM: The aim of this review was to consider current research and reports from the literature about ICU follow-up clinics and their impact on patient outcomes for those who survived hospital after suffering critical illness. METHOD: The literature review included searches of the MEDLINE, EMBASE, and CINAHL databases. Studies were included if they described the setting up and conduct of the ICU follow-up clinic that required a visit to the clinic. RESULTS: Seven studies met the inclusion criteria, six of which were from the UK. The ICU follow-up clinics were predominantly nurse-led. There was no consensus on patient selection criteria for clinic attendance or method of follow-up. Clinic services were most often offered to patients who stayed in ICU three or more days. Attendance rates varied and were not reported for three studies. Attendance appeared to be influenced by the severity of illness. Cancellation and non-attendance rates were high for those studies reporting these data. Patients who did not live within the vicinity of the hospital were often excluded. Information about the sequelae of critical illness was provided and attendees were happy to discuss their experiences at the clinic. However, other important outcomes were not reported. CONCLUSION: Appropriate follow-up for survivors of intensive care and their family is important. However, evidence is limited on the benefit of ICU clinics for patients recovering from critical illness. Further research is needed to examine models that best meet patient needs after critical care.     

重型颅脑损伤病人的观察和护理

[目的]总结重型颅脑损伤（SCI）病人临床观察护理经验,探讨临床观察及护理的措施与方法。[方法]选取我院2003年-2008年收治的200例重型颅脑损伤病人,根据入院后不同时期病情变化的特点,分析观察护理重点、难点及护理对预后的影响。[结果]经过有重点的观察病情变化,精心科学的护理工作,除16例死亡外,其余184例均治愈或好转。经过恢复期帮助病人进行康复锻炼、心理辅导,使其重获信心,回归社会。[结论]按照SCI病人病情进展变化特点分阶段护理,大大提高了病人的生存率,促进了病人身心康复,更好地适应了新型的生物-心理-社会医学模式。     

To treat? to befriend? to prevent? Patients' and GPs' views of the doctor's role

Objective-To examine and compare patients' and GPs' views of the doctor's role and patients' reasons for going to the doctor.

Design-A cross sectional questionnaire survey.

Setting-General practices across England.

Subjects-501 patients and 68 GPs.

Main outcome measures-Beliefs about the doctors' role and beliefs about patients' reasons for going to the doctor in terms of illness treatment, a psychosocial approach and preventive health care.

Results-A majority of both patients and GPs agreed that the doctor's role was primarily to treat illness. However, whereas patients showed greater endorsement for preventive health care and a belief that the doctor's role was to keep people healthy, GPs showed greater support for an emphasis on personal problems. In terms of patients' reasons for visiting their doctor, a majority of both patients and GPs agreed that illness prevention and illness treatment were important. However, more patients believed that patients visit the doctor for illness prevention than GPs, more of whom felt that patients seek help with their personal problems.

Conclusion-The results indicate a mismatch between patients' and GPs' beliefs, which has implications for understanding the impact of recent changes in primary care and the effects on GPs' job satisfaction.