辽宁地区绝经后妇女骨质疏松症知识问卷调查分析

目的了解辽宁地区绝经后妇女对骨质疏松症知识的认知情况,为开展有地域针对性地骨质疏松宣教和防治工作提供依据。方法对2011年7月至2012年7月在沈阳军区总医院就诊的绝经后妇女进行骨质疏松症知识问卷(osteoporosis knowledge tests,OKT)调查,并测定跟骨超声骨密度。结果 267名受试者骨质疏松症知识问卷平均得分(12.83±4.41)分,其中危险因素得分(5.14±2.73)分、运动知识得分(2.86±1.52)分、钙知识得分(4.87±1.62)分。年龄高、学历低、居住于乡镇、诊断为骨质疏松症者问卷得分较低。电视广播媒体为获取骨质疏松症知识的主要来源,多数受试者不重视专业骨质疏松宣教及骨密度筛查。坚持规律运动及补钙的人群比例较低。结论辽宁地区绝经后妇女骨质疏松症知识匮乏,专业人员应加大宣教力度,开展定期宣教,建立骨质疏松防治计划手册,督导个体完成骨质疏松长期防治计划。     

老年骨质疏松症椎体骨折患者钙营养知识及态度调查

目的调查分析老年骨质疏松症椎体骨折患者钙营养知识、态度现状。方法对68例骨质疏松症椎体骨折患者使用骨质疏松知识问卷中的钙营养知识部分及骨质疏松健康信念量表中的钙摄入益处和摄入障碍进行调查。结果 68例椎体骨折患者钙量表知识平均为(4.13±2.52)分,仅8.82%可以正确回答"成人每天的钙摄入量";健康信念量表中的钙摄入益处平均为(21.33±3.58)分,钙摄入障碍平均为(19.74±4.47)分。68例中66.18%少喝/不喝牛奶或酸奶,57.35%喜好素食,42.65%服用维生素D,66.18%通过药物补钙。结论老年骨质疏松症椎体骨折患者钙营养知识水平有待提高,需要平衡补钙益处和补钙障碍的态度。富钙食物的摄入、合理补充钙剂等方面亦存在一定问题,需要通过针对性的健康教育提高钙营养,促进健康行为,从而达到预防骨质疏松症并发症的目的。     

骨质疏松预防与自我管理课程对绝经后女性骨质疏松认知及健康行为的影响

目的评价骨质疏松预防与自我管理课程(osteoporosis prevention and self-management course,OPSMC)对绝经后女性骨质疏松认知及健康行为的影响。方法将2011年7月-2012年7月在沈阳军区总医院就诊的267名绝经后妇女随机分为干预组133例和对照组134例。干预组采用OPSMC规定课程,对照组同步实施与骨质疏松无关的健康宣教。干预前及3个月后分别采用骨质疏松症知识问卷(OKT)、骨质疏松症自我效能量表(OSES)和自设的骨质疏松健康行为问卷对两组受试者进行评价。结果 2组受试者OKT和OSES评分在不同时间点差异有统计学意义(P0.001),不同干预方式对OKT和OSES评分影响不同(P0.001),干预与时间点之间有交互作用(P0.001)。在3个月时,干预组更加重视补充钙剂(19.5%vs1.8%,P0.01)、维生素D(14.4%vs 0.9%,P0.01)、含钙食物摄入(15.3%vs 2.7%,P0.01)、每周锻炼次数(9.3%vs0.9%,P0.01)及强度(27.9%vs 8.8%,P0.01)。结论 OPSMC是一种有效的骨质疏松健康干预措施,短期内可以提高绝经后女性骨质疏松认知水平,促进健康行为。     

社区高血压早期肾损害患者健康促进生活方式调查分析

目的 调查社区高血压早期肾损害患者健康促进生活方式的现况,探讨其影响因素,为开展健康干预活动提供依据.方法 选取上海市某社区151例高血压早期肾损害患者,采用健康促进生活方式评定量表Ⅱ、高血压肾病患者特异性健康促进生活方式问卷、高血压肾病知识问卷及自我效能量表进行调查.结果 患者的健康促进生活方式得分(124.99±24.91)分,家庭经济状况、高血压家族史、医疗费支付方式、高血压肾病知识、自我效能为其主要影响因素(P＜0.05,P＜0.01);患者的特异性健康促进生活方式得分(28.08±4.90)分,高血压肾病知识、自我效能为其主要影响因素(均P＜0.01).结论 社区高血压早期肾损害患者健康生活方式整体水平不高,需加强社区针对性教育,并注重增强患者自我效能,以改善其不良生活方式,延缓疾病进程,提高生活质量.     

慢性病患者健康信息搜寻行为的调查分析

目的了解慢性病患者健康信息搜寻行为现况,为健康教育方案的制订提供参考。方法以方便抽样方法抽取慢性病住院患者313例,采用健康信息搜寻行为问卷对患者进行调查。结果慢性病住院患者信息需求维度得分(4.30±0.67)分,对健康信息搜寻行为的态度维度得分(3.94±0.85)分,获取健康信息的障碍维度得分(3.11±1.04)分,健康信息来源维度得分(3.10±0.96)分。结论慢性病患者对健康信息搜寻行为的态度处于中等偏上水平,对健康信息的需求较高。需开展以患者健康信息需求为导向、由医护人员和患者合作参与的多形式健康教育,以提高和改善慢性病患者的疾病管理能力与信心。     

社区中老年人骨质疏松健康信念及其相关行为调查

应用骨质疏松症(OP)健康信念量表和自制的OP行为问卷,对289名社区中老年人进行调查. 结果不同年龄、学历、性别和摄钙组间的健康信念总分比较,差异有显著性意义(均P<0.05),高龄者、学历低者、男性和低摄钙组的总健康信念水平较低.且社区中老年人的健康信念与预防行为之间相互影响.提出对社区中老年人进行OP健康教育时,应提高健康信念,促使其不良行为的改善.     

妊娠期妇女的健康信念与健康行为调查

目的了解妊娠期妇女的健康信念水平与健康行为,为制定有针对性的干预措施提供参考。方法采用以"健康信念模式"为基础自行设计的调查问卷及孕期身体活动问卷对江门市612名孕妇进行调查,分析其运动状况及健康信念水平。结果妊娠妇女健康信念总分为(70.66±8.46)分,条目均分(3.53±0.42)分,其中感知到的易感性和自我效能水平最高,分别为(4.02±0.78)分、(4.10±0.70)分,感知到的严重性和行为效益认知分别为(3.81±0.68)分、(3.83±0.60)分,感知到的行为障碍认知得分(3.12±0.59)分。运动量达标组健康信念总分、易感性认知、行为障碍认知及自我效能得分显著高于未达标组(均P0.05)。结论妊娠期妇女的健康信念处于中上水平,运动量越大的孕妇健康信念水平越高。围生保健工作者应围绕妊娠期妇女的健康信念水平加强教育和指导,并设计可行的干预方案以促进和提高妇女妊娠期间的运动水平。     

路径式健康教育对骨质疏松患者知信行的影响

目的探讨路径式健康教育对骨质疏松患者知信行的影响。方法选择在我院康复科住院的骨质疏松患者120例作为研究对象,随机分为研究组和对照组各60例。对照组给予药物治疗,同时进行常规健康教育,研究组采用在对照组的基础上实施路径健康教育,分别于干预前、干预后12个月比较两组患者对骨质疏松相关知识掌握情况、健康信念、健康行为内容进行评价。结果两组患者出院后12个月骨质疏松症相关知识得分、健康信念总得分、健康行为得分显著高于对照组(P0.05)。结论给予患者实施路径式健康教育能够改善骨质疏松患者的知信行,有效提高患者及其家属对骨质疏松症防治相关知识的认知水平,增强患者的自我护理能力,防止骨质疏松性骨折,进而提高治疗效果,改善患者的生活质量。     

200例骨质疏松症患者健康知识、信念、行为的调查分析

目的 了解我院2011年6月-2013年3月骨伤科200例骨质疏松症患者健康知识、信念、行为的现状.方法 对骨质疏松症患者发放骨伤科自行编写的骨质疏松症健康知、信、行理论问卷,请患者自行完成或在护士的协助下完成问卷的患者基本信息、骨质疏松症的相关知识、健康信念评估和行为评估四方面的内容.所有问卷中的信息和各部分的得分均进行统计录入和分析.结果 不同年龄骨质疏松症患者健康知、信、行理论问卷的相关知识分值存在显著差异,健康信念评估和行为评估分值未见显著差异.不同工作状态和文化程度骨质疏松症患者健康知、信、行理论问卷的相关知识、健康信念评估和行为评估分值存在显著差异.结论 帮助更多的患者掌握卫生保健知识,树立健康观念,使他们自愿形成健康的行为和生活方式,预防骨质疏松的发生,进行有效的骨质疏松症健康管理.     

临床护理带教老师工作压力及自我效能和带教行为的调查分析

目的分析临床护理带教老师工作压力、自我效能和带教行为水平及其相关因素。方法采用临床教师带教行为问卷、护士工作压力源量表和一般自我效能量表对江苏省3所三级甲等综合医院的139名临床带教老师进行调查。结果临床护理带教老师临床带教行为量表总均分为4.35±0.49,各维度中知识领域得分最低;工作压力源量表总均分为2.54±0.57,在时间分配及工作量问题维度上得分最高;一般自我效能感总均分为2.68±0.61。带教行为与工作压力源呈负相关,与一般自我效能感呈正相关(均P0.01)。结论医院护理管理者应重视提高带教老师的自我效能,降低其工作压力,不断提升临床护理工作和教学质量。     

中老年妇女骨质疏松健康教育现状调查与分析

目的 了解本院骨质疏松俱乐部对中老年妇女开展骨质疏松健康教育的现状,为进一步加强健康教育工作提供依据。 方法 对骨质疏松俱乐部的会员进行随机整群抽样问卷调查,调查数据用SPSS10.0软件进行统计分析。结果 中老年妇女有关骨质疏松的知识得分平均成绩为28.22±7.94,尤其欠缺预防方面的知识,关于补钙、运动的知识存在误区。结论 骨质疏松俱乐部的集体健康教育应成为宣教的主要方法,要加强医护人员在健康教育中的作用,预防骨质疏松要从正确补钙、有效运动开始,树立终身预防的观念。     

微信教育在骨质疏松骨折患者延续护理中的应用效果

目的探讨微信教育在骨质疏松骨折患者延续护理中的应用效果。方法将120例骨质疏松骨折患者按入院先后顺序分为对照组与观察组各60例,两组患者住院期间均给予住院教育,教育内容包括骨质疏松症一般知识、饮食、运动、日照、药物服用方法、防跌倒。对照组出院后将住院教育内容打印发给患者,观察组住院时建立微信群,出院后通过微信进行互动实施健康教育,两组患者均随访12个月,分别在出院时、出院后12个月评估患者的骨质疏松知识、疼痛评分、护理满意度、生活质量。结果观察组患者实施延续护理后较对照组在骨质疏松知识、疼痛评分、护理满意度、生活质量各维度得分差异均有统计学意义(P0.05)。结论微信教育应用于骨质疏松骨折患者的延续护理,可提高患者对骨质疏松症的知识水平,降低患者的疼痛,提高患者满意度和生活质量,确保了骨质疏松骨折患者出院后健康教育的延续性。     

Greater osteoporosis educational outreach is desirable among Chinese immigrants in Chinatown, Chicago

Summary  Osteoporosis beliefs were assessed in immigrant Chinese women in Chinatown, Chicago. Results from a survey utilizing the Osteoporosis Health Belief Scale showed that women expressed concern about osteoporosis but lacked both knowledge of preventive care and health motivation. Introduction  The objective of this study was to assess osteoporosis beliefs in immigrant Chinese women in Chinatown, Chicago. Methods  In a community-based health fair, osteoporosis knowledge and self-efficacy among postmenopausal Chinese immigrants were assessed using the translated Osteoporosis Health Belief Scale. Bone mineral density (BMD) was assessed with calcaneal ultrasound. Results  The study population included 94 women with mean age of 51 ± 9 years, mean length of residence in the United States of 9 ± 7 years, and 73% (n = 76) of whom were recent immigrants. Women expressed concern about the seriousness of osteoporosis and their relative susceptibility to osteoporosis. In particular, women with a prior fracture reported higher seriousness to osteoporosis. Nonetheless, women exhibited low health motivation and low awareness of the benefits of calcium and exercise. Bone densitometry results corresponded to a T score of −1.2 ± 1.5. Multiple regression analysis revealed that a younger age and longer length of residence in the USA were associated with higher BMD. Conclusion  Chinese immigrant women in Chicago exhibit concern regarding osteoporosis, but are unaware of the benefits of calcium and exercise, and exhibit low health motivation. Chinese women in Chinatown lack necessary knowledge about osteoporosis to develop adequate self-efficacy. Public health initiatives should be undertaken among recent immigrant Chinese women. This study was presented at the annual meeting of the International Society of Clinical Densitometry, San Francisco, CA, March 2008.     

骨质疏松骨折患者的健康管理及效果分析

目的：通过对住院骨质疏松骨折患者进行全程健康管理,从而探索最佳的骨质疏松骨折健康管理。方法选择2012年1月－2013年12月在解放军第309医院住院的年龄在50岁～75岁的骨质疏松骨折200例患者为研究对象,分为对照组及干预组,运用前瞻性队列研究方法进行分析。同时采用SPSS12．0统计软件进行数据处理。结果干预后,患者骨质疏松相关知识掌握情况比干预前显著优于对照组;患者相关行为均明显改善,依从性提高;各部位骨密度均高于干预前;患者的疼痛程度较干预前均明显改善,生活质量大幅度提高。结论对骨质疏松骨折患者进行全程的健康管理,促进骨质疏松骨折愈合,提高生活质量,降低骨质疏松再骨折发生,从而为防治骨质疏松骨折提供理论依据。     

Addressing the Musculoskeletal Components of Fracture Risk with Calcium and Vitamin D: A Review of the Evidence

Osteoporotic fractures are an extremely common and serious health problem in the elderly. This article presents the rationale for calcium and vitamin D supplementation in the prevention and treatment of osteoporotic fractures and reviews the literature evidence on the efficacy of this strategy. Two musculoskeletal risk factors are implicated in osteoporotic fractures in the elderly: the loss of bone mass due to secondary hyperparathyroidism and the increased propensity to falls. Calcium and vitamin D reverse secondary hyperparathyroidism with resultant beneficial effects on bone mineral density (BMD). Additionally, calcium and vitamin D supplementation significantly improves body sway and lower extremity strength, reducing the risk of falls. The effects of combined calcium and vitamin D on parathyroid function and BMD provide a strong rationale for the use of this therapy in the prevention and treatment of osteoporosis and osteoporotic fractures. There is general agreement that, in patients with documented osteoporosis, calcium and vitamin D supplementation should be an integral component of the management strategy, along with antiresorptive or anabolic treatment. Frail elderly individuals constitute another major target population for calcium and vitamin D because evidence from randomized studies in institutionalized elderly subjects demonstrates that these supplements reduce osteoporotic fracture risk, particularly in the presence of dietary deficiencies. However, the results of trials in community-dwelling subjects have been equivocal. Within the primary-care setting, further research is required to establish appropriate target subgroups for calcium and vitamin D supplementation; overall, the data are consistent with a benefit individuals with insufficient calcium and/or vitamin D, although patients with documented osteoporosis will derive further benefit in terms of fracture prevention from the addition of an antiresorptive agent.     

Internal fixation of proximal humeral fractures with locking proximal humeral plate (LPHP) in elderly patients with osteoporosis

Background  Different operative techniques used for treating displaced proximal humeral fractures could result in malunion, non-union, osteonecrosis of humeral head, loosening of screw and loss of reduction particularly in comminuted and osteoporotic fractures. Locking compression plate (LPHP) has been proposed for open reduction and internal fixation of these fractures and is associated with less complication rate. Materials and methods  We prospectively assessed the functional outcome and the complications after an average follow-up of 24.9 months in 25 patients of proximal humeral fractures with osteoporosis. Mean age was 62 years. Using AO classification, 48% were type A and 52% type B. Results  Mean constant score was 80 points. According to constant score, 28% had excellent outcome, 64% had good functional outcome, and 8% had moderate outcome. When the results were related to grades of osteoporosis, grade IV osteoporotic fractures had highest average Constant–Murley score (83 points, range 78–88 points), followed by grade III osteoporotic fractures (80 points, range 71–92 points), followed by grade II osteoporotic fractures (78 points, range 66–88 points). Varus malalignment and subacromial impingement were observed in 8% patients. Loosening of implant and loss of reduction were observed in 4% patients. Superficial infection was observed in 4% patients. Conclusions  Locking compression plate (LPHP) is an advantageous implant in proximal humeral fractures due to angular stability, particularly in comminuted fractures and in osteoporotic bones in elderly patients, thus allowing early mobilization.     

Effect of raloxifene combined with monofluorophosphate as compared with monofluorophosphate alone in postmenopausal women with low bone mass: a randomized,controlled trial

Raloxifene effectively reduces the incidence of vertebral fractures in patients with postmenopausal osteoporosis. Recent data suggest that low-dose monofluorophosphate (MFP) plus calcium reduces the vertebral fracture rate in postmenopausal women with moderate osteoporosis. The objective of this study was to evaluate the combination of raloxifene and MFP in the treatment of postmenopausal women with osteopenia, osteoporosis and severe osteoporosis. A total of 596 postmenopausal women with osteopenia, osteoporosis and severe osteoporosis (mean femoral neck T-score of –2.87 SD) were randomized to treatment with 60 mg/day raloxifene HCl and 20 mg/day fluoride ions (as MFP) or 20 mg/day fluoride and placebo for 18 months. All patients received calcium (1000 mg/day) and vitamin D (500 IU/day) supplements. Changes in bone mineral density (BMD), as primary endpoint, and the rate of osteoporotic fractures and biochemical markers, as secondary endpoints, were assessed. As compared with MFP, raloxifene plus MFP was associated with significantly greater mean increases in the BMD of the femoral neck (1.37% versus 0.33%; P=0.004), total hip (0.89% versus –0.42%; P<0.001) and lumbar spine (8.80% versus 5.47% P<0.001). In the raloxifene plus MFP group, 16 patients sustained 17 osteoporotic fractures, as compared with 22 patients sustaining 34 incident osteoporotic fractures in the MFP group (P=0.313). One patient in the raloxifene plus MFP group sustained multiple osteoporotic fractures, as compared with eight patients in the MFP group (P=0.020). MFP alone significantly increased the serum bone alkaline phosphatase (bone ALP) and the urinary C-terminal crosslinking telopeptide of type I collagene (U-CTX). The addition of raloxifene in the combination arm blunted the rise in bone ALP, which remained nevertheless significant, and abolished the increase in U-CTX. The combination of raloxifene with MFP was generally well tolerated. This study demonstrates that, in postmenopausal women with osteopenia, osteoporosis and severe osteoporosis, the combination therapy of raloxifene plus MFP favorably influences the BMD and the bone formation and resorption balance, and may reduce the risk of multiple osteoporotic fractures compared to MFP alone.     

上海地区中老年妇女骨质疏松KAP调查结果的若干分析

本随机上海市７个社区３５００名３５～７５岁中老年妇女进行了有关骨质疏松知识、态度和实践能力（ＫＡＰ）的调查。调查结果反映,有一半以上的人能认识到骨质疏松的危害,但涉及进一步骨质疏松详细知识,仅不能２０％的人掌握。６３．４％的人曾获得过骨质疏松有关知识,其中从电视、书刊、报纸和广告中获得的５８．７％,而从医务人员处获得的只占１４％,另外愿采取补钙措施来预防骨质疏松的人只占４４％,而对已有骨质疏松症