自我管理综合技能训练对糖尿病视网膜病变患者自我效能及生活质量的影响

目的:探讨自我管理综合技能训练对糖尿病视网膜病变(DR)患者自我效能及生活质量的影响。方法:选择2013年1月~2014年12月我院眼科收治的68例DR患者为研究对象,并随机等分为观察组和对照组,对照组给予常规护理,观察组接受为期3个月的自我管理综合技能训练,包括日常生活技能训练、视觉训练、定向行走技能训练、助视器使用视觉训练。分别于干预前、干预1个月、干预3个月采用自我效能感测量表及中文版低视力者生活质量量表对两组患者自我效能及生活质量进行评价。结果:观察组干预后自我效能感评分高于对照组(P0.05)。观察组远视力、日常生活能力、调节能力、读和精细工作及总评分均高于对照组(P0.05)。结论:自我管理综合技能训练能有效提高DR患者自我效能,对改善患者生活质量具有积极的意义。     

技能训练对社区老年性耳聋患者自我效能及生活质量的影响

目的探讨综合技能训练对社区老年性耳聋患者自我效能及生活质量的影响。 方法选取老年性耳聋患者50例,采用随机数字表法分为干预组（25例）和对照组（25例）,2组均接受社区常规照护,干预组在此基础上给予为期4周的自我管理式综合技能训练,包括助听器的适应性训练、听觉补偿技能训练、日常生活技能训练。于干预前、干预结束后当天（干预后）以及干预结束3个月后（随访时）采用一般自我效能感量表(GSS)评估2组患者的自我效能水平,并于干预前和随访时采用健康状况调查问卷(SF-36)评估2组患者的生活质量。 结果干预后和随访时,实验组患者的自我效能评分分别为（27.39±3.43）分和（29.15±2.44）分,分别与组内治疗前和对照组同时间点比较,差异均有统计学意义（P<0.01）;随访时,实验组患者的生活质量各维度评分与组内治疗前和对照组同时间点比较,差异均具有统计学意义（P<0.05）。 结论自我管理模式综合技能训练可显著改善老年性耳聋患者的自我效能和生活质量。     

自我效能干预对慢性前列腺炎病人生活质量的影响

[目的]探讨基于自我效能理论的自我管理干预对慢性前列腺炎病人生活质量的影响。[方法]将110例慢性前列腺炎病人按照随机数字表法分为观察组和对照组各55例,对照组病人接受门诊常规的慢性前列腺炎病人治疗和护理,观察组在常规治疗和护理基础上参加研究者给予的为期3个月的基于自我效能理论的自我管理干预。干预3个月,采用治疗依从性调查表、慢性前列腺炎病人自我效能量表、慢性前列腺炎病人症状评分表(NIH-CPSI)、生活质量量表(SF-36量表)比较两组病人治疗依从性、自我效能感、症状评分、生活质量。[结果]观察组病人干预3个月后病人的治疗依从性、生活质量优于对照组,自我效能感评分均高于对照组,NIH-CPSI评分低于对照组(P0.05)。[结论]慢性前列腺炎病人应用自我效能理论进行自我管理干预,有助于病人选择健康的生活方式,提高治疗依从性,改善临床症状,提高生活质量。     

以家庭为背景的自我效能干预对支气管哮喘患者治疗依从性及生活质量的影响

目的 探讨以家庭为背景的自我效能干预对支气管哮喘患者自我效能、治疗依从性及生活质量的影响.方法 2014年6月～2016年6月选取该院收治的124例哮喘患者,根据随机数字表将患者分为观察组及对照组,每组62例.对照组出院时接受常规出院护理,观察组出院时接受以家庭为背景的自我效能干预,干预时间为3个月,比较两组患者自我管理行为及生活质量的变化.结果 观察组患者干预后自我效能感评分显著高于对照组(P<0.05),观察组饮食依从性、运动锻炼依从性、吸入治疗依从性、规范用药依从性及定期复诊依从性均高于对照组(均P<0.05).观察组干预后活动能力、临床症状、社交心理影响及总评分均高于对照组(均P<0.05).结论 以家庭为背景的自我效能干预能有效提高哮喘患者自我效能及治疗依从性,改善患者生活质量.     

自我管理护理对肺癌化疗患者自我护理能力及生活质量的影响

目的：采用自我管理护理提高肺癌化疗患者的自护能力和生活质量。方法将我院2012年6月至2013年12月收治的80例肺癌化疗患者随机分为观察组和对照组,对照组给予常规护理,观察组在对照组的基础上进行自我管理护理干预,采用自我护理能力测量量表、一般自我效能感量表、简短疲乏量表、生存质量测定量表进行相关效果评价。结果观察组的健康知识水平、自我概念、自我责任感等自护能力高于对照组,自我效能感评分高于对照组,疲乏评分低于对照组,差异有统计学意义（P＜0．05）。观察组在生理因子、心理因子、环境因子、社会因子以及生活质量总分方面均高于对照组,差异有统计学意义（ P＜0．05）。结论自我管理护理能够有效提高肺癌化疗患者的自我护理水平和自我效能感,减少治疗期间的癌因性疲乏的发生,改善患者生活质量。     

多学科团队自我管理在社区冠心病病人干预中的应用研究

[目的]探讨实施多学科团队自我管理干预对社区冠心病病人的有效性。[方法]随机抽取西安市某社区卫生服务中心管辖范围下的6个社区冠心病病人作为干预组(72例),其余6个社区的冠心病病人作为对照组(72例)。干预组实施多学科团队自我管理干预,对照组仅接受社区常规健康教育,于干预前、干预3个月后应用慢性病自我效能量表、冠心病自我管理行为量表、生活质量量表(SF-36)评价干预效果。[结果]干预后3个月干预组自我效能、自我管理行为各维度得分均高于对照组(P0.05);干预组生活质量8个维度中的总体健康状况、生理职能、情感职能、精力、精神健康5个维度得分高于对照组(P0.05),但生理功能、躯体疼痛、社会功能3个维度得分两组比较差异无统计学意义(P0.05)。[结论]对社区冠心病病人实施多学科自我管理干预可以增强病人的自我效能,提高病人的自我管理水平,改善病人的生活质量。     

基于人文关怀的心理护理对恶性黑色素瘤患者遵医行为及生活质量的影响

目的 分析对恶性黑色素瘤患者实施给予人文关怀的心理护理对其遵医行为和生活质量的影响。方法 对 2020 年 9 月至 2022 年 8 月在我院接受治疗的恶性黑色素瘤患者中抽取 80 例患者临床资料进行回顾性分析。根据护理方法的不同将患者分为 对照组和观察组。对照组（40 例）实施常规护理,观察组（40 例）在常规护理基础上实施基于人文关怀的心理护理。比较两 组的自我效能感、遵医行为和生活质量。结果 两组干预前的自我效能感量表、一般康复依从性量表和生活质量评价量表的总 分无统计学差异（P>0.05）。观察组干预 1 周后和干预 1 个月后的自我效能感量表、一般康复依从性量表和生活质量评价量表 评分高于对照组（P<0.05）。结论 恶性黑色素瘤患者实施基于人文关怀的心理护理,可提升自我效能感,增强遵医行为,改善 生活质量。     

成人低视力患者自我效能感与生活质量的调查分析

目的 了解成人低视力患者的生活质量与自我效能感水平,探讨两者之间的关系,为提高和改善其生活质量提供理论依据.方法 随机抽取南昌市东湖区低视力患者70例,应用一般自我效能感量表评估患者的自我效能感,应用低视力者生活质量量表(low vision quality of life questionnaire,LVQOL)的中文版本评估患者的生活质量.结果 成人低视力患者生活质量得分为(35.66±5.54)分,自我效能感得分为(16.07±2.47)分.成人低视力患者自我效能感得分与生活质量得分呈正相关(r=0.755,P＜0.01).结论 在护理工作中,应重视提高成人低视力患者的自我效能感,有效地提高其生活质量.     

健康行为过程取向理论在肝硬化患者中的应用效果研究

目的 探讨健康行为过程取向理论在肝硬化患者中的应用效果。方法 便利抽样法选取2022年2月至9月在山西省某三级甲等医院消化内科住院的82例肝硬化患者为研究对象,采用随机数字表法分为对照组41例,试验组41例。对照组采取常规护理干预,试验组在常规护理基础上实施以健康行为过程取向理论为基本框架的护理干预,包含肝硬化患者自我管理的前意向阶段、意向阶段和行动阶段。比较两组肝硬化患者自我管理能力、自我效能感、生活质量以及干预后3个月计划外再入院率。结果 干预前两组患者各项指标差异无统计学意义(P>0.05),干预后1个月、3个月,试验组患者自我管理能力、自我效能感、生活质量得分高于对照组,干预后3个月患者计划外再入院率低于对照组,差异具有统计学意义(P<0.05);随着时间推移,两组肝硬化患者自我管理能力、自我效能感、生活质量得分逐渐上升,存在时间和组间交互作用(P<0.001)。结论 基于健康行为过程取向理论的健康教育对肝硬化患者的健康行为产生积极作用,可有效提高患者自我管理能力及自我效能感,改善其生活质量,减少患者计划外再入院率。     

授权教育对冠心病患者自我管理行为及自我效能感影响的研究

目的 探讨授权教育对冠心病患者的疾病自我管理行为、自我效能的影响.方法 选取196例冠心病患者随机分为实验组和对照组.由指定的心血管专科医生进行第一次疾病知识宣教后,分别由研究者、心内科注册护士进行相应分组的健康教育.对全部患者在入组时、3,6个月时分别填写“基本情况调查表、冠心病自我管理行为量表、冠心病自我效能问卷量表”,并测量体重指数、腰围、血压、血糖、血脂等.结果 干预后3,6个月与干预前比较,2组冠心病患者自我效能得分、自我管理行为总分及各维度得分均明显改善,差异显著;且实验组的患者在干预后6个月这种差异仍持续存在.与对照组比较,实验组冠心病患者自我效能总分及各维度得分、自我管理行为总分及各维度得分均明显增高,差异显著.而在对照组的患者干预6个月后,自我管理行为中不良嗜好管理、症状管理、急救管理、一般生活管理、疾病知识管理方面无显著改善.结论 授权教育能够明显提高和改善冠心病患者的自我效能及自我管理行为能力,提高患者对自身疾病的管理能力和信心.且在增加患者自我效能感、改善患者自我管理行为方面更为持久,从而超越传统的健康教育方式,有望成为在新的医学模式下的一种有效的健康教育方式.     

Managing low vision patients

1. The ophthalmologist and staff are ultimately responsible for identifying low vision patients. 2. Most low vision patients who have a professional low vision evaluation are able to use vision enhancing devices. 3. In addition to optical magnifyers, new computer and television technology enhances use of residual vision.     

Acquisition and integration of low vision assistive devices: understanding the decision-making process of older adults with low vision.

The purpose of this study was to describe how older adults with low vision make decisions to use low vision assistive devices (LVADs). Analysis of participants' narratives, from both group and individual interviews, revealed three topic areas affecting device use. Two are discussed in this paper: Experiences and Characteristics Leading to Successful LVAD Use Decision Making and Challenges to Successful LVAD Use Decision Making. The third, Adjustment to Low Vision Disability, is briefly discussed. Of particular importance to occupational therapy practitioners in the growing field of low vision rehabilitation was the value placed on low vision rehabilitation services to assist with acquiring devices and integrating them into daily routines. Occupational therapy services were highly regarded. Participants demonstrated the importance of becoming a part of a supportive network of people with low vision to gain access to information about resources. They emphasized the need for systems and policy changes to reduce barriers to making informed decisions about LVAD use. Results indicate that occupational therapists working in low vision can support clients by facilitating development of a support network, acting as liaisons between clients and other health practitioners, especially ophthalmologists, and encouraging policy development that supports barrier-free LVAD acquisition and use. These topics should be incorporated into continuing and entry-level education to prepare practitioners for leadership in the field of low vision rehabilitation.     

Rehabilitation options for patients with low vision.

Loss of vision has a profound effect on an individual's life. Reduced visual function, whether present at birth or appearing later in life, greatly affects one's perception of useful existence. When medical intervention can no longer restore or maintain a person's functional vision, rehabilitative measures are necessary to enable that person to adjust both physically and psychologically to his or her sensory loss. Rehabilitation for low vision offers visually impaired individuals a renewed independence and productivity that will enable them to rejoin society as active participants. Often patients and healthcare providers are unaware of the rehabilitation options that are available to them. Low-vision devices such as magnifiers and telescopes, as well as counseling and vocational training, are among the available options. Rehabilitation nurses are particularly qualified to identify patients with reduced functional ability and to recommend an appropriate visual assessment that can lead to maximized residual vision.     

Characteristics of AMD patients with low vision receiving visual rehabilitation

The purpose of this retrospective study done on 255 AMD patients evaluated at a low vision rehabilitation service was: 1) to describe the visual function characteristics (VFCs) of AMD patients presenting to visual rehabilitation, 2) to document changes in these VFCs between initial and follow-up rehabilitation visits, and 3) to investigate the relationship of the VFCs found at rehabilitation intake to the length of time between initial diagnosis and initial rehabilitation visit. Standard clinical testing (visual acuity and contrast sensitivity) as well as Scanning Laser Ophthalmoscope (SLO) visual function testing were performed to determine visual function including: 1) macular perimetry for scotoma boundary mapping and 2) PRL (preferred retinal locus) location and abilities in fixation, saccadic, and pursuit eye movements. The difference between the first and second visit VFCs were compared to the length of time between visits for 44 of the 255 patients returning for a second visit 0.5 to 4.5 years later. Finally, the initial date of AMD diagnosis was found for 51 of the 255 patients to analyze VFCs as a function of the time duration between diagnosis and the intake to the rehabilitation. Most VFCs had a wide range of results at initial intake to rehabilitation, while all patients had significant visual impairment by 24 months after initial diagnosis. The majority of low vision patients with AMD have bilateral central scotomas with the corresponding visual function and ADL problems that can often be overcome with visual rehabilitation.     

Low vision and mobility scooters: the experiences of individuals with low vision who use mobility scooters

Abstract

Purpose: Older adults with low vision are a growing population with rehabilitation needs including support with community mobility to enable community participation. Some older adults with low vision choose to use mobility scooters to mobilize within their community, but there is limited research about the use by people with low vision. This paper describes a pilot study and asks the question: what are the experiences of persons with low vision who use mobility scooters?

Methods: This study gathered the experiences of four participants with low vision, aged 51 and over, who regularly use mobility scooters. Diverse methods were used including a go-along, a semi-structured interview and a new measure of functional vision for mobility called the vision-related outcomes in orientation and mobility (VROOM).

Findings: Four themes were found to describe experiences: autonomy and well-being, accessibility, community interactions and self-regulation.

Discussion and implications: This study was a pilot for a larger study examining self-regulation in scooter users. However, as roles emerge for health professionals and scooters, the findings also provide evidence to inform practice, because it demonstrates the complex meaning and influences on performance involved in low vision mobility scooter use.

• Implications for rehabilitation

• Scooter use supports autonomy and well-being and community connections for individuals with both mobility and visual impairments.

• Low vision scooter users demonstrate self-regulation of their scooter use to manage both their visual and environmental limitations.

• Issues of accessibility experienced by this sample affect a wider community of footpath users, emphasizing the need for councils to address inadequate infrastructure.

• Rehabilitators can support their low vision clients’ scooter use by acknowledging issues of accessibility and promoting self-regulation strategies to manage risks and barriers.

     

Usability of assistive listening devices by older adults with low vision

Purpose: This study examines the performance of individuals with both hearing and vision loss when using assistive listening devices. Methods: Older adults (age 60–100) with low vision only (n?=?23), combined vision and hearing loss (n?=?25) and a control group (n?=?12) were asked to assemble a pocket talker, and operate a talking clock and an amplified telephone. They either received minimal or no instruction. Success at using the devices properly, as well as performance speed, was recorded. Results: The proportion of individuals with sensory loss that was able to complete our naturalistic tasks without mistakes ranged from 20% to 95%, depending on the device, the task complexity and the instruction provided. Both instruction as well as simple repetition had statistically significant and separate beneficial effects; however, neither was able to bring success to 100% on any device. Speed and task success were linked in an intuitive way, whereby individuals who succeeded at a task also performed it faster. Conclusions: Even minimal explanation during the introduction of assistive listening devices to persons with low vision facilitates user success. Device visibility, cognitive and motor complexity of the task, as well as manual dexterity warrant further investigation as potential barriers to device use.

• Implications for Rehabilitation

• Hearing rehabilitation with individuals affected by vision loss requires additional attention and time to accommodate challenges with visibility and task complexity.

• Even minimal rehabilitation interventions can improve success and speed of device use.

• Repetition (practice) and instruction (strategy) have independent beneficial effects on device use.

• Dexterity, visibility, hand-eye-coordination, task complexity and cognitive ability need to be considered when assigning assistive devices for older adults with vision and/or hearing loss.

     

Recognition distance of pedestrian traffic signals by individuals with low vision

Forty-one individuals with moderate-to-severe vision loss participated in a study to determine the minimum distance they required to correctly identify three different pedestrian traffic icon symbols, one of which was presented with an augmented light source. We found that subjects could identify the WALK icon without the augmented light source information, or animated eyes, from farther away than either the WALK icon with the augmented light source information or the DON'T WALK icon. These results differ from those of a previous study, which found that subjects could correctly identify the WALK icon with the augmented light source from a greater distance than the WALK or DON'T WALK icons without the augmented light source.