普里西特干预对阴茎硬结症患者勃起功能及焦虑抑郁的影响

目的探讨普里西特干预模式对非器质性勃起功能障碍的阴茎硬结症Ⅲ型患者的勃起功能及焦虑抑郁的影响。方法将39例非器质性勃起功能障碍的阴茎硬结症Ⅲ型患者随机分为干预组19例及对照组20例。对照组给予常规护理及宣教,干预组患者及其配偶给予普里西特干预3~4周。结果干预3周后干预组勃起功能评分显著高于对照组,SDS及SAS评分显著低于对照组(P0.05,P0.01)。结论普里西特干预模式有利于改善非器质性勃起功能障碍的阴茎硬结症Ⅲ型患者的勃起功能,减轻焦虑抑郁水平。     

勃起功能障碍的诊断和疗效评估相关问卷

勃起功能障碍(ED)诊断和治疗效果的评估过程中,患者问卷是一种常用评估工具,其种类和数量也日渐增多。本文介绍了几种常见且有效的ED问卷,包括国际勃起功能问卷(IIEF)、男性性健康量表(SHIM)、IIEF勃起功能专项评分(IIEF-EF)、勃起硬度分级(EHGS)、自尊心及性关系问卷(SEAR)、勃起功能障碍治疗满意度量表(ED-ITS),以及勃起质量问卷(QEQ)、治疗满意度评分(TSS)、心理及人际关系评分(PAIRS)、性体验问卷(SEX-Q),并对其临床针对性做了讨论。     

他达拉非不同给药方案对初次性生活失败的男性勃起功能障碍患者疗效观察

目的:评估他达拉非3种不同给药方案对初次性生活失败的年轻男性勃起功能障碍(ED)患者疗效。方法:将夜间阴茎勃起硬度检查正常、心理治疗无效的初次性生活失败的年轻男性ED患者分为他达拉非每日小剂量口服组(每日夜间睡前1~2 h口服他达拉非5 mg)、按需治疗组(性生活前1~2 h口服他达拉非10~20 mg,根据勃起硬度调整剂量)、每日小剂量与按需治疗联合组(无性生活时每日夜间口服他达拉非5 mg,性生活当日于性生活前1~2 h一次性服用他达拉非10~20 mg、其剂量根据勃起硬度确定)共3组,分别给予相应治疗2~3个月。以国际勃起功能指数(IIEF)5个专项评分分别评估疗效。结果:3组IIEF勃起功能、性高潮、插入满意度、总体满意度专项评分较治疗前均显著提高(P均0.05或0.01);按需治疗较每日小剂量治疗显著提高勃起功能和性高潮专项评分(P0.05),但在性欲专项评分方面,其效果低于每日小剂量治疗;当给予联合治疗时,5个专项评分均得到了最佳改善(P均0.05)。结论:由于缺乏专业的性心理治疗机构和医生,单纯心理治疗对心理性ED患者疗效较差,以每日小剂量口服联合按需服用他达拉非可明显提高初次性生活失败的年轻男性ED患者疗效。     

应用自尊心和性关系问卷评价小剂量他达拉非治疗ED疗效

目的:探讨小剂量他达拉非对勃起功能障碍(ED)患者的自尊心、自信心和性关系的影响。方法:17例ED患者每晚口服他达拉非5 mg 12周,用配对t检验比较治疗前后自尊心和性关系问卷(SEAR)、勃起功能国际问卷-5(IIEF-5)和夜间阴茎勃起(NEVA测定)的情况。结果:治疗后SEAR评分、IIEF-5两者均明显提高(P<0.01);夜间阴茎勃起明显改善(P<0.05)。结论:每日小剂量口服他达拉非可显著提高ED患者的自尊心、自信心和性关系满意度,改善ED患者的夜间勃起功能,是治疗ED的有效措施。     

行为心理疗法配合药物在救灾军人早泄治疗中的应用

目的 针对抗震救灾部队所处的特殊环境,探讨综合心理行为配合药物治疗对早泄(premature ejaculation,PE)患者的治疗效果.方法 通过调查,确诊84例PE患者,随机分为心理行为干预组和对照组,每组42例.两组均给予药物盐酸氟西汀治疗,干预组同时配合综合性心理行为治疗,共4周,治疗前后应用阴道内射精潜伏期、患者及其配偶性交满意度评分、焦虑自评量表(SAS)进行评定,并比较两组治疗效果.结果 两组患者平均阴道内射精潜伏期和患者及其配偶性交满意度评分在治疗后较治疗前均显著增加(P<0.01),治疗后干预组患者平均阴道内射精潜伏期和患者及其配偶性交满意度评分显著高于对照组(P<0.01).而两组患者的SAS评分在治疗后显著低于治疗前,治疗后干预组患者SAS评分显著低于对照组(P<0.01).结论 对经历特殊环境的救灾军人,综合心理行为干预可改善传统药物治疗早泄的疗效.     

口服西地那非改善肺动脉高压患者健康相关生活质量和相关功能状态

美国首个关于自尊心及性关系调查问卷的双盲、安慰剂对照研究显示，枸橼酸西地那非能改善勃起功能和ED男性生活质量评分。Ahhof等进行了一项研究，调查了勃起功能改善与自信心，自尊心，性关系满意度的相关性。研究为双盲、安慰剂对照试验后的36周的开放扩展研究。患者均为18岁或以上，临床诊断为勃起功能障碍者，采用国际勃起功能指数对勃起功能进行评定。     

男性性功能障碍相关问卷的应用进展

由于男性性功能障碍发病率的升高,临床医生越来越需要准确、高效的问卷来评估治疗效果和满意度,并帮助患者达到满意的治疗结果。为此,本文总结了一些关于男性性功能障碍的常用问卷,包括勃起功能国际问卷、勃起硬度分级、勃起质量量表、勃起功能障碍治疗满意度调查表、治疗满意度量表、自尊心及性关系问卷、早泄评估表、早泄诊断工具、早泄指数量表、阿拉伯早泄指数量表、老年男性症状量表、中老年男性雄激素缺乏自测表以及迟发型(迟发性性腺功能减退)睾丸功能减退症状调查表,并对它们的临床应用进行了综述。     

从更好的勃起到更好的性生活:万艾可研究进展

万艾可(枸橼酸西地那非)起效快,使患者达到和维持坚硬的勃起,已被证实为首选的勃起功能障碍(ED)治疗药物。近年来,有关万艾可疗效的研究越来越多地关注其对整体性生活的改善,即对患者心理因素的影响。通过应用心理学评价工具,如勃起功能障碍治疗满意度量表、自尊心和性关系问卷、勃起功能障碍心理影响评分等,研究发现万艾可显著改善以下心理性因素:ED患者及其伴侣对性交和性关系的满意度、患者的自信心和自尊心、与伴侣亲近和进行性交的欲望等。服用万艾可的ED患者性交尝试次数显著增加,健康相关的生活质量显著提高。因此,万艾可产生更好的勃起,进一步促进更好的性生活良性循环。     

万艾可治疗后ED患者勃起硬度改善与情感满意度的关系

为了阐述ED患者的勃起硬度与其他相关结果的关系，King等进行了一项研究，综合分析了对全球27组随机双盲安慰剂对照研究和6组开放性研究。评价主观硬度分级，国际勃起功能指数问卷（erectile dys-function inventory，IIEF）中的硬度与性满意度评分，自尊心和性关系（Self-Esteem And Relationship，SEAR）问卷中的总体评分与性生活评分，勃起功能障碍问卷及治疗的满意度。硬度的改善（在合适的量效关系下达到完全的坚挺状态）与其他指标变化有明确的关联性。西地那非100mg可以成就大部分ED患者达到理想的硬度（完全的坚挺）。理想的勃起硬度，可促进主观上的幸福与满足，西地那非100mg是绝大部分ED患者的合适剂量。     

配偶同步参与在治疗男性不育症中的作用

目的 观察配偶同步参与在治疗男性不育症中的作用.方法 84例少弱精子症患者随机分成干预组(43例)和对照组(41例).两组患者均给予相同药物治疗,在这同时,干预组患者配偶被要求来站监测排卵并接受性生活指导及心理支持治疗.治疗前后观察指标包括:精子密度、精子活力、患者配偶妊娠率.结果 两组患者治疗前后精子密度、前向运动精子指标比较差异均具有统计学意义(P＜0.01),而两组治疗后精子密度、前向运动精子指标比较差异无统计学意义(P＞0.05).6个月治疗后,干预组患者配偶妊娠率为39.53％,对照组患者配偶妊娠率为24.39％,差异有统计学意义(P＜0.05).结论 配偶同步参与诊疗可以改善受孕条件,把握受孕时机,对于缩短男性不育症诊疗时程、提高治愈率有重要作用.     

护士长工作满意度调查分析

目的：了解临床护士长工作满意度现状。方法：应用工作满意度量表对68名三级甲等医院护士长进行调查。结果：护士长工作满意度总分78．3±10．6，其内在满足显著高于外在满足及一般满足（均P〈0．05），护士长工作满意度与年龄、职称、工作年限、文化程度、健康状况无显著相关（均P〉0．05）。结论：护士长对工作内容、工作稳定性及上级领导方式方面满意度较高，而对工作环境及人际关系的满意度低。应重视提高护士长的工作满意度，以提高临床管理质量。     

A systematic review of life satisfaction and related factors among burns patients

This systematic review aimed to examine the life satisfaction and related factors among burns patients. A comprehensive systematic search was conducted at the international electronic databases such as Scopus, PubMed, Web of Science, and Persian electronic databases such as Iranmedex, and Scientific Information Database using keywords extracted from Medical Subject Headings such as ‘Burns’, ‘Life satisfaction’, ‘Personal satisfaction’, and ‘Patient satisfaction’ from the earliest to the 1 October 2022. The quality of the studies included in this review was evaluated using the appraisal tool for cross-sectional studies (AXIS tool). A total of 3352 burn patients in the nine cross-sectional studies were included in this systematic review. 70.52% of burn patients were male. The mean age of burn patients was 37.47 (SD = 14.73). The mean score of life satisfaction in burn patients based on SWLS was 23.02 (SD = 7.86) out of 35, based on LSI-A was 12.67 (SD = 4.99) out of 20, and based on the life satisfaction questionnaire was 4.81 (SD = 1.67) out of 7. Factors including time since burn, religion, and constant had a positive and significant relationship with life satisfaction in burn patients. Whereas, factors such as single marital status, age at injury, length of hospital stay, presence of pain, larger total body surface area burn, head and neck burn, functional impairment, family satisfaction, satisfaction with appearance, and previous psychiatric treatment had a negative and significant relationship with life satisfaction in burn patients. In sum, this systematic review showed that burn patients were slightly satisfied with their life. Therefore, health managers and policymakers can improve the quality of life of burn victims by planning psychological counselling and behavioural therapy, and consequently increase their life satisfaction.     

Predictors of patient and surgeon satisfaction after orthopaedic trauma

Introduction

Patient satisfaction has only recently gained attention as an outcome measure in orthopaedics, where it has been reported for joint replacement surgery. Little has been published regarding predictors of patient satisfaction in orthopaedic trauma. This study aims to explore the predictors of patient satisfaction, and of surgeon satisfaction, after orthopaedic trauma.

Materials and methods

Adult patients admitted to hospital with fractures after motor vehicle trauma were surveyed on admission, and at six months. Demographic, injury, socio-economic and compensation-related factors were measured. The two outcomes were satisfaction with progress of the injury, and satisfaction with recovery. The treating surgeons were also surveyed at six months to determine surgeon satisfaction with progress, and recovery (using the same questions), and the presence or absence of fracture union and any complications. Multivariate analysis was used to determine significant predictors of satisfaction for both groups, and satisfaction rates were compared between surgeons and patients.

Results

Of 306 patients recruited, 232 (75.8%) returned completed questionnaires, but only 141 (46.1%) surgeons responded. Patients rated their satisfaction with progress and recovery as 74.6% and 44.4%, respectively, whereas surgeon-rated satisfaction with progress and recovery was significantly higher, at 88.0% and 66.7%, respectively (p < 0.0001).Significant predictors of patient dissatisfaction were: blaming others for the injury, being female, and using a lawyer. Patient-rated satisfaction was not significantly associated with objective injury or treatment factors. The only significant predictor of surgeon dissatisfaction was fracture non-union.

Conclusions

Orthopaedic surgeons overestimated the progress of the injury and the level of recovery compared to patients’ own ratings. Surgeons’ ratings were influenced by objective, treatment-related factors, whereas patients’ ratings were not. Measures of outcome commonly used by orthopaedic surgeons, such as fracture union, do not predict patient satisfaction.

Level of evidence

Level II evidence (prognostic, prospective study).     

急诊就诊流程满意度调查分析

目的调查患者对急诊就诊流程的满意度,分析该流程的不足,优化急诊就诊流程。方法应用自行设计的急诊就诊流程满意度调查表对急诊就诊的1 425例患者或家属进行调查。结果导诊台、建卡挂号处、分诊台、候诊区、抽血处、输液室设施标识满意率均在70.00%以上;导诊、建卡挂号、分诊等流程等候时间满意率均在70.00%以上;而候诊及使用平车等候时间满意率仅56.56%和57.60%;80.00%以上患者在导诊、建卡挂号、分诊、抽血、输液流程等候时间5min,而27.68%患者候诊时间10min。就诊最不便的流程包括候诊、平车使用、抽血及输液4方面。结论急诊科亟需改善抽血处、候诊区、输液室的设施标识,缩短候诊及平车使用流程的等候时间,大力改进急诊就诊流程不便之处,持续优化急诊就诊流程,以改善人民群众就医体验,提高患者满意度。     

Comparison of patient satisfaction after redo and primary fundoplications

Background: Although much has been written about the results and patient satisfaction with fundoplication for the treatment of gastroesophageal reflux disease, the reports have focused primarily on surgical successes. With the growing number of fundoplications being performed, more patients are requiring reoperation because of recurrent symptoms or side effects. Reports of success rates for reoperation are available, but information regarding patient satisfaction is limited. Methods: All the patients undergoing fundoplication at our institution were sent short-form health surveys (SF-12), Gastroesophageal reflux disease–specific quality-of-life questionnaires (QOLRAD), and queries regarding long-term satisfaction. Results: Between November 1992 and July 2000, 221 patients (198 primary and 23 redo) underwent fundoplication. There were 19 open cases (3 primary and 16 redo). In the primary group, 173 patients underwent Nissen, 23 underwent Toupet, and 2 underwent Collis fundoplications. In the redo group, 12 patients underwent Nissen, 9 underwent Toupet, 1 underwent Collis, and l underwent Belsey fundoplications. Follow-up surveys were completed for 130 patients (112 primary and 18 redo) at a mean of 32.6 months (range, 0.8–98 months). In the primary group, 87% of the patients were satisfied with their operation, as compared with 75% in the redo group. There was a trend toward higher SF-12 mental scores (46 ± 12 vs 40 ± 14; p = 0.07) and QOLRAD scores (6.2 ± 1.3 vs 5.2 ± 2.0; p = 0.07) in the primary fundoplication group. There was a significant difference in the SF-12 physical scores between the groups (32 ± 13 for the primary group vs 18.5 ± 11 for the redo group; p = 0.0002). Additionally, 61% of the patients in the redo group were again using antireflux medications, whereas only 24% of the patients in the primary group were using medications again. Conclusion: Gastroesophageal reflux disease symptom scores and quality-of-life scores for patients undergoing redo fundoplication are lower than the scores of patients having primary fundoplication. Quality of life is similar between primary and redo fundoplication patients in the mental component. However, redo patients do not do as well physically more than 2 years after surgery. Presented at the Society of America Gastrointestinal Endoscopic Surgeons (SAGES), New York, New York, USA, 13–16 March 2002     

基于SBAR沟通模式的标准化床边交接班满意度评价

目的评价患者及护士对标准化床边交接班的满意度。方法选取5个外科护理单元,依据SBAR标准沟通模式实施标准化床边交接班。分别在实施前和实施6个月后调查患者、护士对床边交接班的满意度。结果实施后患者及护士对交班满意度部分条目显著高于实施前(P<0.05,P<0.01)。结论标准化床边交接班的实施,有利于提高患者满意度,保证患者安全。在床边交接班取得积极效果的基础上,护理管理者应关注患者及交接班护士的主观感知,从根本上提高床边交接班质量。     

Patient satisfaction of hand therapy services

Study DesignThis study utilized a cross-sectional cohort design that used survey techniques for data collection.IntroductionPatient satisfaction is becoming increasingly important in the health care field; however, it is typically evaluated with the use a single question. Patient satisfaction encompasses numerous aspects that should be considered on evaluation.Purpose of the StudyThe purpose of this study was to determine if the Patient Satisfaction Questionnaire Short Form (PSQ-18) is an appropriate outcome measure to determine patient satisfaction for people receiving hand therapy services and to determine mean satisfaction scores of participants.MethodsParticipants (n = 123) who received hand therapy services from an outpatient hand therapy center and a health care institute were obtained via a convenience sample. The PSQ-18, adapted for hand therapy, was used to assess patient satisfaction.ResultsThe mean satisfaction score was 1.81 (SD = 1.26). The following patient satisfaction subscales were also evaluated: general satisfaction, communication, technical quality, interpersonal manner, time spent with therapists, accessibility and convenience, and financial aspects.DiscussionEighty percent of participants were satisfied with the therapy services they received. Patient satisfaction is complex, involving a multitude of components and thus must be evaluated in a manner that considers its multidimensional aspects.ConclusionThe findings of this study suggest that the PSQ-18 adapted for hand therapy is an appropriate outcome measure to determine patient satisfaction for people receiving hand therapy as it evaluates multiple subscales of the phenomena.     

人格因素对正颌患者术后满意度的影响

目的：探讨人格因素对正颌患者术后满意度的影响，为临床治疗提供科学的理论依据。方法：采用16PF、EPQ人格问卷和正颌患者术后满意度问卷对30例正颌患者进行调查分析。结果：16PF人格问卷中，稳定性、感情与机警两因子标准得分与满意度总分之间呈正相关(r=0．375～0．462)，敏感性因子标准得分与满意度总分之间呈负相关(r=-0．379)。EPQ人格问卷中，P量表的标准得分与满意度总分之间呈负相关(r=-0．402)。结论：情绪稳定、自控倾向强的正颌患者较情绪不稳定者易于满意手术结果。     

Predicting Inpatient Dissatisfaction Following Total Joint Arthroplasty: An Analysis of 3,593 Hospital Consumer Assessment of Healthcare Providers and Systems Survey Responses

Background

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, created by the Centers for Medicare and Medicaid, is directly tied to hospital reimbursement. The purpose of this study is to identify factors that are predictive HCAHPS survey responses following primary hip and knee arthroplasty.