慢性阻塞性肺疾病病人健康行为水平调查及护理干预

[目的]探讨慢性阻塞性肺疾病（COPD）病人健康行为水平和护理干预方法。[方法]随机选取60例 COPD住院病人作为观察组,随机在社区选取60例无COPD的健康老年人为对照组。用健康促进生活方式量表Ⅱ（HPLP Ⅱ）和世界卫生组织生活质量评定量表简表（WHOQOL BERF）分别评定两组对象的健康行为水平和生活质量水平。对观察组病人进行6个月的护理干预,干预结束后再用 HPLP Ⅱ、WHOQOL BERF对观察组进行评定,比较干预前后其健康行为和生活质量水平变化情况。[结果]观察组HPLP Ⅱ总分和自我实现、健康责任、运动和锻炼、压力应对4个分量表评分及WHOQOL BERF总分明显低于对照组（P〈0.01）;经护理干预后,观察组 HPLP Ⅱ总分和健康责任、运动和锻炼、人际关系、压力应对4个分量表评分及 WHOQOL BERF总分明显提高（P〈0.01）。[结论]COPD病人健康行为和生活质量水平较低,通过护理干预,可提高其健康行为水平和生活质量。     

基于健康信念模式的健康教育对社区老年高血压病病人用药依从性的效果观察

[目的]探讨基于健康信念模式的健康教育对社区老年高血压病病人服药依从性的效果。[方法]采用便利抽样法选择洛阳市2个社区的老年高血压病病人100例,将一个社区的病人作为观察组,另一个社区的病人作为对照组,每组50例,对照组病人给予常规的健康指导并解答疾病相关问题,观察组病人进行基于健康信念模式的健康教育。干预前、干预3个月、干预6个月后比较两组病人服药依从性及血压情况,比较两组病人干预6个月后血压达标情况。[结果]观察组病人干预3个月、干预6个月后服药依从性、血压达标情况优于对照组(P<0.05);观察组病人干预6个月后血压下降,且低于对照组(P<0.05)。[结论]基于健康信念模式的健康教育能有效提高社区老年高血压病病人的用药依从性,有效控制血压。     

层级全责一体化护理模式在主动脉夹层病人健康教育中的应用

[目的]探讨层级全责一体化护理模式在主动脉夹层病人健康教育中的应用效果。[方法]将我院2012年10月—2013年10月收治的84例主动脉夹层病人按科室分为观察组(42例)和对照组(42例)。观察组采用层级全责一体化护理模式进行健康教育,对照组进行常规健康教育。评价两组病人健康教育知识掌握情况及术后6个月内的遵医行为。[结果]观察组健康知识掌握率明显高于对照组(P<0.05)。[结论]层级全责一体化护理模式下的健康教育,保证了健康教育的有效性。     

应用健康信念模式改善血管性认知障碍病人日常生活能力的研究

[目的]观察应用健康信念模式对血管性认知障碍病人日常生活能力的改善作用。[方法]选择92例血管性认知障碍病人,按照入院时间顺序分为观察组和对照组各46例,观察组接受以健康信念模式为理论基础的健康教育干预措施,对照组接受常规的健康教育。干预前和实施干预3个月后采用日常生活能力量表进行评定。[结果]干预前两组一般情况及日常生活能力比较,差异无统计学意义;干预后两组的日常生活能力评分差异有统计学意义(P<0.05)。[结论]以健康信念模式为基础的健康教育干预对血管性认知障碍病人的日常生活能力有明显的改善作用。     

健康信念模式在社区糖尿病足危险人群运动锻炼行为改变中的应用

[目的]探讨健康信念模式在帮助社区糖尿病足危险人群改善运动锻炼行为中的作用。[方法]将74例具有糖尿病足危险因素的社区糖尿病病人随机分为干预组和对照组,每组37例,干预组接受为期6个月的以健康信念模式为指导的健康教育和管理,对照组接受常规的社区卫生服务;两组干预前后分别进行糖尿病足运动锻炼行为、空腹血糖、餐后2h血糖、糖化血红蛋白、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇等观察指标的评价。[结果]干预后6个月干预组的糖尿病足运动锻炼行为得分高于干预前水平和对照组同期水平(P0.001);干预后6个月干预组的空腹血糖、餐后2h血糖、糖化血红蛋白、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇较干预前和对照组同期水平均有所改善(P0.05或P0.01)。[结论]健康信念模式对帮助社区糖尿病足危险人群建立良好的运动锻炼行为有促进作用,良好的运动锻炼行为对有效控制病人血糖、血脂水平具有重要意义。     

微信公众平台在膝关节置换术病人术后健康教育中的应用

[目的]探讨微信公众平台在膝关节置换术病人术后健康教育中的应用效果。[方法]将86例膝关节置换术病人随机分为观察组与对照组各43例,对照组病人采取常规健康教育,观察组病人采取以微信公众号为平台的健康教育。采用自行设计的知信行调查问卷调查病人入院时和干预1个月后疾病知识掌握、态度及行为水平,采用自行设计的满意度调查问卷评估病人出院时对健康教育的满意度,术后2周、1个月、3个月、6个月采用膝关节功能评分(HSS)、方盘量角器测量法、Barthel指数(BI)评估病人的膝关节功能、膝关节活动度(ROM)、日常生活活动能力。[结果]观察组病人干预1个月后的知识、态度、行为评分高于对照组(P0.05);观察组病人对健康教育的总体满意度高于对照组(P0.05);观察组病人术后2周、1个月、3个月、6个月HSS评分膝关节活动度、BI评分高于对照组(P0.05)。[结论]在膝关节置换术后应用以微信公众号为平台的健康教育能够有效提高病人的知信行水平、治疗依从性,促进膝关节功能恢复,提高病人满意度。     

应用健康信念模式提高肝硬化病人生存质量的研究

摘要：[目的]探讨健康信念模式在肝硬化病人健康行为改变、提高其生存质量中的作用。[方法]选择120例首次住院、第一诊断为肝硬化的病人作为研究对象,按照入院时间分为对照组61例和干预组59例,对照组接受常规教育,干预组接受以健康信念模式为理论基础的护理干预。两组均在入院第2天及随访3个月后进行问卷调查。[结果]干预前两组病人知识掌握、信念优秀、行为优秀比较,差异无统计学意义（P〉0．05）,干预后两组知识掌握、信念优秀、行为优秀比较,差异有统计学意义（P〈0．01）。[结论]健康信念模式在肝硬化病人建立良好的健康行为方面有促进作用,良好的健康行为对提高病人生存质量。     

IMB模式健康教育在宫颈癌前病变利普刀锥切术中的应用

目的：探讨信息-动机-行为(IMB)模式健康教育在宫颈癌前病变患者利普刀锥切术中的应用效果。方法：将94例宫颈癌前病变接受利普刀锥切术治疗的患者按照随机数字表法分为观察组和对照组各47例,对照组采用常规护理,观察组在对照组基础上采用IMB模式健康教育。比较两组干预前、干预3个月后患者认知度[采用健康促进生活方式量表(HPLP)]、心理状态[采用中文版心理弹性量表(CD-RISC)]、应对方式[采用医学应对调查问卷(MCMQ)]及性生活质量[采用国际女性性功能评估量表(BISF-W)]变化情况。结果：干预3个月后,两组HPLP、CD-RISC、BISF-W评分及MCMQ中面对量表评分均高于干预前,且观察组高于对照组(P<0.05);干预3个月后,两组回避、屈服量表评分均低于干预前(P<0.05),且观察组低于对照组(P<0.05)。结论：对宫颈癌前病变利普刀锥切术患者实施IMB模式健康教育,可提高患者对疾病的认知度、心理弹性水平及性生活质量,改善患者应对方式。     

环节式健康教育模式对冠心病行冠脉搭桥术患者的影响

目的:探讨环节式健康教育模式对冠心病行冠脉搭桥术(CABG)患者的影响。方法:将140例冠心病行CABG患者随机分为对照组和观察组各70例,对照组采用常规健康教育模式,观察组采用环节式健康教育模式,比较两组临床效果。结果:两组术后5个月健康促进生活方式量表Ⅱ(HPLPⅡ)评分高于入院时(P 0. 05),观察组术后5个月HPLPⅡ评分高于对照组(P 0. 05);观察组服药依从性及服药情况优于对照组(P 0. 05),护理满意度高于对照组(P 0. 05)。结论:环节式健康教育模式能够提高冠心病行CABG患者的健康行为水平、服药依从性,改善患者服药情况,提升护理满意度。     

基于问题解决法的认知行为干预对卒中后疲劳病人健康行为及治疗依从性的影响

[目的]探讨基于问题解决法的认知行为干预对卒中后疲劳病人的干预效果。[方法]将62例疲劳严重度量表(FSS)评分≥4分的卒中后疲劳病人随机分为干预组和对照组各31例。干预组给予问题解决法的认知行为干预,对照组给予常规健康教育、心理指导。于干预前和干预后两个月采用健康促进生活方式问卷(HPLP)、疲劳严重度量表对两组生活方式及疲劳程度进行调查,同时通过访谈获取病人服药依从性结果。[结果]干预后干预组HPLP以及服药依从性优于对照组(P0.05)。[结论]基于问题解决法的认知行为干预能改善卒中后疲劳病人健康行为、提高治疗依从性。     

The Precautionary Principle, public health, and public health nursing

ABSTRACT The Precautionary Principle posits that, in the absence of certainty, the appropriate course of action is to err on the side of caution. The Principle has been applied to decision making and policy development related to environmental health issues both internationally and in the United States. The American Public Health Association and the American Nurses Association (ANA) have issued policy statements that invoke the Precautionary Principle, and the Principle has been incorporated into statements that describe the practice of public health nursing. Nursing has always recognized the relationship of the environment with the health of humans—individuals, families, populations, and communities (ANA). The increasing attention to the Precautionary Principle comes at a time of redefinition of the field of public health, environmental public health, and the practice of public health nursing. Thus, it is crucial that practicing public health nurses understand the Precautionary Principle and its relevance to the practice of public health, public health nursing, and the current and future health individuals, families, populations, and communities.     

Enhancing oral health for better mental health: Exploring the views of mental health professionals

The association between oral health, self‐esteem and quality of life is well established yet there is limited research on the impact of addressing the poor oral health of people living with mental health disorders. Greater consideration is warranted on how enhancing oral health in the course of mental healthcare might reduce the burden of a person's ill health. The role of mental health professionals is important in this regard yet uncertainty persists about the role these providers can and should play in promoting oral health care for people with mental health disorders. This qualitative study explored the issue of oral health and mental health with community based mental health professionals in Perth, Western Australia. It examined their views on the oral health status and experiences of their clients, and the different and alternative ways to improve access to care, knowledge and preventative regimens. Findings indicated participants’ ambivalence, reluctance and lack of training in raising oral health issues, despite its acknowledged importance, indicating a siloed approach to care. Findings offer an opportunity to reflect on whether a more integrated approach to oral health care for people with mental health disorders would improve health outcomes.     

Primary health care practitioners' tools for mental health care

The purpose of this study was to describe and analyse the content of mental health care from the practitioner's point of view. The specific aim of this paper was to outline the types of mental health care tools and the ways in which they are used by primary health care practitioners. The data were derived from interviews with doctors and nurses (n = 29) working in primary health care in six different health care centres of the Pirkanmaa region in Finland. The data were analysed by using qualitative content analysis. The tools of mental health care used in primary health care were categorized as communicative, ideological, technical and collaborative tools. The interactive tools are either informative, supportive or contextual. The ideological tools consist of patient initiative, acceptance and permissiveness, honesty and genuineness, sense of security and client orientation. The technical tools are actions related to the monitoring of the patient's physical health and medical treatment. The collaborative tools are consultation and family orientation. The primary health care practitioner him/herself is an important tool in mental health care. On the one hand, the practitioner can be categorized as a meta-tool who has control over the other tools. On the other hand, the practitioner him/herself is a tool in the sense that s/he uses his/her personality in the professional context. The professional skills and attitudes of the practitioner have a significant influence on the type of caring the client receives. Compared with previous studies, the present informants from primary health care seemed to use notably versatile tools in mental health work. This observation is important for the implementation and development of mental health practices and education.     

The role of mental health nurses in planetary health

This article will critically explore the concept of planetary health and locate the role and identity of the mental health nurse (MHN) within it. Like humans, our planet thrives in optimum conditions, finding the delicate balance between health and ill-health. Human activity is now negatively impacting the homeostasis of the planet and this imbalance creates external stressors that adversely impact upon human physical and mental health at the cellular level. The value and understanding of this intrinsic relationship between human health and the planet is in danger of being lost within a society that views itself as being separate and superior to nature. The Period of Enlightenment witnessed some human groups viewing the natural world and its resources as something to exploit. White colonialism and industrialization destroyed the innate symbiotic relationship between humans and the planet beyond recognition and in particular, overlooking the essential therapeutic role nature and the land facilitated within the well-being of individuals and communities. This prolonged loss of respect for the natural world continues to breed human disconnection on a global scale. The healing properties of nature have effectively been abandoned within healthcare planning and infrastructure, which continue to be driven principally by the medical model. Under the theory of holism, mental health nursing values the restorative capabilities of connection and belonging, employing skills to support the healing of suffering, trauma and distress, through relationships and education. This suggests MHNs are well situated to provide the advocacy the planet requires, through the active promotion of connecting communities to the natural world around them, both healing the other.     

社区保健病人健康教育效果评价

目的提高社区保健效果。方法采取集中或个体健康教育形式进行社区护理。结果不同文化程度社区病人健康教育前后焦虑情绪经行乘列卡方检验,有显著性差异,P<0.01;说明社区保健病人经健康教育后大学文化程度者焦虑情绪改善较好。饮食不良行为分别经字2检验,有显著性差异,P<0.01,说明健康教育后社区保健病人饮食不良行为明显改善。自我保健能力分别经字2检验,有显著性差异,P<0.01,健康教育后社区保健病人自我保健能力明显提高。结论对社区保健病人做好健康教育,能减轻病人的焦虑情绪,改善病人饮食不良行为,提高病人自我保健能力。     

Workplace health promotion: the role and responsibility of health care managers

The World Health Organization's (WHO) Ottawa Charter for Health Promotion in 1986 provided the catalyst from which the Health Promoting Workplace movement emerged. Here, an extensive review of the available workplace-related health literature provides the basis for critical discussion and recommendations for health care managers. The findings suggest that health care managers, who practice in all health service settings, should be aiming to initiate and promote radical health promotion reform as set out in the WHO settings-based movement. Developing and implementing sustainable health promotion-orientated and organization-wide healthy workplace policy initiatives represent the most effective way for health care managers to directly benefit from the desirable outcomes that come from creating and maintaining a healthy workforce.     

某银行571名职工健康体检结果分析及健康指导

目的了解合肥市某银行职工的健康状况,以便有针对性的制定健康教育对策,积极预防疾病发生。方法 2012年5月～7月对合肥市某银行571名职工集中进行健康体检,将体检结果采用顺位及构比法,按各年龄段主要异常结果检出率、部分异常结果男女检出率进行综合分析。结果571人体检其合格率为18.21%,检出有异常者467人,阳性病征检出率较高的为幽门螺旋杆菌(Hp)抗体阳性205人(35.90%),高脂血症137人(23.99%),脂肪肝123人(21.54%),颈椎退行性变117人(20.49%),心电图异常96人(16.81%),甲状腺疾病87人(15.24%),高血压71人(12.43%),肝功能异常60人(10.51%),高尿酸51人(8.93%),胆囊疾病49人(8.58%),血糖升高(包括糖尿病)44人(7.71%),泌尿系结石32人(5.60%)。各年龄段Hp抗体阳性、高脂血症、脂肪肝、高血压、血糖升高的检出率随着年龄的增长而增加。高脂血症、脂肪肝、高血压、高尿酸血症、血糖升高、肝功能异常的检出率男性明显高于女性,而甲状腺疾病的检出率女性高于男性。结论本调查对象的健康状况较差,加强职工的健康教育,指导建立良好的生活方式,对预防疾病发生,改善健康状况,提高生活质量意义重大。