中医拔火罐疗法的操作及护理

拔火罐疗法又称角法,是通过物理的刺激和负压人为造成毛细血管破裂淤血,调动人体干细胞修复功能,以及坏死血细胞吸收功能,可促进血液循环,激发精气,调理气血,达到提高调节人体免疫力的作用.拔火罐疗法是借助热力排除罐中空气,利用负压使其吸着于皮肤,造成瘀血现象的一种治病方法.     

Patterns of care in patients utilizing both primary health care and psychiatric care in a Swedish health district

Patterns of care in all patients (N = 546) establishing contact with both primary health care and psychiatric care were studied during 1984 (N = 252) and 1986 (N = 294) in a Swedish health district. Utilization of primary health care was not affected by the sectorization of the psychiatric care organization, while there was a significant increase in utilization of outpatient psychiatric care. Patients with a higher number of visits in outpatient psychiatric care had a lower number of visits in primary health care. The utilization of care was unevenly distributed in the sample; 25% of the patients accounted for almost 60% of the visits in both care organizations. The mental health problems were identified in primary health care in 40% of the patients. This group of patients seemed to be defined as belonging neither to specialized psychiatric care nor to the general practitioner level of primary health care.     

Physicians' interactions with health care teams and systems in the care of dying patients: perspectives of dying patients,family members,and health care professionals

This study investigated the specific physician skills required to interact with health care systems in order to provide high quality care at the end of life. We used focus groups of patients with terminal diseases, family members, nurses and social workers from hospice or acute care settings, and physicians. We performed content analysis based on grounded theory. Groups were interviewed. Two domains were found related to physician interactions with health care systems: 1) access and continuity, and 2) team communication and coordination. Components of these domains most frequently mentioned included taking as much time as needed with the patient, accessibility, and respect shown in working with health team members. This study highlights the need for both physicians and health care systems to improve accessibility for patients and families and increase coordination of efforts between health care team members when working with dying patients and their families.     

Giving health care to minority patients

Health care is usually thought of as a basic right of each individual. This so-called basic right is denied to many mainly because of their economic situation and the color of their skin. There is a need for more blacks, Indians, Mexican-Americans, Puerto Ricans, and Asians in the health care field. The numbers are low and the training process slow. Time is needed to prepare ethnic people of color. Since most of the deliveries of health care are white, these white workers must become sensitive to the traditions, values and attitudes of the ethnic groups of color. Schools of nursing are beginning to include cultural differences in nursing curriculums, but the majority of the nurses who practice are not aware of and are not sensitive to the needs of nonwhite patients. Nursing must help solve problems of the ethnic groups of color. Nurses must become personally involved in the injustices of health care. As Marie Branch states, there must be "personal reeducation." When this occurs, health care to the minority client will improve.     

Preventive health care for older patients

This chapter addresses key components of screening and preventive care for the older population. The older population is heterogeneous, ranging from the competent, active, well individual to the frail, demented individual. Certain preventive measures are important for all individuals such as counseling on exercise and screening for high blood pressure. However, universal cancer, cholesterol, or dementia screening may not be cost effective and beneficial in all older adults. These preventive measures should be guided by the individuals' circumstances including their life expectancy, co-morbid illnesses, functional capacity, and quality of life. Clinicians may be able to individualize preventive medicine decisions by stratifying their patients into well and frail using the guidelines we have provided. The goal of prevention and screening in older patients is to improve function and quality of life. Primary care physicians should facilitate discussion of preventive measures with their older patients as part of their ongoing health care.     

癌症病人的心理保健

癌症是一类严重威胁人体生命健康的常见病、多发病,它的危害越来越严重.关于癌症的病因,人们普遍偏重于理化刺激、病毒、药物、遗传、激素和衰老等因素,而忽视社会、心理、职业、人格特征等.事实上,社会心理紧张刺激在癌症发生和发展中的作用,与理化生物等因素有着同等意义.第十二届国际癌症大会的许多资料反复证明:癌症的发生与社会心理因素有关,癌症病人的存活率及时间与情感状态相联系.     

Priorities in primary health care. The views of patients, politicians and health care professionals

A written inquiry was undertaken to explore the expectations towards primary care physicians (general practitioners), as expressed by patients, local health board members and health centre staff members. Treatment without delay was given top priority both by patients and board members, while continuity of care was considered most important by the health care professionals. Great similarity of opinions was expressed by patients and health board members, while staff members differed significantly in their views. A low degree of participation in the study by the politicians coincided with the authors' experience of lack of interest in the content of primary health care shown by health board members.     

Satisfaction with health care of hemodialysis patients

The purpose of this study was to assess the satisfaction with care of hemodialysis patients, and to explore the relationships between satisfaction with care, quality of life, and background variables. The sample (n = 416) was randomly selected from the adult, in-unit hemodialysis patient population of a north central state. Overall, patients were satisfied with their care (M = 5.04, range = 1 to 6). An ANOVA demonstrated that patients were most satisfied with physician related aspects of care, followed by nursing/dialysis treatment aspects, and least satisfied with financial/transportation aspects (F(2,830) =28.44. p less than .0001). Overall satisfaction with care was most highly correlated with satisfaction with medical (r = .74) and nursing care (r = .74). Satisfaction with care was moderately correlated with quality of life (r = .42) and satisfaction with health and functioning (r = .42). Somewhat weaker relationships were found between satisfaction with care and socioeconomic aspects of life (r = .31), psychological/spiritual aspects (r = .32), and family (r = .27). Patients who had been on dialysis for a shorter length of time or who had less education were more satisfied with care.     

支气管哮喘病人的护理及健康指导

支气管哮喘是危害人民健康的常见病，临床表现为反复发作的喘息、呼气性呼吸困难、胸闷、咳嗽等症状。如果诊治不及时，随病程的延长可产生气道不可逆性改变，因此合理的防治至关重要。目的的治疗主要是控制症状，减少复发，除了合理的治疗方案外，还需要适当的护理及健康指导。为此，我科护理人员加强心理护理及健康指导，效果较好。现总结如下。     

除草剂中毒病人的心理护理及健康教育

除草剂是广泛应用于农村的快速简单的灭虫农药,在各类除草剂中,不同种类及剂型毒性不一,以百草枯毒性最大,敌草快次之,其余为低毒类[1],人体对百草枯的口服致死量是30 mg/kg～50 mg/kg[2],目前尚无特效解毒剂,死亡率高.     

支气管哮喘病人的护理及健康指导

支气管哮喘是危害人民健康的常见病,临床表现为反复发作的喘息、呼气性呼吸困难、胸闷、咳嗽等症状.如果诊治不及时,随病程的延长可产生气道不可逆性改变,因此合理的防治至关重要[1].目前的治疗主要是控制症状,减少复发,除了合理的治疗方案外,还需要适当的护理及健康指导[2].为此,我科护理人员加强心理护理及健康指导,效果较好.现总结如下.     

Response time and health care learning of elderly patients

The purpose of this study was to determine if elderly patients perform better in health care learning when provided slower or self-paced response conditions. The sample consisted of 105 institutionalized elderly people randomly assigned to three response groups: fast-paced, slow-paced, and self-paced. After nutrition instruction, learning performances of each of the three groups were measured. Learning performances under the fast- and slow-paced conditions did not differ; learning performances under the self-paced condition was superior to the two experimenter-paced conditions. Findings of this study document that a self-paced response condition is advantageous for elderly patients.     

The sexual health care needs after colorectal cancer: the view of patients,partners, and health care professionals

Purpose

Sexual dysfunction among patients with colorectal cancer is frequently reported. Studies examining patients’ sexual health care needs are rare. We examined the sexual health care needs after colorectal cancer treatment according to patients, partners, and health care professionals (HCPs). Factors that impede or facilitate the quality of this care were identified.

Method

Participants were recruited from three Dutch hospitals: St. Elisabeth, TweeSteden, and Catharina hospitals. Patients (n?=?21), partners (n?=?9), and 10 HCPs participated in eight focus groups.

Results

It is important to regularly evaluate and manage sexual issues. This does not always occur. Almost all participants reported a lack of knowledge and feelings of embarrassment or inappropriateness as barriers to discuss sexuality. HCPs reported stereotypical assumptions regarding the need for care based on age, sex, and partner status. The HCPs debated on whose responsibility it is that sexuality is discussed with patients. Factors within the organization, such as insufficient re-discussion of sexuality during (long-term) follow-up and unsatisfactory (knowledge of the) referral system impeded sexual health care. The HCPs could facilitate adequate sexual health care by providing patient-tailored information and permission to discuss sex, normalizing sexual issues, and establishing an adequate referral system. It is up to the patients and partners to demarcate the extent of sexual health care needed.

Conclusions

Our findings illustrate the need for patient-tailored sexual health care and the complexity of providing/receiving this care. An adequate referral system and training are needed to help HCPs engage in providing satisfactory sexual health care.     

尿失禁病人的家庭护理和健康指导

尿失禁是指客观存在的非自主的尿液漏出，是泌尿系统常见症状。引起尿失禁的原因有疾病、精神、心理等因索且较复杂。老年人患有尿失禁者高达55％，因各种原因而不能在医院里接受治疗和护理的占70％以上，很多病人因怕被人嘲笑或丧失尊严，不敢多饮水，甚至拒绝外出，使其生活质量受到严重影响。因此，尿失禁已经成为一个令人关注的社会问题。自1998年我院社区服务中心开设以来，为328例尿失禁病人提供了家庭护理和健康指导，使病人尿失禁状况得到极大改善，生活质量提高。现报道如下。     

尿失禁病人的家庭护理和健康指导

尿失禁是指客观存在的非自主的尿液漏出,是泌尿系统常见症状。引起尿失禁的原因有疾病、精神、心理等因素且较复杂[1]。老年人患有尿失禁者高达55%[2],因各种原因而不能在医院里接受治疗和护理的占70%以上,很多病人因怕被人嘲笑或丧失尊严,不敢多饮水,甚至拒绝外出,使其生活质量受到严重影响。因此,尿失禁已经成为一个令人关注的社会问题。自1998年我院社区服务中心开设以来,为328例尿失禁病人提供了家庭护理和健康指导,使病人尿失禁状况得到极大改善,生活质量提高。现报道如下。1临床资料本组328例,其中女203例,男125例,年龄最大91岁,最小5…     

Connected health care: the future of health care and the role of the pharmacist

The population of the world is ageing. As a result, the incidence of chronic disease is projected to increase, there are predicted shortages in health care workforce and budget restraints; implications for future health care provision are serious. The current model of health care is not equipped to deal with these changes. Connected health care, via the use of health informatics, disease management and home telehealth technologies, has been suggested as an approach to ease the projected strain on future health care. Evidence to date suggests a positive impact of the use of connected health care model; however, the majority of studies have overlooked the involvement of the community pharmacist. As the most common point of contact with primary health services for most of the population, the community pharmacist may be well placed to provide connected health care. The research to date is promising with improvements in outcomes for cardiovascular patients noted; however, further work is required to investigate the potential role the community pharmacist can play in the future of connected health care.     

Oral health care for hospitalized patients: the nurse's role

Oral health care is an essential component of daily hygiene for hospitalized patients, and nurses have an important role in helping patients maintain an acceptable level of oral health. This study tested the hypothesis that nursing students are graduating with an insufficient knowledge of oral health care for hospitalized patients. Four groups of senior nursing students comprised the study sample. Study data reveal gaps in the subjects' knowledge of and rationale for oral health care procedures for hospitalized patients. However, the subjects also indicated a high level of interest in improving their ability to offer appropriate oral care services. In addition to study findings, an oral health care instructional unit outline for nursing students is presented.