老年慢性心力衰竭患者医院感染相关因素

目的 探讨分析老年慢性心力衰竭患者医院感染的相关因素及干预对策,以达到更好地为患者治疗和护理的目的.方法 2011年6月-2012年5月共收治慢性心力衰竭患者300例,将其分为观察组与对照组各150例;对照组采用常规护理方法,观察组在常规护理方法的基础上,制定护理干预措施,比较两组患者医院感染的发生率、平均住院日和护理满意度.结果 平均住院日观察组(15.6±1.4)d、对照组(27.2±1.6)d,两组比较差异有统计学意义(P＜0.05);患者满意度观察组为(97.42±6.29)％、对照组为(80.32±5.42)％,两组差异有统计学意义(P＜0.05);对照组发生医院感染10例,感染率为6.67％,其中下呼吸道感染7例、泌尿系感染2例、胃肠道感染1例,观察组无感染病例发生.结论 制定护理干预措施有效预防了医院感染的发生,提高了患者的满意度,缩短了住院日.     

尿毒症患者肺部感染综合护理干预的效果分析

目的研究综合护理干预模式应用于尿毒症肺部感染患者的临床治疗效果,为降低尿毒症肺部感染提供科学数据。方法采取随机对照、问卷调查的研究方法,选择2013年12月-2014年12月在海南省农垦总医院东湖分院接受治疗的80例尿毒症肺部感染患者临床资料,将其随机分为观察组及对照组,每组各40例;观察组患者应用综合护理干预模式,对照组患者应用常规护理模式;观察两组患者肺部感染率、发生肺部感染时间及对护理的满意度;数据采用SPSS 12.0软件进行统计分析。结果患者肺部感染率观察组为11.12%、对照组患者为27.32%,患者感染出现的时间观察组为(4.68±1.69)d、对照组为(2.98±2.66)d,两组比较差异均有统计学意义(P0.05);患者对护理的满意度观察组达到97.50%、对照组为77.50%,两组比较差异有统计学意义(P0.05)。结论综合护理干预模式应用于降低尿毒症肺部感染患者的临床护理效果比较理想。     

护理干预措施对高龄老年肺部感染的临床效果

目的探讨高龄老年肺部感染患者更加有效地护理干预措施。方法选取黑龙江省佳木斯市中心医院收治的高龄老年肺部感染患者64例作为研究对象,随机分为观察组32例和对照组32例。对照组给予抗感染治疗以及维持呼吸道通畅,雾化吸入,观察病情变化,吸氧护理等常规基础护理;观察组在常规护理基础上给予心理护理,用药护理,营养指导,健康宣教,加强基础护理等干预措施。两组均持续观察3个月,比较护理满意度,生活质量以及总有效率。采用SPSS 16.0对数据进行处理,计量资料用(xˉ±s)表示,采用t检验;计数资料用率表示,采用χ2检验。P<0.05为差异有统计学意义。结果观察组总有效率为87.50%,对照组为84.38%,差异无统计学意义(χ2=1.43,P>0.05);观察组护理满意度(87.50%)明显高于对照组(71.88%),差异有统计学意义(χ2=2.31,P<0.05);观察组和对照组生活质量评分分别为(81.28±4.64)分和(65.93±4.45)分,差异有统计学意义(t=5.36,P<0.05)。结论护理干预措施在保证临床疗效的同时,可提高高龄老年肺部感染患者护理满意度及生活质量。     

老年脑卒中后并发吞咽障碍及肺部感染的护理干预

目的:实验研究对老年脑卒中后并发吞咽障碍及肺部感染患者,应用相关护理干预措施的效果.方法:实验所选的对象为,本医院2016年7月—2017年7月收治的老年脑卒中后并发吞咽障碍及肺部感染患者90例,利用抽签法将其分为两组,观察组和对照组,各45例.观察组患者实施综合护理干预措施,对照组只实施常规护理措施,对两组患者的护理效果进行比较.结果:观察组患者的护理有效率显著高于对照组,超过90％,两组差异明显,具有统计学意义(P<0.05).结论:在老年脑卒中后并发吞咽障碍及肺部感染患者治疗中,应用综合护理干预措施,有较好的效果,还显著改善患者的临床症状,提高患者的生活质量,值得广泛应用.     

优质护理干预在降低腹腔镜术后感染中的应用

目的探讨优质护理干预在降低腹腔镜术后感染、并发症的发生及提高患者对护理质量的满意度中的应用。方法选取2012年1月-2013年2月行腹腔镜手术的160例患者,随机分为两组,其中观察组84例,应用优质护理措施进行干预;对照组76例,应用传统常规护理措施进行干预;观察比较两组患者术后的感染率、并发症发生率、焦虑量表(SAS)分值、患者满意度。结果术后感染率观察组为2.83%、对照组为11.84%,两组间比较差异有统计学意义(P<0.05);并发症发生率观察组为9.52%、对照组为23.68%,两组比较差异有统计学意义(P<0.05);观察组与对照组的焦虑量表(SAS)评分均较干预前明显降低(P<0.05),观察组的降低幅度明显大于对照组,差异有统计学意义(P<0.05);对护理干预满意度观察组为92.86%、对照组为80.26%,观察组明显高于对照组,差异有统计学意义(P<0.05)。结论实施优质护理干预能有效降低腹腔镜术后感染及并发症的发生,缓解患者焦虑情绪,并有效提高了患者的护理质量满意度。     

特殊护理干预在老年患者静脉留置针中的应用

目的探讨静脉留置针在老年患者中的应用与护理。方法选择2012年1—12月住院使用静脉留置针的老年患者120例,随机分为观察组和对照组各60例,对照组采用传统方法进行护理,观察组采用特殊护理干预措施进行护理。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果一针穿刺成功率观察组96.7%,对照组85.0%,两组比较差异均有统计学意义(P<0.05)。留置时间观察组(5.5±2.5)d,对照组(3.5±2.0)d,两组比较差异有统计学意义(t=4.839,P<0.05)。观察组患者在皮下血肿、导管阻塞、液体渗漏、静脉炎等方面明显少于对照组,两组比较差异有统计学意义(P﹤0.05)。结论特殊护理干预措施可提高一针穿刺成功率,延长静脉留置针的留置时间,减少置管后不良反应发生率。     

病例管理模式在肺动脉高压肺部感染患者中的应用效果

目的探讨病例管理模式在住院肺动脉高压肺部感染患者干预中的应用效果,以减低感染率。方法调查2011年1月-2014年12月肺动脉高压肺部感染住院患者共394例,选取2011年1月-2013年5月的住院患者197例作为对照组,选取2013年6月-2014年12月住院患者197例患者作为观察组,对照组患者实施传统干预模式,观察组采取病例管理模式,两组患者干预20d后比较不良事件发生率、肺部感染率、平均住院时间及密尔顿抑郁量表(Hamilton RatingScale forDepres-sion.HAMD)评分。结果观察组患者不良事件的发生率为23.8%,低于对照组54.3%,差异有统计学意义(P<0.05);观察组患者的感染率为7.1%,较对照组患者的13.7%有明显下降,差异有统计学意义(P<0.05);观察组患者住院时间为(26.07±0.90)d,对照组患者为(32.74±0.80)d,两组比较差异有统计学意义(P<0.05);HAMD评分干预后较干预前低,差异有统计学意义(P<0.05)。结论实施病例管理模式能有力促进肺动脉高压伴肺部感染患者的治疗,有效预防、控制肺部感染。     

六西格玛管理对老年住院患者肺部感染的预防研究

目的探究六西格玛管理对老年住院患者发生肺部感染的防护效果,优化护理质量。方法选取医院2014年1-12月收治的200例老年住院患者作为研究对象,将2014年1-6月100例老年住院患者设为对照组,2014年7-12月100例老年住院患者设为观察组,对照组采用常规干预方法,观察组采用六西格玛管理干预;干预3个月后,比较两组患者肺部感染率,采用调查问卷方式调查干预满意度及感染防护知识掌握度,采用抑郁自评量表(SDS)和焦虑自评量表(SAS)调查患者的心理状况;应用SPSS 17.0软件对数据进行统计分析。结果观察组感染率为8.0%,对照组为28.0%,观察组肺部感染明显少于对照组,差异有统计学意义(P0.05);满意度调查结果显示,对照组满意度88.00%,而观察组满意度96.00%,明显高于对照组,差异有统计学意义(P0.05);观察组患者感染防护知识掌握度明显优于对照组,差异有统计学意义(P0.05);两组住院老年患者干预前SAS、SDS评分差异无统计学意义;经干预后,观察组SAS、SDS评分显著优于对照组,差异有统计学意义(P0.05)。结论六西格玛管理模式有效降低了住院老年患者肺部感染率,提高患者对干预的满意度及感染防护知识掌握度,减少患者负面情绪的发生,是控制住院老年患者肺部感染的有效管理方法。     

整体护理在产科失血性休克早期救治中的应用

目的探讨整体护理干预方法对妇产科失血性休克早期患者的影响。方法回顾性分析我院收治的148例妇产科失血性休克早期患者的临床护理资料,根据护理方法的不同,将患者分为观察组78例和对照组70例。观察组采取整体护理模式,对照组采取常规护理方法,对两组患者的平均住院日、护理满意度、出院前的SAS及SDS评分进行比较分析。结果观察组的平均住院日为(10.6±3.8)天、对照组为(23.1±5.9)天,两组差异有显著统计学意义(P<0.01)。观察组的护理满意度为94.87%、对照组为81.43%,两组差异有统计学意义(P<0.05)。两组患者在出院前的SAS评分、SDS评分均较病情稳定时降低(P<0.05),但观察组降低更显著(P<0.01)。结论在妇产科失血性休克患者的救治中采用整体护理模式,有利于改善患者的负性心理情绪,提高护理满意度,有助于机体康复,缩短平均住院日。     

预见性护理干预对老年骨折患者的影响观察

目的观察预见性护理干预对老年骨折患者的影响。方法选择2009年2—8月收治的老年骨折患者128例,随机分为对照组和研究组各64例,对照组给予常规护理干预;研究组给予预见性护理干预,包括心理支持、疼痛护理、积极采取预防措施等。比较两组术后并发症发生率、疼痛情况、住院时间以及护理满意度。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果术后并发症对照组60.94%,研究组15.62%,两组比较差异有统计学意义(χ2=27.809,P<0.05);出现明显疼痛者对照组24例,占37.5%;研究组8例,占12.5%。两组比较差异有统计学意义(χ2=10.667,P<0.05);住院时间对照组(19.2±8.3)d,研究组(14.2±6.8)d,两组比较差异有统计学意义(t=3.728,P<0.05);护理满意度对照组87.5%,研究组96.9%,两组比较差异有统计学意义(χ2=3.905,P<0.05)。结论老年患者术后易伴有不良情绪及多种并发症,给予合理的预见性护理干预能够明显提高其术后的生活质量,值得推广。     

有性才会有健康

性是基本的人权。根据我国著名的性学家史成礼教授的研究,性有“三大功能”:生育功能、享乐功能和健康功能。     

Communicating with people with dementia

It can be very difficult to communicate with people with dementia. Each case requires its own unique handling. Not every scenario is covered, as many times your own judgment is what will work, best according to the circumstances. These can change from dawn to evening and from day to day. Never assume things will be the way they were the last time you communicated. Be on your guard. Be adaptable. The article will help get you started to think of your own ways to communicate.     

经方汗证治验

临床上汗证病情复杂,分自汗、盗汗、黄汗和但头汗出,治疗汗证方药诸多,有益气固表、养阴清热和清热除湿等方法,疗效不一。受恩师刘健主任教导和《伤寒论》《金匮要略》病脉证并治启发,以脉证并治、方证对应思想,浅谈桂枝加附子汤、黄芪芍药苦酒汤、柴胡桂枝干姜汤和三物黄芩汤治疗汗证的经验,为经方治疗汗证提供新思路。     

Working with patients with physical disabilities

Medical practices need to make a number of adaptations to ensure that their facilities and staff are accessible to patients and other office visitors with physical disabilities. This article describes 10 specific strategies for preparing your medical practice for patients with disabilities, both inside and outside your office. It describes minimum standards for office doorways, sidewalk inclines, ramps, reception areas, and other adaptations medical offices need to make. The article also describes specific do and don't advice for communicating with patients with physical disabilities. It suggests strategies for preparing written materials for disabled patients, for communicating verbally, and for providing healthcare education. Finally, it suggests an appropriate role for medical practice staff in the delivery of healthcare services to patients with physical disabilities.     

Coping with Children with ADHD: Coping Styles of Mothers with Children with ADHD or Challenging Behaviours

Parents of children with Attention Deficit Hyperactivity Disorder (ADHD) can experience significant levels of stress in their parenting roles, however, little is known about the specific coping strategies used by these parents. This pilot study Investigated the coping strategies used by mothers of children with ADHD. A 34 item questionnaire was developed to identify maternal coping strategies. A cohort of 38 mothers of children with ADHD and a control group of 30 mothers of children without ADHD or any other disability/illness completed the questionnaire. Factor analysis of responses produced three factors: Aggressive/Confrontive Coping, Rational Coping, and Indirect Coping. These factors are similar to coping dimensions proposed by Folkman and Lazarus. Comparisons between the two groups of mothers revealed that mothers of children with ADHD used significantly more Indirect Coping.     

Problems with measuring satisfaction with social care

The measurement of customer satisfaction has become widespread in both healthcare and social care services, and is informative for performance monitoring and service development. Satisfaction with social care services is routinely measured with a single question on overall satisfaction with care, comprising part of the Adult Social Care Survey. The measurement of satisfaction has been problematised, and existing satisfaction measures are known to be under‐theorised. In this article, the process of making an evaluation of satisfaction with social care services is first informed by a literature review of the theoretical background, and second examined through qualitative interviews conducted in 2012–2013 with 82 service users and family carers in Hampshire, Portsmouth and Southampton. Participants in this study were from white British and South Asian backgrounds, and the influence of ethnicity in the process of satisfaction evaluation is discussed. The findings show that the majority of participants selected a positive satisfaction rating even though both positive and negative experiences with services were described in their narratives. It is recommended that surveys provide opportunity for service users and family carers to elaborate on their satisfaction ratings. This addition will provide more scope for services to review their strengths and weaknesses.     

Ending clinical relationships with people with schizophrenia

The potential for the social worker-client relationship to contribute to therapeutic outcomes is not always apparent with clients who have schizophrenia. Their cognitive impairments often make it difficult for these clients to regulate interpersonal boundaries and for social workers to connect with them. Clinical practice is enhanced, however, by recognizing that severely impaired clients have the capacity and desire for relationships with service providers and others. The manner in which the clinical relationship ends is important for maintaining clinical gains and determining whether the client will risk investing in future relationships. The purpose of this article has been to sensitize social workers to the delicate nature of managing the endings of those relationships.