运用King达标理论护理1例高血压病人

King的达标理论重点讨论发生在人与人之间,特别是护士与病人之间的相互作用.强调护理的重点是促进护士与病人在护理活动过程中共同参与,相互作用,鼓励病人主动参与实现获得最佳健康状态目标的活动.护理的目的是帮助每个人维护健康,促使个体在社会中发挥其角色和功能,帮助患病个体恢复健康.现将此理论用于1例高血压病人的护理中,并对应用情况进行了分析.……     

The Timed "up and go" test: reliability and validity in persons with unilateral lower limb amputation.

OBJECTIVE: To determine the interrater and intrarater reliability and the validity of the Timed "up and go" test as a measure for physical mobility in elderly patients with an amputation of the lower extremity. DESIGN: To test interrater reliability, the test was performed for two observers at different times of the same day in an alternating order. To test intrarater reliability, the patients performed the test for one observer on two consecutive visits with an interval of 2 weeks. To test validity, the results of the Timed "up and go" test were compared with the results on the Sickness Impact Profile, 68-item version (SIP68), and the Groningen Activity Restriction Scale (GARS). PATIENTS: Thirty-two patients, age 60 yrs or older, with unilateral transtibial or transfemoral amputation because of peripheral vascular disease. RESULTS: The Timed "up and go" test showed good intrarater and interrater reliability (r = .93 and .96, respectively). A moderate relationship exists between the Timed "up and go" test and the GARS, a good relationship exists with the "physical subscales" of the SIP68, and there is no relationship with the "mental subscales" of the SIP68. CONCLUSIONS: The Timed "up and go" test is a reliable instrument with adequate concurrent validity to measure the physical mobility of patients with an amputation of the lower extremity.     

Living with severe hypoxic COPD: the patients' experience

AIM: To describe the experience of living with severe oxygen-dependent chronic obstructive pulmonary disease (COPD). METHOD: Unstructured, tape-recorded interviews were used to collect data from 10 patients with COPD. The interviews were undertaken in the patients' own homes. RESULTS: Recurrent themes emerged from the data. All participants reported physical and emotional problems, mainly caused by breathlessness. Half of the sample discussed feeling depressed and 80 per cent discussed how COPD had affected their family life. Participants discussed how difficult it was to stop smoking, and the guilt they felt when they realised their smoking had caused their disease. Half of the sample discussed needs, such as better communication between health professionals and patients about the diagnosis and prognosis. Long-term oxygen therapy was described in negative terms by 10 per cent of the sample. CONCLUSION: Severe COPD has an impact on all aspects of a patient's quality of life. A palliative, interdisciplinary approach from primary and secondary care, social services and the voluntary agencies needs to be adopted at an earlier stage of the disease. Patients should be encouraged to participate in the planning and management of their treatment to improve their experience of the disease in the future.     

Validation of the Reintegration to Normal Living Index for community-dwelling persons with chronic spinal cord injury

Hitzig SL, Romero Escobar EM, Noreau L, Craven BC. Validation of the Reintegration to Normal Living Index for community-dwelling persons with chronic spinal cord injury.ObjectiveTo determine the validity (construct, concurrent) of the Reintegration to Normal Living (RNL) Index for measurement of community participation in adults with chronic spinal cord injury (SCI).DesignCross-sectional telephone survey.SettingRehabilitation institute.ParticipantsCommunity-dwelling adult men and women (N=617) with SCI who were at least 1 year postinjury.InterventionsNot applicable.Main Outcome MeasuresRNL Index and Satisfaction With Life Scale (SWLS).ResultsReliability of the RNL Index was determined by using Cronbach α, and construct validity was established through confirmatory factor analysis (CFA). In addition, general linear models to predict RNL Index scores were conducted to establish concurrent validity. The RNL Index is a reliable measure of community participation (α=.87). CFA analyses suggested that the RNL Index loads onto a 2-factor solution and is distinct from the SWLS. Significant predictors of RNL Index score included years post-injury, impairment, ambulatory status, employment, and poor health, which yielded R²=.26 (P<.001).ConclusionsThe RNL Index is a valid and reliable measure of community participation for persons with chronic SCI of traumatic cause.     

"Hypnopuncture"--a dental-emergency treatment concept for patients with a distinctive gag reflex

The present case report describes a newly developed dental treatment concept for patients with a distinctive gag reflex. "Hypnopuncture" is a combination therapy of hypnosis and acupuncture. Its simple, fast, and effective application autonomous of the cause makes it a valuable tool for dental-emergency treatment procedures. Physiologic and psychological aspects of gagging are influenced at the same time. The protocol is illustrated in the case of a 76-year-old patient with a severe gag reflex who was successfully treated by this combination approach. Necessary and effective therapeutic measures from both acupuncture and hypnosis are portrayed.     

A rejoinder to "Exercise Programs for Patients with Post-Polio Syndrome: a case report"--a short communication

This communication is in response to the article by Michael T Gross and Charles P Schuch entitled "Exercise Programs for Patients with Post-Polio Syndrome: A Case Report" published in the January 1989 issue of Physical Therapy. The investigators examined the effects of a rigorous isokinetic training program on peak torque of the knee flexor and extensor muscles of a post-polio patient. The literature on post-polio syndrome, however, does not support the use of either conventional muscle strengthening regimens or rigorous isokinetic exercise programs in the management of post-polio syndrome. In addition, based on the observation that there was no appreciable increase in muscle strength in either the affected or the apparently unaffected leg, the investigators concluded that their rigorous exercise program was not deleterious. The lack of a normal training response, however, is consistent with bilateral muscle fatigue secondary to overuse rather than muscle weakness secondary to disuse. This result is consistent with the need for a balance between rest and low-intensity exercise, which will help to maintain or enhance function while slowing rather than hastening further deterioration. We hope that this rejoinder clarifies some of the misconceptions that may arise from the Gross and Schuch article and that physical therapists consider very carefully the rationale for any type of exercise program for post-polio patients.     

Living with chronic obstructive pulmonary disease (COPD): part II. RNs' experience of nursing care for patients with COPD and impaired nutritional status

This study is the second part of a project with the main purpose of obtaining a deeper understanding of the consequences of living with chronic obstructive pulmonary disease (COPD) concerning meal-related situations and an impaired nutritional status. COPD is a slowly progressive lung disease that results in several complications, including malnutrition. Nutritional status is an important part of COPD treatment, and there are criteria recommended for nutritional assessment and interventions among patients with COPD. Despite this, patients with extreme malnutrition and unnoticed weight loss are reported. The aim of the study was to investigate how Registered Nurses (RNs) in primary care describe nutritional assessment practices and interventions in COPD patients with impaired nutritional status. An interview approach using semistructured questions and case vignettes was chosen. The sample included 19 RNs working specifically with COPD patients. Data from interviews were analysed using qualitative content analysis, and nine categories corresponding to the aim were identified. The RNs reported that their assessment of nutritional status was based largely on intuition. Assessment also included detection of the patients' current beliefs and being sensible about information provision - When and How. Interventions were supportive eating interventions, practical and cognitive participation, and making patients aware of the illness trajectory. An overall category that influenced nursing was respecting patients' feelings of shame and guilt about a self-inflicted disease. It seems that RNs use intuition because of a lack of knowledge of systematic methods of nutritional assessment. The findings also indicate that the RNs attempted to build a relationship of trust with the patients rather than provide early information on sensitive topics (e.g. nutritional information). The study reports areas of nursing care for COPD patients that must be improved in the future.     

注重科研能力，造就素质人才

大学生是一个基础知识比较扎实，思想比较活跃，思维相当敏捷的特殊群体，富有时代气息和巨大的发展潜能。既是人类千百年积累起来的各种专业知识的汲取者，也是与更新的科学研究工作的后备力量。在汲取知识的同时培养其创新意识与科研能力是一个关注的永恒的话题。     

注重科研能力,造就素质人才

大学生是一个基础知识比较扎实,思想比较活跃,思维相当敏捷的特殊群体,富有时代气息和巨大的发展潜能。既是人类千百年积累起来的各种专业知识的汲取者,也是与更新的科学研究工作的后备力量。在汲取知识的同时培养其创新意识与科研能力是一个关注的永恒的话题。1科研能力的涵义     

Symptom "accommodation" in patients with COPD

Patients with COPD often learn to "accommodate" their symptoms, which makes it difficult for health professionals to assess the impact of the condition on their daily lives. This article explores the concept of accommodating COPD symptoms and gives advice to encourage optimal treatment.     

"Camping up" self-esteem in children with hemophilia.

Children with hemophilia have often been viewed at greater risk for altered self-esteem than their healthy counterparts. Our article shares the positive effects of the camp experience on children with hemophilia and subsequent enhancement of self-esteem. Interaction and support in the camp environment provide an opportunity for these children to gain independence and "prove" their self-worth and ability. Previous literature has provided a variety of findings on the relationship between chronic illness, such as hemophilia, and self-esteem alterations. We identify many opportunities for future education and research to provide quality nursing support to this unique population.     

Return to work for persons with traumatic brain injury.

Individuals with traumatic brain injuries experience an array of physical, cognitive, and emotional changes that often make return to preinjury employment unlikely and locating new employment difficult. The authors review the literature related to the return to work for persons with traumatic brain injuries. This includes return to work outcomes, factors influencing return to work, and vocational programs that enhance employment, including a supported employment approach. Guidelines for professionals engaged in supported employment practices are also provided.