社区康复中的转介服务

社区康复（CBR）,自1976年由世界卫生组织倡导,20余年来受到众多国家和地区的欢迎,得到许多国际组织、政府和非政府组织的支持。社区康复顺应了全球残疾人的康复需求,也顺应了慢性患者、老年人和其他有各种功能障碍以至影响正常生活、学习和工作的康复对象的要求。它不仅适合于发达国家,更适合于发展中国家。据统计目前90多个发展中国家开展了社区康复［’1。随着社区康复的广泛深入开展,社区康复的管理与实施已由单个部门发展到多部门协调,动员社会力量,以社会化的方式进行;资源利用由单纯依靠社区内扩展到积极争取社区外各层次…     

心脏康复研究的最新进展

心脏康复医学是一门发展中的科学，它的理论与实践处于起步阶段，为适应心血管医学发展的需求，要掌握心脏临床医学的发展动向，并突出本学科特点的优势，发展成为心血管医学中重要的组成部分。心脏康复的研究有着广阔的应用前景，其研究成果将丰富康复医客心血管临床医学。     

心脏康复研究进展

心脏康复( cardiac rehabilitation,CR)是心血管疾病的治疗策略之一,效益成本比高,已做为心血管疾病治疗的Ⅰa类推荐[1-2].CR的获益在各类心血管疾病患者中得到证实,包括心肌梗死、冠脉搭桥术后、心脏瓣膜修补术后、冠脉介入术后、稳定型心绞痛、慢性稳定性心力衰竭、心脏移植术后、心律失常及重度高血压...     

心脏瓣膜置换术后康复指导

心脏瓣膜置换是根精心脏瓣膜狭窄与关闭不全的有效方法。瓣膜置换术后并不是治疗过程的完全结束．而是术后心脏功能准护过程的开始。因此，对心脏瓣膜置换术后病人给予必要的医疗监护皿康复指导至关重要。     

心脏康复评估内容与方法

心脏康复是为心血管疾病和高危患者提供的个体化预防和治疗方法。其中,心脏康复评估是个体化治疗有效与否非常重要的前提保证。该文系统介绍了心脏康复评估中需要的各项评估内容和工具,供临床工作者参考。     

心脏康复研究的最新进展

心脏康复医学是一门发展中的科学,它的理论与实践处于起步阶段,为适应心血管医学发展的需求,要掌握心脏临床医学的发展动向,并突出本学科特点的优势,发展成为心血管医学中重要的组成部分。心脏康复的研究有着广阔的应用前途,其研究成果将丰富康复医学和心血管临床医学。     

植入式自动心律转复除颤器及其在心脏康复中的应用

植入式自动心律转复除颤器 (implantablecar dioverterdefibrillator ,ICD)作为一种治疗严重心律失常的设备 ,具有高效、安全、实用的特点 ,能显著降低室性心律失常患者猝死的风险和死亡率 ,在国际上受到广泛关注[1] 。室性快速心律失常 ,如室性心动过速 (ventriculartarchycardie ,VT)、室颤 (ventricularfibrillation ,VF)等 ,是引起心脏性猝死的主要原因。随着临床对室性心律失常识别能力的提高 ,以及各种有效抗心律失常措施 ,如药物、电消融、射频消融、心脏外科等的应用 ,在一定程度上降低了室性心律失常导致患者猝死的风险。但上述…     

心脏康复及其在我国的发展

随着经济的发展和医学的进步,我国人口的平均寿命已从解放初期的35岁,延长到现在的男性71岁、女性73岁,疾病流行的模式已发生了根本性改变。据统计,2006年我国居民的主要死因依次为恶性肿瘤、脑血管病、心脏病、呼吸系统疾病等。习惯上,常将心脏病与脑血管病并称为心血管疾病。2002年世界心脏病学大会指出,心血管疾病仍是全球第一死因。     

超觉静坐训练对居家心脏康复作用的研究进展

超觉静坐训练(TM)是一种压力管理策略,可有效减少心血管事件风险、改善生活质量。其在居家心脏康复(HBCR)中的作用逐渐凸显。TM与脑区、免疫功能及自主神经系统密切相关,表现为对心血管危险因素管理、结构功能改变及预防的效果等,在心脏康复过程中发挥着重要作用。文章介绍TM的概念、处方及优势,重点阐述TM对HBCR的作用机制、作用效果,并总结其发展前景。     

心脏康复护理专家共识

目的形成《心脏康复护理专家共识》（以下简称《共识》）,规范医疗机构心脏康复护理相关工作。方法 在全面回顾国内外心脏康复相关指南、专家共识、系统评价、原始研究等文献及相关疾病诊疗方案、管理共识等相关文献的基础上,形成《共识》初稿,并邀请心血管领域的临床护理、医疗以及护理管理等相关领域专家开展专家论证。结果 共邀请37名专家开展了3轮专家论证,对初稿进行修改和完善,形成终版《共识》,包括心脏康复护理工作目标,心脏康复护士资质、培训、核心能力与职责,心脏康复护理工作内容,心脏康复护理质量管理,心脏康复患者安全管理5个方面。结论 《共识》是在综合专家意见及心脏康复相关指南、共识及临床研究基础上形成,可为医疗机构开展心脏康复护理工作提供参考。     

Factors influencing referral of cardiac patients for cardiac rehabilitation.

This study asked the question: Are there differences in the characteristics and referral rates of men and women who are referred for cardiac rehabilitation? The sample consisted of 203 men (n = 148) and women (n = 55) who were hospitalized with at least one cardiac diagnosis and were eligible for Phase II cardiac rehabilitation. Hospital records were reviewed to obtain information on gender, age, ethnicity, insurance coverage, marital status, employment status, proximity to rehabilitation services, transportation availability, concurrent disease processes, domestic responsibilities, documentation of referral for cardiac rehabilitation, and the attending physician. A survey sent to the patients approximately 3 weeks after their discharge from the hospital also addressed these variables. Logistic regression analysis indicated only one predictor of referral: the gender of the physician. Male physicians were more likely to refer patients for cardiac rehabilitation. This finding must be viewed with caution because of the small number of female patients and female physicians included in the study. The current literature reflects conflicting findings about the proposed relationships; therefore, they merit further investigation.     

慢性心力衰竭的康复治疗

随着全球人口老龄化以及冠心病、高血压等慢性疾病患者生存寿命的延长，慢性心力衰竭（简称心衰）的发病率迅速增长，尤其是居高不下的致死率仍为临床心脏专家所面临的一个重大挑战。康复疗法作为心衰治疗的一个重要组成部分，正越来越受到人们的关注。     

生理性缺血训练在心脏康复中的研究进展

冠状动脉侧支循环的生成有利于改善冠心病患者心脏功能,增加病理性缺血心肌血液供应,减少冠心病患者死亡率。本文综述新型生理性缺血训练模式及其对冠状动脉侧支循环生成作用的效果。     

Profile of atrial fibrillation inpatients: Cardiovascular risk factors and cardiac rehabilitation programme delivery and referral patterns

Atrial fibrillation (AF) is increasingly common; however, the cardiovascular risk factor profile and the patterns of delivery and referral to cardiac rehabilitation (CR) in this population are poorly described. We conducted an audit of medical records (n = 145) of patients admitted with AF in one local health district in Sydney, Australia. Patients were aged a mean 72 years, and 51% were male. Lack of risk factor documentation was common. Despite this, 65% had two or more modifiable cardiovascular risk factors, including hypertension (63%) and hypercholesterolaemia (52%). Referral to Phase II CR occurred for 25% and was decreased with permanent AF diagnosis and increased with more risk factors. AF patients admitted to hospital have multiple cardiovascular risk factors but limited risk factor screening and/or referral to outpatient CR programmes.     

Influences on women's participation in cardiac rehabilitation.

The purpose of this study was to compare the cardiac rehabilitation referral and enrollment rates of men and women eligible for cardiac rehabilitation. A review of 202 hospital charts found that men and women were equally likely to be referred for cardiac rehabilitation, but women were significantly less likely to enroll (p < 0.05). Ten women who did not enroll and 20 women who did enroll were interviewed to determine factors that influenced their participation in the program. Major motives for enrolling included a desire to improve one's health and the strength of the physician's recommendation. Barriers to enrollment included concern for family members, transportation problems, physical limitations, and expense. Surprisingly, all of the women who did not enroll showed an interest when contacted after they were discharged from the hospital. Based on the findings of this study, it was recommended that cardiac rehabilitation staff telephone women after they are discharged to answer questions, clarify misconceptions, and encourage enrollment in a cardiac rehabilitation program.     

Patient-provider communication regarding referral to cardiac rehabilitation.

This study investigated the dynamics of patient-provider communication in the cardiac rehabilitation (CR) referral process, to identify which aspects lead to CR participation. Semi-structured individual interviews were conducted with 31 patients eligible for CR. Questions probed the content and perception of the discussion that patients had with healthcare providers (HCP) regarding CR attendance. The interviews were audiotaped, transcribed, and imported into N6 software for grounded analyses. Key emerging themes were identified: illness perceptions; HCP encouragement; timing of discussion; and ease of referral. CR attenders were apt to self-advocate to ensure their enrollment in CR, whereas nonattenders were more likely to minimize the seriousness of their disease, and less likely to persevere to overcome obstacles in enrolling in a CR program. Surprisingly, the strength of the HCP referral did not influence the decision to attend CR as strongly when compared to the HCP's ability to facilitate enrollment in a CR program.     

加强心脏康复医学教育以适应心脏疾病治疗技术的发展

作者在文中阐述了心脏病介入治疗与心脏康复治疗同步进行的必要性，并对心脏康复医学教育的方法学进行了探讨。