前瞻性干预对剖宫产产妇产后恢复及并发症的影响

目的探讨前瞻性干预对剖宫产产妇产后恢复及并发症的影响。方法选取132例剖宫产产妇,随机分为对照组和观察组各66例。对照组采用常规护理干预,观察组采用前瞻性护理干预。比较2组恢复效果、并发症发生率以及干预前后焦虑自评量表(SAS)、抑郁自评量表(SDS)评分。结果观察组产妇术后住院时间、下床活动时间、排气时间显著短于对照组(P 0. 05)。观察组产妇术后并发症总发生率为4. 54%,对照组为19. 70%,差异有统计学意义(P 0. 05)。观察组产妇术后SAS、SDS评分显著低于对照组(P 0. 05)。结论前瞻性护理干预有利于产妇的恢复,可降低并发症发生率。     

心理护理干预对脑出血患者及家属心理健康的影响

目的 探讨心理护理干预对脑出血患者及家属心理健康状况的影响.方法 将96例脑出血患者采用随机数字表法分为两组,均给予常规治疗及护理,研究组在此基础上实施心理护理干预,观察1个月.于干预前和干预后1个月采用焦虑自评量表和抑郁自评量表评价两组患者及家属的焦虑、抑郁情绪,采用症状自评量表评价家属的心理健康状况.结果 干预后研究组患者焦虑自评量表及抑郁自评量表评分均显著低于干预前(P＜0.01),对照组与干预前比较差异无显著性(P＞0.05),研究组评分均显著低于对照组(P＜0.01).两组患者家属焦虑自评量表及抑郁自评量表评分均较干预前显著降低(P＜0.05或0.01),研究组较对照组下降更显著(P＜0.01).干预后研究组患者家属症状自评量表各项评分均显著低于干预前(P＜0.01),且显著低于对照组(P＜0.05或0.01).结论 心理护理干预能有效缓解患者及家属的焦虑、抑郁情绪,提高其心理健康水平.     

舒适护理在血液透析患者护理中的应用效果观察

本文选取于2014年2月~2015年6月就诊我院进行透析治疗的88例血液透析患者,并均分为观察组与对照组各44例。对照组的血液透析患者采取常规护理,观察组的血液透析患者在对照组护理基础上给予舒适护理。比较两组血液透析患者的护理满意度、焦虑自评量表评分、抑郁自评量表评分与并发症的发生情况。观察组血液透析患者的护理满意度(97.73%)明显高于对照组(84.09%),比较差异显著,具有统计学意义(P0.05);观察组血液透析患者的抑郁自评量表评分(42.13±6.59)分、焦虑自评量表评分(41.64±6.45)分,均明显低于对照组血液透析患者的抑郁自评量表得分(47.56±5.26)分、焦虑自评量表得分(48.56±7.23)分,比较差异显著,具有统计学意义(P0.05);观察组血液透析患者的透析并发症发生率(6.82%)明显低于对照组的透析并发症发生率(27.27%),比较差异显著,具有统计学意义(P0.05)。血液透析患者应用舒适护理可有效的提高透析患者对护理的满意度,透析并发症发生率明显降低,帮助透析患者较好的调整不良情绪,值得在临床上推广应用。     

急性心肌梗死患者标准化抢救护理流程的实践

目的探讨标准化抢救护理流程在急性心肌梗死(AMI)抢救中的应用价值。方法将100例AMI患者随机分为对照组(常规护理方案救治)与观察组(标准化抢救护理流程救治)各50例,比较2组分诊评估时间、首份心电图采集时间、抢救时间、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、抢救成功率、护理满意度、住院时间及不良事件发生率。结果观察组分诊评估时间、首份心电图采集时间、抢救时间显著短于对照组(P 0. 05); 2组干预后SAS评分、SDS评分显著低于干预前,且观察组显著低于对照组(P 0. 05);观察组抢救成功率、护理满意度显著高于对照组,住院时间显著短于对照组(P 0. 05);观察组不良事件发生率8. 00%,显著低于对照组24. 00%(P 0. 05)。结论标准化抢救护理流程能缩短AMI患者诊治时间,缓解不良情绪,提高救治成功率,减少不良事件的发生。     

CCU急性左心衰58例心理护理效果观察

目的:探讨心理护理对急性左心衰患者心理障碍及病情改善的影响.方法:将116例急性左心衰患者随机分为心理护理组及常规护理组各58例,常规护理组患者实施常规护理,心理护理组患者在常规护理基础上实施心理护理.采用Zung抑郁自评量表(SDS)及焦虑自评量表(SAS)进行心理评估,比较两组患者SDS、SAS分值.结果:73.41%的急性左心衰患者存在一定程度的心理障碍,以抑郁、焦虑多见.经过心理护理之后,患者焦虑、抑郁症状明显改善,心理护理组SDS、SAS评分显著低于常规护理组,两组比较差异有统计学意义(P＜0.05).结论:急性左心衰患者易出现抑郁、焦虑、恐惧等心理问题,心理干预能显著改善其心理障碍,提高患者生活质量,促进康复.     

优质护理服务在乳腺癌护理过程应用中的作用

目的 探讨优质护理服务在乳腺癌护理过程应用中的作用.方法 选取住院的乳腺癌患者120例,随机分为对照组与观察组,每组60例.两组乳腺癌患者均采用乳腺癌根治术治疗.对照组术后护理过程中采用常规护理措施,观察组术后护理过程中实施优质护理服务.采用焦虑自评量表(SAS)与抑郁自评量表(SDS)对两组患者护理前后进行心理状况评分,观察两组患者并发症发生率.结果 观察组患者SAS得分与SDS得分明显低于对照组(P＜0.01),对照组并发症的发生率(80.0％)高于观察组(33.3％)(P＜0.01).结论 优质护理服务应用于乳腺癌护理过程中,能够使患者不良心理状况明显好转,且可使乳腺癌术后并发症的发生率明显降低,应该将优质护理服务作为临床治疗过程中的辅助手段加以推广并应用.     

综合护理干预对神经症患者心理健康的影响

目的 探讨综合护理干预对神经症患者心理健康状况的影响.方法 将100例神经症患者随机分为观察组和对照组,每组50例.两组均接受常规治疗及护理,观察组在此基础上予以综合护理干预.观察6周.于综合护理干预及干预前6周末,采用抑郁自评量表、焦虑自评量表评定焦虑抑郁状况,自拟健康知识知晓率测评表统计患者对健康知识的掌握状况,记录患者的睡眠时间,调查患者护理满意度.结果 干预6周末,两组抑郁自评量表、焦虑自评量表评分均较干预前显著下降(P＜0.01),观察组较对照组下降更显著(P＜0.01);观察组健康知识知晓率、患者满意度显著高于对照组(P＜0.05或0.01),而住院时间显著低于对照组(P＜0.01).结论综合护理干预能有效缓解神经症患者的焦虑、抑郁情绪,提高健康知识知晓率及护理满意度,缩短住院时间,促进患者早日康复.     

临终白血病患者家属心理反应调查及护理干预

目的:探讨临终白血病患者家属心理反应及护理干预措施.方法:采用焦虑自评量表(SAS)及抑郁自评量表(SDS)对132名临终白血病患者家属进行心理反应调查.护理干预前将临终白血病患者家属SAS、SDS评分与国内常模比较,护理干预4周后,患者家属SAS、SDS评分与干预前进行比较.结果:护理干预前白血病患者家属的SAS评分和SDS评分高于国内常模,两者比较均有极显著性差异(P<0.01);护理干预后患者家属的SAS、SDS评分与干预前比较有显著性差异(P<0.01,P<0.05).结论:针对家属的不同心理反应,采用相应的护理干预措施,使患者家属保持良好的心态,利于临终关怀事业的发展.     

老年左心耳封堵术患者围术期护理干预效果

目的 观察老年左心耳封堵术(LAAC)患者接受围术期护理干预的临床效果。方法 选取89例行LAAC的心房颤动(AF)患者为研究对象。采用抽签法将患者分为对照组44例和研究组45例,对照组给予围术期常规护理,研究组给予围术期精细化护理。比较2组抑郁自评量表(SDS)评分、焦虑自评量表(SAS)评分、生活质量综合评定问卷-74(GQOL-74)评分、并发症发生率和护理满意度。结果 护理后,2组SAS、SDS评分均较护理前降低,且研究组低于对照组,差异有统计学意义(P<0.05);护理后,2组GQOL-74评分均较护理前上升,且研究组高于对照组,差异有统计学意义(P<0.05);护理后,研究组并发症发生率为6.67%,低于对照组的25.00%,差异有统计学意义(P<0.05);护理后,2组活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)均较护理前延长,且研究组长于对照组,纤维蛋白原(Fbg)指标水平较护理前降低,且研究组低于对照组,差异有统计学意义(P<0.05);护理后,研究组护理满意度为93.33%,高于对照组的75.00%,差异有统计学...     

心理干预对抑郁症患者焦虑抑郁情绪的影响

目的 探讨心理干预对抑郁症患者焦虑、抑郁情绪的影响.方法 将60例抑郁症患者随机分为两组.每组30例.两组患者均口服赛乐特治疗,并予以精神科常规护理,研究组在此基础上联合心理干预.观察2个月.于心理干预前及干预1个月、2个月末采用焦虑自评量表及抑郁自评量表评定临床疗效.结果 心理干预1个月末起研究组焦虑自评量表及抑郁自评量表评分均较干预前显著下降(P＜0.01),对照组干预2个月末焦虑自评量表评分较干预前显著下降(P＜0.01);同期比较,干预1个月末研究组焦虑自评量表评分较对照组下降更显著(P＜0.01),干预2个月末研究组焦虑自评量表及抑郁自评量表评分均较对照组下降更显著(P＜0.01).结论 心理干预能有效改善患者的焦虑、抑郁情绪,促进患者的心身健康,提高其生活质量.     

Self and near relative ratings of functional level one year after traumatic brain injury

Purpose: To quantify traumatic brain injury (TBI) patients’ perceptions of own function by the Patient Competency Rating Scale (PCRS) one year after injury, and to examine self-awareness of functional deficits by comparing PCRS ratings from patients (PCRS-P) and PCRS ratings from near relatives (PCRS-R), and to identify predictors of awareness deficits. Method: A cohort of 50 severe (n?=?33) and moderate (n?=?17) TBI patients. Awareness of deficits was investigated by subtracting PCRS relative ratings from PCRS patient ratings. Predictors of PCRS ratings and differences were assessed by stepwise multiple regression analyses.Results: The average patient PCRS sum score was 122/150 (95% CI?=?115; 129) as compared to a sum score of 117/150 (95% CI?=?110; 125), given by their relatives (p?=?0.93). The patients scored themselves slightly higher than their relatives in the domains of activities of daily living (ADL) and cognitive function (p < 0.001, p < 0.001). Regression analyses showed that Glasgow Coma Scale (GCS)score at admission to rehabilitation was the strongest predictor of patient PCRS (B?=?3.314, p?=?0.008). The strongest predictor of differences between patient and relative PCRS was GCS acute (B= ?3.530, p?=?0.001).Conclusions: TBI patients demonstrated a slight “awareness gap” in ADL and cognitive function. Low GCS in the acute phase and high age were the strongest predictors of self- awareness deficits.

Implications for Rehabilitation

• Traumatic brain injury (TBI) may result in various cognitive, motor, sensory, social and emotional deficits. How TBI patients perceive their own functional level is less described.

• Lack of awareness is associated with poorer functional outcome, higher caregiver distress and poor compliance with rehabilitation.

• TBI patients demonstrated a slight “awareness gap” in ADL and cognitive function.

• Low Glasgow Coma Scale score in the acute phase and high age were the strongest predictors of self-awareness deficits.

     

慈溪市护士心理健康状况调查及分析

目的对慈溪市在职护士的心理健康状况进行调查,以了解护士的心理现状,分析心理失衡的原因,为护理管理者提供依据。方法用症状自评量表对护士进行心理测试。结果护士群体与常模比较,除偏执因子与常模无显著差异外,其他各项均明显高于常模。不同级别医院护士、私营与公立医院护士、管理者与非管理者的因子分比较,部分因子分存在统计学差异。结论慈溪市大部分护士存在心理问题,其影响因素分别为社会因素、职业因素和自身因素,对此应针对性进行干预。     

应用血管封堵器对脑血管支架植入术患者焦虑情绪的影响

目的观察脑血管支架置入术患者应用血管封堵器后对焦虑情绪的影响。方法 选择80例患者，将其中未使用血管封堵器的患者40例设为对照组，使用血管封堵器患者40例设为实验组，对2组患者焦虑情况及护理满意度进行比较。结果实验组患者焦虑情况较对照组患者明显减轻。结论脑血管支架置入术患者术后使用血管封堵器，患者焦虑情绪可得到明显改善。     

Comparative Responsiveness of Verbal and Numerical Rating Scales to Measure Pain Intensity in Patients With Chronic Pain

Verbal rating scale (VRS) and numerical rating scale (NRS) are regularly used to assess and monitor pain in chronic pain patients. Although the NRS has been generally preferred, limited comparative responsiveness evidence was reported. This study compared the responsiveness of VRS and NRS measuring current pain and investigated the influence of different references (ie, worst, least, average, and current pain or their composite) on the NRSs' responsiveness. Two hundred fifty-four chronic pain patients attended a 10-day pain self-management program and were assessed with two 6-point VRSs (assessing current pain) and four 11-point NRSs (assessing worst, least, average, and current pain) at pre- and posttreatment. A patient-reported rating of pain improvement was used as the criterion for standardized response mean and receiver operating characteristic curve analyses. Results showed that the VRSs and NRSs exhibited small responsiveness in all patients, but the magnitude of responsiveness became moderate to large in patients with improved pain. However, in patients with pain improvements, the NRS current pain item and composite score (made up of the 4 pain items) were found to have significantly larger responsiveness and greater discriminatory ability to detect the presence of improvement than other current pain VRSs and the NRSs assessing worst, least, and average pain. Potential implications for clinical practice are discussed.     

中西医结合治疗脑卒中后抑郁障碍52例临床分析

目的观察中西医结合治疗脑卒中后抑郁障碍 (PSDD)的临床疗效。方法对 52例PSDD患者治疗前后进行抑郁自评量表 (SDS)测评 ,并对所获资料进行统计分析。结果抑郁症状消失率为 78.85 % ;SDS标准分均数值经治疗后明显下降 ,差异有显著性 (P <0 .0 0 1 ) ;各项目所引出的症状得分均数值亦明显下降。结论中西医结合治疗PSDD可取得较好疗效     

视觉模拟量表和语言评价量表用于术后疼痛评估的比较

目的探讨是否可以使用简单的语言评价量表代替视觉模拟量表进行手术后疼痛的评估。方法将美国麻醉医师协会(ASA)Ⅰ -Ⅲ级的120例患者依其受教育程度的高低分2组 :初中及初中以下文化程度组(Ⅰ组 ,n=45) ,高中及高中以上文化程度组 (Ⅱ组 ,n=75)。患者于术后进行视觉模拟量表(VAS)和语言评价量表(VRS)的填写。麻醉医生对如何进行量表的填写向患者进行解释 ,并记录以下数据 :每位患者VAS和VRS的数值 ,填写VAS和VRS量表前向患者解释的次数 (Nvas和Nvrs)。结果Ⅰ组和Ⅱ组的VAS和VRS评分均有显著相关性 (P<0.01) ,其相关系数分别为0.936和0.901。在Ⅰ组中Nvas较Nvrs高 (P<0.05) ,同时Nvas在Ⅰ组中较Ⅱ组中高 (P<0.05) ,但在Ⅱ组中Nvas和Nvrs无显著差异(P>0.05)。结论在对患者进行术后疼痛评定时VRS和VAS具有良好的相关性 ,而VRS更适用于文化程度低及抽象概念理解有困难的患者 ,如老人     

Reliability and validity of the Tegner and Marx activity rating scales in Iranian patients with anterior cruciate ligament injury

Purpose.?The aims of this study were to culturally translate and validate the Persian version of Tegner and Marx activity rating scales and to investigate their psychometric properties in a sample of patients (n == 100) with anterior cruciate ligament (ACL) injury.

Method.?Four questionnaires were completed by the respondents: Tegner and Marx activity scales, Knee injury and Osteoarthritis Outcome Score (KOOS) and Short-Form 12 Health Survey (SF-12). The Tegner and Marx were re-administered to 45 patients in the retest session, with time interval of 2–6 days between the two sessions. Test–retest reliability and internal consistency were assessed using intra-class correlation coefficient (ICC) and Cronbach's alpha, respectively. To evaluate construct validity of Tegner and Marx compared to similar and dissimilar concepts of KOOS and SF-12, the Spearman's rank correlation was used.

Results.?Both Tegner and Marx activity scales have a high ICC level. The minimum Cronbach's alpha level of 0.70 was exceeded by Marx scale. In terms of construct validity, most of a priori hypotheses were confirmed.

Conclusions.?The Persian version of Tegner and Marx seems to be suitable for Iranian patients with ACL injury. Future studies are needed to investigate the psychometric properties of these questionnaires for Iranian patients with different knee problems.     

"长海痛尺"在疼痛评估中的应用

目的 探讨“长海痛尺”在临床应用中的可行性和实用性。方法 设计“长海痛尺”并将其应用于临床6个月后，调查评估及患对此量表的评价。结果 疼痛评估对“长海痛尺”的满意度为88．28％，患对“长海痛尺”的满意度为90％。结论 “长海痛尺”设计合理，使用方便，在疼痛评估时能更好地满足医护人员及患的需要。