对骨科患者实施健康教育的体会

骨折或骨病的患者存在恐惧、悲观、焦虑、痛苦等心理,骨科病区健康教育内容应针对患者心理,向患者反应讲解骨科疾病的常识及复位前、后相关知识、注意事项以及功能锻炼、心理与疾病的关系,治疗进展等,帮助病人树立战胜疾病的信心并从根本上帮助病人建立健康生活方式,从而尽快康复。     

全方位护理在创伤骨科患者中的应用

目的：探究全方位护理在创伤骨科患者中的应用效果。方法将收治的150例创伤骨科患者分为对照组与观察组,前组予以常规护理,后组予以全方位护理,对比两组患者的护理效果。结果观察组SDS、SAS评分低于对照组,护理满意度高于对照组,功能康复优良率高于对照组,疼痛不适评分低于对照组,精神状态、治疗依从性、疾病认知程度优于对照组。结论将全方位护理应用于创伤骨科患者中,可以缓解患者焦虑、抑郁等不良情绪,改善患者精神状态,提高其治疗依从性与护理满意度,具有极高的临床推广价值。     

典型非铀矿山工人氡危险认知研究

目的 调查非铀矿山工人对氡所致健康危害的认知水平及影响因素。方法 采用当面填写调查表或询问方式调查了9个省区24个矿山的2836名矿工。结果 13.3%的矿工知晓氡,其中,29.0%的人知道氡的来源,8.5%的矿工对氡危害有一定认识,仅有1.8%的矿工对氡致健康危害有正确认知。在影响非铀矿山工人对氡致健康危害正确认知水平的因素中,受教育程度与氡认知水平正相关;正式职工对氡的认知水平优于临时雇用工人;性别、年龄、从事现工作的工龄等因素对氡认知水平没有明显影响;不同省区及矿山的氡认知水平不同。结论 我国非铀矿山矿工对氡危险认知水平较低,应进一步落实并规范《职业病防治法》规定的职业危害告知义务。     

知识宣教对久坐人员职业病防治知识的提高作用探究

目的研究知识宣教对久坐人员职业病防治知识的提高作用。方法选取2018年7月~2019年7月进行职业健康体检的劳动者596例,采用随机数字法将其分为对照组和实验组,每组各298例。对照组不进行干预,实验组采用知识宣教进行干预。比较两组干预前后久坐职业病防治知识掌握程度、比较两组干预前后久坐职业病防治前后态度正确性、比较两组干预前后久坐职业病防治行为正确性。结果干预前两组职业病防治知识掌握程度无显著性差异,干预后实验组职业病防治知识掌握程度显著高于对照组(P<0.05);干预前两组职业病防治态度正确性无显著性差异,干预后实验组职业病防治态度正确性显著高于对照组(P<0.05);干预前两组职业病防治行为均较低,差异无统计学意义,干预后实验组职业病防治行为正确性显著高于对照组(P<0.05)。结论知识宣教对久坐人员职业病防治中,能有效提高知识掌握程度、增加职业病防治态度与职业病防治行为。     

骨科住院患者健康教育需求情况调查

目的:调查骨科患者对健康需求的具体内容.方法:自制"骨科患者健康教育需求调查表",让患者和家属自行填写,再进行归纳总结.结果:骨科患者及其家属对健康教育需求表现在这几方面:疾病(伤情)相关知识、治疗方案与疗程、治疗费用、愈后情况、合理用药与饮食、康复训练、复诊随访等方面.结论:对住院患者及其家属进行有针对性的健康教育,可以增加患者对医护人员的信任感,提高患者治疗依从性,提高临床治疗效果和临床治愈率.     

健康心理学的研究进展

健康心理学研究包括的范围很广，并且涉及许多疾病。本文从疾病的定义、疾病评估、乳腺癌的治疗和对高血压认知的影响等方面讨论健康心理学研究。     

某单位中层干部三年健康体检分析

随着我国经济的进一步发展,城市生活水平的提高,不健康的生活方式和不良饮食习惯导致的疾病日益增多,高血压、高血脂、心血管疾病、糖尿病等慢性病的患病率呈逐年上升趋势,在很多欧洲国家已经将机关工作人员（包括公务员）产生的一些病症列为职业病的范畴。机关办公自动化程度的提高,对工作要求就更高,压力增大,健康状况不如人意。机关工作人员的健康问题已引起全社会的关注和讨论。为了解贵州机关干部的健康状况,为相关部门提供疾病防治依据,我们对贵州某机关单位中层干部近三年的健康体检情况进行了分析。     

妊娠期416例口腔健康认知情况调查与分析

牙体和牙周疾病是妊娠期妇女的常见病,不仅影响妊娠期妇女咀嚼、消化和吸收功能,同时也直接影响胎儿的生长发育,甚至引起妊娠不良结局。妊娠期妇女作为特殊人群,其对口腔健康知识的认知程度直接关系到母婴健康。为了解妊娠期妇女口腔保健知识水平,加强其口腔健康教育,2008年3—6月,我们选择妊娠期妇女416例,进行了口腔健康认知情况随机抽样调查。现分析报告如下。     

手术治疗发育性髋关节脱位的健康教育

发育性髋关节脱位(developmental dislocation of the hip,DDH)是一种先天性疾病,是临床小儿骨科的常见病和多发病,其诊断和治疗也较困难〔1〕。目前临床治疗根据患儿情况,采用手术治疗或非手术治疗,在疾病治疗过程中,健康教育贯穿全程。对患儿及家长的健康教育,直接关系着患儿功能的康复程度。我科自2011年1～10月,对DDH患儿及其     

整体护理程序在老年慢性阻塞性肺部疾患健康教育的应用

目的:应用整体护理程序对老年慢性阻塞性肺部疾病患者实施健康教育,提高患者对疾病发生发展和预防保健知识的认知程度,主动参与积极配合治疗预防和减少疾病复发率,延缓疾病的发展,提高患者回归家庭后的生活质量.方法:通过对我院116名老年慢性阻塞性肺部疾病患者应用整体护理程序,采用呼吸系统疾病护理计划评估表收集健康资料,评估患者症状体征及健康知识的缺乏程度和学习能力,制定个体化的健康教育计划,根据疾病的不同阶段不同表现及采取的治疗护理方案,给予有针对性的健康指导.结论:患者对疾病的发生发展和预防保健知识有进一步认识,患者依从性提高,积极主动配合治疗,缩短了住院时间,减少了并发症发生,提高了患者生活质量.     

Role of radiology in occupational medicine

This review discusses the contribution of radiology to occupational medicine as well as work-related problems in radiology departments. Research issues are emphasized. Radiology has been used especially when diagnosing occupational respiratory and locomotive system problems and solvent-induced encephalo- and hepatopathy. The aim of research in these areas is usually to characterize occupational diseases and to identify physico-chemical hazards in the work place by comparing between groups of workers and non-exposed controls. Radiological imaging allows an objective characterization of the disease, and it may clarify the pathogenesis of the process and provide a useful epidemiological tool. Advanced statistical methods are often needed to adjust analyses for confounding variables. As the diagnostic requirements are increasing, more sensitive and sophisticated radiological methods, such as high-resolution computed tomography, magnetic resonance imaging and magnetic resonance spectroscopy, may be required for the early recognition of occupational health risks. This necessitates good cooperation between occupational health units and well-equipped imaging departments. Considering occupational problems in radiology departments, the increasing use of digital radiology requires ergonomic measures to control and prevent locomotive problems caused by work with computers. Radiation protection measures are still worth concern, especially in interventional radiology.     

MRI of the postoperative shoulder

Performing and interpreting MRI of the shoulder in patients after surgery is a difficult task. The normal anatomic features are distorted by the surgical alterations as well as the artifacts that result from metal and other materials used in the surgical procedures. This article reviews the common surgical procedures undertaken in patients with rotator cuff disease and shoulder instability, and how they affect the appearance of the relevant anatomic structures on MRI examination. It also reviews the more common causes for residual and recurrent abnormalities seen in such patients and how MRI can be used to diagnose such lesions, thus aiding the orthopedic surgeon in treating these difficult clinical problems.     

Making your orthopedic office profitable through the addition of ancillary services

With the precipitous decline of orthopedic reimbursement over the past six years, it will be critical to the success of the majority of orthopedic groups to improve their revenue stream in the future. This will involve improving management, reducing overhead, and adding ancillary services to obtain facility fee revenue. Ancillary service possibilities for the orthopedist include an in-office surgicenter with a pain center, MRI, physical therapy with orthotics and braces, occupational health department, pharmacy, and independent medical examination company.     

Revision anterior cruciate ligamentsurgery: Preoperative evaluation and considerations

An orthopedic surgeon must carefully evaluate each patient before proceeding with revision anterior cruciateligament (ACL) surgery. A concerted effort directed at delineating the reason(s) for failure of the primary reconstruction should be undertaken to prepare an orthopedic surgeon for revision ACL surgery. The evaluation should include a detailed history from the preoperative period of the primary ACL until the present. Physical examination should evaluate the knee for previous scars as well as associated laxity. Diagnostic studies should at a minimum include plain radiographs and magnetic resonance imaging. In addition, the operative surgeon should be experienced in ACL surgical techniques, have the appropriate tools and fixation devices, and have several graft choices. Finally, if there is any question about the ability to place the tunnels appropriately or obtain solid fixation, strong consideration should be given to staging the revision reconstruction.     

我国职业性放射性疾病与职业健康监测系统构建与初步应用

目的 研制职业性放射性疾病与职业健康监测系统,掌握我国放射工作人员的职业健康管理现状。方法 依据相关法规和标准,根据不同的需求,完成了系统的设计。结果 初步建立了职业性放射性疾病与职业健康监测系统。系统有4个模块,3个级别的用户,系统运行平稳。结论 通过数据的收集,掌握了放射诊疗活动中存在的职业性放射性疾病的某些关键风险点,为卫生行政部门的决策和修订法规标准提供科学依据。     

放射工作人员职业心理压力的调查分析

目的 通过调查放射工作人员的职业心理压力及心理健康状况,分析压力负荷对健康的影响.方法 采用中文版知觉压力量表、一般健康量表及放射知识问卷,对220名放射工作人员进行了职业心理压力和心理健康现状调查.结果 调查显示,调查对象中,具有正高职称的人员压力分值最低,为18.18±6.12.工作人员的压力分值和健康分值存在正相关关系(r=0.484).19.1%的人表示有时会因所从事工作的危险性而有压力.结论 放射工作人员的职业心理压力与心理健康状况存在一定的相关性,应采取针对性的减压和心理干预措施,以保障放射工作人员身心健康.     

Stress fractures in runners

Stress fractures are a relatively common entity in athletes, in particular, runners. Physicians and health care providers should maintain a high index of suspicion for stress fractures in runners presenting with insidious onset of focal bone tenderness associated with recent changes in training intensity or regimen. It is particularly important to recognize “high-risk” fractures, as these are associated with an increased risk of complication. A patient with confirmed radiographic evidence of a high-risk stress fracture should be evaluated by an orthopedic surgeon. Runners may benefit from orthotics, cushioned sneakers, interval training, and vitamin/calcium supplementation as a means of stress fracture prevention.     

The beneficial relationship of the colocation of orthopedics and physical therapy in a deployed setting: Operation Iraqi Freedom

In a deployment setting, orthopedic and musculoskeletal injuries represent the majority of both combat-related and noncombat-related injuries. To expeditiously and efficiently manage the large influx of patients, our experience revealed the tremendous benefits of having physical therapy colocated with an orthopedic surgeon in a level III combat support hospital. A physical therapist, working in a physician extender role, can treat the majority of nonsurgical orthopedic patients, thus allowing the orthopedic surgeon to focus his or her skills and time on surgical interventions. This physician extender role, although often overlooked during peacetime, becomes essential during wartime, when critically injured patients are abundant and physicians are in short supply. The lessons learned support the continued colocation of physical therapy and orthopedics in a deployment setting and recognize the need to have more physical therapists placed at level I and II echelons of care.     

Surgical care in the isolated military hospital

BACKGROUND: To maintain the health of service members and their families throughout the world, the Department of Defense has established several isolated military hospitals (IHs). The operational environment of IHs is such that illness and traumatic injury requiring surgical intervention is common. This study sought to examine the general and orthopedic surgical experience at an IH to determine whether surgical care could be provided in an effective and safe manner. METHODS: All patients evaluated by the general and orthopedic surgeon at Guantanamo Bay Naval Hospital from October 1, 1998, to April 1, 1999, were included in this study. The following data were retrospectively reviewed: patient demographic data, diagnosis, initial and follow-up care, medical evacuation data, operative procedures, and complications. RESULTS: There were 336 patients who presented for surgical evaluation, resulting in 660 follow-up appointments during the study period. There were 31 medical evacuations (3 emergent). The surgical services performed 122 major operative procedures. There were 58 inpatient admissions. There was 1 death, and surgical complications occurred in 2 patients, for an overall morbidity and mortality of 1.4% and 0.7%, respectively. CONCLUSION: Our data show that an IH is capable of providing surgical care, including care for traumatic injuries, in a safe manner. This is the first study that provides objective evidence that general and orthopedic surgery at an IH can be provided within the standard of care.     

如何正确理解和使用辐射屏蔽防护设计中的U、T因子

目的 了解我国职业卫生监督和服务机构的有关人员对辐射屏蔽防护设计中利用因子（U）、驻留因子（T）理解的现状，分析存在的主要问题，提出改进建议。方法选择建设项目辐射屏蔽防护设计中的一个典型案例，对相关人员的认知水平以笔试形式考核，收集考卷，进行分类统计、分析。结果通过对87份有效考卷的分析，U、T因子使用过程中存在的主要问题是对辐射源项与职业病危害因素的关系区分不清、场所危害和接触危害的概念理解不贴切等。结论应加强对有关法律、法规和技术标准，特别是《电离辐射防护与辐射源安全基本标准》（GB18871—2002）的学习和领会，预防和控制放射性职业病危害的发生。