结构化健康教育在糖尿病患者中的应用

目的:探讨结构化健康教育在糖尿病患者中的应用效果。方法:将162例住院治疗的血糖控制不佳的糖尿病患者随机分为观察组83例和对照组79例,对照组采取常规教育干预措施,观察组在常规措施的基础上进行结构化健康教育,比较两组干预前后血糖、糖化血红蛋白等生化指标变化情况、患者及家属对护理过程满意度及出院时两组对胰岛素认知情况。结果:观察组对胰岛素治疗认知各项得分均高于对照组(P0.05),观察组干预后血糖和糖化血红蛋白均低于对照组(P0.05),观察组及家属对护理过程满意度高于对照组(P0.05)。结论:结构化健康教育可有效提高2型糖尿病胰岛素治疗血糖控制不佳患者对胰岛素治疗的认知水平,建立健康的生活方式,有利于患者血糖控制,提高患者及家属对护理过程满意度。     

结构化教育在中青年缺血性脑卒中患者中的应用

目的 探讨基于结构化的健康教育方案在中青年缺血性脑卒中患者自我管理中的应用效果。方法 选取2021年8月—12月在湖南省某三级甲等医院神经内科2个病室住院的中青年缺血性脑卒中患者作为研究对象,分别设为试验组（n=30）和对照组（n=28）。试验组实施中青年缺血性脑卒中患者结构化健康教育方案,结合患者手册、小视频、挂图等工具,开展以认识脑卒中、如何建立健康生活方式、用药指导与定期随访为主题的健康教育,对照组实施神经内科常规健康教育方案,包括院内指导与每周1次的健康教育宣传会。入院时、出院后1个月、出院后3个月,采用中风自我管理行为评定量表对患者进行调查。结果 两组自我管理行为组间与时间有交互效应（F=28.520,P<0.001）,简单效应分析显示,出院后3个月试验组自我管理水平高于对照组（P<0.05）。两组患者疾病管理维度（F=13.290,P<0.001）、安全用药管理维度（F=4.073,P=0.022）、饮食管理维度（F=9.656,P<0.001）、康复锻炼管理维度（F=5.204,P=0.009）组间与时间有交互效应,简单效应分析显示,出院后1个月、...     

Teach-back教育模式在COPD患者中的应用价值

目的:探讨Teach-back教育模式在COPD患者健康教育过程中应用的临床价值。方法:采用方便抽样法,选择湖州市中心医院2018年3月—2019年3月收治的100例COPD患者为研究对象,随机分为对照组和研究组,每组50例。对照组采用常规健康教育,干预组在使用常规健康教育的基础上采用Teach-back教育模式。比较...     

结构化健康教育在重症脑卒中患者家属中的应用

目的探究结构化健康教育在重症脑卒中患者家属中的应用效果。方法于2018年1月—12月分别将河南省某综合医院2个院区的神经科ICU中选择符合纳入标准的重症脑卒中患者家属纳入试验组(41名)和对照组(42名);试验组由ICU健康教育专职岗位护士实施结构化健康教育,对照组由责任护士实施常规健康教育。比较两组重症脑卒中患者家属的满意度、知识和技能掌握情况及迁移应激水平情况。结果试验组实施结构化健康教育后满意度、知识和技能掌握情况及迁移应激水平情况均较对照组有所改善(P<0.05)。结论结构化健康教育在重症脑卒中患者家属中应用有效,可提高重症脑卒中患者家属脑卒中知识水平和照护技能,值得推广。     

康复训练联合健康教育在老年COPD患者中的应用

目的:探讨康复训练联合健康教育在老年慢性阻塞性肺疾病(COPD)患者中的应用效果。方法:将102例老年COPD患者随机分为对照组和观察组各51例,对照组给予肺康复训练联合常规健康教育,观察组在对照组基础上给予基于视频宣教和回授法的健康教育,比较两组干预效果。结果:观察组出院时、干预12周、干预24周时布里斯托慢性阻塞性肺疾病知识问卷(BCKQ)正确率均高于对照组(P0.05);观察组用药依从性、康复训练依从性优于对照组(P0.05);两组干预后用力肺活量(FVC%)、第1秒用力呼气量(FEV_1)与干预前相比均显著升高(P0.05),且观察组高于同期对照组(P0.05);两组干预后圣乔治呼吸问卷(SGRQ)评分、抑郁自评量表(SDS)评分、焦虑自评量表(SAS)评分均低于同组干预前,且观察组低于对照组(P0.05)。结论:肺康复训练联合基于视频教育和回授法的健康教育模式可提高老年COPD患者健康知识掌握程度,提高其用药和康复训练的依从性,改善肺功能,提高生活质量,缓解患者的负性心理,值得临床推广应用。     

可视化健康教育在COPD稳定期患者护理中的应用

目的探讨可视化健康教育在COPD稳定期患者护理中的应用效果。方法将2016年4月至2017年6月我院呼吸科COPD患者118例随机分成试验组60例和对照组58例,住院治疗期间对试验组患者实施可视化健康教育,对照组实施传统健康教育,并提供相应学习资料供患者出院后使用。比较两组患者COPD护理相关知识与技能掌握情况及出院后身体状况。结果试验组患者出院后健康教育内容掌握程度、呼吸功能锻炼完成情况、活动耐力、满意度高于对照组(P0.05),两组患者出院后6个月内复吸烟率差异无统计学意义(P0.05)。结论可视化健康教育能够有效提高患者健康教育效果和自我护理的技能,有利于维持病情稳定。     

多元化健康教育在COPD患者腹部手术中的应用

目的:探讨多元化健康教育在合并慢性阻塞性肺部疾病(COPD)患者腹部手术中的应用效果。方法:将67例患者随机分观察组34例和对照组33例,观察组采用多元化健康教育,对照组采用传统护理模式进行健康教育。结果:观察组满意度、遵医行为及健康知识达标率均高于对照组(P<0.05),住院时间低于对照组(P<0.05)。结论:在COPD患者腹部手术中应用多元化健康教育,有助于规范护理行为,降低并发症的发生,有助于规范护理行为,减少住院时间,从而提高了护理质量。     

结构化健康教育在癌痛患者疼痛管理中的应用

目的:探讨结构化健康教育在癌痛患者疼痛管理中的应用效果。方法:选取2017年5月至2019年9月该院肿瘤内科收治的癌症患者80例为研究对象,采用住院编号奇偶数字排列法将其分为观察组和对照组各40例。对照组患者给予常规健康教育干预。观察组在此基础上给予结构化健康教育干预,观察并比较两组患者干预前后的疼痛控制障碍、疼痛自我...     

系统性个性化健康教育在门诊COPD稳定期患者中的应用

目的:探讨系统性个性化健康教育在门诊COPD稳定期患者中的应用效果。方法:将124例COPD稳定期患者随机分为对照组59例和观察组65例,对照组给予门诊常规健康教育,观察组在此基础上给予系统性个性化干预,干预6个月后比较两组对疾病认知度及呼吸功能锻炼依从性。结果:观察组对疾病认知度及呼吸功能锻炼依从性均优于对照组(P0.05,P0.01)。结论:对COPD稳定期患者加强健康教育,能够显著提高患者认知度和依从性,从而提高患者生活质量。     

多元化健康教育在合并COPD手术治疗患者中的应用

目的探讨多元化健康教育在合并慢性阻塞性肺部疾病（chronic obstructive pulmonary disease,COPD）手术治疗患者中的应用效果。方法选择合并COPD行腹部手术治疗患者60例,随机分为实验组和对照组,每组各30例,对照组采用传统健康教育方法,实验组采用多元化健康教育方法。比较实施健康教育前后两组患者知识行为和疾病发生发展情况。结果实验组患者相关知识知晓率、自我控制率、药物使用依从性、戒烟情况和伤口愈合情况优于对照组;不良行为发生率、疾病急性发作和并发症发生率低于对照组,两组比较,均P〈0.05,差异具有统计学意义。结论采用多元化健康教育在提高患者对疾病知识认识的同时,能有效预防并发症发生,提高患者自我管理水平。     

The Effect of a Structured Education Programme on Relatives' Knowledge of Communication with Stroke Patients

A structured education programme comprising a video, lecture and booklet was designed to provide general information about communication problems following stroke. It was designed to be used as an adjunct to face-to-face counselling. Seventeen relatives of stroke patients with communication problems were then exposed to this programme while thirteen received traditional ad hoc counselling from speech pathologists without benefit from the structured education programme. It was found that relatives who received the programme showed a significantly greater knowledge of stroke and its effects on communication than those who did not receive the programme.     

Structured approach to patients with memory difficulties in family practice

Objective

To provide family physicians with a structured approach to patients presenting with memory difficulties.

Sources of information

The approach is based on an accredited memory clinic training program developed by the Centre for Family Medicine Memory Clinic in partnership with the Ontario College of Family Physicians.

Main message

Use of a structured clinical reasoning approach can assist physicians in achieving an accurate diagnosis in patients presenting with memory difficulties. Delirium, depression, and reversible causes need to be excluded, followed by differentiation among normal cognitive aging, mild cognitive impairment, and dementia. Obtaining collateral history and accurate functional assessment are critical. Common forms of dementia can be clinically differentiated by the order in which symptoms appear and by how cognitive deficits evolve over time. Typically, early signs of Alzheimer dementia involve impairment in episodic memory, whereas dementia involving predominantly vascular causes might present with early loss of executive function and relatively preserved episodic memory. Frontotemporal dementia and Lewy body spectrum disorders might have early loss of executive function and visuospatial function, as well as characteristic clinical features.

Conclusion

A clinical reasoning approach can help physicians achieve early, accurate diagnoses that can guide appropriate management and improve care for patients with memory difficulties.While current Canadian consensus guidelines suggest that most patients with dementia can be adequately assessed and managed by their primary care physicians,¹ the issues for patients with memory difficulties are complex and are often challenging to address in family practice. Indeed, for primary care physicians, studies have demonstrated that complexity of care and diagnostic uncertainty remain considerable barriers to the early diagnosis and management of dementia.^2–5 Currently, most people living in the community with dementia remain undiagnosed and untreated,^6–8 yet early detection offers important benefits.⁹ These include the option of early initiation of appropriate medications^1,10 and access to supports,^11–13 the opportunity for patients to maximally participate in future care planning,^14,15 and possible net fiscal benefits.¹⁶Achieving an early, accurate diagnosis is therefore an important first step in helping to guide appropriate further management for these patients. Medical education literature suggests that use of a clinically relevant framework or scaffolding can help in assessing patients with complex problems,^17,18 and applying a structured clinical reasoning approach might help family physicians to simplify the process of assessing patients who present with memory difficulties.     

Implementation of Objective Structured Clinical Examination in Midwifery Education

Evaluation is a fundamental component of the teaching process. Hence, a set of objective structured clinical examination standardized stations was prepared for the evaluation of midwifery students. Data on students’ perception of the value of the experience were also collected. The results of the evaluation documented the level of success and failure for each student. The majority of students (94%) were satisfied with the assessment techniques and enjoyed the learning experience. The integration of the objective structured clinical examination into the curriculum provided useful information on students’ clinical performance.     

The Effects of a Structured Education Course on Stroke Survivors Living in the Community

Forty‐one community dwelling stroke survivors were measured on three dependent variables—depression, hope, and ways of coping—in this quasi‐experimental, repeated‐measure study. The subjects were randomly assigned to a treatment group or control group. The treatment group attended a series of eight 2‐hour educational classes during a 4‐week period. At the end of the series of classes, the tests of depression, hope, and ways of coping were readministered to the subjects in both groups. The results of comparing the two groups favored the treatment group; they were statistically significant for depression and for hope and approached significance for coping. These study results support the use of structured education classes to facilitate the adaptation of stroke survivors who have returned to living in the community.     

健康教育路径在突发性耳聋患者健康教育中的应用

目的:探讨健康教育路径在突发性耳聋患者健康教育宣教中的应用效果.方法:选取2015-2018年解放军第942医院五官科收治的突发性耳聋患者40例作为研究对象,随机分为观察组和对照组,每组20例.对照组采用一般健康宣教模式,观察组采用健康宣教路径对患者实施健康教育路径.结果:2组患者知识掌握情况,满意度,睡眠质量比较差异...     

结构化教育对2型糖尿病患者干预效果的系统评价

目的系统评价结构化教育对2型糖尿病(type 2diabetes mellitus,T2DM)患者的干预效果。方法计算机检索中国生物医学文献服务系统(SinoMed)、中国学术期刊网全文数据库(China national knowledge infrastructure,CNKI)、万方数据库、中国科技期刊数据库、PubMed数据库、Web of Science引文索引数据库、Elsevier Science Direct全文期刊数据库等数据库,收集2000-2015年国内外公开发表的关于结构化教育应用于T2DM患者的随机对照试验(randomized controlled trial,RCT),并采用RevMan 5.3统计软件进行分析。结果最终纳入9篇RCT文章,共3342例T2DM患者。Meta分析结果显示:观察组患者的糖尿病(diabetes mellitus,DM)知识、自我管理行为量表(summary of diabetes self-care activities scale,SDSCA)、DM管理自我效能量表(diabetes management self-efficacy scale,DMSES)得分均明显高于对照组(均P0.01);但在改善糖化血红蛋白(glycosylated hemoglobin,HbA1c)方面,与对照组比较,差异无统计学意义(P0.05)。结论结构化教育能够提高T2DM患者的DM相关知识水平以及自我效能感,改善患者的自我管理行为。     

客观结构化临床考核在护士能级进阶中的应用

目的探讨客观结构化临床考核(objective structured clinical examination,OSCE)在护士能级进阶中应用的可行性。方法便利抽样法选取2015年新疆医科大学第五附属医院拟晋级的护士109例为研究对象,根据护士晋级对专业综合能力的考核要求,设计标准化临床病例,在临床实际情境下,运用标准化患者,采用OSCE对拟晋升的不同级别护士进行考核,分析试卷质量和成绩。结果试卷的质量:信度、效度、难度、区分度合格;试卷的成绩:基础护理技能考站不同晋级护士考核成绩差异无统计学意义(P0.05),其余考站考核成绩的差异均有统计学意义(均P0.05)。结论 OSCE可应用于护士能级进阶,体现了护士临床能力的实际水平,为护士分层培训及晋级提供了依据。