农村慢阻肺病人家庭氧疗现状调查与护理

目的:了解农村慢性阻塞性肺疾病(COPD)患者家庭氧疗情况。方法:采用问卷形式对60例患者家庭氧疗认知、使用情况进行调查。结果:家庭氧疗的使用率仅为8.3%,使用时间为2-10h;未使用率为91.7%。结论:COPD患者对长期家庭氧疗的重要性认识不足,呼吸科医护人员应加强对COPD病人氧疗相关知识的教育和指导,为病人提供支持和帮助。     

老年COPD稳定期患者家庭氧疗的调查

[目的]了解伴严重低氧血压的老年慢性阻塞性肺疾病(COPD)稳定期患者家庭氧疗的状况.[方法]收集华西医院老年科门诊及住院COPD患者共187例,给予调查问卷,问卷内客包括一般基线资科及氧疗情况调查.[结果]COPD患者实施氧疗者占59.9%,未实施氧疗的原因包括:经费原因、不了解氧疗重要性及害怕对氧疗产生依赖;对氧疗知识完全掌握者<40.4%;每日坚持吸氧15h者仅占7.1%;影响氧疗时间的因素包括制氧机原因及氧疗对日常活动的影响.[结论]对COPD稳定期患者,应该加强家庭氧疗的护理及教育.     

家庭氧疗适合谁

家庭氧疗被认为是最能影响慢性阻塞性肺疾病（简称慢阻肺）等预后的主要因素之一,对降低病死率、提高生活质量起着明显的作用。但是,不少患者和用氧者对吸氧知识还不够了解,甚至存在滥用氧或不敢用氧的情况。那么,究竟如何正确吸氧呢？哪些患者需要家庭氧疗氧疗是指各类缺氧疾病的治疗,吸入高浓度氧使血浆中溶解氧量增加,能改善组织的供氧。那么,哪些患者需要家庭氧疗呢？     

家庭氧疗的现状及改善策略

目的了解家庭氧疗的现状,探讨改善策略。方法对使用家庭氧疗的60名用户进行入户问卷调查。结果受访60人中,8人对家庭氧疗知识严重缺乏;放置不合理或不安全11人;14人未合理安排吸氧时间,25人遵医嘱夜间吸氧。结论要使家庭氧疗更多更好地发挥其治疗和保健作用,需要医务人员、氧气公司、家庭氧疗用户等多方面的积极配合。     

慢性阻塞性肺病住院患者氧疗状况调查及护理

目的了解慢性阻塞性肺病（COPD）患者对氧疗知识的认知状况及影响氧疗依从性的有关因索，提供开展氧疗护理的依据。方法采用自行设计的问卷，对54例COPD患者进行调查。结果患者的氧疗知识严重缺乏，氧疗的依从性差。绝大多数患者的吸氧时间都没有达到氧疗规范的要求，每日总吸氧时间≤2h的31例（57．4％），≤8h的14例（25．9％），了解日吸氧时间应≥15h的只有6例（11．1％）。依从性差与缺乏正确的氧疗知识、自理能力、家庭经济状况和吸氧不舒适密切相关。结论需采取多种形式的健康教育和有效的护理对策，大力普及氧疗知识，注重对家属的教育，提高COPD患者氧疗的依从程度，减少再入院的次数，提高患者的生活质量和生存率，降低患者的死亡率。     

健康教育可提高慢性阻塞性肺病患者家庭氧疗的依从性

慢性阻塞性肺疾病 (ChronicObstructivePulmonaryDisease ,简称“慢阻肺”)是危害人类健康的重要疾患 ,随着人口老龄化加速 ,慢阻肺发病率呈明显上升趋势。慢阻肺患者在缓解期仍有低氧血症 ,严重影响患者的活动能力和生活质量 ,有相当多的文献报导 ,家庭氧疗被认为是最能影响慢阻肺预后的重要治疗方法之一 ,是慢阻肺缓解期治疗的一场革命[1 ] 。由于患者对疾病知识的缺乏 ,尤其对氧疗知识的严重缺乏 ,影响了慢阻肺患者对家庭氧疗的遵医行为[2 ] ,使家庭氧疗得不到很好的开展 ,本研究旨在探讨增加氧疗知识教育对慢性阻塞性肺病患者家庭氧疗…     

走出家庭氧疗的误区

对于一些慢性疾患的康复治疗，家庭氧疗越来越受到人们的关注，它已经成为低氧血症COPD病人的重要治疗方式之一，但是由于病人及家属对氧疗知识的缺乏，氧疗在使用过程中也存在一些误区，病人认为吸氧越多越好或不吸氧影响不大或感到气促才吸氧，错误的用氧方法会给病人带来不必要的副作用，甚至还会造成生命危险。有地区性调查显示。100％患者对家庭氧疗指征和吸氧持续时间不了解。73％对用氧安全不了解，35．5％对吸氧浓度不了解。无1例进行正确家庭氧疗。因此对病人及患者家属进行家庭氧疗的适应症、治疗方法、副作用发生的机制及其预防的教育势在必行。     

新疆维吾尔族呼吸系统疾病患者氧疗依从性调查及护理干预

目的探讨影响维吾尔族呼吸系统疾病患者氧疗依从性因素及护理干预效果。方法对2011年6月至2011年12月收治的68例维吾尔族呼吸系统疾病患者住院期间的氧疗依从性情况,进行回顾性分析。结果影响患者氧疗依从性的主要因素为知识缺乏和语言沟通不畅,通过有效的护理干预,患者氧疗依从性明显提高。结论对维吾尔族呼吸系统疾病患者进行氧疗知识的健康教育,有利于提高患者的氧疗依从性。     

长期家庭氧疗对稳定期慢性阻塞性肺疾病的疗效研究

目的探讨长期家庭氧疗对稳定期慢性阻塞性肺疾病(COPD)患者的疗效。方法将80例稳定期慢性COPD患者随机分成治疗组和对照组各40例。两组患者均接受常规治疗,治疗组另加用长期家庭氧疗。两组患者研究期间无急性发作。治疗28 w后应用St George’s呼吸问卷(SGRQ)评价患者治疗前后的生存质量;应用BODE指数来评定治疗效果。结果与治疗前比较,治疗组治疗后SGRQ问卷总分有明显改善;BODE指数分值明显下降(p﹤0.05)。对照组治疗前后SGRQ问卷总分和BODE指数分值无明显变化(p>0.05)。结论长期家庭氧疗可有效地提高稳定期慢性COPD患者的生存质量,改善预后。     

浅谈家庭氧疗及注意事项

家庭氧疗被认为是最能影响COPD预后的主因素之l。由于新的氧疗技术的产生和氧疗方法的不断改进,不仅提高了氧疗效果,也给患者的使用带来了极大方便,使长期氧疗的应用更加广泛。家庭氧疗不但提高病人生活质量、而且增强运动耐力和生活自理能力、防止心肺功能的恶化,从而减少失代偿性呼吸衰竭的发生次数减少住院次数、时间和医疗费用。提倡长期家庭氧疗,在医护人员的指导下,正确使用氧疗装置,掌握用氧的安全知识,说明长期氧疗的重性,以提高用氧的顺从性。本文就家庭氧疗的相关知识及注意事项作简介绍。     

Relationship between activities of daily living and residential environment for patients receiving home oxygen therapy

PURPOSE: The purpose of this study was to investigate the relationship between ADL and residential environment for patients receiving home oxygen therapy. METHODS: We interviewed 27 HOT patients with chronic respiratory failure, aged 53-85, at an internal medicine outpatient clinic of a national hospital in Yokohama city, using a questionnaire focusing on physical condition, dyspnea, ADL, and residential environment. RESULTS: 1. Of the patients 21 (78%) were III-IV level by Hugh-Jones classification. HOT patients experienced severe dyspnea when climbing stairs and bathing. Their ADL was limited to within their own homes. HOT patients opt to use taxies more often than facilities such as buses and trains. 2. Out of 20 patients living in a two-story house, the ADL of 16 (80%) were limited to downstairs. Two patients living in apartment houses without an elevator complained of great difficulties in going down stairs to go out. Twelve of the patients (44%) interviewed resided in hillside area, the distance to the nearest bus stop being greater than in flat area. 3. A public financial support for house innovation has been offered for some time, but most of the patients did not have any information about this system. They had not realized how their residential environment might affect their ADL. CONCLUSION: These results suggest that more education for HOT patients is needed. They should be clearly shown the importance of the residential environment in enhancers their ADL.     

A brief training program on resident assessment instrument improves motivation of nursing home staff

The Resident Assessment Instrument (RAI) has been designed to improve the quality of assessment and care in nursing home patients through a better understanding of resident needs. We organized three short courses (two weeks) on RAI, involving sixty-six nursing home health professionals. The course provided students both a theoretical and practical knowledge of RAI. At the end of the program, participants were asked to answer to an anonymous questionnaire about the course itself and their future professional motivation. The participants showed increased motivation and attitudes toward the elderly care. The good results obtained indicates that RAI not only may improve quality of nursing home care, but it is also an useful tool in the training of geriatric professionals enhancing their motivation and job satisfaction.     

Successful withdrawal of thyroid hormone therapy in nursing home patients

BACKGROUND: Studies of community-dwelling patients have indicated that substantial numbers of patients might have had thyroid hormone therapy prescribed inappropriately and that thyroid hormone therapy in some can be discontinued without adverse effects or evidence of clinical hypothyroidism. We wanted to find out whether thyroid hormone therapy in selected nursing home patients could be withdrawn without adverse effect. METHODS: Participants for the study were drawn from four skilled nursing facilities in Connecticut. All patients on thyroid hormone therapy who resided in one of the four facilities at the time the study began were eligible if they met the inclusion criteria and gave consent to participate in the study. We measured baseline thyrotropin (TSH) levels and reduced thyroid hormone therapy by approximately onehalf if baseline TSH levels were 7 mU/L or less. If at a 1-month follow-up measurement a patient's TSH level was 7 mU/L or less, we discontinued thyroid hormone therapy. If TSH levels remained 7 mU/L or less at the next follow-up measurement 1 month later, we measured the free thyroxine (T4) level. If the free T4 level was normal, the patient remained off thyroid hormone therapy, and a final TSH value was measured after a further 2 months. RESULTS: There were 915 patients residing at the four homes at the time the study began. One hundred fifteen were on thyroid hormone therapy; 40 had elevated TSH levels in their nursing home records; and 31 refused to participate in the study. Twenty-two patients were excluded because they died or were discharged before completion of the study, had an elevated baseline TSH reading, or were taking medications that could complicate the accurate measurement of TSH. Twenty-two patients began hormone withdrawal. One patient had an increase in psychiatric symptoms during the withdrawal phase. No other adverse effects were noted. Eleven patients (50%) had the thyroid hormone therapy withdrawn successfully. CONCLUSION: Thyroid hormone therapy was successfully withdrawn from one half of the nursing home residents studied. Previous studies conducted in community-dwelling patients have shown similar findings. Many older patients began taking thyroid hormone therapy when younger either for inappropriate reasons or for what turned out to be transient hypothyroidism. If the findings of this study are generalizable for other nursing home residents, there are important implications for health and health care costs.     

Patient compliance with a home parenteral nutrition program

A systematic study of patient compliance to home parenteral nutrition (HPN) was done by an independent nurse who visited 10 patients and families at varying periods after HPN had been started. A compliance scale was based on assessment of aseptic technique, sequence of steps followed, safety precautions, proper use of equipment, and knowledge of complications. Compliance percentiles ranged from 73 to 97, with a median of 95. Seven of the 10 patients scored 90% or more in overall compliance. The only category that clearly showed a deficiency was patient knowledge of potential complications of HPN. Factors that correlated positively with a high compliance score were male sex, absence of children in the home, and wives who were enthusiastic about HPN and who offered the most moral support. This study shows that patients with chronic disabling diseases of the small bowel and severe malnutrition can be managed safely at home with HPN if they are properly trained and supervised.     

氧疗过度给氧的危害

人类发现氧气的存在后便慢慢地认识到氧在生命运动中的机制,氧气逐渐被利用到各种疾病的治疗中。氧疗用于纠正缺氧,提高动脉血氧分压和氧饱和度的水平,改善组织缺氧,促进代谢,以维持机体生命活动,是辅助治疗多种疾病的重要方法之一。但过度给氧可导致氧中毒,对机体多系统造成损伤的现象逐渐受到人们的重视。本文旨在探讨氧疗过度给氧的危害,为临床合理氧疗提供理论依据。     

Patients' perceptions of home health occupational therapy

Home health occupational therapy plays an important and growing role in patients' recovery. Home health treatment is unique in that the therapist is a visitor in the patient's home environment. A phenomenological approach was used to examine perceptions of five individuals who were interviewed twice to collect their impressions of home health occupational therapy. Participants' goals for therapy as solicited by home health occupational therapists and participants perceived goals were not always pursued collaboratively. Therapeutic and compensatory occupations were incorporated less often than purposeful exercise. Participants valued those occupations engaged in, despite limited physical recovery. Participants' perceptions of occupational therapists were generally positive. Participants were unprepared for discharge, which was perceived as significant and they as helpless to prevent it despite desire for continued services. Few occupations reported in their treatment coincided with participants' difficulty distinguishing between occupational and physical therapies. Continued research focused on patients' perceptions of home health occupational therapy would be useful in further examining this phenomenon and would enlighten home health occupational therapy practice.     

Survey of home nutritional support patients

Patients receiving home parenteral nutritional services from a major corporate provider were surveyed using a written questionnaire. The survey questioned the patients about use of home parenteral nutritional services and the quality of life while receiving home parenteral therapy. Patient satisfaction with home nutritional support services, and the impact home therapy has on patient medical, financial and psychosocial status were examined. Life satisfaction measures were compared with that of end stage renal disease patients and the overall United States population. Of the 1140 patients sent the written questionnaire, 347 (30.4%) returned the survey. Half the patients had been placed on home parenteral nutrition services because of short bowel syndrome. The mean length of time respondents had been receiving home parenteral nutrition services was 35 months, reporting approximately one hospitalization per year due to complications of their home parenteral nutrition. Blood infection with catheter as focus was most frequently reported as being responsible for hospitalization. The number of hospitalizations due to complications of home parenteral nutrition therapy was positively correlated with length of time on the program. Overall, respondents were satisfied with their home nutrition services, but were less satisfied with life as a whole when compared to the overall United States population and to end stage renal disease patients.