中医整体护理在脑卒中患者中的应用

2006年7月～11月，我们对90例脑卒中患者实施中医整体护理，并配合中医护理技术及早期的康复训练，取得满意效果。现报告如下。     

癌症患者灵性需求的研究进展

<正>1998年WHO将灵性健康增加为健康的组成部分之一,提及要重视并提供患者身体、心理、灵性与社会文化层面的照顾[1],随后关于灵性的研究越来越多,尤其是癌症患者的灵性研究。由于疾病的特殊性,癌症患者往往要承受癌症以及治疗所造成的痛苦与不适症状,面对病情与生命的不确定性,常会产生焦虑、抑郁、伤心等负性情绪反应,加上家庭社会支持网络的改变或不足,易导致患者觉得人生缺乏意义及价值感,感到无力、无助甚至有自杀的危机,     

老年恶性肿瘤患者灵性护理需求现状及影响因素研究

目的了解老年恶性肿瘤患者对灵性护理的需求现状及影响因素,为减轻患者身心痛苦和提高患者生存质量提供理论依据。方法应用一般资料问卷、中文版护士灵性护理需求量表对住院的老年恶性肿瘤患者107例进行问卷调查。结果老年恶性肿瘤患者灵性护理需求总分为(34.63±5.79)分,处于中度水平。多元线性回归分析结果显示,文化程度、宗教信仰、家庭人均月收入、病程是影响老年恶性肿瘤患者灵性护理需求的影响因素(P<0.01或P<0.05)。结论老年恶性肿瘤患者存在不同程度的灵性护理需求,医护人员应根据患者的具体需求情况,采取针对性干预措施减轻患者的身心痛苦,提高患者生存质量。     

脑卒中患者院外连续护理需求的探讨

目的拟观察及分析脑卒中患者院外连续护理的需求,为进一步构建脑卒中连续护理模式提供基础。方法采用问卷调查法。便利抽样调查在2012年9月至2013年1月上海长海医院和郑州大学第一附属医院神经内科住院治疗的68例脑卒中患者,了解患者对院外连续护理的需求。结果、91．2％的患者认为医院非常或有必要与出院患者保存联系,同时有89．7％的患者非常需要或需要在社区内接受医务人员的连续指导。在信息的传递方面72．1％的患者愿意将住院信息传递给社区,89．4％的患者愿意将出院后的治疗信息传递给医院。由于89．2％的患者出I完后的康复场所都是在家庭社区内,但是40．3％的患者不知道社区医务人员专业技能和社区的康复器材是否可以满足自己的需求。结论需加强完善我国脑卒中患者的院外连续护理模式,建立一个医院一社区一家庭的脑卒中院外连续护理体系。     

国内肿瘤患者灵性需求影响因素的Meta分析

目的 总结国内肿瘤患者灵性需求的水平及其影响因素,为制定相应干预策略提供循证依据。方法 检索中国知网、万方、维普中文科技期刊、中国生物医学、PubMed、Cochrane Library、Web of Science和Embase数据库资源,收集关于国内肿瘤患者灵性照护服务需求影响因素的研究;检索起止时间为建库至2021年6月1日;应用Stata15.1软件进行Meta分析。结果共纳入19篇文献,4 159例肿瘤患者,其灵性照护服务需求得分主要分布在中等水平;Meta分析结果显示,年龄（SMD=0.56,95%CI:0.27～0.85）、宗教信仰（SMD=0.65,95%CI:0.31～0.99）、民族（SMD=0.48,95%CI:0.26～0.70）、文化程度（SMD=0.30,95%CI:0.13～0.47）、病程（SMD=0.28,95%CI:0.18～0.39）、对死亡的恐惧（SMD=0.52,95%CI:0.24～0.79）是国内肿瘤患者灵性需求的影响因素。结论 临床医护人员应充分考虑国内肿瘤患者灵性需求的影响因素,并制定相应的干预策略,针对性提供灵性照护。     

癌症患者灵性需求与干预方法的研究进展

目的 总结癌症患者灵性需求的研究现状及其主要的干预方法,为灵性照护的临床实践提供理论依据。方法 通过检索PubMed、Web of Science、CNKI等数据库,归纳癌症患者灵性需求的相关概念、评估方法及研究现状,并对其主要的干预方法进行综述。结果 灵性需求是个人寻找人生目的与价值的期望,尚无统一的评估工具。目前,灵性需求的主要干预方法有意义疗法、尊严疗法、宗教疗法、艺术疗法等,我国关注较多的是意义疗法和尊严疗法。结论 灵性需求的分类及评估方法尚不统一,我国癌症患者普遍存在灵性需求,建议医护工作者根据我国的文化背景和患者特点,结合多种干预方法,进一步探讨适合我国国情的灵性照护模式。     

脑卒中患者家庭护理需求调查与分析

目的：调查脑卒中患者家庭护理方面的需求，为脑卒中患者家庭护理服务提供依据。方法：使用自行设计的调查表对脑卒中患者及家属进行问卷调查。结果：患者对家庭护理的需求积极，但因年龄、文化程度、经济状况而异。患者对家庭护理需求的方面包括基础护理、康复护理、专业护理、心理护理及提供专业知识指导。结论：建立完善的家庭护理体系及社区保障系统是提高脑卒中患者生存质量的重要途径。     

首发脑卒中患者延续性护理需求调查分析

目的调查首发脑卒中患者延续性护理需求,为制订护理对策提供依据。方法采用脑卒中延续性护理需求调查问卷对102例首发脑卒中患者在出院时进行调查;采用美国国立卫生研究院卒中量表（thenationalinstitutesofhealthstrokeseale,NIHSS）和生活自理能力Barthel指数（barthelindex,BI）量表分别评估脑卒中患者在人院和出院时神经功能缺损及生活自理能力情况,并分析患者延续性护理需求与其NIHSS、BI评分的相关性。结果首发脑卒中患者延续性护理需求排列前5位分别是‘脑卒中知识”、“安全用药知识”、“康复锻炼知识”、“血压控制及自我监测知识”、“饮食知识”,需求比例在94．11％～87．25％。首发脑卒中患者延续性护理需求评分与其NIHSS评分呈正相关（r=0．271,P〈0．05）,与BI评分呈负相关（r=-0．226,P〈0．05）。结论首发脑卒中患者对延续性护理需求普遍存在,内容是多方面的;首发脑卒中患者神经功能缺损越严重、生活自理能力越低,其对延续性护理需求越高。     

Adolescent cancer survivors' experiences of supportive care needs: A qualitative content analysis

Supportive care is an important strategy that can help cancer survivors manage changes and problems during their follow‐up care. Identifying patients' care needs is one of the primary steps of the nursing process to plan effective nursing interventions. The aim of this study was to explore adolescent cancer survivors' supportive care needs. Purposeful sampling was adopted to select 49 participants from hospitals to participate in face‐to‐face, semistructured interviews. The qualitative content analysis method was conducted for data analysis. Ten subcategories and four main categories – empathetic care, information about survival period, instrumental support, and cooperation in care – were extracted from the data. These four categories formed a major theme, “supportive care”, as the primary healthcare need. This study highlights that supportive care should be developed collaboratively by family and healthcare providers to meet the needs of adolescent cancer survivors. Survivors' strengths and limitations should be identified, and then supportive care can be provided, such as giving appropriate information, enabling survivors to access supportive networks, and improving survivors’ confidence and autonomy with their self‐management.     

Navigating stroke care: the experiences of younger stroke survivors

Abstract

Purpose: Although stroke is associated with ageing, a significant proportion of strokes occur in younger people. Younger stroke survivors have experienced care available as inappropriate to their needs. However, insufficient attention has been paid to how the social context shapes their experiences of care. We investigated this question with younger stroke survivors in Greater London, UK. Method: We conducted in-depth interviews with individuals aged between 24 and 62 years. Interviews were analysed thematically, with interpretation informed by Bourdieu’s concepts of field, capital and habitus. Results: In the acute care setting it was implicit for participants that expertise and guidance was to be prioritised and largely this was reported as what was received. Individuals’ cultural capital shaped expectations to access information, but health care professionals’ symbolic capital meant they controlled its provision. After discharge, professional guidance was still looked for, but many felt it was limited or unavailable. It was here that participants’ social, cultural and economic capital became more important in experiences of care. Conclusions: The field of stroke shaped younger stroke survivors’ experiences of care. Navigating stroke care was contingent on accessing different forms of capital. Differences in access to these resources influenced longer term adjustment after stroke.

• Implications for Rehabilitation

• Stroke care can be conceptualised as a temporal field of social activity and relationships which shapes variations in experiences of care among younger stroke survivors, and differences in expectations of support at different time points after stroke.

• On entering the field of stroke participants reported needing health care professional guidance and expertise to manage the acute event, yet difficulties accessing information in hospital limited the agency of some individuals wanting to take an active role in their recovery.

• After discharge from hospital variations in experiences of care among participants were more evident, with a number still seeking professional guidance, and requiring the capital and agency to navigate the field of stroke.

• Despite international efforts to improve the quality of acute care, effective models of community stroke care still need to be developed.

     

全方位护理对脑卒中患者生活质量的影响

目的探讨全方位护理对脑卒中患者生活质量的影响及康复效果。方法采用全方位护理对56位脑卒中患者分别从健康教育、心理、生活、功能锻炼、康复护理及出院指导进行护理,采用国际普适生活质量量表(SF-36)对患者的生活质量进行评价与效果观察。结果 56例脑卒中患者接受全方位护理干预后,SF-36生活质量各维度评估指标(除3BP)均明显高于入院时。结论全方位护理对提高生活质量及康复的效果显著。     

中风患者急性期中医整体护理的效果观察

目的探讨适用于中风急性期患者的中医整体护理模式.方法任选60例中风急性期患者(全部经CT或MR确诊),将住院号为双数者列为观察组,住院号为单数者列为对照组,每组30例.观察组实施具有中医特色的中医整体护理康复计划,对照组采取常规护理方法,就其两组效果进行观察对比.结果观察组总有效率96.7%,对照组总有效率60% .采用EPI 6.0 统计学软件进行Ridit分析,Z=5.057,P＜0.01,两组疗效有显著性差异.结论中医整体护理能促进中风急性期患者的康复,显著降低致残率,提高患者生存质量.     

Spiritual Dimensions of the Perioperative Experience

Nurses recognize the importance of spiritual care for facilitating healing and positive outcomes. Nurses caring for patients in highly technical surgical environments have unique opportunities and challenges when attending to patients' spiritual needs.Patients facing surgery often regard the event and the health implications associated with it as having meaning and significance for their lives. They draw upon spiritual resources to respond to the challenges of their illness and surgery.This article addresses the effect of life transition and uncertainty on a patient's surgical experience. Suggestions are made for ways perioperative nurses can provide spiritual care to help create healing environments. AORN J 89 (May 2009) 875-882. © AORN, Inc, 2009.     

A framework for care during the stroke experience.

This article describes a model we developed to guide the selection and design of nursing activities that will facilitate the health of persons with stroke and their families. Care in the context of stroke has been structured by the medical model's focus on functional ability. As a result, nursing is viewed as ancillary to other professions; yet, studies of the stroke experience from the patient's view suggest that distinctive nursing interventions are needed. Current models of illness do not sufficiently address the nature of stroke and thus cannot serve as a framework for nursing care. Our model conceptualizes stroke as a progressive, holistic experience with physiological, psychological, and social dimensions. It was developed from a synthesis of research articles identified through searches of CINAHL, MEDLINE, and PSYCHLIT (1980-1999) indexes using the terms "stroke," "stress," "coping," "chronic illness," and "transitions and growth" and from our clinical experiences. Our research established that the stroke experience involves the deterioration of the whole person and the development of a new person through discovery and resynthesis. Each of these processes progressively dominates the experience and together they form a three-phase model. This model of the stroke experience suggests that nursing care should focus initially on limiting deterioration and then concentrate on facilitating growth. Selection of specific interventions requires an understanding of the uniqueness of each stroke experience, as well as the commonalities, among these experiences.     

Satisfaction of Nigerian stroke survivors with outpatient physiotherapy care

Objective: To investigate the satisfaction of stroke survivors with outpatient physiotherapy care. Methods: Sixty stroke survivors were surveyed using the European Physiotherapy Treatment Outpatient Satisfaction Survey (EPTOPS). Focus group discussion (FGD) was also conducted with four stroke survivors from the same sample. Data were analyzed using the Kruskal Wallis test and Spearman’s correlation coefficients at p = 0.05. FGD was transcribed and thematically analyzed. Results: Nearly all the participants (98.3%) indicated one of good, very good, and excellent improvement in their clinical conditions with physiotherapy. Majority expressed satisfaction with their physiotherapy care, the modal response being very good (59.3%). Patients’ satisfaction and socio-demographics were not significantly correlated (p > 0.05). Overarching themes from FGD were physiotherapy in stroke rehabilitation, satisfaction with physiotherapy care, cost, and lack of continuity of care as sources of dissatisfaction. Physiotherapists’ demeanor was a facilitator of satisfaction. Conclusion: The stroke survivors were generally satisfied with outpatient physiotherapy care. However, lack of continuity and cost of care were sources of dissatisfaction among patients. Delivery of physiotherapy to stroke survivors in Nigeria should be structured to allow for continuity of care as this may enhance satisfaction. Implementation of inexpensive rehabilitation strategies may help reduce cost of physiotherapy.