消化内科降低头皮钢针使用率管理的效果及分析

目的 探讨采用干预后,消化内科头皮钢针使用率的变化,对结果 进行分析以指导临床工作.方法 回顾性分析2017年9月-10月在我院消化内科住院患者头皮钢针使用率,共226例.采取干预后统计2017年11月-12月消化内科住院患者头皮钢针使用率,共263例.干预前后两组患者均为在消化内科首次住院.干预前对患者实施常规护理,干预组患者进行外周浅静脉留置针的集束化健康教育,观察干预前、后两组患者头皮钢针使用率的变化并对结果 进行分析.结果 实施集束化健康教育后消化内科住院患者头皮钢针使用率显著降低.结论 实施集束化健康教育能够降低消化内科住院患者头皮钢针使用率,减少患者多次穿刺的痛苦,有效保护血管.     

微创埋线法及健康教育对支气管哮喘患者急性发作的影响

目的观察微创埋线法及健康教育对支气管哮喘患者的影响。方法选择88例支气管哮喘患者随机分为宣教组（43例）和对照组（45例）。对照组在吸氧、抗感染、解痉平喘、止咳化痰等治疗症状缓解后,单纯配合微创埋线疗法等常规指导,出院后不再进行追踪教育。宣教组在住院期间给予有针对性的健康教育外,出院后配合微创埋线疗法及健康教育定期防视1年,比较两组支气管哮喘患者发作频率及再住院次数情况。结果宣教组支气管哮喘患者发作频率及住院率显著低于对照组。结论配合微创埋线疗法及全程开展健康教育,可提高患者自我护理能力,减少支气管哮喘患者发作频率及住院次数,提高患者的生活质量。     

糖尿病患者的护理保健及健康教育研究

目的 探讨护理保健及健康教育在糖尿病患者治疗中的应用研究.方法 选取2013年1月-2013年12月期间该院收治的120例糖尿病患者,将入选患者随机分为两组,试验组和对照组,其中对照组给予常规治疗,试验组在常规治疗的基础上辅以健康教育干预,两组干预时间均为2个月.结果 试验组的血糖控制情况明显好于对照组;试验组的并发症发生情况明显低于对照组.结论 对糖尿病患者实行健康教育临床效果值得肯定,临床上应重视糖尿病患者的健康教育工作,同时选用合理的健康教育方式,以此提高糖尿病患者的治疗效果.     

糖尿病患者的护理保健及健康教育研究

目的探讨护理保健及健康教育在糖尿病患者治疗中的应用研究。方法选取2013年1月—2013年12月期间该院收治的120例糖尿病患者,将入选患者随机分为两组,试验组和对照组,其中对照组给予常规治疗,试验组在常规治疗的基础上辅以健康教育干预,两组干预时间均为2个月。结果试验组的血糖控制情况明显好于对照组;试验组的并发症发生情况明显低于对照组。结论对糖尿病患者实行健康教育临床效果值得肯定,临床上应重视糖尿病患者的健康教育工作,同时选用合理的健康教育方式,以此提高糖尿病患者的治疗效果。     

集束化护理在瓣膜置换术后患者Ⅰ期康复中的应用研究

目的 探讨集束化护理在瓣膜置换术后患者Ⅰ期心脏康复中的应用效果。方法 将2018年4月1日至2018年11月30日某三甲医院行瓣膜置换术后50例患者作为对照组进行历史回顾，将2019年1月1日至2019年8月31日术后50例患者作为试验组。对照组实施常规护理，试验组实施循证支撑下的集束化护理（评估、综合呼吸功能训练、运动锻炼、运动观察、健康教育）。比较两组患者干预后2周的生命体征（PaO2、PaCO2、SpO2、呼吸频率、心率、血压）、6MWTS、BI指数、监护室住院时间、呼吸机使用时间和引流管留置时间。结果 干预后2周试验组各项生命体征、6MWTS、BI指数、监护室住院时间、呼吸机使用时间和引流管留置时间优于对照组，差异具有统计学意义（P＜0.05）。结论 瓣膜置换术后患者实施集束化护理能够有效改善患者术后心脏功能，缩短患者的住院时间，促进患者心脏康复。     

质量改进模式指导的集束干预策略在预防机械通气患者谵妄中的应用

目的探讨质量改进模式(QI)指导的集束干预策略在预防机械通气患者谵妄中的指导作用。方法将经口气管插管机械通气患者148例随机分为两组,对照组采用常规护理;试验组采用集束干预策略,即以QI模式为理论指导,依据总结证据、探讨实施的潜在障碍、确定效果评价指标、保证措施的有效落实4步流程图对患者进行干预。比较两组谵妄发生率,并观察集束干预策略的依从性。结果试验组谵妄发生率(28.9%)低于对照组(47.2%)(P<0.05);试验组集束干预策略的依从性达标率从63%提高到86%,谵妄发生率从53.3例/1 000ICU住院日下降到21.6例/1 000 ICU住院日,差异均有统计学意义(P均<0.05)。结论应用QI模式指导的集束干预策略可降低机械通气患者谵妄发生率,提高医护人员的依从性。     

家属参与的健康教育护理方案对宫颈癌患者化疗期间并发症发生率的影响

目的探讨家属参与的健康教育干预方案对宫颈癌患者化疗期间并发症发生率的影响。方法采用临床试验的方法,收集宫颈癌化疗患者164例,随机分为对照组(82例)和干预组(82例),对照组给予常规护理,干预组接受由家属共同参与的健康教育护理方案。观察两组患者住院化疗期间恶心、呕吐、腹泻、便秘发生情况及血清钠离子、钾离子水平,分别对两组患者护理效果进行评价。结果干预组患者化疗期间恶心、呕吐、腹泻、便秘及低钠、低钾血症发生率低于对照组,且两组患者的低钠、低钾血症发生率比较差异具有统计学意义(P0.05)。结论宫颈癌患者化疗期间实施由家属共同参与的健康教育及护理方案可显著降低化疗期间并发症的发生率。     

弹力带抗阻力训练对AIDS合并肌肉减少症患者肌力改善情况的分析

目的 探讨弹力带抗阻力训练对AIDS合并肌肉减少症（简称肌少症）患者握力、Berg平衡及Barthel指数改善情况的分析。方法 选取成都市公共卫生临床医疗中心感染科106例AIDS合并肌少症患者作为研究对象。对照组进行常规健康教育,试验组在常规健康教育的基础上实施8周弹力带抗阻力训练干预,两组均干预8周。于干预前及干预后对两组患者进行握力、Berg平衡及Barthel指数测试,评估弹力带抗阻力训练对AIDS患者肌少症的干预效果。结果 共干预完成104例,试验组53例,对照组51例。干预后对照组握力值、Berg平衡测试、Barthel指数测评分别为22.40(20.10,24.90)、52.00(47.00,54.00)、52.00(47.00,54.00),干预后试验组握力值、Berg平衡测试、Barthel指数得分别为27.00(23.45,30.55)、54.00(51.00,56.00)、95.00(90.00,97.50)。组间比较,干预后两组握力值、Berg平衡测试、Barthel指数测评分比较差异均有统计学意义（P<0.05）;组内比较,对照组干预前后握力、Berg平...     

眼球运动训练对老年AIDS患者平衡能力的影响研究

目的 探讨眼球运动训练对老年AIDS患者平衡能力的影响。方法 采用随机对照试验,选取成都市公共卫生临床医疗中心感染科100例老年AIDS患者作为研究对象,按计算机随机数字表法随机分为对照组和试验组各50例。对照组进行常规健康教育,试验组在常规健康教育的基础上实施8周眼球运动训练干预,两组均干预8周。于干预前及干预后对两组患者进行Berg平衡功能测试和起立-行走计时测试,评估眼球运动训练对老年AIDS患者平衡能力的干预效果。结果 共干预完成99例老年AIDS患者,试验组50例,对照组49例。干预后对照组Berg平衡功能测试、起立-行走计时测试分别为51.00(46.50,53.00)分、13.20(11.70,15.85)s,试验组分别为55.00(50.00,56.00)分、9.55(8.20,12.70)s。组间比较,干预后试验组平衡功能测试结果高于对照组,起立-行走计时测试用时少于对照组,差异均有统计学意义（P<0.01）;组内比较,试验组干预前后握力、Berg平衡及Barthel指数测评比较差异均有统计学意义（P<0.01）,对照组干预前后比较差异均无统计学意义（P&...     

集束化干预策略在心肌梗死患者运动康复中的应用

目的探讨集束化干预策略在心肌梗死患者运动康复中的应用效果。方法选取我院心内科收住的心肌梗死患者103例,应用计算机随机抽样,分为干预组51例和对照组52例。两组患者均进行常规药物治疗、健康教育、出院宣教及出院随访。干预组在此基础上增加集束化干预策略。比较两组患者出院前及干预后1个月、6个月与12个月6分钟步行试验结果、左心室射血分数、生存质量评分以及住院时间和再入院率。结果两组患者出院前、干预后1个月、6个月及12个月6分钟步行试验结果差异具有统计学意义(P0.05);出院后6个月及12个月左心室射血分数以及生存质量评分结果差异具有统计学意义(P0.05);两组患者住院时间和再入院率的比较结果差异具有统计学意义(P0.05)。结论在心肌梗死患者运动康复中应用集束化干预策略,能改善患者活动能力,缩短住院时间和降低再入院率,提高患者的生存质量。     

Combining pharmacy expertise with asthma educator certification: assessing the impact on inner-city asthma patients

Objective: Asthma is one of the major causes of hospital readmissions in the South Bronx. The goal of this study was to assess the impact of asthma education provided by registered pharmacists with asthma educator certification (AE-C), on medication adherence and hospitalizations/Emergency Department (ED) visits. Methods: This was a retrospective chart review of patients seen in the pulmonary clinic from October 2014 to August 2015 for asthma education by AE-C pharmacists. Medical records were reviewed over an 18-month period – 9?months before and after the initial asthma education session. Data obtained included adherence to asthma controller inhalers based on pharmacy refill claims, asthma control using asthma control test (ACT) scores and asthma-related hospitalizations or ED visits within 30?days of asthma education. Pre-education data served as the pre-intervention group data and post-education data served as the post-intervention group data, allowing each patient to serve as their own control. Results: We found a statistically significant improvement in average medication adherence, i.e. asthma controller inhaler fills at pharmacy (46.3% vs 67.9%, p-value <0.001) and asthma control (15.71% vs 56.38%, p-value <0.001) between the pre-intervention and the post-intervention groups. Additionally, a lower hospitalization/ED utilization rate (31.2% vs 6.38%, p-value <0.001) was observed in the post-intervention group within 30?days of education. Conclusions: Asthma education provided by AE-C pharmacists had a positive impact on asthma care in our inner-city community. Improving medication adherence and asthma control as well as decreasing hospital utilization could potentially decrease health care costs in addition to improving quality of life.     

健康教育路径在巨脾型晚期血吸虫病围手术期患者中的应用

目的 目的 探讨健康教育路径对巨脾型晚期血吸虫病 （晚血） 围手术期患者的效果。方法 方法 巨脾型晚血围手术期患 者60例随机分为观察组和对照组, 每组30例。观察组按健康教育路径表的标准化流程从入院到出院实施护理及健康教 育, 对照组给予常规健康教育。比较两组患者对护理工作的满意度、 住院时间和住院总费用及健康教育掌握度。结果 结果 观察组和对照组患者满意度分别为90.0%和60.0%, 差异有统计学意义 （χ2 = 7.57, P＜0.05）; 两组平均住院时间分别为 14.0±3.5 d和19.0±6.8 d, 差异有统计学意义 （t = 2.85, P＜0.01）; 两组平均住院费用分别为 （1.5±0.5）万元和 （2.2±0.7）万 元, 差异有统计学意义 （t = 24.57, P＜0.01）。术后第10天, 两组健康知识掌握度分别为96.7%和50.0%, 差异有统计学意 义 （χ2 =16.86, P＜0.001）。结论 结论 实施健康教育路径可促进巨脾型晚血围手术期患者康复, 提高患者满意度及健康知识 掌握度, 缩短住院时间, 节省住院费用。     

临床护理路径整合整体护理在晚期血吸虫病腹水型患者中的应用

目的 目的 评价晚期血吸虫病 （晚血） 腹水型患者临床护理路径 （CNP） 与整体护理整合的效果。方法 方法 将226例晚 血腹水型患者随机分为观察组与对照组, 每组113例。观察组实施CNP整合整体护理, 对照组实施整体护理。观察两组 患者的临床相关指标, 并对其出院前后的生存质量进行评估。结果 结果 观察组患者好转率、 满意度、 健康知识知晓率分别 为93.8%、 100%、 97.4%, 均明显高于对照组, 差异均有统计学意义 （P均 < 0.05）; 病死率为0, 并发症发生率为2.7%, 均低 于对照组, 差异均有统计学意义 （P均 < 0.05）; 住院时间为 （12.2 ± 0.7）d, 住院费用为 （4 725.0 ± 310.1） 元, 均低于对照 组, 差异均有统计学意义 （P均 < 0.01）。出院后6个月, 观察组患者各领域生存质量明显好于对照组, 差异均有统计学意 义 （P均 < 0.05）。结论 结论 CNP整合整体护理能提高晚血腹水型患者的好转率、 降低病死率, 并能缩短住院时间, 节省住院 费用。此护理模式适宜在血防专科医院晚血救治临床护理工作中推广应用。     

护理健康教育路径在慢性肝炎患者中的应用

目的探讨慢性肝炎患者健康教育路径,可以规范肝病科护士健康教育工作并提高了护理质量。方法将106例慢性肝炎患者随机分为实验组及对照组各53例。实验组由责任组护士根据患者具体情况将健康教育路径表统一放置病房内,并按健康教育路径表时间顺序逐步落实,打勾,且根据护士和患者反馈信息,及时调整,完善。对照组采用传统入院宣教,疾病知识宣教,出院指导等健康教育方法。结果实验组中患者满意度高于对照组,疾病复发率显著低于对照组,两组之间存在显著性差异（P〈0.01）。结论对慢性肝炎患者实施健康教育路径,能提高护理质量,是行之有效的护理工作方法。     

三位一体支气管哮喘教育管理模式对病情控制水平和生命质量的影响

目的评估三位一体支气管哮喘(简称哮喘)教育管理模式对患者病情控制水平和哮喘生命质量的影响。方法北京大学人民医院三位一体哮喘教育管理模式由哮喘专业门诊、哮喘宣教中心和哮喘患者协会构成。2005年4月至6月选择北京大学人民医院接受三位一体哮喘教育管理的门诊患者为教育组(56例);选择另一家三级医院未接受系统哮喘教育管理的门诊患者为对照组(30例)。采用面对面问卷方式调查两组近8周的病情控制水平和生命质量评分并进行对比分析。结果两组病情的良好控制率分别为61%(34例)和10%(3例),教育组优于对照组,差异有统计学意义(χ2=20.50,P<0.01);两组哮喘患者生命质量总评分分别为(155±12)分、(132±24)分,教育组亦优于对照组,差异有统计学意义(t=5.17,P<0.01)。结论三位一体哮喘教育管理模式可以有效提高哮喘患者的病情控制水平和哮喘生命质量。     

Effects of a self-management asthma educational program in Taiwan based on PRECEDE-PROCEED model for parents with asthmatic children.

This study was conducted to evaluate the comparative effectiveness of two different asthma educational programs. One was self-management asthma education based on the PRECEDE-PROCEED model to change the influential factors based on a previous need assessment study in Taiwan. The other consisted of regular outpatient asthma education. The purposes were: 1) to compare differences in the asthma knowledge, self-efficacy, perceived effectiveness, children's cooperation, doctor-patient communication, and self-management behaviors in the experimental and control groups before education, and 2 weeks, 3 months, and 6 months after education; and 2) to compare differences in drug use, medication utilization, asthma severity, signs/symptoms of asthma, school absenteeism, and exercise ability before education, and 2 weeks, 3 months, and 6 months after education. Parents of asthmatic children were recruited from among outpatients of Chang Gung Children's Hospital, Taoyuan, Taiwan. They were grouped by registration number: those with even numbers were assigned to the experimental group, and those with odd numbers were assigned to the control group. Measurements were collected four times from all parents by means of a questionnaire and chart review. The General Linear Model: Repeat Measurement was used to compare variance differences. The following results were found. 1) Asthma knowledge, self-efficacy, perceived effectiveness, children's cooperation, and self-management behaviors significantly improved after the self-management asthma educational program based on PRECEDE-PROCEED. Except for perceived effectiveness, all variables still had good effectiveness after 6 months of follow-up. The experimental group was better than the control group in knowledge, children's cooperation, and self-management behaviors at the 3-month follow up, as well as in knowledge and children's cooperation at the 6-month follow-up. 2) In both the experimental and control groups, the educational program had a good impact on the health outcome. The average degree of drug use was reduced from 2.7 to 2.1. The number of visits was reduced from 4.75 to 3.55 per half year in the experimental group, and from 5.8 to 3.48 in the control group. The severity of asthma was reduced from 2.7 to 2.1. The signs/symptoms of asthma decreased, school absenteeism was reduced, and exercise ability improved after education at the 6-month follow-up in both groups. From the results of this study, the theory-based educational program had a good effect on self-management behaviors. From the repeat measurement analysis, we can understand the changing trend of the determinants, behaviors, and outcome indicators. The trend indicated that educational effects were sustained for at least 3 months, with some for 6 months. In order to maintain the educational effects, further specific series of educational programs can be designed based on the patterns of self-management behavior stages every 6 months. The effects of health outcomes may show significant differences using longer follow-up times in future clinical trials.     

健康教育对老年高血压伴抑郁症患者血压的影响

目的探讨健康教育对改变老年高血压伴抑郁症患者治疗态度及应用降压和抗抑郁药物治疗对血压的影响。方法将55例老年高血压伴抑郁症患者随机分为2组,干预组28例,给予降压、抗抑郁治疗及健康教育;对照组27例,仅给予降压及抗抑郁治疗。分别于入院时和出院6个月内对治疗态度及服药依从性和治疗效果进行评定。结果入院时治疗态度问卷评分及服药依从性两组间差异均无统计学意义(P>0.05);出院后干预组治疗态度问卷评分明显优于对照组[(19.6±3.7)分对(12.9±4.2)分,P<0.013;服药依从性、疗效明显优于对照组(P<0.05)。结论通过对老年高血压伴抑郁症患者进行健康教育,不仅能改变患者治疗态度、提高患者遵医服药依从性,还能明显提高血压控制率。     

Effects of a Self-Management Asthma Educational Program in Taiwan Based on PRECEDE-PROCEED Model for Parents with Asthmatic Children

This study was conducted to evaluate the comparative effectiveness of two different asthma educational programs. One was self-management asthma education based on the PRECEDE-PROCEED model to change the influential factors based on a previous need assessment study in Taiwan. The other consisted of regular outpatient asthma education. The purposes were: 1) to compare differences in the asthma knowledge, self-efficacy, perceived effectiveness, children's cooperation, doctor-patient communication, and self-management behaviors in the experimental and control groups before education, and 2 weeks, 3 months, and 6 months after education; and 2) to compare differences in drug use, medication utilization, asthma severity, signs/symptoms of asthma, school absenteeism, and exercise ability before education, and 2 weeks, 3 months, and 6 months after education. Parents of asthmatic children were recruited from among outpatients of Chang Gung Children's Hospital, Taoyuan, Taiwan. They were grouped by registration number: those with even numbers were assigned to the experimental group, and those with odd numbers were assigned to the control group. Measurements were collected four times from all parents by means of a questionnaire and chart review. The General Linear Model: Repeat Measurement was used to compare variance differences. The following results were found. 1) Asthma knowledge, self-efficacy, perceived effectiveness, children's cooperation, and self-management behaviors significantly improved after the self-management asthma educational program based on PRECEDE-PROCEED. Except for perceived effectiveness, all variables still had good effectiveness after 6 months of follow-up. The experimental group was better than the control group in knowledge, children's cooperation, and self-management behaviors at the 3-month follow up, as well as in knowledge and children's cooperation at the 6-month follow-up. 2) In both the experimental and control groups, the educational program had a good impact on the health outcome. The average degree of drug use was reduced from 2.7 to 2.1. The number of visits was reduced from 4.75 to 3.55 per half year in the experimental group, and from 5.8 to 3.48 in the control group. The severity of asthma was reduced from 2.7 to 2.1. The signs/symptoms of asthma decreased, school absenteeism was reduced, and exercise ability improved after education at the 6-month follow-up in both groups. From the results of this study, the theory-based educational program had a good effect on self-management behaviors. From the repeat measurement analysis, we can understand the changing trend of the determinants, behaviors, and outcome indicators. The trend indicated that educational effects were sustained for at least 3 months, with some for 6 months. In order to maintain the educational effects, further specific series of educational programs can be designed based on the patterns of self-management behavior stages every 6 months. The effects of health outcomes may show significant differences using longer follow-up times in future clinical trials.     

Effects of a Self‐Management Asthma Educational Program in Taiwan Based on PRECEDE‐PROCEED Model for Parents with Asthmatic Children

This study was conducted to evaluate the comparative effectiveness of two different asthma educational programs. One was self‐management asthma education based on the PRECEDE‐PROCEED model to change the influential factors based on a previous need assessment study in Taiwan. The other consisted of regular outpatient asthma education. The purposes were: 1) to compare differences in the asthma knowledge, self‐efficacy, perceived effectiveness, children's cooperation, doctor–patient communication, and self‐management behaviors in the experimental and control groups before education, and 2 weeks, 3 months, and 6 months after education; and 2) to compare differences in drug use, medication utilization, asthma severity, signs/symptoms of asthma, school absenteeism, and exercise ability before education, and 2 weeks, 3 months, and 6 months after education. Parents of asthmatic children were recruited from among outpatients of Chang Gung Children's Hospital, Taoyuan, Taiwan. They were grouped by registration number: those with even numbers were assigned to the experimental group, and those with odd numbers were assigned to the control group. Measurements were collected four times from all parents by means of a questionnaire and chart review. The General Linear Model: Repeat Measurement was used to compare variance differences. The following results were found. 1) Asthma knowledge, self‐efficacy, perceived effectiveness, children's cooperation, and self‐management behaviors significantly improved after the self‐management asthma educational program based on PRECEDE‐PROCEED. Except for perceived effectiveness, all variables still had good effectiveness after 6 months of follow‐up. The experimental group was better than the control group in knowledge, children's cooperation, and self‐management behaviors at the 3‐month follow up, as well as in knowledge and children's cooperation at the 6‐month follow‐up. 2) In both the experimental and control groups, the educational program had a good impact on the health outcome. The average degree of drug use was reduced from 2.7 to 2.1. The number of visits was reduced from 4.75 to 3.55 per half year in the experimental group, and from 5.8 to 3.48 in the control group. The severity of asthma was reduced from 2.7 to 2.1. The signs/symptoms of asthma decreased, school absenteeism was reduced, and exercise ability improved after education at the 6‐month follow‐up in both groups. From the results of this study, the theory‐based educational program had a good effect on self‐management behaviors. From the repeat measurement analysis, we can understand the changing trend of the determinants, behaviors, and outcome indicators. The trend indicated that educational effects were sustained for at least 3 months, with some for 6 months. In order to maintain the educational effects, further specific series of educational programs can be designed based on the patterns of self‐management behavior stages every 6 months. The effects of health outcomes may show significant differences using longer follow‐up times in future clinical trials.     

加强健康教育在肺结核合并糖尿病护理中的作用效果分析

目的探究加强健康教育在肺结核合并糖尿病护理产生的作用效果。方法选取该院2017年7月—2019年7月收治的104例肺结核合并糖尿病患者,并且随机将患者分为对照组和实验组,每组52例,实验组患者采用加强健康教育的干预方式,对照组患者采用常规方式护理,对比两组患者护理情况。结果两组患者在接受护理后对比,实验组患者的用药依从性总依从率为96.15%,明显高于对照组(80.77%),差异有统计学意义(P<0.05);两组患者在接受护理后自我护理能力水平对比,实验组患者的自我护理能力更高,差异有统计学意义(P<0.05);两组患者护理后血糖变化以及血脂变化对比,实验组患者实际情况优于对照组,差异有统计学意义(P<0.05);两组患者护理后满意度比较,实验组总满意度98.08%高于对照组总满意度84.62%,差异有统计学意义(P<0.05)。结论在肺结核合并糖尿病护理中医护人员加强健康教育能够促进患者的治疗效果,并且护理效果得到极大的提升,因此值得在临床医学中应用。