优质护理服务对消化性溃疡患者心理状态及生活质量的影响

目的分析优质护理服务对消化性溃疡患者心理状态及生活质量的影响。方法选取我院2015年7月至2016年7月收治的132例消化性溃疡患者,随机分为两组各66例。对照组实施常规护理,观察组在常规护理基础上实施优质护理服务,比较两组的护理效果。结果两组护理后的SAS、SDS、NHP评分均较护理前显著降低(P<0.01),且观察组的各项评分均显著低于对照组(P<0.01)。观察组的护理满意度为95.45%,显著高于对照组的84.85%(P<0.05)。结论优质护理服务能改善消化性溃疡患者的心理状态及生活质量,促进患者康复,提高患者满意度。     

针对性护理对老年冠心病患者SAS及SDS评分的影响

目的探讨针对性护理对老年冠心病患者SAS及SDS评分的影响。方法72例老年冠心病患者随机分为两组各36例。观察组行针对性护理干预,对照组行常规护理,比较两组的护理效果。结果护理前,两组的生活质量评分无统计学差异(P>0.05);护理后,观察组的各项生活质量评分均显著优于对照组(P<0.05)。护理前,两组的情绪评分无统计学差异(P>0.05);护理后,观察组的SAS、SDS评分均显著低于对照组(P<0.05)。观察组的护理满意度为97.22%,显著高于对照组的77.78%(P<0.05)。结论给予老年冠心病患者针对性护理干预可显著改善患者的生活质量以及负面精神状态,提高护理满意度。     

优质护理管理质量持续改进在子宫肌瘤患者护理中的效果及对生活质量的影响分析

目的 观察子宫肌瘤患者护理中的应用优质护理管理质量持续改进的效果和对生活质量的影响。方法 以80例在我院治疗的子宫肌瘤患者为研究对象,时间为2019年1～12月,均分为对照组(40例,一般常规护理)和观察组(40例,优质护理管理质量持续改进),对比两组患者护理效果、护理满意度、护理前后SDS评分、SAS评分及生活质量评分。结果 观察组患者护理质量评分、护理满意度均优于对照组患者,差异有统计学意义(P<0.05);两组患者生活质量,观察组患者在社会功能、躯体功能、心理功能、物质生活方面均优于对照组,差异有统计学意义(P<0.05)。护理前两组SDS评分、SAS评分,差异无统计学意义(P>0.05);护理后SDS评分、SAS评分均优于护理前,其中观察组患者的焦虑、忧郁程度少于对照组,差异有统计学意义(P<0.05)。结论 对子宫肌瘤患者采用优质护理管理质量持续改进,可以提升护理质量,减少患者的焦虑、忧郁的心理状况,提高了患者的生活质量。并获得较高的护理满意度。     

人文关怀护理对肺癌终末期患者心理状态及生活质量的影响

目的探讨人文关怀护理对肺癌终末期患者心理状态及生活质量的影响。方法选取2017年1月至2019年2月我院收治的130例肺癌终末期患者,随机分为两组各65例。对照组采用常规临终护理,观察组在常规临终护理基础上加强人文关怀护理。比较两组护理前后的心理状态及生活质量。结果护理前,两组的SAS评分、SDS评分、各项生活质量评分比较,差异无统计学意义(P>0.05);护理后,观察组的SAS、SDS评分均显著低于对照组,各项生活质量评分均显著高于对照组,差异均具有统计学意义(P均<0.05)。结论人文关怀护理能有效改善肺癌终末期患者的焦虑、抑郁情绪,提高残存时间的生活质量。     

优质护理应用于尿毒症患者的效果观察

目的:探讨对尿毒症患者应用优质护理产生的效果.方法:将80例尿毒症患者随机分为观察组和对照组各40例,观察组给予优质护理,对照组行常规护理,比较两组患者的焦虑评分(SAS)、抑郁评分(SDS)、并发症发生率及护理满意度.结果:两组患者护理前SAS及SDS评分均无明显差异(P>0.05),护理后两项评分均比护理前降低,且观察组的SAS及SDS分值均明显低于对照组(P<0.05).此外,观察组的并发症发生率、护理满意度均明显优于对照组,差异具有统计学意义(P<0.05).结论:对尿毒症患者应用优质护理,可以缓解患者的焦虑和抑郁情绪,降低并发症发生率,提高患者的护理满意度,具有积极的临床意义.     

无缝隙护理管理模式在内镜室中的应用效果观察

目的观察无缝隙护理管理模式在内镜室中的应用效果。方法选取我院2016年3月至2016年6月接受消化内镜检查的1 000例患者,随机分为观察组和对照组各500例。对照组采用常规护理干预,观察组采用无缝隙护理管理模式。比较两组患者的SAS评分、SDS评分、护理满意度和不良反应发生率。结果护理前,两组患者的SAS评分和SDS评分比较差异均无统计学(P>0.05);护理后,两组患者的SAS评分和SDS评分较护理前均明显降低(P<0.05),且观察组的SAS评分和SDS评分均明显低于对照组(P<0.05)。观察组的护理满意度为99%,明显高于对照组的60%(P<0.05)。观察组的不良反应发生率为4.2%,明显低于对照组的11.6%(P<0.05)。结论无缝隙护理管理模式在内镜室中的应用效果显著,可有效改善患者的紧张、焦虑情绪,提高患者的护理满意度,减少不良反应发生,提高护理质量。     

时效性激励护理模式在改善脑卒中患者不良情绪中的作用

目的探讨时效性激励护理模式在改善脑卒中患者不良情绪中的作用。方法选取126例脑梗死患者,随机将其分为两组各63例,对照组采用常规护理模式,研究组采用时效性激励护理模式,比较两组的焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、护理满意率以及生活质量评分。结果护理前,两组焦虑自评量表(SAS)、抑郁自评量表(SDS)评分比较差异无统计学意义(P>0.05);护理后,研究组的SAS、SDS评分均明显低于对照组(P<0.05)。研究组的护理满意率明显高于对照组(P<0.05)。护理后,研究组的SF-36生活质量评分明显高于对照组(P<0.05)。结论时效性激励护理模式通过显著改善脑梗死患者的焦虑和抑郁情绪,从而改善遵医行为,提高护理与生活质量。     

优质护理对脑梗死患者不良情绪及护理满意度影响

目的:探究优质护理在临床脑梗死患者不良心理状态、护理满意度中的临床效果.方法:回顾性分析2014年2月至2016年4月102例在我院脑梗死患者,随机分对照组和观察组,51例对照组采用常规护理,51例观察组实施优质护理干预.采用焦虑自评量表(SAS)和抑郁自评量表(SDS)对两组患者心理状态进行评估及日常生活能力量表(ADL)对生活质量评估,并统计对护理满意度.结果:治疗前,两组患者的心理状态、生活质量方面均无明显差异,P<0.05.治疗后,相比对照组,观察组心理状态SAS、SDS评分及ADL生活质量评分有明显增高优势,且护理满意度评分较高,P<0.05.结论:优质护理对于脑梗死疾病的治疗、预后具有重要作用,可提高患者生活质量,改善患者日常生活能力,较好缓解不良情绪,促进医患关系融洽.     

护理干预对脑卒中患者负性情绪和生活质量的影响

目的:探讨分析护理干预对脑卒中患者负性情绪和生活质量的影响.方法:选取2013年8月—2016年8月期间我科收治的58例脑卒中患者作为观察对象.将其简单随机分为两组,观察组29例,对照组29例.一组患者使用常规护理(对照组),另一组患者在常规护理的基础上,给予综合护理干预(观察组).护理后,对比2组患者的焦虑(SAS)、抑郁(SDS)负性情绪以及生活质量评分.结果:观察组患者护理后SAS、SDS评分均低于对照组(P<0.05);且生活质量各指标评分均显著优于对照组,P<0.05.结论:综合护理干预可改善脑卒中患者的负性情绪,提高其生活质量,可推广使用.     

多学科团队合作模式在老年高血压合并慢性心衰患者护理中的应用

目的探讨多学科团队合作模式在老年高血压合并慢性心衰患者护理中的应用。方法选取我院收治的78例老年高血压合并慢性心衰患者,按就诊顺序分为观察组和对照组各39例。对照组采用常规护理方式,观察组采用多学科团队合作护理模式。比较两组患者护理前后的生活质量、心理状况和不良心血管事件发生率。结果护理前,两组患者的LHFQ、PULSES、SAS、SDS评分比较差异均无统计学意义(P>0.05)。护理后,两组患者的LHFQ评分上升,PULSES、SAS、SDS评分下降,差异均有统计学意义(P<0.05)。观察组的LHFQ评分高于对照组,且PULSES、SAS、SDS评分均低于对照组,差异有统计学意义(P<0.05)。观察组的不良心血管事件发生率为5.13%,低于对照组的20.51%,差异有统计学意义(P<0.05)。结论多学科团队合作模式优于常规医疗模式,可有效整合专业护理意见,给予患者更科学全面的护理。     

Too Much Ado about Propensity Score Models? Comparing Methods of Propensity Score Matching

OBJECTIVE: A large number of possible techniques are available when conducting matching procedures, yet coherent guidelines for selecting the most appropriate application do not yet exist. In this article we evaluate several matching techniques and provide a suggested guideline for selecting the best technique. METHODS: The main purpose of a matching procedure is to reduce selection bias by increasing the balance between the treatment and control groups. The following approach, consisting of five quantifiable steps, is proposed to check for balance: 1) Using two sample t-statistics to compare the means of the treatment and control groups for each explanatory variable; 2) Comparing the mean difference as a percentage of the average standard deviations; 3) Comparing percent reduction of bias in the means of the explanatory variables before and after matching; 4) Comparing treatment and control density estimates for the explanatory variables; and 5) Comparing the density estimates of the propensity scores of the control units with those of the treated units. We investigated seven different matching techniques and how they performed with regard to proposed five steps. Moreover, we estimate the average treatment effect with multivariate analysis and compared the results with the estimates of propensity score matching techniques. The Medstat MarketScan Data Base provided data for use in empirical examples of the utility of several matching methods. We conducted nearest neighborhood matching (NNM) analyses in seven ways: replacement, 2 to 1 matching, Mahalanobis matching (MM), MM with caliper, kernel matching, radius matching, and the stratification method. RESULTS: Comparing techniques according to the above criteria revealed that the choice of matching has significant effects on outcomes. Patients with asthma are compared with patients without asthma and cost of illness ranged from 2040 dollars to 4463 dollars depending on the type of matching. After matching, we looked at the insignificant differences or larger P-values in the mean values (criterion 1); low mean differences as a percentage of the average standard deviation (criterion 2); 100% reduction bias in the means of explanatory variables (criterion 3); and insignificant differences when comparing the density estimates of the treatment and control groups (criterion 4 and criterion 5). Mahalanobis matching with caliber yielded the better results according all five criteria (Mean = 4463 dollars, SD = 3252 dollars). We also applied multivariate analysis over the matched sample. This decreased the deviation in cost of illness estimates more than threefold (Mean = 4456 dollars, SD = 996 dollars). CONCLUSION: Sensitivity analysis of the matching techniques is especially important because none of the proposed methods in the literature is a priori superior to the others. The suggested joint consideration of propensity score matching and multivariate analysis offers an approach to assessing the robustness of the estimates.     

"创伤评分系统"软件的研制

目的：研制集多种院前和院内评分为一体的简捷方便的评分工具软件系统。方法：将创伤评分各指标参数进行比较归类分解，编制评分系统功能与流程，采用Delphi语言进行编程。结果：成功编制出“创伤评分系统”软件，该软件功能主要包括：新建、查询、打印、资料备份与恢复、字典维护等功能；可实现步步提示查询AIS评分和诊断、同时计算10种常用创伤评分、数据资料随意组合查询、结果导出和打印等。结论：该软件资料录入简捷方便，计算简单准确，资料查询筛选方便为创伤临床医师提供了一种科学、便捷、高效的工具．     

Primary care. Score draw

Many primary care trusts missed targets for increasing the number of problem drug users in treatment. Data collection problems were a major contributing factor to missed targets. Training more GPs to provide drug treatment is the best way to increase treatment and meet future goals.     

快速急性生理评分与快速急诊内科评分对急诊危重病人预后的临床意义

目的探讨快速急性生理评分(RAPS)与快速急诊内科评分(REMS)对预测急诊危重症病人的预后的临床意义。方法回顾分析急诊抢救室收治的169例急危重症病人并进行RAPS与REMS评分,比较存活组与死亡组之间两种评分的分值。结果随着REMS评分或RAPS评分分值的增加,病人病死率明显增加(均P<0.05)。结论 REMS作为一种简单的评分系统,能够初步预测急诊危重病人的预后,具有一定的临床应用价值。     

Evaluating Community-Based Translational Interventions Using Historical Controls: Propensity Score vs. Disease Risk Score Approach

Many community-based translations of evidence-based interventions are designed as one-arm studies due to ethical and other considerations. Evaluating the impacts of such programs is challenging. Here, we examine the effectiveness of the lifestyle intervention implemented by the Special Diabetes Program for Indians Diabetes Prevention (SDPI-DP) demonstration project, a translational lifestyle intervention among American Indian and Alaska Native communities. Data from the landmark Diabetes Prevention Program placebo group was used as a historical control. We compared the use of propensity score (PS) and disease risk score (DRS) matching to adjust for potential confounder imbalance between groups. The unadjusted hazard ratio (HR) for diabetes risk was 0.35 for SDPI-DP lifestyle intervention vs. control. However, when relevant diabetes risk factors were considered, the adjusted HR estimates were attenuated toward 1, ranging from 0.56 (95% CI 0.44–0.71) to 0.69 (95% CI 0.56–0.96). The differences in estimated HRs using the PS and DRS approaches were relatively small but DRS matching resulted in more participants being matched and smaller standard errors of effect estimates. Carefully employed, publicly available randomized clinical trial data can be used as a historical control to evaluate the intervention effectiveness of one-arm community translational initiatives. It is critical to use a proper statistical method to balance the distributions of potential confounders between comparison groups in this kind of evaluations.