帕金森病患者认知功能障碍的相关因素分析及护理干预

目的 了解帕金森病患者认知功能障碍的相关因素,提出护理干预措施.方法采用简明精神状态量表、统一帕金森病评定量表Ⅲ、Hoehn-Yahr分级量表、汉密尔顿抑郁量表,分别评价患者认知功能、帕金森病严重度以及情绪状态.结果 60例患者认知功能障碍的发生率为46.7%(28/60);多元Logistic回归分析显示,认知功能障碍与年龄、性别、统一帕金森病评定量表Ⅲ评分相关.结论 帕金森病认知功能障碍发生率较高,主要影响因素是年龄、性别及运动功能,进行相关训练以减缓进程.     

渐进式康复干预结合经颅磁治疗对帕金森病患者睡眠障碍及负性情绪的影响

目的:探讨渐进式康复干预结合经颅磁治疗对帕金森病患者睡眠障碍和负性情绪的影响。方法:选取2016年4月1日～2020年10月1日收治的86例帕金森病患者,将奇数号43例作为对照组,进行常规康复护理;将偶数号43例作为观察组,进行渐进式康复干预结合经颅磁治疗。比较两组睡眠障碍[采用帕金森病睡眠量表(PDSS)、失眠严重程度指数(ISI)]、情绪状况[采用正负性情绪量表(PANAS),包括正性情绪(PA)和负性情绪(PN)]及症状表现[采用帕金森病综合评分量表(UPDRS)]。结果:干预后,观察组PDSS、ISI、PA、PN、UPDRS评分均优于对照组(P0.01)。结论:对帕金森病患者开展渐进式康复干预结合经颅磁治疗,能有效缓解患者睡眠障碍和负性情绪,从而改善临床症状。     

帕金森病患者睡眠障碍研究进展

目的介绍帕金森病患者睡眠障碍相关研究,为进一步制定干预措施提供参考。方法检索数据库,回顾文献,对帕金森病患者睡眠障碍情况进行概述,并归纳和总结其测评工具、影响因素、负性影响以及干预措施。结果当前成熟量表用于测评帕金森病患者的睡眠,有帕金森病睡眠量表、Epworh嗜睡量表、匹兹堡睡眠质量指数、RBD筛查量表。帕金森病患者睡眠障碍的影响因素主要有帕金森病病情严重程度、夜间运动症状、夜间非运动症状、药物使用、合并原发性睡眠障碍,且各因素之间存在交互作用。睡眠障碍严重影响患者的情绪状态和生存质量,改善帕金森病患者睡眠障碍的措施主要包括药物治疗和非药物治疗,非药物治疗包括运动疗法、认知行为干预、光线疗法、针灸疗法等。结论睡眠障碍是帕金森病患者最常见的非运动症状之一,其发生率较高,给患者带来了各种各样的负性影响。需根据帕金森病患者个体化情况、采取对应的干预措施,改善帕金森病患者睡眠情况。     

NICU患者情绪障碍的干预

对NICU患者可能出现的各种情绪障碍的影响因素进行分析,并提出相应的护理干预, 以减轻患者情绪障碍发生的频次和严重程度,促进患者康复.     

帕金森病患者伴行为精神症状的护理研究进展

帕金森病(PD)患者可能出现睡眠障碍、自主神经功能障碍、认知能力减退以及焦虑、抑郁等神经精神症状,对患者身体健康和生活质量产生不利影响。当前,PD患者伴行为精神症状主要采取药物治疗和护理干预相结合治疗,改善患者症状,延长患者生命,适当护理不但可以提高药物疗效,还可以增加患者治疗自信心,保持良好的情绪状态,从而提高身体对疾病的抵抗力和恢复能力。本文就PD的精神症状表现及护理等方面的研究进展作一综述,为临床提供参考意义。     

护理干预对出院后帕金森病后抑郁障碍的疗效观察

目的 探讨护理干预对出院后帕金森病患者抑郁障碍的作用及影响.方法 帕金森病后抑郁障碍出院患者92例,随机分为观察组和对照组各46例.对照组出院后按常规定期复查,观察组在此基础上,由责任护士对家属及照顾者进行护理培训,并以定期和电话访问的形式进行心理干预和康复指导.干预前后,所有患者分别评定疗效和生存质量.结果 出院后采用相应护理干预措施,帕金森病患者抑郁障碍病情减轻,生存质量得到显著提高(P＜0.05).结论 采取出院后护理干预措施,能有效改善帕金森病后抑郁障碍症状,提高患者的生存质量.     

护理干预对出院后帕金森病后抑郁障碍的疗效观察

目的 探讨护理干预对出院后帕金森病患者抑郁障碍的作用及影响.方法 帕金森病后抑郁障碍出院患者92例,随机分为观察组和对照组各46例.对照组出院后按常规定期复查,观察组在此基础上,由责任护士对家属及照顾者进行护理培训,并以定期和电话访问的形式进行心理干预和康复指导.干预前后,所有患者分别评定疗效和生存质量.结果 出院后采用相应护理干预措施,帕金森病患者抑郁障碍病情减轻,生存质量得到显著提高(P＜0.05).结论 采取出院后护理干预措施,能有效改善帕金森病后抑郁障碍症状,提高患者的生存质量.     

护理干预对出院后帕金森病后抑郁障碍的疗效观察

目的 探讨护理干预对出院后帕金森病患者抑郁障碍的作用及影响.方法 帕金森病后抑郁障碍出院患者92例,随机分为观察组和对照组各46例.对照组出院后按常规定期复查,观察组在此基础上,由责任护士对家属及照顾者进行护理培训,并以定期和电话访问的形式进行心理干预和康复指导.干预前后,所有患者分别评定疗效和生存质量.结果 出院后采用相应护理干预措施,帕金森病患者抑郁障碍病情减轻,生存质量得到显著提高(P＜0.05).结论 采取出院后护理干预措施,能有效改善帕金森病后抑郁障碍症状,提高患者的生存质量.     

帕金森病的护理评估与干预

帕金森病,又称震颤麻痹,是由于黑质变性,引起纹状体中乙酰胆碱与多巴胺的功能失去平衡而发病。临床上主要表现为震颤、强直、运动障碍以及自主神经障碍等症状。由于其症状随着病程的延长而逐渐加重,最终常导致患者肌肉严重强直,生活难以自理,给广大患者晚年生活带来了无尽的痛苦。在治疗疾病的过程中,若能正确的评估由疾病所引起的危险因素,并及时采取恰当的护理干预措施,就可以使患者的消极功能结果转化为积极功能结果[1],从而提高患者生活质量。本文就帕金森病的护理评估与干预措施进行探讨。1护理评估1.1安全评估由于帕金森病患者往往伴随运动障碍与平衡障碍的症状,这就使其生活自理能力随病情的进展而逐渐下降,     

住院老年脑梗死患者抑郁情绪调查及心理护理干预

目的对住院老年脑梗死患者抑郁情绪的状况进行调查,并探讨心理护理干预措施的疗效。方法采用问卷方法调查住院老年脑梗死患者抑郁情绪及主要相关因素;通过筛选确诊患有抑郁情绪患者78例,随机分为两组,对照组患者进行常规护理,干预组患者在常规护理基础上采取心理护理干预,在护理干预3周后比较两组患者临床疗效及抑郁自评量表（SDS）评分。结果住院老年脑梗死患者抑郁情绪主要相关原因有新发的躯体疾病、生活能力下降、自尊障碍、孤独心理及经济负担等;护理干预后两组患者临床疗效及SDS评分比较,差异有统计学意义（P〈0．05）。结论抑郁情绪是住院老年脑梗死患者常见的负性心理问题,影响了患者躯体疾病的恢复。采取相应的心理护理干预措施能改善患者的抑郁情绪,提高治疗效果,促进康复。     

冥想训练结合音乐治疗对帕金森病患者睡眠障碍的影响效果研究

目的 探讨冥想训练结合音乐疗法对帕金森病患者睡眠障碍的影响效果。方法 采取便利抽样方法对2018年1月-2019年6月50例帕金森病伴有睡眠障碍患者进行研究,利用问卷星平台收集资料,患者入院24小时内采用PD睡眠量表（PDSS）、39项帕金森病生存质量（PD-Q39）量表进行评估,在常规护理基础上分步骤实施冥想训练和音乐治疗,至21天再次评估,比较患者干预前后2种量表评分值变化。结果 50例PD患者均有睡眠障碍,发生率高,干预前后PDSS、 PDQ-39评分值有差异,具统计学意义（P＜0.05）。结论 对伴有睡眠障碍的帕金森病患者,冥想训练结合音乐疗法可显著改善患者睡眠障碍症状,提高睡眠质量,从而促进其日常生活能力和生活质量的提高。     

Effectiveness of multidisciplinary interventions to improve the quality of life for people with Parkinson's disease: A systematic review

Aims

To conduct a systematic review and critically evaluate the literature on the effectiveness of multidisciplinary interventions to improve quality of life for people with Parkinson's disease.

Methods

An electronic search of the following publication databases was performed for records from 1995 to 2011: CINAHL PLUS (EBSCO), Joanna Briggs Institute, Pubmed, Web of Science (ISI), psycINFO, Scopus and Cochrane library. The keywords used were Parkinson's disease, nursing, allied health, doctor, intervention, quality of life, rehabilitation, multidisciplinary team and their various combinations. Key terms were matched to MeSH subject headings and exploded where relevant to include all subheadings and related terms to each key term used. 1808 articles were initially identified based on our selection criteria and the reference list of these articles was hand searched. Nine studies were included after this sifting process and critiqued by two reviewers.

Results

Three randomised controlled trials and 6 non-randomised cohort studies were included. For these studies the level of evidence ranged from the Scottish Intercollegiate Network (SIGN) level of 1- to 2-. The outcome measures assessed were heterogeneous, including measures of disability of disease, stage of disease and various quality of life measures.

Conclusion

The evidence quantifying positive and sustained effects of multidisciplinary interventions to improve quality of life for people with Parkinson's disease is inconclusive. There has been relative lack of controlled experimentation to quantify therapy outcomes. The studies reviewed were varied and lacked long-term follow-up to quantify retention of the intervention. It is recommended that interventions to improve quality of life are tested in randomised controlled trials using standardised outcome measures, adequately powered samples and longer follow-up periods to assess intervention sustainability.     

太极拳运动对帕金森病患者认知功能及健康相关生活质量的影响

目的:探讨太极拳运动对轻度认知障碍帕金森病患者认知功能和健康相关生活质量的影响。方法:将52例轻度认知障碍帕金森病患者随机分为干预组28例和对照组24例。对照组仅接受常规药物治疗和运动建议,干预组在此基础上进行24式杨氏太极拳训练。干预前后采用蒙特利尔认知评估量表(Mo CA)和39项帕金森病生活质量问卷(PDQ-39)进行评定。结果:干预16周后,干预组Mo CA评分较干预前明显提高(P0.05),PDQ-39评分明显降低(P0.05),对照组无显著改变。干预后,干预组Mo CA评分明显高于对照组(P0.05),PDQ-39评分明显低于对照组(P0.05)。结论:太极拳运动对轻度认知障碍帕金森病患者改善认知功能和提高生活质量具有积极意义。     

护理干预对老年慢性阻塞性肺疾病患者用氧效果影响

目的探讨护理干预对老年慢性阻塞性肺疾病患者用氧治疗效果。方法选取本院呼吸科收治慢性阻塞性肺疾病(COPD)老年患者125例,根据护理方法不同分为观察组和对照组,给予相应护理后比较2组患者满意度,同时分析影响护理干预的相关影响因素。结果观察组患者护理满意程度高于对照组;病程、合并症、不良情绪、机械损伤4项为影响护理干预老年慢性阻塞性肺病患者用氧效果的相关风险因素。结论老年慢性阻塞性肺疾病采取护理干预后能提高用氧治疗效果,改善患者治疗期间生存质量,同时应根据患者情况对认知和依从性进行纠正。     

心理干预在帕金森病患者治疗中的应用及效果观察

目的:探讨心理干预在帕金森病患者治疗中的应用方法及临床效果。方法:将60例帕金森病患者随机分为干预组和对照组各30例,对照组给予左旋多巴等药物治疗及基础护理,干预组在此基础上实施心理干预,疗程为24周。比较两组患者干预前后汉密尔顿抑郁量表(HAMD)和生活质量量表(PDQ-39)评分情况。结果:两组患者干预后HAMD和PDQ-39评分均优于干预前(P<0.05),干预组干预后HAMD和PDQ-39评分优于对照组(P<0.05)。结论:心理干预可缓解帕金森病患者抑郁情绪,提高其生活质量,值得临床推广应用。     

基于中文版MDADI的康复治疗对帕金森病合并吞咽困难患者康复的影响

目的:探讨基于中文版安德森吞咽困难量表(MDADI)的康复治疗对帕金森病合并吞咽困难患者营养和神经功能康复的影响。方法:将帕金森病合并吞咽困难患者72例随机分为研究组和对照组各36例。对照组常规行饮食干预,研究组根据MDADI总量表得分进行饮食干预。比较2组治疗前后营养指标水平、吞咽困难分级及Barthel指数。结果:治疗2周后,2组吞咽困难程度均较治疗前明显改善(P0.05),且观察组优于对照组(P0.05)。治疗后,2组血清血红蛋白、白蛋白水平、血脂水平较治疗前均明显提高(均P0.05),且研究组高于对照组(均P0.05)。治疗后,2组Barthel指数均较治疗前明显提高(均P0.05),且观察组高于对照组(P0.05)。结论:基于中文版MDADI的饮食干预有助于改善帕金森病合并吞咽困难的营养状况和神经功能。     

Prospective cohort study of type 2 diabetes and the risk of Parkinson's disease

OBJECTIVE—To evaluate the association between type 2 diabetes and newly reported Parkinson''s disease.RESEARCH DESIGN AND METHODS—Our study included 21,841 participants in the Physicians’ Health Study, a cohort of U.S. male physicians. Diabetes and Parkinson''s disease were self-reported via questionnaire. We used time-varying Cox regression to calculate adjusted relative risk (RR) for Parkinson''s disease.RESULTS—Over 23 years, 556 individuals with Parkinson''s disease were identified. Subjects with diabetes had an increased Parkinson''s disease risk (multivariable-adjusted RR 1.34 [95% CI 1.01–1.77]). The association remained significant after exclusion of those with known vascular disease. The diagnosis of diabetes was clustered around the diagnosis of Parkinson''s disease and was more apparent among men with short diabetes duration and those without complications from diabetes.CONCLUSIONS—Results of this large prospective study in men do not suggest that diabetes is a preceding risk factor for Parkinson''s disease. Whether the positive association may be explained by ascertainment bias or a common underlying biological mechanism remains to be established.A positive association between diabetes and Parkinson''s disease has been found in some epidemiologic studies (1–4) but not in others (5–7). Diabetes might promote Parkinson''s disease through various pathways, including suppression of central dopamine levels, inflammation, oxidative stress, and cerebrovascular disease. We evaluated the relationship between type 2 diabetes and Parkinson''s disease in detail in a large prospective cohort.     

Rehabilitation in atypical neurological disease: a case report

The rehabilitative management of neurological diseases such as Parkinson''s disease (PD) and multiple sclerosis (MS) is complex; drug treatment alone is generally insufficient. Multidisciplinary rehabilitation programs can fundamentally contribute to the management of neurological patients and have important positive repercussions on their quality of life. We describe the unusual case of a 70-year-old man with a diagnosis of both MS and PD, who presented with motor and cognitive impairments. He was admitted to our institute for a rehabilitation program. Motor, cognitive, and linguistic abilities were evaluated at admission and 60 days after the multidisciplinary rehabilitation, which included motor exercises, speech therapy, and cognitive interventions. The multidisciplinary rehabilitation improved the patient’s functional status and exerted positive effects on his mood, autonomy in activities of daily life, perception of quality of life, cognitive performance, and speech skills. It is important to find new methods for treating neurological patients to better manage the social and economic implications of neurological disease, and to ensure a long course of treatment and rehabilitation.