肠造口患者电话咨询数据的分析及对策

目的了解肠造口患者电话咨询情况,为完善健康教育内容和方法提供依据。方法开通24 h电话咨询热线,由专人负责接受肠造口患者主动电话咨询,统计分析190例(300频次)电话咨询患者的年龄、造口时间、咨询内容等项目。结果 68.4%电话咨询为61~80岁肠造口患者;术后1年内患者电话咨询频次较高(占80.0%)。咨询内容主要为造口用品信息、造口周围皮肤、排泄物渗漏、心理和日常生活问题。结论肠造口患者出院后有较多护理问题需要解决。根据患者电话咨询常见问题,充实健康教育内容,采取多种形式延伸护理措施对提高肠造口患者相关知识和技能具有一定促进作用。     

101例肠造口患者健康教育需求调查分析

目的 了解肠造口患者的健康教育需求,以便进行有针对性的健康教育,提高患者生活质量.方法 采用便利抽样方法,对101例肠造口患者进行健康教育需求方式、来源及内容进行调查,采用描述性统计分析.结果 肠造口患者住院期间健康教育方式以系统讲解(76.2%)为主;出院后健康教育方式以电话回访(89.1%)为主;获取知识对象以造口治疗师(84.2%)为主;专科知识需求以造口袋更换技巧(93.1%)、造口并发症的预防(92.1%)为主;生活方面需求以饮食方面(97.0%)为主.结论 患者对造口护理健康教育需求较高,健康教育方式及来源多样,护理人员需制定针对性、个体化的健康教育计划,满足肠造口患者的健康教育,提高其生活质量.     

慢性心力衰竭患者健康教育需求的调查分析

目的通过调查了解慢性心力衰竭患者对健康教育的内容及方法,以便更好地开展有针对性的健康教育。方法选择2014年1—6月在复旦大学附属华山医院静安分院就诊的慢性心力衰竭患者102例,采用自制调查问卷了解患者在入院期间健康教育的方式选择和内容,以及出院后健康教育的方式和内容。结果 102例慢性心力衰竭患者在入院期间最想了解的健康教育内容是发病原因和治疗方法等6项内容;出院后最想了解的健康教育内容是急救常识、服药注意事项和预防疾病复发措施等6项内容。患者入院期间对健康教育方式首选医务人员个别指导,占90.12%。患者出院后对健康教育方式首选电话咨询,占99.02%。结论了解慢性心力衰竭患者健康教育需求,确定健康教育的方式及内容,有助于制定个性化方案,才能有效的提高患者自理能力,降低疾病复发,改善生活质量。     

结核病专科咨询内容结构分析与对策

目的 分析结核病专科咨询内容结构,了解患者的健康需求,为完善现有的专科健康教育内容,制定个性化健康教育计划提供依据.方法 对门诊咨询和人工电话咨询资料2 877例次进行整理、归类和分析.结果 求询者以18～60岁青壮年、外省市、初中文化、已婚、初诊、工人、肺结核居多;求询原因以担心家人被传染结核病为主,占31.62%;求询者结核病知识主要来源于网络,占54.01%;求询内容分布：知识类占67.43%,信息类占13.1%,服务类占13.45%,心理类占6.01%;求询者心理问题主要为恐惧,占46.76%;98.75%的问题可通过咨询直接解决.结论 对咨询资料进行分析,开展咨询服务,有助于完善健康教育内容,开展护理延伸服务,提高对患者的治疗效果.     

产妇出院后电话咨询内容分析

目的了解产妇出院后需要进一步解决的问题,逐步完善现有的健康教育内容.方法将230位出院产妇的电话咨询内容分类、统计.结果电话咨询257次,咨询内容从多到少依次为:新生儿喂养,产妇乳房护理,新生儿大便观察,新生儿脐部护理,新生儿哭闹及产妇恶露的观察.结论产妇出院后需要解决的问题较多,应加强产妇住院期间的健康教育,并重视对产妇出院后的随访.     

家庭访视对直肠癌腹壁造瘘口患者自我护理行为的影响

目的 了解直肠癌腹壁造瘘口患者出院后存在的家庭和社会问题及家庭访视对问题解决的效果.方法 对36例直肠癌腹壁造瘘口出院患者进行家庭访视,评估患者健康情况及对相关知识,相关技能知晓情况,给予健康教育及心理治疗.结果 患者出院后第一次家庭访视与经过4个月家庭访视及健康教育效果比较,各项护理指标均有显著改善(P<0.05).结论 对出院后直肠癌造瘘口患者开展家庭访视和健康教育,可促进康复并提高患者自我护理能力,减少并发症的发生率,从而提高患者的生活质量.     

腹腔镜下可调控性胃绑带术病人的健康教育需求调查

[目的]了解腹腔镜下可调控性胃绑带术病人的健康教育需求,有针对性地做好病人的健康指导。[方法]对64例行该手术的病人发放自行设计的调查问卷,重点了解入院时需求内容,住院期间获得健康教育方式的需求、围术期需求内容以及出院后咨询方式等。[结果]入院时病人主要需求内容是了解手术效果和手术对健康的影响,在围术期病人对健康教育的需求内容多样化,在获得健康教育知识途径方面,住院期间病人最希望与已经手术的病人交流经验,而出院后半数以上病人选择电话和网络咨询方式。[结论]腹腔镜下可调控性胃绑带术病人的健康教育内容需求具有阶段性,不同时期病人选择的教育方式各异,护士要把握时机有针对性地开展形式多样的健康教育,而护士及时更新知识、扩大知识范畴对满足病人的健康教育需求十分重要。     

肠造口患者健康教育需求调查

目的:了解肠造口患者的健康教育需求,更好地为肠造口患者开展健康教育提供依据。方法:根据临床所遇到的问题,自制问卷调查表,对80例肠造口患者在健康教育的内容、方法及对象的需求进行调查。结果:肠造口患者对健康教育的需求内容是多种多样的,需求率为45%～100%,对教育方法的需求以个别指导(95.00%)和健康教育处方(87.50%)为主,其他多种方法为辅。对实施教育者的需求特点为36例(45.00%)患者选择医师,首选护士者为28例(35.00%)。结论:肠造口患者对造口护理相关知识的健康教育需求非常强烈,且内容广泛,对健康教育方法的需求具有多样性的特点,护理人员应制定个体化的健康教育计划,在合适的时间、合适的场合,以合适的方法,传授合适的内容,使其接受有效的健康教育,提高生活质量。     

浅谈对造口患者回访工作的实践和体会

随着人们生活水平的不断提高，造口患者对生活质量的要求与期望也相应提高。患者不仅要求在住院期间能够得到良好的服务及生命保障，而且要求出院后也能有良好的全程服务及生活护理保障。我科坚持一切“以病人为中心”的人文关怀理念，以提高医院服务质量和信誉为出发点，自2007年7月开始开展了由经过培训的造口护士对出院后造口患者定期电话回访并适时上门访视的一系列全过程系统服务，了解造口患者出院后的心理状况、生活现状及造口情况，有针对性地进行进一步的健康指导，使患者得到适时的帮助，及时解决了造口患者家庭护理中遇到的困难，现报道如下。     

院外延续护理在社区肠造口患者中的应用

总结87例社区肠造口患者的院外延续护理.肠造口患者出院时建立健康档案,电话随访每周1次,上门随访每月1次,及时解决患者造口护理中存在的问题;每3月集中授课1次,每3月举办造口患者联谊会,以提高患者及家属对造口护理的认知水平.院外延续护理持续1年,患者的生活质量得到提高.     

电话回访对肝胆外科出院患者自我护理行为影响的研究

目的通过电话回访对肝胆外科出院患者进行健康教育,解决患者出院后存在的健康问题,以提高其自我护理能力,促进康复。方法建立患者健康档案,对出院后需要继续治疗或休息的患者进行电话回访式健康教育。于出院后1周开始对患者进行电话回访,持续一个月,根据患者的健康状况每周对患者进行1～2次健康教育,内容包括引流管护理、伤口护理、饮食休息指导等,对电话回访前和回访后患者的自我护理情况进行比较。结果经χ~2检验,回访前、后患者的自我护理能力的差异具有统计学意义(P<0.05)。结论电话回访式健康教育的开展体现了护理模式的转变,将医院健康教育工作延伸到出院患者的治疗康复过程中,能提高患者的自我护理能力,值得推广。     

施行糖尿病患者康复教育的临床意义

Background:Diabetes is a kind of chronically permanent disease.Management during hospitalization was insufficient.Now,health education is the important project in diabetes study.Patients' lifestyle ,attitude to condition and previous treatment showed obvious impact on diabetes control.Some investigators indicated patients had less knowledge about diabetes-related matters,and their self-health idea was unobvious.They rarely abided by physicians' demands.So,rehabilitative education is important for diabetes patients. Objective:To observe the therapeutic effect of rehabilitative education on diabetes patients. Unit:Department of Leader Health,Laiwu People's Hospital. Subjects:80 diabetes were recruited during July 1997 to July 2001.Among these patients,46 were males,34 were females aged 12～ 72(mean age:56.5).42 had high school education and others had middle school education. Intervention:Based on education project for diabetes developed by Endocrine Institute of Hunan Medical University,health education was conducted during hospitalization.After admission,《 Elementary knowledge about diabetes prevention and treatment》 was given to patients.Extensive education ways were used for diabetes patients and their family members.Patients can seek tele-medical directions with telephone or letters according to their demands. Patients were evaluated before and after education. Main prognosis indexes:Comprehensive condition for elementary knowledge about diabetes,fasting blood glucose and accordance behavior were evaluated. Result: (1)Elementary knowledge about diabetes was mastered by 26% patients before education and 80% after education.(2)Fasting blood glucose was (8.22± 0.80)mmol/L before education and (6.10± 0.50)mmol/L after education(P< 0.05).Follow-up showed no changes in fasting blood glucose after discharge.(3) Accordance rate of drugs uptake,diet control,activity intensity,detection of blood glucose and urinary glucose was 50% before education and 85% after education. Conclusion:Rehabilitative education can enhance patients' self regulation and self detection ability,delay development of complications.     

女大学生痛经健康教育需求的调查分析

[目的]了解女大学生痛经病人对健康教育的需求情况,以提高健康教育的效果。[方法]采用自行设计的调查问卷对126例门诊痛经女大学生进行健康教育需求调查。[结果]女大学生痛经病人对健康教育的需求较高;不同类别病人健康教育需求率总体差异无统计学意义;病人乐于接受的健康教育方式依次为医护人员讲解、QQ咨询、电话咨询以及健康知识讲座等;病人急于了解的健康教育内容依次为预防知识、合理饮食与注意事项以及发病原因等。[结论]女大学生痛经病人对健康教育的需求较高,通过对女大学生痛经病人健康教育内容和方式需求的分析,医护人员可有针对性地为病人提供科学的、有效的健康教育服务。     

专题口诀卡依托式宣教在肠造口老年患者造口袋更换中的应用

目的 观察专题口诀卡依托式宣教在肠造口老年患者造口袋更换中的应用效果。方法 选择2016年1月—2019年8月接受肠造口术的老年病例68例为研究样本,将收治于单号病室的34例老年病例设为对照组,收治于双号病室的34例老年病例设为观察组,对照组接受常规造口护理指导,观察组在此基础上加用专题口诀卡依托式宣教干预,比较2组造口袋更换知识掌握度、操作技能、操作时间及对教育方式认可度。结果 观察组老年肠造口病例干预后的造口袋更换知识掌握度、操作技能评分显著高于对照组(t=20.334,P<0.001;t=16.767,P<0.001),操作时间显著短于对照组(t=-18.558,P<0.001), 教育方式认可度评分显著高于对照组(P＜0.05)。结论 采用专题口诀卡依托式宣教对肠造口老年患者实施造口袋更换指导,对于其造口袋更换知识、技能均具备良好提升效应,提高了老年造口患者的生活质量,深受认可。     

老年结肠造口患者造口护理知识及行为的调查研究

目的探讨老年结肠造口患者造口护理知识、行为的现状及影响因素。方法利用自制调查问卷对2013年4月~10月在我院造口门诊就诊的100例老年结肠造口患者进行调查。结果老年结肠造口患者对知识的了解程度不高,对知识的需求较大,造口护理行为有待提高,知识掌握越充分,护理行为越好。造口时间1年、未参加培训的患者知识掌握情况及造口护理行为评分较造口时间≥1年、参加培训患者差,有显著性差异(P0.05)。结论老年结肠造口患者的造口护理行为较差,造口时间、培训与否是影响造口护理的重要因素。应着重改变现有的健康教育方式,根据老年结肠造口患者的特征开展健康教育。     

The impact of follow-up telephone calls to patients after hospitalization

We studied whether pharmacists involved in discharge planning can improve patient satisfaction and outcomes by providing telephone follow-up after hospital discharge. We conducted a randomized trial at the General Medical Service of an academic teaching hospital. We enrolled General Medical Service patients who received pharmacy-facilitated discharge from the hospital to home. The intervention consisted of a follow-up phone call by a pharmacist 2 days after discharge. During the phone call, pharmacists asked patients about their medications, including whether they obtained and understood how to take them. Two weeks after discharge, we mailed all patients a questionnaire to assess satisfaction with hospitalization and reviewed hospital records. Of the 1,958 patients discharged from the General Medical Service from August 1, 1998 to March 31, 1999, 221 patients consented to participate. We randomized 110 to the intervention group (phone call) and 111 to the control group (no phone call). Patients returned 145 (66%) surveys. More patients in the phone call than the no phone call group were satisfied with discharge medication instructions (86% vs. 61%, P = 0.007). The phone call allowed pharmacists to identify and resolve medication-related problems for 15 patients (19%). Twelve patients (15%) contacted by telephone reported new medical problems requiring referral to their inpatient team. Fewer patients from the phone call group returned to the emergency department within 30 days (10% phone call vs. 24% no phone call, P = 0.005). A follow-up phone call by a pharmacist involved in the hospital care of patients was associated with increased patient satisfaction, resolution of medication-related problems, and fewer return visits to the emergency department.     

Improving Self-Efficacy of Patients With a New Ostomy With Written Education Materials: A Quality Improvement Project

PurposeThe purpose of this quality improvement project was to determine if supplementing the current education process for new ostomates with standardized, health literate written education materials which are initiated preoperatively improves patient self-efficacy for management of their new ostomy.DesignA convenience sample of 25 patients undergoing new ostomy placement were selected to receive the written education materials. The project occurred in two outpatient clinics and an 874-bed hospital.MethodsPreoperative education by wound, ostomy, continence (WOC) nurses in the outpatient clinic was supplemented by the new health literate written education materials, and this education continued during the postoperative period before hospital discharge. Stoma self-efficacy was measured at three timepoints: pre- and posteducation in the outpatient clinic and before discharge from the hospital following surgery.FindingsMean total self-efficacy scores significantly increased from 27.32 (SD = 12.15, confidence intereval [CI] = 22.30, 32.34) pre-education in the clinic to 39.56 (SD = 9.26, CI = 35.74, 43.38) posteducation in the clinic (P = .000), and further increased to 47.20 (SD = 7.38, CI = 44.14, 50.25) at discharge from the hospital postsurgery (P = .0004).ConclusionsInitiating education preoperatively and supplementing it with standardized, health literate written education materials improved patients’ stoma self-efficacy. By improving self-efficacy, patients may be more effective in self-management of their ostomy and better prepared to care for themselves upon discharge from the hospital to prevent complications and improve outcomes.     

What do patients bring up in consultations? An observational study in general practice

Objective. The main aim of the study was to investigate how many and what kind of problems patients present in consultations with their general practitioner (GP). A secondary aim was to explore patients’ views on what is important in consultations. Design. Cross-sectional study including observation of unselected consultations with recording on a pre-designed scheme, and a brief questionnaire filled in by patients. Setting. Four general practices in Oslo, Norway. Subjects. A total of 201 patients in consultations and 177 patients waiting to see their GP. Main outcome measures. Number and characteristics of problems raised by patients, and whether the problems were handled by GPs during the ongoing consultation. Patients’ expectations for the consultation. Results. The mean number of problems raised was 2.6 (range 1–16), and when appointments for acute conditions were excluded, the mean number was 3.3. Somatic problems comprised about half of all problems, and in more than one-quarter of consultations a mental health issue was presented. Female sex and increasing age predicted an increasing number of problems raised. In one-quarter of encounters four or more problems were presented. The vast majority of problems were dealt with by the GPs during the ongoing consultation. “That I am able to address all the problems I have” was rated as highly important by patients. Conclusion. GPs deal with multiple and unrelated problems in daily consultations, which is highly valued by patients. Management of concurrent problems in brief encounters demands training and adequate working conditions, in order to sustain this core value of general practice.