肾病综合征患者服药信念与服药依从性的调查

目的评估肾病综合征患者的服药信念,并探讨患者的服药信念与服药依从性的相关性。方法选取肾病综合征患者97例,采用服药信念和Morisky服药依从性问卷进行调查。结果患者服药依从性得分为6.71±1.54,处于中等水平;患者的服药信念与服药依从性显著相关(P<0.05)。结论肾病综合征患者的服药信念与服药依从性相关,医护人员可通过了解患者的服药信念,从而帮助选择更合适的方法以提高患者服药依从性。     

类风湿关节炎患者用药依从性的相关研究进展

近年来,关于类风湿关节炎的治疗方法不断革新,类风湿关节炎的缓解率也不断上升,但是,类风湿关节炎患者在治疗过程中仍然存在问题,长期用药依从率低是不容忽视的一点.类风湿关节炎患者用药特点为治疗药物种类多、用药方案复杂、调整频繁,很多研究通过用药依从性的测评发现类风湿关节炎患者用药依从性不高,可通过教育、认知行为、多成分干预...     

健康教育对类风湿患者应用改善病情的抗风湿药物依从性的影响

目的:探讨健康教育对类风湿关节炎(RA)患者应用改善病情的抗风湿药物依从性的影响.方法:将104例RA患者随机分成实验组和对照组,对照组患者住院时给予常规护理,实验组患者住院时、出院后进行持续性的、有计划、有目的、有组织的健康教育,对两组RA患者从住院时计起1、6及12个月分别进行治疗依从性评价.结果:应用改善病情的抗风湿药物治疗1个月,两组患者的依从性差异无统计学意义(P＞0.05),改善病情的抗风湿药物治疗6、12个月差异有统计学意义(均P＜0.05).结论:针对性健康教育能提高RA患者应用DMARDs药物治疗的依从性.     

心脏移植免疫抑制药物服药依从性与结局的研究

目的 探讨心脏移植受者免疫抑制药物服药依从性与服药信念和患者结局间的关系。方法 采用便利抽样法,选取118例心脏移植受者,使用一般情况调查表、免疫抑制药物依从性Basel评估量表（Basel Assessment of Adherence with Immunosuppressive medication Scale, BAASIS）、服药信念量表（Beliefs about Medication Questionnaire, BMQ）进行调查。结果 58.62%心脏移植受者术后服药依从性差,服药信念各维度得分：药物有害（11.12±2.83）分、药物过度使用（10.07±2.62）分、服药必要性（18.19±2.43）分、服药顾虑（16.21±3.89）分,服药必要性与顾虑差值得分为（1.98±5.03）分。服药依从性与药物过度使用、服药顾虑、服药必要性与顾虑差值的得分比较,差异有统计学意义（P <0.05）。服药依从性与排斥反应、非计划性入院成正相关,与是否发生术后并发症成负相关,差异有统计学意义（P <0.05）。结论 心脏移植受者服药依从性较差,服药依从性与服药信念...     

家庭关怀度与服药信念在老年缺血性卒中患者药物素养和服药依从性之间的中介作用

目的 探究家庭关怀度、服药信念在老年缺血性卒中患者药物素养与服药依从性之间的中介效应。方法 便利抽取316例老年缺血性卒中患者为调查对象,采用药物素养调查问卷、服药信念特异性问卷、家庭APGAR问卷、Morisky服药依从性量表进行问卷调查,通过分层回归和Bootstrap法进行中介效应分析。结果 老年缺血性卒中患者药物素养得分为（5.03±1.60）分,家庭关怀度得分为7.00（4.00,10.00）分,服药信念得分为9.00（3.00,14.00）分,服药依从性得分为（6.18±1.65）分。药物素养、服药信念、家庭关怀度与老年缺血性卒中患者服药依从性呈正相关（均P＜0.05）;家庭关怀度、服药信念在老年缺血性卒中患者药物素养和服药依从性之间存在链式中介作用（β=0.177,P＜0.05）。结论 药物素养可直接或间接通过服药信念和家庭关怀度影响老年缺血性卒中患者服药依从性,可通过提高老年缺血性卒中患者药物素养、增强服药信念及鼓励家庭成员支持患者,以改善患者服药依从行为。     

乳腺癌内分泌治疗患者服药信念现状及影响因素分析

目的探讨乳腺癌内分泌治疗患者对服药信念现状及其影响因素,为提高患者服药依从性提供参考。方法采用一般资料调查表和服药信念量表(BMQ)对192例辅助内分泌治疗的乳腺癌患者进行现况调查。结果乳腺癌患者服药信念得分为(1.57±0.43)分,各维度中必要性得分13.78±2.46、服药顾虑得分12.21±2.31、药物有害得分11.69±1.54、药物过度使用得分9.07±1.33分。药物有害信念、对内分泌治疗的了解程度、药物种类、药物不良反应、服药时间、化疗是乳腺癌患者服药信念的影响因素(P0.05,P0.01),可解释24.4%的总变异。结论乳腺癌内分泌治疗患者服药信念处于低水平,医护人员应根据患者服药信念水平及影响因素采用针对性的干预措施,从而改善患者的服药信念,提高服药依从性。     

类风湿关节炎患者功能锻炼的现况调查

目的 了解类风湿关节炎患者关节功能锻炼的执行情况,为开展功能锻炼健康教育提供依据.方法 选取门诊随诊或住院治疗的类风湿关节炎患者83例,采用自行设计的调查表进行问卷调查.结果 54.22％的患者从未进行过功能锻炼;在有锻炼经历的患者中55.26％没有人指导,47.37％没有开始锻炼的具体时间,42.11％每日锻炼时间少于1 5 min,只有23.68％每天坚持锻炼.结论 类风湿关节炎患者较少实施功能锻炼.在患病早期开展系统、科学的健康教育,针对不同人群设计个性化教育方案,是成功普及类风湿关节炎功能锻炼的前提.     

类风湿关节炎患者骨质疏松健康教育相关 因素调查分析

目的 对类风湿关节炎患者进行骨质疏松健康教育相关因素调查分析,以指导临床医师和患者加强类风湿关节炎骨质疏松发生的防治.方法 采用统一问卷表,对在海阳市第三人民医院2011年6月至12月门诊就医的112名类风湿关节炎患者,随机按问卷项全面询问,并完成该问卷表的填写,分析相关因素,将数据用SPSS13.0统计软件进行处理分析.结果 知道年龄与骨质疏松相关者60.71%,性别与骨质疏松相关者20.54%.知道吸烟、过量饮酒、饮用咖啡和喝浓茶与骨质疏松相关者8.93%.知道绝经与骨质疏松相关者60.71%,少或不锻炼与骨质疏松相关者32.14%,钙摄入不足与骨质疏松相关者52.68%,接受日照少与骨质疏松相关者47.32%.知道应用激素与骨质疏松相关者73.21%,知道类风湿关节炎能引起骨质疏松者22.32%.接受过骨健康公共教育者5.36%,生活中注意钙营养的摄入者49.11%,不嗜烟酗酒者78.57%(24例有嗜烟酗酒习惯的均为男性),少喝浓咖啡者93.75%,接受阳光照射者25.89%,加强运动者78.57%.用药物补钙者33.93%,用保健品补钙者43.75%.定期进行骨密度和骨质量的监测者18.75%.类风湿关节炎患者对引起骨质疏松危险因素的认知率和在建立骨健康生活方式方面,文化程度高、经济收入好的明显优于文化程度低、经济收入差的,P＜0.05.结论 类风湿关节炎患者对骨质疏松相关知识知晓率很低,加强类风湿关节炎患者骨质疏松健康教育,让患者了解骨质疏松的重要危险因素,引导患者自愿放弃不良行为和生活方式,掌握骨质疏松的干预要点,对类风湿关节炎患者骨质疏松的治疗及预防骨折的发生有重要作用.     

精神分裂症患者服药依从性与家庭环境的相关性研究

目的 了解精神分裂症复发患者的服药依从性状况,并分析服药依从性与家庭环境的相关性.方法 对102例复发入院的精神分裂症患者进行问卷调查.调查表包括一般资料、家庭环境量表和服药依从性问卷.结果 患者服药依从性得分为(12.03±3.19)分,其中约50%患者有不按时服药、自行停药、只在感觉不舒服时才服药等行为,服药依从性...     

Septic arthritis in patients with rheumatoid arthritis

There is an increasing number of rheumatoid patients who get septic arthritis. Chronic use of steroids is one of the important predisposing factors. The clinical picture of septic arthritis is different in immunocompromised patients like patients with rheumatoid arthritis. The diagnosis and management are discussed in this review article.     

Renal involvement in patients with rheumatoid arthritis

In rheumatoid arthritis (RA) kidney is commonly affected organ with clinical presentation characterised by proteinuria (often nephrotic range) and microhematuria followed by chronic renal failure. This condition is well recognized as a rheumatoid nephropathy (rheumatoid glomerulonephritis), which is mediated by an immunological inflammation and by nephrotoxic effects of numerous drugs usually used in rheumatoid arthiritis treatment, such as NSAID, DMARD. In the patohistological examination various kinds of associated renal lesions could be seen. The most often are amyloidosis, glomerulonephritis, interstitial nephritis. In this study, we presented 15 patients, 10 women and 5 men, mean age of 60.2 with average rheumatoid arthritis duration of 19.4 years and signs of rheumatoid nephropathy. In all patients renal biopsy was performed with frequency of histopathological findings as follows: amyloidosis in 5 patients, IgA nephropathy in 3 patients, FSGS in 3 patients, mesangial proliferative glomerulonephritis in 3 patients, minimal change disease, pauci-immune glomerulonephritis and thin membrane disease in 1 patient. In all patients (except patient with thin membrane nephropathy) we started immunossuppresive therapy with glucocorticoids in combination with cyclophosphamide or cyclosporin or azatioprine. In conclusion, in all patients with rheumatoid arthritis, parameters of renal function should be monitored and in the case of patologic results, renal biopsy should be be performed. In the treatment of RA patients with related renal disorder, suspected causal drug should be removed from the treatment and specific immunosuppressive therapy initiated.     

Intubation difficulties in patients with rheumatoid arthritis

Background : Fibreoptic intubation has been suggested to be the best method to manage a compromised airway. This retrospective study was designed to compare endotracheal intubation with the help of a rigid laryngoscope or a fibrescope in patients with rheumatoid arthritis.
Methods : Intubation difficulties with the laryngoscope and the fibrescope in patients with rheumatoid arthritis were investigated during a period of five and a half years. The anaesthesia records were used for analysis. The patients were divided into two groups (group I with 41 patients and group II with 37 patients) reflecting the change in the routine airway management in patients with rheumatoid arthritis in our hospital from the beginning of 1993. Before that time the patients were usually intubated orotracheally under general anaesthesia, but since 1993 rheumatoid patients with anticipated difficulties in endotracheal intubation have been preferably intubated fibreoptically awake under sedation and topical anaesthesia with a fibrescope.
Results : Major difficulties in endotracheal intubations were encountered in 13% of patients in group I and in 8% in group II. On two occasions in group I tracheostomy was needed. In one of these patients, emergency tracheostomy was performed. In the latter group, the main reason for prolonged fibreoptic intubations was lack of experience.
Conclusion : The introduction of fibreoptic intubation technique has had a favourable influence on the safety in the airway management of surgical patients with rheumatoid arthritis.     

Occipitocervical fusion in patients with rheumatoid arthritis

Instability and deformity of the cervical spine caused by rheumatoid arthritis is a well known entity. Operative intervention is indicated for patients with progressive deformity and when pain is resistant to conservative treatment. In a series of 39 patients who underwent posterior occipitocervical fusion with a Y plate, 22 patients were observed clinically and radiographically at average 41.5 months after surgery. In 35 of the 39 patients the main indication for surgery was pain, and in 30 of the 39 patients additional neurologic deficit (radiculopathy or myelopathy) was present. Thirty-one of the 39 patients had atlantoaxial instability. The atlantoaxial instability was associated with cranial migration of the dens in 19 patients. According to the classification of Conaty and Mongan 77.3% patients had satisfactory results and 22.7% had unsatisfactory results. Of the 30 patients with neurologic deficit, nine patients had a significant improvement. No patient had a worse result after surgery. Solid fusion was seen in all 22 patients at followup. Seven patients experienced complications directly related to the surgical procedure. Posterior fixation combined with anterior decompression in the presence of spinal stenosis represents a useful and safe method to treat instability and deformity caused by rheumatoid arthritis. Early surgical procedures may reduce the complication rate.