血友病儿童家庭治疗现状调查

[目的]探讨血友病儿童家庭治疗现状。[方法]采用自行设计的血友病病人家庭治疗状况调查表对28例血友病患儿家属进行问卷调查。[结果]开展血友病家庭治疗的病人占调查者的28．57％，21例患儿的父母不愿将孩子的病情公开，患儿凝血因子使用量明显不足。[结论]为血友病患儿争取必要的医疗资源是提高其生活质量的关键。医护人员应为血友病家庭提供急需的培训和监管指导。     

血友病儿童家庭治疗现状调查

[目的]探讨血友病儿童家庭治疗现状。[方法]采用自行设计的血友病病人家庭治疗状况调查表对28例血友病患儿家属进行问卷调查。[结果]开展血友病家庭治疗的病人占调查者的28.57%,21例患儿的父母不愿将孩子的病情公开,患儿凝血因子使用量明显不足。[结论]为血友病患儿争取必要的医疗资源是提高其生活质量的关键。医护人员应为血友病家庭提供急需的培训和监管指导。     

国外血友病家庭治疗和护理管理现状

归纳了近年来国外家庭治疗和护理管理的主要进展,即国外家庭护理观点的演变、患者管理,分析了患者评估、资料管理、患者对血友病知识及对家庭治疗、护理和自我管理的需求.在此基础上,对我国血友病家庭治疗和护理的前景进行了展望.     

家庭治疗和护理行为干预模式在血友病患儿中的应用

目的探讨适合地方血友病诊疗中心开展的儿童血友病家庭治疗和护理行为的干预模式。方法由血友病护士和2～18岁的血友病患儿及其父母组成护理干预小组,针对儿童血友病家庭治疗和护理中存在的问题进行讨论和归纳,通过文献回顾和专家咨询,制定综合性护理干预措施,包括个体化凝血因子注射培训指导、血友病知识讲座、血友病患儿家庭联谊会、家庭治疗护理行为随访等,并于干预前后对儿童血友病家庭治疗和护理行为进行测评比较,判断干预效果。结果干预后血友病患儿家庭的治疗和护理行为的测评显示,22个具体行为中,19个行为明显改善,干预前后比较,差异有统计学意义（χ2值分别为59．88,36．47,96．30,13．57,34．67,55．06,55．06,21．85,22．69,45．69,39．33,68．25,11．99,35．39,35．39,17．24,81．51,85．75,13．57;P〈0．01）;“准确记录每一次出血及处置经过”由干预前的2例（3．85％）上升至干预后的48例（92．31％）,“按月向血友病护士报告出血及治疗护理信息”由干预前的5例（20％）上升至干预后的52例（100％）,干预前后比较,差异均有统计学意义（χ2值分别为81．51,85．75;P〈0．01）。结论综合性护理干预措施可以在改善儿童血友病家庭治疗和护理的行为的同时实现血友病诊疗中心对血友病患儿病例信息的有效管理,适合在我国地方血友病诊疗中心开展。     

广州地区29例血友病患儿家庭治疗及护理现状调查

目的了解广州地区血友病患儿家庭治疗与护理现状,提高家庭治疗与护理水平。方法对广州市血友病治疗中心登记在册的29例广州地区血友病患儿及其父母进行问卷调查,主要内容为患儿一般情况、2006年家庭治疗与护理现状及FISH评分（Functional Independence Score in Hemophilia）。结果只有少数血友病患儿开展凝血因子家庭注射,凝血因子使用量明显不足,治疗效果与血友病患儿家庭护理状况不佳、血友病患儿未能获取有效社会支持有关。结论血友病专业医护人员在指导家庭治疗和护理服务方面只发挥了有限的作用,对血友病患者的健康教育和护理与国际水平相比存在很大差距,缺乏有经验的血友病专业护士．缺少必要的医疗资源,未能建立起紧密的医患合作关系。     

血友病A家庭治疗46例经验总结

血友病A是一种X染色体连锁遗传性出血性疾病。男性血友病患病率约1/10000,我国约有男性患者120000人,血友病A约占85%[1]。患者因凝血因子Ⅷ(FactorⅧ,FⅧ)缺乏,终生有自发性或轻微外伤后出血倾向。软组织血肿和关节积血可导致剧烈疼痛、严重的跛行性关节病,颅内出血易导致死亡。血友病A目前虽然无法根治,但及时、足量输注FⅧ能有效的预防和治疗出血,减轻患者痛苦,降低致残率。即使是血浆中FⅧ活性(FⅧ∶C)<1%的重型患者,如果自儿童起就获得较好的治疗,成年后完全可以和正常人一样生活、工作。在医疗机构指导下开展家庭治疗是实现这一目…     

A型血友病患儿家庭治疗护理状况回顾性调查分析

目的调查中国A型血友病4～18岁患儿家庭治疗和护理状况。方法 2006年、2010年两次对血友病家庭治疗和护理状况进行调查。结果 A型血友病患儿诊断年龄和治疗年龄晚于首次出血年龄;凝血因子用量不足;血友病性骨关节病患病率高;开展了家庭治疗的血友病患儿从55例上升到119例,血友病患儿及家庭对发病原因、遗传规律、出血严重程度的评估和正确服用止痛药物认知率分别从80.8%、78.5%、37.4%和48.4%上升到94.7%、94.1%、52.7%和85.5%;在开展家庭康复训练、保持治疗记录完整两方面没有明显改善。结论 A型血友病患儿诊断治疗延迟,凝血因子用量不足,骨关节病发病率高,家庭护理水平仍然有待于进一步提高。     

患儿的家庭治疗及护理

家庭治疗是一种新的治疗模式 ,它给一些患病儿童的治疗带来了一些在医院治疗所达不到的优点。介绍了患儿家庭治疗的常见病、优点及对家庭的要求。     

患儿的家庭治疗及护理

家庭治疗是一种新的治疗模式,它给一些患病儿童的治疗带来了一些在医院治疗所达不到的优点。介绍了患儿家庭治疗的常见病、优点及对家庭的要求。     

血友病病人家庭治疗现状及影响因素的质性研究

[目的]深入了解血友病病人家庭治疗现状,识别影响血友病病人家庭治疗的因素.[方法]运用质性研究方法,对7例血友病病人进行深入访谈,现场笔录,并运用类属分析法进行整理分析.[结果]血友病病人家庭治疗现状不容乐观,其主要原因有4方面,即血友病病人认同家庭治疗但不深刻、血友病病人及家属对家庭注射的恐惧、对医院的信任及经济原因.[结论]应建立起有效的血友病医疗护理网络,加强对血友病病人及家属的鼓励、监督及支持,让更多的血友病病人及家庭接受家庭治疗.     

发热患儿家庭护理现状调查及分析

目的探讨发热患儿家庭护理现状。方法采用简单随机抽样问卷调查的方式,调查重庆医科大学儿童医院门诊内科就诊的发热患儿家属对患儿发热家庭护理知识现状及需求。结果80％以上家属知道什么是发热,但只有33．3％家属基本掌握解决孩子发热的应急措施,90％以上家属希望获得有关孩子发热的家庭护理知识,而且年龄越小及家属文化越低的患儿其家属对发热患儿家庭护理知晓度越低。结论应加强门诊发热患儿家属健康教育,特别是婴幼儿家属及文化水平低的家属,提高患儿家属对发热知识的认知水平及家庭护理水平。     

家庭护理干预对儿童期糖尿病患儿治疗依从性及生活质量的影响

目的探讨家庭护理干预对儿童期糖尿病患儿治疗依从性及生活质量的影响。方法将90例1型糖尿病(T1DM)儿童随机分为观察组和对照组,各45例。对照组实施常规护理,观察组在对照组的基础上实施家庭护理干预。干预后随访24周,评价2组患儿治疗依从性并观察干预前及干预后24周时Peds QLTM 4.0量表评分。结果观察组的依从率84.44%(38/45)显著高于对照组的66.67%(30/45)(P0.05);干预后24周时,2组患儿Peds QLTM 4.0生存量表各方面功能评分均显著高于干预前,且观察组显著高于对照组(P0.01)。结论家庭护理干预能够提高儿童期糖尿病患儿的治疗依从性和生活质量。     

小儿应用空气压缩泵雾化吸入的心理分析及护理对策

目的探讨小儿应用空气压缩泵雾化吸入的护理方法。方法对应用空气压缩泵雾化吸入治疗小儿进行心理辅助，医疗护理。结果应用空气压缩泵雾化吸入治疗小儿7154例次，通过心理辅助，临床护理，顺利完成雾化治疗7123例次，中途停止雾化吸入治疗31例次，治疗依从性为99％。结论恰当的心理护理及临床护理有助于小儿顺利完成雾化吸入治疗。     

小儿糖尿病的家庭护理干预效果观察与分析

[目的]探讨并分析小儿糖尿病家庭护理干预的效果。[方法]随机将糖尿病患儿82例分为对照组40例与干预组42例,对照组按常规治疗和护理,干预组在常规治疗和护理的基础上给予系统全面而个性化的家庭护理干预,半年后对两组患儿的糖化血红蛋白值(HbA1C)、饮食控制、遵医嘱用药、规律锻炼、自我监测等方面进行评价。[结果]干预组患儿的HbA1C与对照组比较,差异有统计学意义(P<0.01)。饮食控制、遵医嘱用药、规律锻炼、自我监测指标执行情况均高于对照组,差异有统计学意义(P<0.01)。[结论]正确家庭护理干预可有效控制小儿糖尿病病情,减少并发症发生。     

Institutionalized elders with dementia: collaboration between family caregivers and nursing home staff in Taiwan

Aims and objectives. To explore the process of development of collaborative relationship between family caregivers of institutionalized elders with dementia and nursing home staff in Taiwan. Background. Evidence suggests that family members are continuously involved in the lives of loved ones and have not given up their roles as caregivers after the institutionalization of a family member. Little is known, however, about how family caregivers develop a collaborative relationship with nursing home staff, particularly in Asian countries. Design and methods. Grounded theory methodology was used. Data were collected via interviews and observations from 11 family caregivers of patients who were suffering from dementia and living in an institution for persons with dementia in northern Taiwan. Data were analysed by constant comparative analysis. Results. Findings revealed that ‘institutional social penetration’ was the process most used by family caregivers to achieve an harmonious collaborative relationship with the nursing home staff. Institutional social penetration is a dynamic process, which includes three components: self‐disclosure, evaluation of care and penetration strategies. Family caregivers, who had developed a ‘socially penetrating’ relationship with the nursing home staff, were more likely to disclose information in more breadth and depth, to receive positive care evaluations and to adopt multiple effective penetration strategies. Conclusions. Institutional social penetration between family caregivers and nursing home staff can sensitize healthcare providers to meet the family's needs during the placement of their loved one and provide a basis for developing intervention strategies. Relevance to clinical practice. Findings of this study may help healthcare providers to understand the ways in which collaborative relationships develop between the families of elders with dementia and nursing home staff. Interventions can be developed to facilitate self‐disclosure of both the family members and nursing home staff through timely feedback and familiarising family caregivers with different penetration strategies.     

Comparisons of the cost-effectiveness among hospital chronic care, nursing home placement, home nursing care and family care for severe stroke patients

AIM: This study compared the cost and effectiveness of long-term institutional care and home care for stroke patients with severe physical disabilities. BACKGROUND: Whether home care is more economical or effective than institutional care for patients with chronic illnesses remains controversial when the cost of family labour is considered. Thus, decisions concerning the appropriate type of care setting for patients with severe chronic illness remain difficult. METHODS: From November 1995 to March 1996, 313 hospitalized stroke patients with severe physical disabilities treated at one of five hospitals in the Taipei metropolitan area were followed from the day of hospital discharge until the third month after discharge. These 313 patients were divided into four groups as follows: (1) 106 who were admitted to a chronic care unit in a hospital, (2) 60 who were admitted to nursing homes, (3) 60 who received professional home nursing care and (4) 87 who returned home without receiving professional care. The change of physical functional status in the patient was examined as the difference between activities of daily living (ADL) scores measured at discharge and at the end of the third month after discharge. RESULTS: Information on family costs for caregiving, including pay for long-term services utilized, labour costs for caregiving and out-of-pocket expenditures for miscellaneous materials was obtained during a weekly telephone interview. The results indicated that caring for patients in their own homes was not only more expensive but was also less effective in improving ADL scores than caring for patients in nursing homes and in chronic care units of hospitals. CONCLUSIONS: The results suggest that caring for patients with severe physical disabilities in institutions is more appropriate than caring of them at home.