翻转课堂教学在角膜塑形术首次戴镜患儿中的应用

目的探讨翻转课堂教学在角膜塑形术首次戴镜患儿中的应用效果。方法将160例角膜塑形术患儿按时间段分为对照组和干预组各80例,对照组给予常规健康教育,干预组采用翻转课堂教学。比较两组患儿戴镜成功率和满意度。结果干预组患儿戴镜一次成功率、总成功率及满意度评分显著高于对照组(均P0.01)。结论翻转课堂教学能提高角膜塑形术患儿戴镜成功率,提升患儿及其家长的满意度。     

Orthokeratology contact lenses for reshaping of cornea of near-sighted adolescents: nursing care

目的 探讨角膜塑形镜治疗青少年近视的疗效及护理方法.方法 58例(11 4眼)青少年近视眼患者戴角膜塑形镜,于戴镜前,戴镜1d、1周、1个月后分别检测视力和屈光度,观察并发症,同时加强心理护理、检查护理、取戴镜护理、镜片的护理和保养、并发症护理及饮食指导.结果 58例(114眼)患者戴角膜塑形镜后1d、1周、1个月的视力均较带镜前显著升高,屈光度显著下降.无一例出现角膜溃疡、白斑、浑浊等并发症.结论 青少年近视眼患者戴角膜塑形镜期间配合系统护理和健康指导,对患者戴镜期间裸眼视力提高,屈光度降低,预防及减少并发症有重要作用.     

家庭肠内营养健康相关生活质量问卷的汉化及信效度评价

目的 对家庭肠内营养健康相关生活质量问卷进行汉化,并在炎症性肠病行家庭肠内营养患者中进行信效度检验.方法 对英文版问卷进行翻译和跨文化调适,形成中文版本.采用方便抽样法,选取185例行家庭肠内营养患者进行调查,评价中文版本的信效度.结果 中文版问卷保留原17个条目,包括身体功能(14个条目)、日常活动和社会生活(3个条目)2个维度.2个因子累积方差贡献率为52.676％.内容效度指数为0.96.总问卷Cronbach's α系数为0.904,折半信度系数0.899,重测信度为0.709.结论 中文版家庭肠内营养健康相关生活质量问卷具有良好的信效度,可以作为我国家庭肠内营养患者生活质量的评估工具.     

老年住院患者照护者健康素养问卷的编制及信效度检验

目的 编制老年住院患者照护者健康素养问卷并检验其信效度。 方法 以健康素养概念模型为理论基础，通过文献回顾、小组讨论、专家咨询、预调查形成初始版老年住院患者照护者健康素养问卷，选取229名老年住院患者照护者进行调查，对问卷进行信效度检验。 结果 老年住院患者照护者健康素养问卷包括健康知识、照护技能、知识获取、心理支持、寻求帮助5个维度共30个条目。通过探索性因子分析共提取5个公因子，累计方差贡献率为71.462%；问卷水平的内容效度指数为0.867，条目水平的内容效度指数为0.800～1.000；问卷Cronbach′s α系数为0.947，折半信度为0.893，重测信度为0.954。 结论 老年住院患者照护者健康素养问卷具有良好的信效度，能够用于评估老年住院患者照顾者健康素养水平。     

结膜炎患儿家长对点眼知识的认知与行为调查

目的 了解结膜炎患儿家长点眼知识的认知与行为现状,为高质量的延续性护理提供依据.方法 选取门诊结膜炎患儿家长112名,采用自行设计的结膜炎患儿家长点眼知识的认知与行为问卷进行调查.结果 超过半数的患儿家长相关知识匮乏,家庭点眼操作过程中存在诸多问题.结论 应当对结膜炎患儿家长进行细致化、规范化指导,提供高质量的延续性服务,以规范其点眼行为,缩短患儿病程.     

COPD患者肺康复训练知信行问卷的编制及信效度检验

目的编制慢性阻塞性肺疾病患者肺康复训练知识、态度、行为的调查问卷,为针对性开展健康教育、改善肺康复训练行为提供评估工具。方法采用文献分析法、访谈法、德尔菲法及预调查形成待验问卷;采用便利抽样法,选取慢性阻塞性肺疾病患者400例进行调查,对待验问卷进行项目分析和信效度评价,形成正式问卷。结果总问卷条目23个。探索性因子分析提取3个公因子,累积解释变异率63.042%,3个因子条目分布与预想较为一致。验证性因子分析显示,知识、态度、行为的因子负荷均在0.5以上,模型拟合较好。总问卷内容效度指数为0.880,Cronbach′sα系数0.822,折半信度系数0.782,重测信度系数0.999。结论本问卷具有良好的信效度,可以作为初步了解慢性阻塞性肺疾病患者肺康复训练现状的测评工具。     

农村居家失能老年人健康管理需求评估问卷的编制及信效度检验

目的 编制农村居家失能老年人健康管理需求评估问卷,并检验其信效度.方法 以奥马哈问题分类系统为理论框架,综合文献回顾形成问卷条目池,对18名专家进行2轮Delphi专家函询形成预试问卷.对河南省213名农村居家失能老年人进行调查,检验问卷的信效度.结果 探索性因子分析共提取6个公因子29个条目,包括健康档案、身体评估、...     

现代角膜塑形镜控制青少年近视的临床观察

近年来,我国青少年近视眼患病率不断攀升,近视患者升学,参军和工作都会受到限制,近视眼的防治成为一个全球性的医学和社会问题.为探讨现代角膜塑形镜控制青少年近视眼的近期疗效,选取2009年5月至2010年8月在我院眼科门诊配戴现代角膜塑形镜资料完整的136例(264眼)进行分析研究,报告如下.     

角膜塑形镜治疗青少年近视的疗效观察及护理

目的探讨角膜塑形镜治疗青少年近视的疗效及护理方法。方法58例(114眼)青少年近视眼患者戴角膜塑形镜,于戴镜前,戴镜1d、1周、1个月后分别检测视力和屈光度,观察并发症,同时加强心理护理、检查护理、取戴镜护理、镜片的护理和保养、并发症护理及饮食指导。结果58例(114眼)患者戴角膜塑形镜后1d、1周、1个月的视力均较带镜前显著升高,屈光度显著下降。无一例出现角膜溃疡、白斑、浑浊等并发症。结论青少年近视眼患者戴角膜塑形镜期间配合系统护理和健康指导,对患者戴镜期间裸眼视力提高,屈光度降低,预防及减少并发症有重要作用。     

老年人口腔自我保健健康信念问卷的编制及信效度检验

目的 编制老年人口腔自我保健健康信念问卷并检验其信效度。方法 以健康信念模式为理论基础,通过文献回顾、半结构访谈构建条目池,通过专家函询、预调查形成初始问卷,便利抽样选取565名社区老年人进行问卷调查,检验信效度。结果 老年人口腔自我保健健康信念问卷包括感知益处、感知障碍、感知严重性、感知易感性和感知自我效能5个维度共25个条目。探索性因子分析共提取5个公因子,累计方差贡献率为71.524%;验证性因子分析：χ2/df=2.766,IFI=0.929、CFI=0.928、TLI=0.917、PCFI=0.798、PNFI=0.768,RMESA=0.079。I-CVI为0.833~1.000,S-CVI/UA为0.920;问卷总体Cronbach′s α系数为0.959。结论 老年人口腔自我保健健康信念问卷信效度良好,可用于老年人口腔自我保健健康信念测评。     

老年慢性病患者健康赋权量表的研制及信效度检验

目的研制符合我国文化背景的老年慢性病患者健康赋权测评工具。方法通过文献回顾、质性访谈和专家咨询等方法,形成老年慢性病患者健康赋权预试量表;选取326例老年慢性病患者对预试量表进行信效度检验。结果正式量表由26个条目组成,包括责任信念、获取支持、增长知识、参与治疗、重建自我5个维度,共解释总变异量的68.513%。总量表Cronbach′sα系数为0.927,折半信度为0.842。5个维度的Cronbach′sα系数为0.832~0.899,折半信度为0.842~0.904。条目内容效度(CVI)为0.80~1.00。结论老年慢性病患者健康赋权量表信效度良好,可为评估老年慢性病患者健康赋权状况提供参考。     

胃食管反流病患者自我管理行为量表的编制及信效度检验

目的为胃食管反流病(GERD)患者自我管理行为提供测评工具。方法采用文献分析法结合访谈形成原始条目池,经专家评议、预调查后形成预试量表,对280例GERD患者进行调查,检测量表的信度、效度和反应度。结果量表的总体Cronbach′sα系数为0.859;重测信度为0.914;内容效度指数(CVI)为0.837;以慢性病自我效能量表为效标,两者存在显著正相关(P<0.01);采用主成分分析提取出4个公因子,累积方差贡献率为52.11%,与理论构建基本相符;经自我管理项目干预后,GERD自我管理行为量表各维度得分及总分均较治疗前增加。结论编制的GERD自我管理行为量表具有较好的信度、效度和反应度,适宜作为GERD患者自我管理行为的评估工具。     

专科护士工作投入量表的编制及信效度检验

目的 编制适合我国文化背景的专科护士工作投入量表并进行信效度检验,为专科护士工作投入水平测量提供工具.方法 根据文献回顾、半结构式访谈及专家函询形成量表初稿;通过江苏省专科护士在线培训平台对2260名省级专科护士进行问卷调查.结果 探索性因子分析提取5个公因子共32个条目,累积方差贡献率为63.281％;验证性因子分析...     

老年社会衰弱指数的汉化及信效度检验

目的 汉化老年社会衰弱指数,并检验其信效度,为临床评估老年人的社会衰弱提供可靠的工具.方法 根据Brislin翻译模型对英文原版量表进行翻译、综合、回译;通过专家函询及预测试,对翻译的量表进行跨文化调适,形成中文版量表;采用便利抽样法对太原市4个社区的358名老年人进行调查,评价量表信效度.结果 中文版量表包括7个维度...     

全角膜移植术后移植排斥反应及继发性青光眼的防治研究

目的探讨全角膜移植术后移植排斥反应和继发性青光眼的预防和治疗的有效方法,提高全角膜移植术的成功率。方法回顾性分析全角膜移植患者50例(50只眼)。手术方式包括带周边巩膜环的创缘叠加式缝合全角膜移植或移植片和植床边对边缝合的全角膜移植。术后眼表面分别应用他克莫司(tacrolimus,FK506)和环孢素(cyclosporin,CsA)预防和治疗移植排斥反应。应用房水引流植入物或睫状体冷凝术治疗角膜移植术后青光眼,比较其疗效。结果术后随访6～27个月。总的眼球保存率是96%,角膜移植片透明率是42%,手术后获得了超过0.05以上的视力16例,最好视力为1.2。FK506组的最终视力和术后12个月移植片透明率均高于CsA组(P0.01和P0.05)。FK506组和CsA组术后12个月的移植片透明率分别是61%和24%。与边对边缝合全角膜移植相比,叠加式缝合全角膜移植能明显降低手术后青光眼发生率(P0.01)。房水引流植入物和睫状体冷凝术均可有效控制全角膜移植术后青光眼,但睫状体冷凝术的并发症较严重。结论通过改良手术技术,应用强效免疫抑制剂FK506和房水引流植入物,全角膜移植术不仅可以挽救角膜严重损毁的眼球,而且可以使患者的视力得到较好的恢复。     

The triple procedure; combined penetrating keratoplasty, cataract extraction and lens implantation.

Results of combined keratoplasty, extracapsular cataract extraction and lens implantation (triple procedure) are reported for 67 eyes having at least 12 months follow-up. The average age of the patients was 73; the majority were female with a pre-op diagnosis of Fuchs's dystrophy. Post-op visual acuities were 20/40 or better in 72% of the eyes. No implants were removed and only one eye required regrafting. The discission rate was 32%; discissions were usually performed a year post-op. We feel the favorable results are due to uniform use of microsurgical extracapsular catarat extraction at the time of surgery with good capsular fixation of the lens implant.     

Development and psychometric evaluation of the pediatric anesthesia emergence delirium scale

BACKGROUND: Emergence delirium has been investigated in several clinical trials. However, no reliable and valid rating scale exists to measure this phenomenon in children. Therefore, the authors developed and evaluated the Pediatric Anesthesia Emergence Delirium (PAED) scale to measure emergence delirium in children. METHODS: A list of scale items that were statements describing the emergence behavior of children was compiled, and the items were evaluated for content validity and statistical significance. Items that satisfied these evaluations comprised the PAED scale. Each item was scored from 1 to 4 (with reverse scoring where applicable), and the scores were summed to obtain a total scale score. The degree of emergence delirium varied directly with the total score. Fifty children were enrolled to determine the reliability and validity of the PAED scale. Scale validity was evaluated using five hypotheses: The PAED scale scores correlated negatively with age and time to awakening and positively with clinical judgment scores and Post Hospital Behavior Questionnaire scores, and were greater after sevoflurane than after halothane. The sensitivity of the scale was also determined. RESULTS: Five of 27 items that satisfied the content validity and statistical analysis became the PAED scale: (1) The child makes eye contact with the caregiver, (2) the child's actions are purposeful, (3) the child is aware of his/her surroundings, (4) the child is restless, and (5) the child is inconsolable. The internal consistency of the PAED scale was 0.89, and the reliability was 0.84 (95% confidence interval, 0.76-0.90). Three hypotheses supported the validity of the scale: The scores correlated negatively with age (r = -0.31, P <0.04) and time to awakening (r = -0.5, P <0.001) and were greater after sevoflurane anesthesia than halothane (P <0.008). The sensitivity was 0.64. CONCLUSIONS: These results support the reliability and validity of the PAED scale.     

Development and Psychometric Evaluation of the Pediatric Anesthesia Emergence Delirium Scale

Background: Emergence delirium has been investigated in several clinical trials. However, no reliable and valid rating scale exists to measure this phenomenon in children. Therefore, the authors developed and evaluated the Pediatric Anesthesia Emergence Delirium (PAED) scale to measure emergence delirium in children.

Methods: A list of scale items that were statements describing the emergence behavior of children was compiled, and the items were evaluated for content validity and statistical significance. Items that satisfied these evaluations comprised the PAED scale. Each item was scored from 1 to 4 (with reverse scoring where applicable), and the scores were summed to obtain a total scale score. The degree of emergence delirium varied directly with the total score. Fifty children were enrolled to determine the reliability and validity of the PAED scale. Scale validity was evaluated using five hypotheses: The PAED scale scores correlated negatively with age and time to awakening and positively with clinical judgment scores and Post Hospital Behavior Questionnaire scores, and were greater after sevoflurane than after halo-thane. The sensitivity of the scale was also determined.

Results: Five of 27 items that satisfied the content validity and statistical analysis became the PAED scale: (1) The child makes eye contact with the caregiver, (2) the child's actions are purposeful, (3) the child is aware of his/her surroundings, (4) the child is restless, and (5) the child is inconsolable. The internal consistency of the PAED scale was 0.89, and the reliability was 0.84 (95% confidence interval, 0.76-0.90). Three hypotheses supported the validity of the scale: The scores correlated negatively with age (r = -0.31, P <0.04) and time to awakening (r = -0.5, P <0.001) and were greater after sevoflurane anesthesia than halothane (P <0.008). The sensitivity was 0.64.     

石河子市学龄前儿童口腔健康相关生活质量的调查

目的:利用中文版学龄前儿童口腔健康影响程度量表(ECOHIS)对石河子地区学龄前儿童进行口腔健康状况的调查,掌握该地区学龄前儿童口腔健康现状。方法:选择石河子地区300例学龄前儿童进行中文ECOHIS量表调查。同时了解调查对象的饮食习惯及口腔卫生行为。结果:本研究总量表的克朗巴赫α系数为0.899,Guttman分半信度系数为0.799。有龋患儿的ECOHIS得分显著高于没有龋齿的儿童,且ECOHIS得分与口腔健康状况之间有明显相关性。同时,ECOHIS量表的得分与儿童饮食习惯及口腔卫生行为存在"一定"的相关性。结论:本研究显示该量表具有良好的信度与效度,适用于石河子市学龄前儿童。学龄前儿童口腔问题主要是由不健康的饮食行为和卫生行为以及家长对口腔护理的不重视等引起。