社区失智老人照顾者积极感受及影响因素分析

目的了解社区失智老人照顾者积极感受现况并探究其影响因素,为制定有效的社区护理干预方案提供指导。方法应用照顾者积极感受量表对80名社区失智老人照顾者进行测评。结果80名社区失智老人照顾者积极感受得分(28.53±5.37)分,得分率63.40%;回归分析结果显示,失智老人患病严重程度及是否患有其他慢性疾病是影响照顾者积极感受的主要因素(均P0.01)。结论社区失智老人照顾者积极感受水平中等,生活展望态度不佳。建议完善失智症患者的社区医疗服务,减轻失智症家庭的疾病负担,同时可开展社区失智症照顾指导干预,提高社区失智老人照顾者应对失智症的信心,提升居家照顾者的积极感受。     

维持性血液透析患者家庭照顾者心理一致感现状及影响因素

目的 探讨维持性血液透析患者家庭照顾者心理一致感现状及影响因素,为制订有效的护理干预方案提供指导.方法 便利抽样选取武汉市2所三甲医院维持性血液透析患者家庭照顾者237名,采用一般资料问卷、心理一致感量表、照顾准备度量表及积极感受量表进行调查.结果 维持性血液透析患者家庭照顾者心理一致感得分为(56.37±11.77)分.家庭照顾者心理一致感与照顾准备度、积极感受呈正相关(均P＜0.01).多元线性回归分析显示,照顾准备度及积极感受是家庭照顾者心理一致感的主要影响因素(均P＜0.01),共可解释其38.0％的总变异量.结论 维持性血液透析患者家庭照顾者心理一致感处于较低水平.医护人员需针对影响因素给予指导干预,提高其心理一致感,促进心理健康.     

胃肠癌患者家属照顾者反应及与成人依恋关系的研究

目的了解胃肠癌患者家属照顾者反应水平及与成人依恋的相关性。方法采用修订版照顾者反应评估量表和亲密关系体验量表对192名胃肠癌患者家属照顾者进行调查。结果照顾者反应中自尊维度得分最高(4.33±0.45)分,缺乏家庭支持维度得分最低(1.86±0.55)分;照顾者依恋焦虑得分(3.51±0.85)分,依恋回避得分(2.62±0.80)分。依恋回避与自尊呈负相关,与缺乏家庭支持呈正相关;依恋焦虑与经济负荷、缺乏家庭支持呈正相关(均P0.01)。结论胃肠癌患者家属照顾者对照顾压力负荷既有积极感受也有消极反应,成人依恋可影响照顾者反应,以依恋理论为指导制定干预措施可以减轻照顾者负担。     

老年慢性病患者家庭照顾者应对方式对虐待老人倾向的影响

目的探讨老年慢性病患者家庭照顾者应对方式现状及对虐待老人倾向的影响。方法便利选取老年慢性病患者家庭照顾者402人,采用简易应对方式问卷和中文版照顾者虐待老年人评估量表进行调查。结果照顾者虐待倾向得分中位数为3分,四分位数间距为4分;分值在2分及以下者有146人(36.32%),3分及以上者有256人(63.68%)。照顾者积极应对维度得分低于国内常模,消极应对维度得分高于常模(均P0.01);照顾者积极应对方式与虐待倾向呈显著负相关(P0.01),消极应对方式与虐待倾向呈显著正相关(P0.01);照顾者应对方式是虐待倾向的影响因素,积极应对方式是虐老倾向的保护因素,消极应对方式是虐老倾向的危险因素,应对方式能解释照顾者虐老倾向总变异的29.0%。结论老年慢性病患者家庭照顾者应对方式趋于消极且其虐老风险较高。护理人员应鼓励照顾者多采取积极应对方式,避免长期采用消极应对方式,以减少虐老风险,提高照顾质量。     

慢性肾脏病患儿家庭抗逆力现况及影响因素调查

目的 探究慢性肾脏病患儿家庭抗逆力现状,分析其影响因素,为针对性干预提供参考.方法 采用便利抽样方法,选取山东省3所三甲医院儿科肾病病区的203名慢性肾脏病患儿照顾者作为研究对象,使用一般资料调查表、中文版家庭抗逆力评定量表、照顾负担量表、疾病管理能力亚量表、简易版慢性肾病患儿照顾者疾病认知问卷进行调查.结果 慢性肾脏病患儿家庭抗逆力得分(95.30±9.83)分.多元逐步回归分析显示,慢性肾脏病患儿住院时间、照顾者照顾负担、疾病管理能力、疾病认知是慢性肾脏病患儿家庭抗逆力的主要影响因素(P＜0.05,P＜0.01).结论 慢性肾脏病患儿家庭抗逆力处于中等偏下水平,医护人员需针对家庭抗逆力影响因素加强干预,缓解照顾者照顾负担,提高其疾病认知与管理能力,为家庭提供充足资源,以有效提升家庭抗逆力,稳固家庭功能.     

系统性红斑狼疮患者家庭抗逆力与照顾负担的相关性研究

目的 探讨系统性红斑狼疮患者家庭抗逆力对照顾者负担的影响,以实施针对性护理干预提供参考.方法 选择138个系统性红斑狼疮家庭,采用Zarit照顾者负担量表和家庭抗逆力调查表进行调查.结果 系统性红斑狼疮患者家庭抗逆力总分为(77.95士20.91)分,照顾负担总分为31.00(22.00,43.25)分;家庭抗逆力与照顾负担呈负相关(P＜0.01).患者性别、家庭类型、照顾者职业及婚姻状况是影响家庭抗逆力的因素(P＜0.05,P＜0.01).结论 系统性红斑狼疮家庭照顾负担处于中等水平,家庭抗逆力水平对照顾负担有负向缓冲作用,应积极采取提高患者家庭抗逆力水平的护理措施,以减轻家庭照顾负担.     

社区失智老年人居家照顾者照顾负荷及影响因素分析

目的了解社区失智老年人居家照顾者照顾负荷现况,探索其影响因素。方法应用居家照顾者负担量表(CBI)对80名社区失智老年人居家照顾者进行测评。结果 80名社区失智老年人居家照顾者照顾负荷得分为54.72±13.15,得分率57.00%。多元回归分析示,影响照顾负荷的因素包括失智老年人患病严重程度、最近一年有无意外事件及家庭人均月收入(P0.05,P0.01)。结论社区失智老年人居家照顾者存在一定程度的照顾负荷,需加强对社区失智老年人居家照顾者的关心,在社区开展的失智症护理干预指导及照顾者自我生活干预指导,提高其照护能力,减轻照顾负荷。     

失智症家庭照护者社会资本量表的汉化及信效度检验

目的 汉化失智症家庭照护者社会资本量表，并检验其信度和效度。方法 对量表进行翻译、回译和跨文化调适，形成中文版失智症家庭照护者社会资本量表。采用方便抽样方法调查221名失智症家庭照护者，评估量表的信效度。结果 经跨文化调适和项目分析，中文版失智症家庭照护者社会资本量表共确立15个条目。探索性因子分析析出3个因子，累计方差贡献率为75.668%,3个因子为互惠性、信任度和邻里支持，与原量表一致，与相依关系量表的效标关联效度为0.419(P<0.05)。总量表的Cronbach′s α系数为0.936,3个因子的Cronbach′s α系数为0.859～0.947。结论 中文版失智症家庭照护者社会资本量表的信效度良好，适用于评估失智症家庭照护者的社会资本水平。     

孤独症谱系障碍患儿照顾者家庭坚韧力状况及影响因素研究

目的探讨孤独症谱系障碍患儿照顾者家庭坚韧力状况及其影响因素。方法采用一般人口学资料问卷、儿童孤独症评定量表、家庭坚韧性量表和亲职压力简表对189例孤独症谱系障碍患儿照顾者进行问卷调查。结果孤独症谱系障碍患儿照顾者家庭坚韧力量表总分为(39.28±6.03)分。家庭坚韧力量表得分与亲职压力简表总分及各维度得分呈负相关(P0.05,P0.01);多元逐步线性回归分析结果显示,亲子愁苦、困难儿童、疾病程度和亲子互动关系失调因子可预测家庭坚韧力54.8%的变异量。结论孤独症谱系障碍患儿照顾者家庭坚韧力量表得分处于较低水平,医护人员应在关注患儿疾病的同时,通过心理咨询和提供亲子互动空间缓解患儿照顾者的亲职压力水平,积极发挥其主观能动性,提高家庭应激能力和坚韧力。     

照顾者反应与缺血性脑卒中患者残障接受度的相关性分析

目的了解缺血性脑卒中(CIS)患者的照顾者反应和残障接受度现状并分析两者的相关性,为采取针对性措施改善患者残障接受度提供参考。方法采用照顾者反应量表和残障接受度量表对211例CIS患者和211名主要照顾者进行问卷调查。结果 CIS患者残障接受度总分为(127.89±29.11)分,其中低接受度占56.40%,中接受度占28.91%,高接受度占14.69%;不同残障接受度患者的健康问题、时间安排受打扰、经济问题、家庭支持缺乏和自尊评分比较,差异有统计学意义(P0.05,P0.01)。残障接受度总分及各维度得分与照顾者反应中的健康问题、时间安排受打扰、经济问题、家庭支持缺乏呈负相关(P0.05,P0.01);残障接受度总分及各维度得分与照顾者反应中的自尊呈正相关(P0.05,P0.01)。照顾者反应中的家庭支持缺乏、自尊和经济问题是患者残障接受度重要因素。结论 CIS患者残障接受度处于较低水平,照顾者反应为其影响因素,护士可从照顾者反应入手对患者进行护理干预来改善残障接受度。     

Hybrid BOA-GWO-PSO algorithm for mitigation of congestion by optimal reactive power management

The generation of power with load optimization, particularly in the current deregulated electricity market conditions, is a very important process for improved planning and operation of the grid. In addition, it is very important for the system not to experience problems due to congestion, have tensile stability, and protection to increase the share of electricity from renewable sources with the current supply system. This article presents load balancing with the butterfly optimization algorithm (BOA) in a hybridized form to minimize and maximize loads when used in pool and hybrid markets. The methods have been designed to prevent the drawbacks of BOA and generate a better trade-off between exploration and exploitation abilities by hybridizing it with particle swarm optimization (PSO) and gray wolf optimizer (GWO). Empirical research on other algorithms shows that proposed hybrid BOA-GWO-PSO algorithm performs better and shows potential in diverse problems. These studies give it a significant advantage over BOA in general, and when it is employed to solve complex optimization problems validated on benchmark IEEE 30 bus system. A comparative analysis has been conducted to validate the potency of the hybrid BOA-GWO-PSO approach with some conventional meta-heuristic algorithms. Analysis of results by mathematical validation on 23 benchmark functions and application in congestion management by optimal reactive power management (RPM) reveal that the proposed technique has the potent to solve real world optimization problems and is competitive with recent methods reported in state-of- art literature.     

Analysis of active surveillance as a treatment modality in ductal carcinoma in situ

Ductal carcinoma in situ (DCIS) is a nonobligate precursor of invasive breast cancer. Current clinical trials are exploring active surveillance (AS) of DCIS. The purpose of this study is to characterize current practice trends in the use of AS. The findings may inform clinical trials and provide insight into factors influencing adoption into practice. The National Cancer Database was used to identify women diagnosed with DCIS from 2004 to 2015. Management with AS was defined as any patient not undergoing surgery, chemotherapy, or radiation therapy. Multivariable logistic regression was used to assess patterns of AS. Of 84 281 women with DCIS, 342 (0.4%) underwent AS. Increased age (OR 1.16, CI 1.15‐1.17), Hispanic or non‐Hispanic black ethnicities (OR 1.91 CI 1.42‐2.56; 1.54 CI 1.13‐2.10), treatment at an academic facility (OR 1.64 CI 1.31‐2.10), and low‐volume facilities (OR 1.60 CI 1.06‐2.42) were associated with an increased use of AS. Patients with ≥1 comorbidities (OR 0.70 CI 0.49‐0.98), high‐grade tumors (OR 0.671 CI 0.51‐0.89), and private insurance (OR 0.69 CI 0.53‐0.89) less frequently underwent AS. Of all patients undergoing AS, 11% received endocrine therapy. Active surveillance is currently an infrequently used treatment modality for patients with DCIS. We observed variations in AS based on age, ethnicity, comorbidities, facility type, facility volume, insurance status, and tumor grade. Most patients managed with AS did not receive hormone therapy. This information may further inform strategies for clinical trials, as well as guide quality of care in the adoption of future management options for DCIS.     

珍珠层成骨活性物质的研究进展

骨质疏松症是骨代谢异常导致的骨量减少及骨微结构改变,骨脆性增加后继发骨折的一类全身性骨病,近年来已成为影响老年生活质量的主要因素之一。目前,其治疗药物在疗效及长期应用上存在问题,而珍珠层含有成骨活性物质,具有应用于骨质疏松症及其他骨病的潜力。该文就珍珠层活性成分的特点、提取方法及成骨作用研究进展进行综述。     

血栓性浅静脉炎新处方的成分 -靶点网络药理作用研究

目的:利用网络药理学研究方法预测通过数据挖掘获取的治疗血栓性浅静脉炎的新处方的作用机制。方法:利用TCMSP数据库挖掘新处方组成药物的入血成分及作用靶点,通过DisGeNET、GeneCards、OMIM等数据库筛选出血栓性浅静脉炎的相关靶点。运用Cytoscape软件构建新处方药物干预血栓性浅静脉炎的"药物-成分-靶点-疾病"网络,通过STRING数据库构建关键靶点相关作用网络并进行信号通路富集分析。结果:新处方药物的79种有效成分可能通过介导121条通路作用于101个核心靶点干预血栓性浅静脉炎。结论:新处方药物可能通过调控PTGS1、NCOA1、NCOA2等靶点,介导流体剪切应力与动脉粥样硬化、AGE-RAGE、p53、TNF-α等信号通路发挥抑制炎性反应、保护内皮细胞等药理作用,干预血栓性浅静脉炎。     

Active follow-up of prostate cancers

Today, earlier diagnosis of prostate cancer has allowed including, beside standard curative treatments, active follow-up of the disease. Such therapeutic management is based on a better knowledge of the natural history of prostate cancer and on possible detection of cases with slow progression. However, all criteria of selection of tumours that are likely to benefit from such surveillance are not always reliable and in some cases invasive treatment should replace surveillance. Analysis of active follow-up series shows that patients who benefit from such treatment have an unchanged prognosis. Active surveillance of prostate cancers may be considered a valuable option provided very strict limits are established regarding patients selection and follow-up.     

Contralateral force sense deficits are related to the presence of functional ankle instability.

Residual symptoms that often follow lateral ankle sprains can lead to functional ankle instability. Proprioceptive deficits have been identified as one factor that may contribute to the presence of functional ankle instability. Sixty participants were recruited to participate in the study. Seven questions were used to determine the presence of functional ankle instability in each participant. A point was added for each "yes" response to produce an index that represents an interval data scale of functional ankle instability. Contralateral force sense and active joint reposition sense were measured in all participants. Pearson product moment correlations were calculated to determine the relationship between functional ankle instability and force sense and active joint reposition sense. We found a significant relationship with force sense and functional ankle instability. Specifically, force sense variable error at both test forces (10 and 30% of maximal voluntary isometric contraction) were positively correlated to the presence of functional ankle instability, r=0.26; p相似文献