非意愿妊娠妇女对紧急避孕知识认知程度的调查

为了解非意愿妊娠妇女对紧急避孕知识的认知程度 ,以预防意外妊娠 ,降低人工流产率 ,保护妇女身心健康 ,采用自行设计的问卷 ,随机对 2 2 0例非意愿妊娠妇女进行了调查。结果 64.5 5 %的妇女完全不了解紧急避孕方法 ;在表示了解的妇女中 ,仅 3 8.4 6%所叙述的方法是完全正确的 ;使用过紧急避孕方法者占 19.5 5 % ;79.5 5 %的妇女迫切需要给予指导。在对紧急避孕知识的了解程度、使用情况及指导需要上 ,妇女的婚姻状况不同 ,差异均无显著性意义 ( P>0 .0 5 ) ;而文化程度不同则差异有显著性或极显著性意义 ( P<0 .0 5或 P<0 .0 1)。提示迫切需要加强紧急避孕知识的宣传教育工作 ,以降低非意愿妊娠的发生 ,文化程度低者应成为教育的重点对象     

市郊绝经后妇女骨质疏松症知识知晓情况的调查

目的了解市郊绝经后妇女的骨质疏松症知识水平以及影响因素。方法采用一般资料问卷和骨质疏松症相关知识问卷对246名市郊绝经后妇女进行调查。结果市郊绝经后妇女对骨质疏松症相关知识得分(9.47±6.38)分,及格率仅14.63%。65岁以上、文盲及小学文化程度者或不在婚妇女的知识水平显著低于65岁以下、初中文化程度或在婚的绝经后妇女(均P0.05)。年龄、文化程度、婚姻是骨质疏松症相关知识得分的影响因素(P0.05,P0.01)。54.06%的市郊绝经后妇女主要从医护人员处获得知识,且77.24%的市郊妇女最希望与医护人员面对面交谈获取知识。结论市郊绝经后妇女骨质疏松症知识亟需提高,社区医护人员以及政府应针对市郊农村人群的特征,采取有效措施,提高其骨质疏松症知识水平。     

对女性开展乳房自查瑜伽操培训的效果

目的探讨对女性进行乳房自查瑜伽操培训的可行性,以提高女性乳房自查依从性。方法将参加乳房保健讲座的514名女性,按照时间顺序分为对照组（n=278）与瑜伽组（n=236）。对照组接受传统的多媒体授课,进行有关乳腺肿瘤知识和乳房自查手法和技巧培训3次。瑜伽组亦接受3次培训,第1次讲座以多媒体教学方式为主,讲授乳腺肿瘤相关知识和乳房自查的必要性;第2~3次讲座将瑜伽运动与乳房自查结合,现场指导受试者练习乳房自查瑜伽操和乳房保健瑜伽操。结果瑜伽组女性乳房自查依从性和对乳房自查操作的兴趣显著高于对照组（P〈0.05,P〈0.01）。瑜伽组各项动作（除指腹触摸动作外）正确率显著高于对照组（均P〈0.01）。结论接受乳房自查瑜伽操培训的女性能更好地掌握自查方法并具有更好的依从性,对乳房自查的兴趣浓厚;乳房自查瑜伽操兼具预防及保健作用。     

正常女性人群乳房常识问卷调查分析

目的了解正常女性人群对乳房常识、乳房美学知识、乳房保健知识以及乳腺癌的认识情况。方法调查问卷共涉及四大项30个题目，发出调查问卷210份，回收有效问卷197份，回收有效率为93．8％，全部输入SPSS10．0中进行分类统计分析。结果人们能正确认识乳房功能的仅33．0％；积极哺乳的人群仅占33．0％，且尚有6．1％的人们拒绝哺乳；有乳房自查的仅63．9％，其中定期检查的仅占19．3％；不能正确选择就诊科别的占22．4％，对重要的乳房自查与临床体检的知晓率仅73．1％。在乳房三种必须就诊的异常症状中，就诊率仅在64．0％～86．3％之间；对乳腺癌危险因素的认识，79．2％的人群知道乳腺癌有遗传倾向，而对其他三项危险因素，回答正确率低于40％。结论对正常女性人群特别是30岁以上的女性人群进行乳房保健知识和乳腺癌相关知识的健康教育很有必要。     

对女性开展乳房自查瑜伽操培训的效果

目的探讨对女性进行乳房自查瑜伽操培训的可行性,以提高女性乳房自查依从性。方法将参加乳房保健讲座的514名女性,按照时间顺序分为对照组(n=278)与瑜伽组(n=236)。对照组接受传统的多媒体授课,进行有关乳腺肿瘤知识和乳房自查手法和技巧培训3次。瑜伽组亦接受3次培训,第1次讲座以多媒体教学方式为主,讲授乳腺肿瘤相关知识和乳房自查的必要性;第2~3次讲座将瑜伽运动与乳房自查结合,现场指导受试者练习乳房自查瑜伽操和乳房保健瑜伽操。结果瑜伽组女性乳房自查依从性和对乳房自查操作的兴趣显著高于对照组(P0.05,P0.01)。瑜伽组各项动作(除指腹触摸动作外)正确率显著高于对照组(均P0.01)。结论接受乳房自查瑜伽操培训的女性能更好地掌握自查方法并具有更好的依从性,对乳房自查的兴趣浓厚;乳房自查瑜伽操兼具预防及保健作用。     

关于女性乳腺疾病患者对保乳及乳房重建认同度的调查

目的通过调查女性乳腺疾病患者对于保乳和乳房重建手术的认同度,初步探讨国内保乳率和乳房重建率低下的原因,以指导乳腺外科医生更有针对性地进行沟通和选择治疗方式。方法通过自制问卷对华西医院乳腺外科收治的139例乳腺癌患者和224例非乳腺癌患者的年龄、职业、学历、对于保乳手术及乳房重建手术的态度以及重建方式的选择进行调查。结果乳腺癌组回收有效问卷117份,非乳腺癌组回收199份。乳腺癌组选择保乳率为23.9%(28/117),选择乳房重建率为35.9%(42/117)。非乳腺癌组选择保乳率为53.3%(106/199),选择乳房重建率为63.8%(127/199)。在2组中,选择保乳率和乳房重建率均随患者年龄增大而下降(乳腺癌组P值分别为0.002和0.000,非乳腺癌组P值分别为0.000和0.000),随学历增高而升高或有升高趋势(乳腺癌组P值分别为0.029和0.296,非乳腺癌组P值分别为0.081和0.019)。乳腺癌和非乳腺癌患者中系个体经营者的选择保乳率及乳房重建率均相对较高(P=0.013,P=0.042;P=0.032,P=0.044)。患者的年龄、职业和学历与乳房重建方式的选择无关(P0.05)。结论年纪较轻、文化程度较高、工作条件较好的乳腺疾病患者保乳及乳房重建的愿望较强烈,应注重加强与该类患者之间进行关于保乳及乳房重建相关知识的沟通,有针对性地选择适合患者条件的治疗方式。     

女性乳房自我检查现状调查分析

随机选取不同年龄,职业和各文化层次的女性共计972名为研究对象.自行设计问卷,分层次抽样1000份,收回有效问卷972份,调查分析唐山市女性乳房疾患自我检查现状.结果真实反映了唐山市妇女乳房自查现状,结果不容乐观,普及乳房健康知识,加强培训和技术指导工作是非常重要的.     

乳腺癌患者乳房保健知识的认知调查及护理对策

目的了解乳腺癌患者对乳房保健知识的认知情况,为临床正确开展乳房健康保健提供科学依据。方法采用自设问卷对48例乳腺癌患者进行乳房保健知识调查。结果仅6.25%乳腺癌患者能够定期进行乳房自查、知道乳房自查最佳时间是月经后4～7d、了解乳房检查手段,93.75%患者不了解月经周期与乳房不适关系。结论乳腺癌患者对乳房保健知识的认知度较低,需加强对乳腺疾病的科普教育工作,定期为成年女性体检,促使她们自觉地防治乳腺疾病,以达到乳腺癌早期诊断、早期治疗的目的,提高乳腺癌患者的生存率。     

急性心肌梗死院前延误现状及对护理工作的启示

目的了解急性心肌梗死（AMI）住院患者院前延误现状．分析其影响因素，以便采取有效的干预措施，减少AMI的院前延误。方法通过查阅出院病历和电话回访的方法回顾性调查59例AMI患者院前延误情况。结果59例AMI患者院前延误1～72h，中位时间6．5h，院前延误率57．6％（34／59）；年龄≥65岁，女性、初中及以下文化程度，既往无冠心病史者院前延误率显著高于年龄〈65岁，男性、高中及以上文化程度和有冠心病史者（P〈0．05。P〈0．01）。结论AMI患者院前延误问题严重，应加强社区人群冠心病知识教育，尤其是高龄女性，初中以下文化程度者，以改善AMI患者院前延误情况。提高救治率。     

乳腺癌术后患者对乳房重建认知与态度的调查分析

目的了解乳腺癌术后患者对乳房重建的认知和态度现状及影响因素,为实施护理干预及相关知识教育提供参考。方法对乳腺癌术后患者280例采用一般资料问卷和自行设计的乳房重建认知与态度问卷进行调查。结果乳腺癌术后患者对乳房重建的认知得分为(15.39±4.45)分,82.78%患者对乳房重建的认知处于一般以下水平。态度得分为(47.12±9.35)分,仅有21.85%患者对乳房重建持积极态度。年龄、文化程度、是否在职、家庭经济负担影响患者对乳房重建认知及态度(均P0.01)。结论乳腺癌术后患者对乳房重建的认知不足,重建态度不够积极。年轻、文化程度高、在职、家庭经济负担轻的患者更希望进行乳房重建。医护人员应有针对性地加强乳房重建相关知识信息的教育与普及,使患者决策最佳治疗方案。     

Socioeconomic Factors, not Ethnicity, Predict Breast Self-Examination

Abstract: The American Cancer Society has recommended monthly breast self-examinations (BSEs) to aid in the early detection of breast cancer. Compliance with BSE recommendations has been shown to be decreased in certain ethnic groups. This investigation evaluates relevant variables involved in BSE compliance in an urban breast cancer screening center. A survey over a 1-year period (June 1996–June 1997) was given to all patients on their initial visit to the Breast Health Center at Tulane University Medical Center. Demographic and socioeconomic factors associated with the compliance of BSE were explored. The overall rate of BSE was relatively high at 80%. There was no difference between ethnic groups in rates of BSE (Caucasians 21% versus African Americans 20%). Statistically significant variables associated with BSE noncompliance were high school education (did not complete high school 16% versus completed high school 33%; p < 0.0004), employment status (employed 16% versus unemployed 31%; p < 0.0004), and marital status (married 15% versus single/divorced 22%; p < 0.05). While the majority of women in our study practiced BSE and ethnicity did not predict BSE, several socioeconomic factors were predictive of BSE compliance. Efforts to increase community outreach to lower socioeconomic patients as well as efforts to ensure proficient BSE techniques by patients may help detect early breast cancer.     

Education of medical students in clinical breast examination during surgical clerkship

BACKGROUND: Medical student training in clinical breast examination is deficient at most medical schools. The use of silicone breast models may allow the education of abnormal and normal findings. This study examines the efficacy of silicone breast models to educate medical students in clinical breast examinations during their third-year surgical rotation. METHODS: Medical students were randomly selected to participate in formalized training sessions in clinical breast examination or as a control group. Presession and postsession testing with silicone breast models were performed. True positives (masses that were present and documented by the student) and false positives (masses that were not present but were documented by the student) were recorded. RESULTS: Medical students undergoing the training sessions demonstrated improved true positive scores (2.2 to 2.8; P <0.05) as well as improved false positive scores (3.0 to 2.0; P = 0.30) and total scores (-0.8 to 0.8; P = 0.07). Students who documented an increase in the number of breast examinations during their rotations had statistically lower false positive scores. CONCLUSIONS: Students after formalized clinical breast examination sessions do improve their ability to detect breast masses, although they continue to detect masses that are not present. Experience of actual breast examinations during their surgical rotations may refine their clinical skills.     

Management of women who present with T4 breast cancer

The purpose of this study was to review the clinical presentation and outcome of women who present with large or locally invasive (T4) breast carcinoma. This retrospective study was conducted at the University of Mississippi Medical Center, a state tertiary care referral institution. One hundred twenty-nine women between the ages of 28 and 85 years (mean, 55 years) presented with T4 breast carcinoma. Follow-up was available for 128 women. Only 23 women have survived (18%), 5 of whom (21.7%) have metastatic disease. Mean survival for those who died was 21.6 months, compared to 76.3 months for survivors. Survival was not influenced by tumor characteristics (P > 0.5), but was strongly influenced by nodal status (P < 0.001) and by the presence of metastases at the time of diagnosis (P < 0.001). Survival was strongly related to mode of therapy (P < 0.01), but this was principally related to very high mortality rates in women who received no therapy (100%), surgery only (92.3%), or chemotherapy only (95%). The best survival was seen in women who received chemotherapy prior to surgery (40%); their survival was superior to that of women treated initially by surgery, followed by chemotherapy (16.3%, P = 0.04). However, when women who presented with metastatic disease were excluded, survival was not different between these two groups (P = 0.18). Despite public education efforts and the wide availability of screening programs for breast carcinoma, many women still present with locally advanced disease. Outcome can be favorable in the absence of node involvement or metastatic disease, even in the presence of large, fungating tumors. Multimodality therapy gives the best results, but early surgery may be required for progression of disease during chemotherapy or because of extensive ulceration at initial presentation.     

人工流产妇女的紧急避孕知识评估

为了解城市人工流产（人流）妇女的紧急避孕（ＥＣ）的知识水平，１９９６年３～５月，在河南省郑州市８所大医院，我们采用以医院为基础的描述性流行病学方法，共调查了１５２０名寻求人流的妇女。我们列出了３０个有关ＥＣ方面的问题，请应答者逐题回答。然后按照回答的对错，逐题评分，总分为３０分。结果表明，３８．８％的妇女得分小于５分；６９．５％的小于１０分；９１．５％小于１５分。在年龄大于２９岁和小于２５岁者中，小于５分的比例都明显高于２５～２９岁年龄组（Ｐ＜０．０１）。文化程度越高，小于５分的比例越低。初中以下者有５２．７％小于５分；高中以上者仅有２９．６％小于５分（Ｐ＜０．０１）。工人小于５分明显高于知识分子（４４．２％比２５．３％，Ｐ＜０．０１）。认为，目前城市人流妇女的ＥＣ知识极为贫乏，这种贫乏在不同年龄、文化水平和职业间有明显差异。     

Decreased postoperative pain, narcotic, and antiemetic use after breast reduction using a local anesthetic pain pump

The purpose of this study was to conduct a prospective trial evaluating the efficacy of a local anesthetic pain pump in breast reduction surgery. Ninety-eight women undergoing bilateral breast reduction were enrolled. Thirty-seven patients received a pain pump containing 0.25% bupivicaine, and 61 patients received no pain pump. Parameters measured included subjective pain, episodes of postoperative nausea and vomiting (PONV), and the amount of narcotics and antiemetics used. Patients receiving a pain pump reported significantly lower pain scores on the day of surgery, as well as on the first and second postoperative days when compared with patients who did not (P < 0.01). The amount of intravenous and oral narcotics used paralleled the reduction in pain (P < 0.01), and there were fewer episodes of PONV and antiemetics used in the patients receiving a pain pump (P < 0.01). A postoperative local anesthetic pain pump can reduce pain, narcotic use, and PONV in women undergoing breast reduction.     

初次产检孕妇对乙型肝炎病毒感染及母婴传播防治措施知晓度分析

目的分析初次产检孕妇对乙型肝炎病毒感染及母婴传播防治措施的知晓度。 方法选取2016年1月至2018年1月于南方医科大学顺德医院附属杏坛医院进行初次产检的800例孕妇作为调查对象，向初次产检孕妇发放《乙型肝炎病毒感染及母婴传播知识》调查问卷，匿名回收。分析孕妇对乙型肝炎病毒感染及母婴传播防治措施知晓度及相关影响因素。 结果本研究共发放800份调查问卷，收回739份，其中有效问卷734份，占发放调查问卷的91.75%；734名初次产检孕妇对HBV感染知晓情况的平均得分为（6.10 ± 1.31）分，对母婴传播防治措施知晓的平均得分为（3.86 ± 1.53）分；以25～35岁孕妇最多（69.48%），35岁以上孕妇最少（占4.77%），大于35岁孕妇的知识得分为（6.97 ± 1.08）分，3个年龄段孕妇的得分差异有统计学意义（F = 7.231、P = 0.040）。本研究对象中首次怀孕孕妇较多（占74.80%），但有过孕育经验的孕妇知识得分和态度得分分别为（6.29 ± 1.44）分和（3.99 ± 1.57）分，与首次怀孕孕妇相比，差异有统计学意义（t = 1.412、P = 0.029，t = 1.902、P = 0.016）；不同受教育水平（小学及以下、初中、高中以上）孕妇的知识得分与态度得分差异有统计学意义（F = 31.391、P = 0.001，F = 8.273、P = 0.001）；78例慢性乙型肝炎病毒感染孕妇的知识得分与态度得分高于无乙型肝炎病毒感染的孕妇，分别为（6.66 ± 1.17）分和（4.35 ± 1.43）分，差异有统计学意义（F = 6.632、P = 0.016，F = 2.413、P = 0.029）。 结论初次产检孕妇对乙型肝炎病毒感染及母婴传播防治措施相关知识的了解不充分，且年龄和教育水平为影响受访者乙型肝炎相关知识和对母婴阻断措施态度的重要因素。     

The Effect of the 2009 USPSTF breast cancer screening recommendations on breast cancer in Michigan: A longitudinal study

In 2009, the revised United States Preventive Services Task Force (USPSTF) guidelines recommended against routine screening mammography for women age 40‐49 years and against teaching self‐breast examinations (SBE). The aim of this study was to analyze whether breast cancer method of presentation changed following the 2009 USPSTF screening recommendations in a large Michigan cohort. Data were collected on women with newly diagnosed stage 0‐III breast cancer participating in the Michigan Breast Oncology Quality Initiative (MiBOQI) registry at 25 statewide institutions from 2006 to 2015. Data included method of detection, cancer stage, treatment type, and patient demographics. In all, 30 008 women with breast cancer detected via mammogram or palpation with an average age of 60.1 years were included. 38% of invasive cancers were identified by palpation. Presentation with palpable findings decreased slightly over time, from 34.6% in 2006 to 28.9% in 2015 (P < .001). Over the 9‐year period, there was no statistically significant change in rate of palpation‐detected tumors for women age <50 years or ≥50 years (P = .27, .30, respectively). Younger women were more likely to present with palpable tumors compared to older women in a statewide registry. This rate did not increase following publication of the 2009 USPSTF breast cancer screening recommendations.     

A significant number of women present with palpable breast cancer even with a normal mammogram within 1 year

Background

Although mammography is the gold standard for breast cancer screening, clinical breast examination (CBE) and self breast examination (SBE) are important adjuncts whose utility has been questioned.

Methods

A retrospective review of invasive breast cancer patients from 2000 to 2008 was performed. We compared 3 groups: breast cancer detected by (1) imaging only (nonpalpable) or palpable mass with a normal mammogram (2) ≥1 year (mammogram ≥1 year) or (3) <1 year (mammogram <1 year).

Results

Of 1,222 women, presentation included 67% nonpalpable, 21% mammogram ≥1 year, and 13% mammogram <1 year. Patients presenting with palpable masses on SBE or CBE even with a normal mammogram within 1 year tended to have more aggressive tumors (larger size, lymph node positive, and triple-negative disease) resulting in more aggressive therapy (a higher mastectomy rate and a greater likelihood of chemotherapy).

Conclusion

A significant number of women present with palpable breast cancer within 1 year of a normal mammogram, many with an aggressive cancer. Therefore, we continue to advocate SBE and CBE for breast cancer screening.     

中青年乳腺癌患者术后的美容需求分析

调查中青年乳腺癌患者术后的美容需求，探寻相应的护理干预措施。方法 选择东莞市厚街 医院2020年2月-2023年2月收治的100例中青年乳腺癌术后患者，对所有患者进行资料收集和问卷调查，了 解其美容需求，并针对不同患者的特点提出有效的护理干预措施。结果 100例中青年乳腺癌术后患者的需 求率为78.00%，其中青年期美容需求率为100.00%，高于中年期的52.17%（P＜0.05）；学历大专及以上美容 需求率为96.77%，高于中学和小学及以下的77.78%和54.17%（P＜0.05）；职业干部美容需求率为100.00%， 高于工人和农民的90.00%和48.57%（P ＜0.05）；付费方式公费医疗者美容需求率为80.46%，与其他付费方 式和自费医疗的62.50%和60.00%比较，差异无统计学意义（P＞0.05）。结论 中青年乳腺癌患者术后美容需 求较高，尤其是年龄较小、职业干部、文化程度较高者需求更高，因此临床需重视相应的护理干预措施， 帮助其减轻负性情绪，提高对生活的信心，促进康复，使得患者更快的回归社会。     

Effect of physical activity during teenage years,based on type of sport and duration of exercise,on bone mineral density of young,premenopausal Japanese women

In this cross-sectional study, 91 healthy premenopausal women aged 20-39 years were investigated to determine the effect of physical activities during their teenage years on their current bone mineral densities (BMD). We measured whole-body BMD (WBMD), lumbar BMD (LBMD), and radial BMD (RBMD) with dual energy X-ray absorptiometry (DXA). Using a questionnaire, we asked the women about their physical activities during junior and senior high school and at present. We also asked about their current nutritional status and past and current milk intake. After adjusting for age, body mass index (BMI), current total calorie and calcium (Ca) intake, and milk intake when they were teenagers and at present, we determined that subjects who exercised during extracurricular activities at each of the three periods (during junior and senior high school and at present) had significantly higher WBMD and LBMD (P <0.01, respectively) than did those who did not exercise at those times. Subjects who played high-impact sports at each period had significantly higher WBMD and LBMD than did subjects who played low-impact sports (P <0.05, respectively). Subjects who had exercised regularly from their teenage years to the present had significantly higher BMD at all sites than BMD in other subjects after adjusting for the potential confounders described above (P <0.05, respectively). Our data suggest that continuous exercise beginning in junior high school, especially high-impact sports, may be associated with greater current bone mass. It is important to incorporate adequate exercise beginning in the teenage years to lower one's future risk for osteoporosis.