结肠造口患者癌因性疲乏症状体验与自我管理效能感的相关性研究

目的分析结肠造口患者癌因性疲乏症状体验与自我管理效能感的相关性。方法采用癌症疲乏量表、中文版癌症自我管理效能感量表对84例结肠造口患者进行调查,数据采用SPSS 19.0进行描述性分析、Pearson相关分析。结果结肠造口患者的癌因性疲乏症状体验总分为(33.97±4.95)分,自我管理效能感得分为(75.00±10.41)分。疲乏症状体验总分与自我管理效能感总分之间呈负相关(r=-0.501,P0.01)。结论结肠造口患者普遍存在癌因性疲乏症状困扰,自我管理效能感有待提高。护理人员应及时准确对结肠造口癌因性疲乏患者进行全面评估,加强症状宣教工作,制定高效的症状管理项目,提高结肠造口患者的自我管理效能,以改善患者的生活质量。     

以信息化为基础的延续护理在临时性回肠造口病人中的应用评价

[目的]探讨基于信息化为基础的延续护理对临时性回肠造口病人的影响,为医护人员实施护理干预措施提供参考。[方法]选取在福建省肿瘤医院行低位直肠癌根治性手术的120例病人,病人均行临时性回肠造口术,术后3~6个月行造口还纳术。运用随机数字表法将120例病人分为对照组和观察组各60例。对照组采用常规护理,观察组在常规护理的基础上给予延续护理。比较两组的生活质量、癌因性疲乏、造口术后并发症、自我效能及满意度。[结果]所有临时性造口病人出院时生活质量及自我效能均较差。二次手术前观察组病人生活质量和自我效能高于对照组(P<0.05),观察组病人癌因性疲乏评分低于对照组,造口并发症例数少于对照组(P<0.05),满意度评分高于对照组(P<0.05)。[结论]信息化为基础的延续护理可促进临时性回肠造口病人康复,提高生活质量、自我效能,减少造口并发症,提高病人的满意度。     

系统性护理对胃癌化疗患者癌因性疲乏、自我效能 及生活质量的影响

目的 探讨系统性护理干预对胃癌化疗患者癌因性疲乏、自我效能及生活质量的影响.方法 选取2013年1月至2014年12月本院行化疗治疗的胃癌患者84例为研究对象,随机分为观察组及对照组,各42例.对照组行常规性护理,观察组行系统化护理干预,干预前后应用癌因性疲乏量表、自我效能量表及简易健康量表(SF-36)对两组患者癌因性疲乏、自我效能及生活质量进行评价.结果 观察组患者干预后癌因性疲乏总评分显著低于对照组(P<0.05);观察组患者干预后自我效能评分高于对照组(P<0.05);观察组患者干预后生活质量评分显著高于对照组(P<0.05).结论 对胃癌化疗患者实施系统化护理干预,能有效提高其自我效能,改善癌因性疲乏,提高生活质量,值得推广应用.     

肺癌化疗患者癌因性疲乏对自我效能感及希望水平的影响

目的探讨肺癌化疗患者癌因性疲乏对自我效能感及希望水平的影响。方法选取2018年8月至2019年8月就诊于我院的肺癌化疗患者260例,均采用Piper疲乏评估量表(PFS-R)、一般自我效能感量表(GSES)、Herth希望量表(HHI)进行调查,根据PFS-R量表得分分为轻度疲乏组16例、中度疲乏组221例、重度疲乏组23例。比较3组自我效能感及希望水平,并分析癌因性疲乏与自我效能感、希望水平相关性。结果 260例肺癌化疗患者PFS-R量表调查总分为(5. 65±0. 84)分,中度疲乏者最多,占85%。重度疲乏组的GSES及HHI量表得分低于轻度和中度疲乏组,差异有统计学意义(P 0. 05)。经Spearman相关性分析显示,肺癌化疗患者癌因性疲乏与自我效能感、希望水平呈负相关(P 0. 05)。结论肺癌化疗患者癌因性疲乏普遍存在,其与自我效能感、希望水平呈负相关,可通过提高自我效能感和希望水平来缓解癌因性疲乏。     

直肠癌永久性结肠造口患者自我效能及影响因素的调查

目的描述直肠癌永久性结肠造口患者自我效能水平,探讨其影响因素。方法采用造口自我效能问卷,对107例直肠癌永久性结肠造口患者进行问卷调查,用Logistic回归等方法进行统计分析。结果造口患者自我效能处于中等水平,得分(82.40±19.83)分。70%的患者性生活效能、性生活满意度效能处于低水平。影响造口患者自我效能的因素为化疗、造口自理水平、造口术后时间(P0.05)。结论医护人员应关注造口患者性生活方面的问题,加强对化疗患者的随访指导,循序渐进地提高造口者的自理水平,从而改善造口患者的自我效能。     

结直肠癌造口患者感知控制与自我护理效能分析

目的了解结直肠癌造口患者排便控制及自我护理效能现状。方法 2014年1月至2016年6月,便利抽样法选择新疆医科大学附属第四医院直肠癌造口术后患者120例。采用自制量表调查患者排便规律及排便感知情况,采用造口自我效能量表调查患者自我护理效能,并对结果进行统计分析。结果本组患者中,101例(84.2%)排便时间不固定,排便次数1~3次/d者40例(33.3%),排便前有便意者55例(45.8%);上述3项指标均随造口术后时间的延长而升高(均P0.05)。造口自我效能量表患者平均得分(84.2±16.4)分,自我护理效能以中等水平最为常见,累计98例,占85.2%。造口时间、文化程度、年龄及排便感知是患者自我护理效能的独立影响因素(均P0.05)。结论结直肠癌造口患者排便感知情况相对较差,自我效能相对较低,需促进其社区康复,以提高其生活质量。     

肿瘤化疗患者癌因性疲乏导致自我效能差的影响因素与防护措施

目的探讨影响肿瘤化疗患者癌因性疲乏患者自我效能差的因素,并提出相应预防措施。方法选取2016年9月至2018年9月我院收治的87例肿瘤化疗患者作为研究对象,其中有21例患者出现由于癌因性疲乏致自我效能差,其余66例患者未发生癌因性疲乏致自我效能差,采用单因素和多因素logistic回归分析,分析影响肿瘤化疗患者癌因性疲乏致自我效能差的因素。结果肿瘤化疗患者癌因性疲乏导致自我效能差的影响因素包括文化水平、家庭月收入、医疗费用支付方式、病理类型、肿瘤临床分期、心理状态、躯体疲乏得分、情感疲乏得分、认知疲乏得分、治疗依从性、疼痛程度; logistic回归分析显示,心理状态、躯体疲乏得分、认知疲乏得分、疼痛程度为肿瘤化疗患者癌因性疲乏自我效能差的独立危险因素。结论影响肿瘤化疗伴有癌因性疲乏患者自我效能差的独立危险因素为心理状态、躯体疲乏得分、认知疲乏得分差、疼痛程度,因此,护理人员应采用健康教育和心理干预等多方面提高患者对化疗积极应对。     

以问题为导向护理干预对胃癌术后患者癌因性疲乏及自我效能的影响

目的:探讨以问题为导向护理干预对胃癌术后癌因性疲乏及自我效能的影响。方法:选择我院2016年3月~2017年6月收治的100例胃癌术后患者为研究对象,随机等分为观察组与对照组,对照组接受常规护理,观察组接受以问题为导向护理干预,对两组患者干预前后癌因性疲乏及自我效能情况进行观察。结果:干预前两组患者癌因性疲乏总评分无明显差异(P0.05),干预后观察组患者癌因性疲乏总分明显低于对照组(P0.05)。干预前两组患者自我效能感评分无明显差异(P0.05),干预后观察组自护效能感评分明显高于对照组(P0.05)。两组患者干预前自护能力各维度评分无明显差异(P0.05),干预后观察组自我能力各维度评分高于对照组,差异有统计学意义(P0.05)。结论:以问题为导向护理干预可降低胃癌术后患者癌因性疲乏,提高自我效能感与自护能力,值得临床推广。     

直肠癌结肠造口患者正念水平对其自我管理行为的影响

目的了解直肠癌结肠造口患者的正念水平对其自我管理行为的影响,为临床护理工作提供指导依据。方法应用一般资料调查表、五因素正念量表和自我管理行为量表对258例直肠癌永久性结肠造口患者进行调查。结果直肠癌结肠造口患者的正念水平评分为(97.45±10.28)分;自我管理行为评分为(41.50±5.21)分;直肠癌结肠造口患者的文化程度、肿瘤临床分期和正念水平是自我管理行为的主要影响因素。结论直肠癌永久性结肠造口患者的正念水平越高,自我管理行为越好,有利于其家庭康复和生活质量的提高。     

结直肠癌造口患者自我护理效能和社会支持度相关性研究

目的:分析结直肠癌造口患者自我护理效能和社会支持度的相关性,为改进结直肠癌造口患者的临床护理工作提供理论依据。方法:对52例结直肠癌造口术后患者应用造口自我效能量表(SSES)、社会支持评定量表(SSRS)及一般情况调查表进行问卷调查。采用Epidata3.1建立数据库,应用SPSS17.0软件进行数据分析,相关性分析用线性回归和Pearson相关分析法。结果:52例患者自我护理效能和社会支持度均处于中等水平;结直肠癌造口患者自我护理效能和社会支持度无相关性(P0.05)。结论:在今后的工作中,提高此类患者的生存质量要从多角度考虑。     

现代残疾康复理念、政策与社区康复体系研究

本研究分析了当代残疾康复的理念和理论架构,构建了以国际公约、决议和政策、国内法律和政策以及操作性工具3个层次的康复理论体系;运用包容性发展,分析探讨了当代社区康复的体系和特点;就发展康复事业、为残疾人提供全面系统的康复服务提出相关的政策建议。     

我院文职护士管理和培训的实践与体会

目的构建文职护士培训、使用及管理的科学方法。方法通过规范管理、科学施训、作为骨干大胆任用等多种管理方式,使文职护士得到充分的发展。结果文职护士群体成长为医院优秀骨干,首批满3年的文职护士顺利通过续聘考核。结论科学的管理培训是文职护士成长的重要基石,对医院护理管理有着重要作用。     

国内外唇腭裂专科护理发展现状的文献研究及分析

目的了解和分析国内唇腭裂专科护理工作发展的现状。方法检索并分析万方医学网、中国知网、Springer Link及PubMed英文数据库近6年有关唇腭裂手术的围术期护理、患儿的喂养、手术安全管理、围术期疼痛研究以及心理护理的相关文献。结果共检索出国内文献89篇(核心期刊20篇)、国外文献22篇,其中围术期护理38篇、患儿的喂养16篇、手术安全管理10篇、围术期疼痛研究10篇、心理护理15篇。结论与国外文献相比,国内论文总结和回顾性居多,应增加研究探讨性论文,从而促进唇腭裂临床护理工作专科化的发展。     

城乡学童个性行为特征调查

目的探讨农村与城市儿童的个性行为特征。方法将97名农村学龄儿童设为农村组,97名城市学龄儿童设为城市组,采用艾森克个性问卷一儿童版和Achenbach’s 行为量表一儿童版进行评定分析。结果两组学龄儿童艾森克个性问卷各维度评分均无显著性差异（P均〉0．05）,且与全国常模相一致（P均〉0．05）;农村组男学童Achenbach’s行为量表违纪行为、攻击行为及外向型因子分均显著高于城市组,女学童退缩、社交问题因子分均显著高于城市组（P〈0．05或0．01）,其他因子分均无显著性差异（P均〉0．05）。结论农村与城市儿童个性无显著差异,而农村儿童存在较多的行为问题,可能与其所受教养和生活方式有关。     

Comparison of short-term and long-term protocols for stabilization and preservation of RNA and DNA of Leishmania, Trypanosoma, and Plasmodium

Molecular tools continue to be important in the prevention and control of parasitic diseases. However, using these techniques directly in the field remains a major challenge. Therefore, the preservation of clinical samples collected from endemic field areas for later analysis remains an important preanalytical process. This study aimed at identifying a suitable protocol for stabilization and preservation of RNA and DNA in bioclinical specimens for Trypanosoma, Leishmania, and Plasmodium research. Both spiked and unspiked blood samples were preserved in 7 protocols (different media; storage temperatures). Samples were evaluated for possible degradation of DNA and RNA along the storage duration up to the 10th week. Nucleic acid targets were assessed as follows: (i) Trypanosoma and Plasmodium RNA analysis was done using real-time nucleic acid sequence-based amplification (RT-NASBA) for 18S rRNA and for stage-specific Pfs25 mRNA, respectively; (ii) Trypanosoma DNA assessment analysis was conducted by using a conventional PCR for 18S rDNA; (iii) Leishmania RNA analysis was performed with a quantitative NASBA for 18S rRNA and Leishmania DNA assessment with an RT-PCR for 18S rDNA. Findings suggested that a newly developed L3™ buffer proved to be reliable and suitable for both short- and long-term preservation of parasite nucleic acid material. This buffer is envisaged to be suitable for utilization in field situations where resources are limited.     

History of violence and subjective health of mother and child

Objective: To study the self-reported prevalence of experienced violence among a cohort of women about two years after giving birth, their health during pregnancy, pregnancy outcomes and their experience of their child’s health.

Setting and subjects: In 2011, a total of 657 women participated in phase III of the Childbirth and Health Cohort Study in Icelandic Primary Health Care, 18 to 24 months after delivery. The women had previously participated in phase I around pregnancy week 16 and phase II 5–6 months after delivery. Data were collected by postal questionnaires.

Main outcome measures: Women’s reported history of experienced violence, sociodemographic and obstetric background, self-perceived health, the use of medications and their child’s perceived health.

Results: In phase III, 16% of women reported experiencing violence. These women felt less support from their current partner (p?p?p?p?p?p?=?0.008).

Conclusions: Our study confirms that a history of violence is common among women. A history of violence is associated with various maternal health problems during and after pregnancy, a higher rate of caesarean sections and maternal reports of health problems in their child 18–24 months after birth.

• KEY POINTS

• Violence is a major concern worldwide. Understanding the impact of violence on human health and developing effective preventive measures are important elements of any public health agenda.

• ??The reported prevalence of experiencing violence was 16% among women attending antenatal care in the primary health care setting in Iceland.

• ??Women with a history of violence reported worse health in general during pregnancy and delivered more often by caesarean section, compared to women with no such history.

• ??Mothers with a history of violence also evaluated the general health of their child as worse than women with no such history.

• ??The findings of this study support the importance of recognizing and addressing experienced violence among women in primary care.

     

Rates and risks of transmission of smallpox and mechanisms of prevention

In 1980, the World Health Organization declared smallpox eradicated from the world; the last known natural case had occurred in Somalia in 1977, and the United States had stopped routinely vaccinating its citizens in 1972. However, with increasing concerns regarding domestic and international terrorism, smallpox has resurfaced as a potential threat to global health. We review the direct and indirect modes of smallpox transmission and how patterns of transmission vary substantially, depending on the severity of circulating disease, vaccination status, environmental and socioeconomic factors, and the setting of an outbreak. We examine mechanisms for controlling outbreaks of disease and preventing further transmission in the event of an outbreak, with an emphasis on smallpox vaccination.     

通用设计原则与产品研发策略

本文介绍了通用设计的概念和设计原则,并阐述了根据此原则实施通用设计的产品研发策略。通用设计惠及的不仅是残疾人,也惠及了包括普通公众在内的广泛人群,以及企业。应将通用设计的原理应融入政府相关政策和未来发展的规划中,为残疾人以及更多人群提供合理便利的通用设计产品。     

胃癌DNA含量与E-cad、EGFR表达的关系及其意义

目的　探讨胃癌组织DNA含量与E cad、EGFR表达的关系 ,评价其在浸润、转移潜能及预后判断中的作用。方法　应用图像分析仪及SP免疫组化法检测 30例正常胃黏膜上皮、30例不典型增生和 5 0例胃癌组织DNA含量与E cad、EGFR蛋白表达情况。结果　①正常胃黏膜上皮、Ⅰ、Ⅱ、Ⅲ级不典型增生及胃癌组的DI、PI、S %、>5c %逐渐增高 ,与胃癌分期、淋巴结转移显著相关 (P <0 0 1)。②E cad在正常胃黏膜上皮阳性表达率 10 0 % ,EGFR呈阴性表达 ;Ⅰ、Ⅱ、Ⅲ级不典型增生及胃癌E cad阳性表达率逐渐降低 ,EGFR的阳性表达率逐渐升高 ,且差异显著 (P <0 0 5 ) ;E cad表达减弱、EGFR表达升高与胃癌分化差、淋巴结转移显著相关 (P <0 0 1)。③E cad表达阴性的胃癌DNA指数及EGFR表达水平显著高于E cad阳性 (P <0 0 1)。结论　检测DNA含量及E cad、EGFR蛋白表达有助于胃癌的早期诊断及转移潜能和预后的判断。     

Quality and suitability of antimicrobial discs: theoretical and practical sources of error and variability

ABSTRACT

Introduction: The use of antimicrobial discs remains one of the main methods for assessing antibiotic activity. Most discs are made to one of three main standards (FDA, WHO, DIN); these all describe an assay method for assessing the quality of discs using a linear method. Theory predicts a curved relationship, and this is backed up in many cases in practice. In such cases, the assays are potentially invalid. Other sources of uncertainty arising from the manufacturing processes employed are also discussed.

Areas covered: This includes error arising from applying FDA, WHO, and DIN standards, the manufacturing techniques employed, and variation in the materials used in production. The need for a specification that relates directly to the use of the discs is also discussed.

Expert opinion: Manufactured discs, some of which may be out of specification due to curvature and other sources of error, have been used to establish quality zone sizes. Quality zone sizes have then been used to measure the quality of discs. This circular quality system where there is no quantitative check is potentially unsafe. In the many decades of their use, there has been no comprehensive check on the quality of manufactured discs using quantitative, validated assays.