原发性高血压患者的健康教育

目的探讨通过对原发性高血压患者进行健康教育，控制及减少高血压的发病率及并发症，提高生存质量，减轻家庭及社会的负担。方法对我科2012年1～7月建立健康档案的260例原发性高血压患者进行健康教育，包括合理膳食、适当进行运动、保持良好的心态、合理用药等。结果260例原发性高血压患者对高血压的防治知识有了全面的认识，92％的患者掌握了相关知识，83％的患者能够保持稳定的情绪，84％的患者改变了原有的不良生活方式，没有发生心、脑、肾并发症，患者的生活质量得到了提高。结论高血压患者对该病的认识及重视程度有了进一步的提高，健康教育在高血压病的治疗及日常保健方面取得了一定的效果。对高血压患者进行健康教育是降低发病率、减少并发症、提高生活质量的关键。     

高血压患者的社区护理干预

通过在社区对高血压患者进行生活方式及用药的护理干预，提高患者对高血压病的认识，改善不良的生活方式，合理用药，控制血压的稳定。结果显示：患者对高血压病有了明显的认知，改善了不良的生活方式，合理用药，使血压的控制率有了显著提高。     

浅谈健康教育在肝硬化合并消化道出血患者中的应用体会

随着医学模式的转变，住院患者的健康教育已成为临床护理工作的一项重要内容，通过对肝硬化合并消化道出血患者在住院期间的分段健康教育，使患者的遵医行为、健康生活方式、治疗的满意度及生活质量有了明显提高，再次出血的发生率明显减少，生存质量有了很大的提高。     

健康教育对高血压患者治疗依从性的影响

目的 探讨健康教育对高血压患者服药依从性及治疗效果的影响。方法 根据123例高血压患者的不同情况，对其进行有目的、有计划、有步骤的健康宣教。结果 经健康教育后，患者治疗主动性有明显提高，服药依从性增强，血压控制率也得以提高。结论 健康教育可使高血压患者对自身疾病有比较清楚的认识，改变不良生活习惯，提高治疗依从性。     

精细化护理在骨科的应用效果与评价

目的分析骨科实施精细化护理的效果，为患者提供满意的服务。方法对骨科216例住院患者进行问卷调查，了解护士精细化护理的效果。结果在骨科实施精细化护理，增强了患者对护士的信任感，减少了并发症，提高了患者的满意度。结论根据骨科患者起病急、病程长、心理负担重、护理风险因素多的特点，根据患者不同阶段的服务需求实施精细化护理，不但患者的满意度有明显的提高，而且还更有效改善了患者的愈后。     

手术室患者的护理需求调查及对策

目的：探讨手术室患者的护理需求调查及对策。方法：回顾笔者所在医院收治的外科手术患者，采取自行设计问卷调查患者的护理需求。结果：通过对患者进行问卷调查，97％以上的患者对问卷中的术前、术后各项目有需求，术中有接近半数的患者对室内安静舒适或术中放轻音乐有需求。结论：通过对患者术前、术中、术后采取科学、有效、合理的护理，满足患者的护理需求，提高了护理水平，促进了患者的康复。     

影响消化内科患健康教育者效果的原因及改进措施

目的：为了提高对消化内科住院患者健康教育的有效性。方法：随机抽取近6月内住院患者进行问卷调查，分析影响消化内科健康教育效果的原因，制定改进措施。结果：经过1年实施改进措施，护士在健康教育理论知识、技能运用、效果评价能力等方面均有提高，病人患者满意度及自我管理依从性提高，患者熟练掌握健康教育知识，减少了并发症和复发率。结论：护士提高专业水平，改进健康教育的方法，选择适当的教育方式，健康教育的效果有显著提高。     

健康教育路径在传染患者隔离管理中的应用

目的应用规范的健康教育路径于传染患者的隔离管理中可提高传染患者对隔离的知晓性和顺从性，降低传染病对社会的危害性。方法制定健康教育路径，将100例人院患者随机分成实验组与对照组。实验组采用健康教育路径，对照组采用传统的健康教育方法。结果实验组和对照组患者及家属在认知水平、行为改变、角色应对能力、不良情绪改变、出院患者满意度等方面均有明显差异。结论健康教育路径可提高健康教育效果，能有效地提高患者的遵医行为，是连接患者与家属之间情感的纽带，使出院患者提高了公共卫生的意识以及改变了患者的不良生活行为和不良嗜好。因此，对传染病住院患者采用健康教育路径进行隔离管理是一种比较可行的方法。     

社区家庭病床冠心病患者干预效果分析

目的对社区家庭病床冠心病患者进行行为干预，为开展社区冠心病防治提供依据。方法采用问卷调查方式，对社区30例家庭病床冠心病患者实施行为干预。结果家庭病床的冠心病患者经过干预后，对冠心病知识、认知有了明显提高，卫生总需求提高73．3％。结论建立社区冠心病患者管理、进行社区行为干预，是减少冠心病发病次数、降低并发症、提高其生活质量的便捷、低廉、有效的途径。     

防痨宣教在肺结核患者护理中的作用

目的探讨防痨宣教在肺结核患者护理中的作用。方法在治疗护理肺结核患者过程中，防痨宣教尤为重要。要想控制肺结核病的传播，对传染源进行成功的治疗管理，实现“高治愈率”，最关键的是在护理过程中，对患者进行有目的、有计划的健康宣教，使其了解健康知识，提高患者对治疗的依从性【ll，做到在护理人员面视下口送药到手，看服到口，咽下再走。结果通过对我科2012—2013年200例肺结核患者的治疗效果观察，发现实施了全面细致的防痨宣教后，患者满意度普遍提高，复发率大大降低，治愈率显著提高。结论对结核患者进行防痨宣教，对促进患者的规律治疗，减少耐药肺结核患者，提高治愈率和发现率均起到不可估量的作用。     

癌症患者心理韧性的影响因素及护理干预体会

目的：探讨癌症患者的心理韧性特点和影响因素，实施相应的护理干预策略，促进癌症患者的临床护理效果。方法：根据国外心理学专家对心理韧性的研究理论，结合临床不同类型、不同病期癌症患者的心理韧性表现，采取适宜的护理对策。结果：癌症患者心理韧性的异常影响因素有效的得到改善，从而提高癌症患者的自我效能和生存质量，延长生存期。结论：对癌症患者心理韧性的研究进一步细化，为癌症患者的身、心健康提供了一个新视角。     

Bilateral breast cancer and familial aggregations

Bilateral breast cancer and familial aggregation among Japanese female patients with breast cancer were studied and results were compared with those among American female patients. Out of 3365 female patients with breast cancer mastectomized at the Cancer Institute Hospital, Tokyo from 1946 to 1975, 92 cases were primary bilateral breast cancer. The crude incidence of bilateral cancer was 2.7%, whereas it was reported to range between 3.0% and 6.8% among American female patients. The true incidence rate of breast cancer after operation for unilateral breast cancer was calculated to be 3.4 per 1000 Japanese patients per year, while it was reported to be between 5.8 and 7.1 among American patients. These figures for American patients are roughly twice as large as those for Japanese females. In the bilateral breast cancer group, there was a high frequency of familial history of breast cancer, about three times higher than that in the unilateral breast cancer group. Further, in the bilateral breast cancer group, about half of the patients were nulliparous and 60% of the patients had breast cancers associated with fibrocystic disease in the same breast tissues. These figures were about three times greater than for those in the unilateral breast cancer group.     

An Epidemiological Survey of Cachexia in Advanced Cancer Patients and Analysis on Its Diagnostic and Treatment Status

Recently, an international consensus diagnostic criterion for cancer cachexia was proposed. The aim of the study is to assess the prevalence of cachexia in patients with advanced cancer and to assess the current status of the diagnosis and management of cancer cachexia. A total of 390 patients with advanced cancer were included. There were 140 patients with cachexia and the prevalence was 35.9%. The prevalence was highest in pancreatic cancer (88.9%), followed by gastric cancer (76.5%) and esophageal cancer (52.9%). Sixty-three patients with cancer cachexia have CT scans available for muscle mass evaluation and 98.4% were sarcopenic. Cachectic patients have a significantly lower overall quality of life and a higher symptom burden. According to oncology physicians, only 33 patients were considered to have cancer cachexia. The false negative rate amounted to 76.4%. The positive rate was related to the body mass index and Eastern Cooperative Oncology Group performance status of the patients. There were few types of pharmacological approaches for cancer cachexia and more than half of cachectic patients did not receive any anticachexia treatment. These results indicate that the prevalence of cachexia in advanced cancer patients was high. However, cancer cachexia was rarely recognized and clinical management for cancer cachexia was very inadequate.     

血管内皮生长因子表达水平与宫颈癌患者预后的关系

目的 探讨血管内皮生长因子(VEGF)表达水平与宫颈癌患者预后的关系.方法 以136例宫颈癌患者为研究对象,分别采用免疫组化法和酶联免疫法对其癌组织和血清中VEGF的表达水平进行半定量和定量检测.分析VEGF表达水平与宫颈癌临床病理特征及预后的相关性,并通过Cox风险回归模型明确VEGF表达水平与宫颈癌患者预后的独立相...     

因子分析法评价肺癌患者生存质量

目的分析影响肺癌患者生存质量(qualityoflife,QOL)的关键因子,为肺癌的防治工作提供参考。方法应用肺癌生存质量FACT-L(4.0)中文版调查表,对164例肺癌患者进行生存质量测评,采用因子分析法研究肺癌患者生存质量的相关因素。结果在肺癌生存质量的13个因素中存在5种主要支配因子。结论肺癌患者早期发现,多学科治疗,可延长生存时间,同时提高生存质量。     

中国胰腺癌发病趋势分析和预测

目的分析上海2002—2006年发病的胰腺癌患者生存情况。方法利用上海市肿瘤登记处收集的2002—2006年胰腺癌登记和生存随访报告资料,采用寿命表法和Ederer Ⅱ法计算胰腺癌患者的观察生存率(OS)和相对生存率(RS),分析影响胰腺癌患者生存率的因素。结果2002—2006年上海市胰腺癌患者5年OS为6.63%,RS为10.11%。不同年龄段胰腺癌患者的5年OS不同,随着年龄增大,生存率逐渐降低。诊断时期为Ⅰ期、Ⅱ期的胰腺癌患者生存率高于Ⅲ期、Ⅳ期。肿瘤位于胰体的患者生存率高于其他部位。不同性别、市郊间患者生存率无明显差别。30年间,上海市区男女胰腺癌生存率均有所上升。结论上海市胰腺癌生存率逐步提高,年龄、肿瘤分期、亚部位等因素对胰腺癌生存率有影响。     

The incidence of cancer in schizophrenic patients.

A cohort of 6168 schizophrenic patients was followed from 1957 to 1984 to determine the incidence of cancer in these patients. In the male schizophrenic patients the incidence of cancer was found to be significantly reduced in comparison with the general Danish population. This reduction was especially marked for cancer in the respiratory system, cancer of the prostate and cancer of the bladder. In the female patients the overall incidence of cancer did not differ from that of the general Danish population, but there was an increased risk of cancer of the digestive tract, especially cancer of the pancreas and a slight increase of the risk of breast cancer. In the female patients the risk of respiratory cancers and cancer of the female genital organs, especially cancer of the uterine cervix, was reduced. These alterations of the incidence of cancer in schizophrenic patients cannot be ascribed to differences in diagnostic accuracy. As a possible explanation of these findings a reduced exposure to well known carcinogens such as cigarette smoke may be relevant. We speculate that exposure to neuroleptics such as phenothiazines and reserpine may also be part of the explanation for the findings.     

Malnutrition among gynaecological cancer patients

OBJECTIVE: To assess the nutritional status of patients with gynaecological cancer. DESIGN: A prospective study assessing the nutritional status of gynaecological patients with suspected or proven gynaecological cancer. SETTING: Queensland Centre for Gynaecological Cancer, Brisbane, Australia; a tertiary referral centre for gynaecological cancer. SUBJECTS: One hundred forty-five patients with suspected or proven gynaecological cancer aged 20-91 years. INTERVENTION: Scored patient-generated subjective global assessment (PG-SGA) and serum albumin before treatment. RESULTS: One hundred and sixteen (80%) patients were categorized as PG-SGA class A, 29 (20%) patients were PG-SGA B and none of the patients were PG-SGA C. Ovarian cancer patients had significantly lower serum albumin levels (P=0.003) and higher PG-SGA scores (P<0.001) than patients with other types of cancer and benign conditions. Sixty-seven per cent of patients with ovarian cancer were classified as PG-SGA B. After adjusting for patient's age, body mass index and albumin level, ovarian cancer patients were 19 times more likely to be categorized as PG-SGA class B compared to patients with benign conditions (95% confidence interval: 3.03-129.8; P=0.002). CONCLUSION: Malnutrition in gynaecological cancer patients is a significant problem, especially among those patients diagnosed with ovarian cancer.     

Cancer chronicity: new research and policy challenges

Cancer centers are organized to serve the needs of patients who can benefit from medical and surgical interventions aimed at curing cancer and preventing recurrence. However, comprehensive cancer care must also encompass the needs of patients with incurable but treatable cancers, some of which can potentially be managed as chronic diseases through outpatient care and self-management. Treating cancer as a chronic disease, and helping patients to live with cancer as a chronic disease, calls for health care that complements services that exist for patients with curable disease, for patients who have completed treatment, and for patients whose disease no longer responds to treatment. Research should focus on the chronic cancer patients to understand how cancer treatment can better serve this growing patient population.     

Family physician involvement in cancer care follow-up: the experience of a cohort of patients with lung cancer

PURPOSE There has been little research describing the involvement of family physicians in the follow-up of patients with cancer, especially during the primary treatment phase. We undertook a prospective longitudinal study of patients with lung cancer to assess their family physician’s involvement in their follow-up at the different phases of cancer.METHODS In 5 hospitals in the province of Quebec, Canada, patients with a recent diagnosis of lung cancer were surveyed every 3 to 6 months, whether they had metastasis or not, for a maximum of 18 months, to assess aspects of their family physician’s involvement in cancer care.RESULTS Of the 395 participating patients, 92% had a regular family physician but only 60% had been referred to a specialist by him/her or a colleague for the diagnosis of their lung cancer. A majority of patients identified the oncology team or oncologists as mainly responsible for their cancer care throughout their cancer journey, except at the advanced phase, where a majority attributed this role to their family physician. At baseline, only 16% of patients perceived a shared care pattern between their family physician and oncologists, but this proportion increased with cancer progression. Most patients would have liked their family physician to be more involved in all aspects of cancer care.CONCLUSIONS Although patients perceive that the oncology team is the main party responsible for the follow-up of their lung cancer, they also wish their family physicians to be involved. Better communication and collaboration between family physicians and the oncology team are needed to facilitate shared care in cancer follow-up.