家庭化护理服务模式运用于肝脏恶性肿瘤患儿的实施效果

目的探讨家庭化护理服务模式运用于肝脏恶性肿瘤患儿的实施效果。方法选取2018年4月至2019年4月到湖南省儿童医院接受治疗的肝脏恶性肿瘤患儿60例作为研究对象,随机将其分对照组和观察组,各30例。对照组行常规护理,观察组行家庭化护理服务模式。观察对比两组患儿的治疗依从率、中断治疗情况和患者家长对护理服务的满意情况。结果观察组患儿的治疗依从率高于对照组,观察组患儿由于护理原因中断治疗率小于对照组,观察组患儿家长对于护士护理的满意度高于对照组,差异均有统计学意义(均P<0.05)。结论家庭化护理服务模式是一种有效的针对肝脏恶性肿瘤患儿的护理模式,可以有效提高患儿的治疗依从率,减少由于护理原因中断治疗的情况,增加患儿家长对护理的满意度。     

恶性肿瘤患儿父母疾病不确定感状况、自我效能及相关影响因素分析

目的:探究恶性肿瘤患儿家长疾病不确定感及自我效能的影响因素。方法:选取在本院接受治疗的64例恶性肿瘤患儿,其家长人数64人,对患儿家长进行问卷调查,调查表包括自我效能调查表、一般情况调查表、疾病不确定感量表。对影响家长不确定感、相关因素及自我效能情况进行分析。结果:恶性肿瘤患儿父母疾病不确定感总分为(91.34±11.35)分;积极应对、一般自我效能感与父母疾病不确定感为负相关性(P<0.05);多重线性回归分析表示,能够影响患儿家长疾病不确定感的主要因素为自我效能、积极应对能力、患儿病情状况及家长文化水平(P<0.05)。结论:为了能够降低家长对疾病的不确定感,需要对其进行护理干预增强患儿家属对疾病的认知能力,从而降低患儿的心理压力,进一步提升治疗效果。     

护理干预对婴幼儿反复喘息预后及家长心理行为的影响

目的:探讨护理干预对婴幼儿喘息患儿的预后及家长心理行为的影响。方法:对婴幼儿喘息患儿在药物治疗基础上对其家长进行5～6个月的心理行为干预治疗,应用SCL-90症状自评量表分别对干预前及干预后180例患儿家长进行心理状况调查。结果:护理干预后其家长的各项心理症状评分均低于干预前,经比较差异有统计学意义(P<0.001)。干预后婴幼儿喘息患儿的疾病诊断率明显高于干预前,喘息发作的次数明显减少,规范治疗人数明显增高,干预前后比较差异有统计学意义(P<0.01)。结论:婴幼儿喘息患儿家长容易出现心理行为问题,对婴幼儿喘息患儿家长进行必要的心理行为干预治疗,对明确喘息的病因、控制喘息的发作、治疗预后和矫治不良行为、改变家庭环境均有积极作用。     

健康教育在心内膜弹力纤维增生症患儿家长中的应用

目的:探讨对患儿家长进行合理的健康教育在心内膜弹力纤维增生症(EFE)患儿护理中的应用,明确其对患儿家长治疗依从性、焦虑状态及护理满意度的影响。方法:将近10年来收治的56例EFE患儿随机分为对照组24例和观察组32例,对照组仅给予EFE的常规护理干预,观察组除给予EFE常规护理干预外对患儿家属进行合理的健康教育。比较两组患儿家长对治疗的依从性、焦虑状态及护理满意度。结果:观察组患儿家长在接受健康教育后对疾病的预后及护理措施的认识程度有所提高,治疗的依从性明显改善,焦虑状态明显降低,与对照组相比差异有统计学意义(P0.05);观察组患儿家长对护理工作的满意度显著高于对照组(P0.05)。结论:对EFE患儿家长进行合理的健康教育,能够提高其对治疗的依从性,缓解焦虑情绪,提高患儿家长对护理工作的满意度,值得在临床应用。     

唇腭裂患儿家长的心理状况调查与心理护理

目的：分析唇腭裂患儿家长的心理状况并探讨其心理护理方法。方法调查94例唇腭裂患儿家长的心理状况,并给予心理护理干预,探讨干预效果。结果94例患儿家长均存在不同程度心理问题,心理护理干预前自我评定抑郁量表（SDS）及自我评定焦虑量表（SAS）评分均明显高于国内常模（P＜0．01）;经心理护理干预,SDS及SAS评分均明显降低（P＜0．01）,且干预后评分与国内常模比较差异无统计学意义（P＞0．05）。结论唇腭裂患儿家长普遍存在不同程度心理问题,心理护理干预可有效改善其心理状况,对患儿积极接受治疗及健康成长均具有重要意义。     

宣教干预对小儿脓胸治疗转归的作用

[目的]探讨对患儿家长实施宣教干预在小儿脓胸治疗中的效果。[方法]对16例小儿脓胸患儿的护理过程进行分析总结,通过病史资料分析找出陪护家长对疾病认知护理知识缺失的共同特点,对患儿家长家施心理、胸部理疗、术后活动、引流管管理和饮食生活等方面的宣教干预措施,观察效果。[结果]家长全部接受相关干预措施,掌握相关治疗护理配合方法,16例小儿脓胸患儿全部治愈。[结论]宣教干预护理措施对小儿脓胸治疗良好转归具有重要作用。     

焦点式心理护理对牙外伤患儿及家长心理状态的影响

目的:探讨焦点式心理护理对牙外伤患儿及家长心理状态的影响。方法:选取2015年1月~2016年9月到我院牙科就诊的牙外伤患儿150例及其家长150名,随机等分为对照组和试验组,对照组采用常规护理,试验组在对照组基础上加用焦点式心理护理。分别比较两组患儿家长护理前后SAS评分、SDS评分、心理状态评分(MSSNS)情况及两组患儿的治疗依从性。结果:护理前两组患儿家长的SAS评分、SDS评分和MSSNS评分差异均无统计学意义(P0.05),护理后两组患儿家长的SAS评分、SDS评分和MSSNS评分均有所下降(P0.05),且试验组家长SAS评分、SDS评分和MSSNS评分均低于对照组,差异具有统计学意义(P0.05)。试照组患儿治疗依从性优于对照组(P0.05)。结论:焦点式心理护理有利于减轻牙外伤患儿及其家长的焦虑、抑郁心理,改善患儿和家长的心理状态,提高患儿治疗依从性。     

儿科重症监护病房患儿及家长的心理护理

目的探讨研究儿科重症监护病房患儿及家长的心理特点及心理护理体会。方法选取2010年5月至2012年5月我院重症监护室收治的患儿276例,对所有的患儿均进行常规的护理,同时针对重症监护病房患儿及家长的心理特点,给予相应的心理护理。结果276例患儿中康复或好转出院254例,转院继续治疗12例,死亡10例。269例患儿家长对医护人员的护理服务满意度为97．5％。结论根据重症监护病房患儿及家长不同的心理特点,给予针对性的心理护理,改善或避免了患儿及家长的不良心理,促进了患儿的早13康复。     

A型肉毒毒素注射治疗痉挛型脑瘫患儿的观察护理

目的:探讨痉挛型脑瘫患儿肌内注射A型肉毒素(BTX-A)的护理特点。方法:应用BTX—A局部多点注射痉挛型脑瘫患儿痉挛肌肉共103例,并对患儿注射前进行护理评估,注射中积极配合医师,严格执行无菌操作,注射后密切观察患儿的不良反应及对家长进行健康教育,做好各阶段家长及患儿的心理护理。结果:103例患儿均顺利完成注射治疗,无1例出现皮下血肿、感染等并发症,家长的配合程度增加,加强康复训练后均有不同程度的疗效。结论:提出护理工作在BTX—A注射治疗过程中的重要性,做好注射治疗前、中、后的配合与护理,将大大提高BTX—A注射治疗的成功率,缩短患儿康复治疗时间,降低家长心理压力。     

新确诊脑瘫患儿家长的心理状况调查

目的:了解新确诊脑瘫患儿家长的心理状况,为采取相应的心理护理措施提供依据.方法:采用自制问卷调查表、焦虑自评量表(SAS)和抑郁自评量表(SDS)分别对40例新确诊脑瘫患儿家长和同期住院非脑瘫患儿家长的心理状况进行调查.结果:新确诊脑瘫患儿家长SAS总分及SDS总分明显高于非脑瘫患儿家长(P＜0.05).结论:新确诊脑瘫患儿家长存在明显的抑郁、焦虑等负性情感.责任护士加强与患儿家属的沟通、宣教,了解心理状况,给予针对性心理护理,提高应对能力,积极配合治疗.     

PICU危重患儿家属心理反应及需求的调查研究

目的探讨儿科重症监护病房(PICU)危重患儿父母的心理反应及心理需求,为临床医疗护理工作提供有力的参考依据。方法采用随机抽样方法,对PICU100例危重患儿的父母进行心理反应测定及心理需求调查。结果患儿父母心理反应包括:担心患儿得不到很好的照顾、担心治疗失败、担心后遗症、对治疗方法不了解、担心经济问题、不了解疾病等出现焦虑,与常模比较,差异有显著意义(P<0.05)。心理需求包括:希望医护人员更好地关心和照顾小儿,希望医护人员发挥最好的医术将患儿疾病治好;希望医护人员多解释病情,及时通报病情变化。结论PICU抢救危重患儿的同时要注重患儿父母的心理反应以及心理需求,给予家属早期心理干预,积极沟通,加强业务学习和技能训练,为患儿提供精湛的技术,提供更加温馨的医疗护理及多形式的健康知识教育,使患儿父母了解PICU的管理模式及更多疾病的相关知识,消除紧张、焦虑、甚至抑郁等负性心理,提高护理工作效率,有利于患儿康复。     

Nursing care of patients with laryngeal carcinoma

The patient with cancer of the larynx can provide a challenge to the nursing staff. All aspects of nursing management are encompassed in providing care to this unique group of patients. Prevention and early detection are mandatory in the treatment of the patient with cancer of the larynx. Acute care/intensive care nursing, teaching, general medical surgical nursing, rehabilitative nursing, and psychological counseling are all required for any patient undergoing treatment for a cancer of the larynx. The nurse is in a key position to coordinate the care received by these patients and their family members in order for the patient to resume a reasonable quality of life.     

影响儿科住院患者护理依从性的心理因素及对策

目的探索儿科护理依从性的影响因素,为儿科护理提供心理学依据及方法指导。方法对30名护理人员实施访谈,并采用自行设计的问卷对儿科住院患者家属进行调查,以护理依从性差者作为观察组,护理依从性佳者作为对照组,比较两组患者在年龄、陪护者人数、家属心理因素及护患配合等方面的差异。结果121例儿科住院患者中依从性佳者占59.5%,依从性差者占40.5%,单因素χ2分析共筛选出8个因素影响依从性,多因素Logistic回归分析筛选出家属受教育水平、家属恐惧焦虑程度、对疾病与治疗的认知程度、与护理人员的沟通、因程序太复杂未依从是依从性差的独立预测因素。结论提高护理效能,完善住院患者健康教育的内容,利用好家庭社会支持,加强护患双向沟通交流是改善护患关系,提高儿科住院患者护理依从性的有效手段。      

日间手术在小儿外科开展的护理体会

目的：凭我院儿科接诊儿科患者资料,分析日间手术的护理体会。方法：对我院小儿外科所有患儿进行建档,抽取其中150例患儿(纳入时间2021年1月～2022年1月),采用骰子法单双数法将患儿分成两组,一般组行常规护理(n=75),护理组行日间手术护理(n=75),对两组患儿的护理及治疗情况进行探索。结果：一般组患儿恶心呕吐、创面感染、创面渗血的发生率高(P＜0.05),用Zung式心理法评估患儿的SDS(抑郁自评量表)、SAS(焦虑自评量),发现护理组的评分低,且患儿家长的护理满意度高(P＜0.05)。结论：日间手术护理具有较好的作用,对患儿预后恢复是有利的,尤其是可降低患儿术后感染的风险,并发症发生率低,患儿家长对整体护理满意度、认可度较高,值得推广。     

一例新冠疫情期间胰腺癌术后并发粘连性肠梗阻的营养支持护理

总结一例胰腺癌术后并发粘连性肠梗阻的营养支持护理经验。护理要点包括：肠外营养与肠内营养支持护理、新冠疫情期间功能锻炼、心理护理。经过积极治疗与精心护理,现患者顺利康复出院。     

人性化服务在儿科分诊护理管理中的应用

目的：探讨人性化管理理念在儿科门诊分诊护理管理中的应用效果。方法：对2010年5月～2011年5月在儿科门诊就诊的354例患儿家长实施人性化服务,并调查家长对护理服务的满意度情况。结果：通过1年的实施,患儿家长对护士行为举止、服务态度、就诊环境、护士总体满意度、护士的仪表仪容的满意度为95%以上。结论：人性化管理理念在护理管理中的应用,对提高患儿及家长满意度及医院的社会、经济效益具有积极的作用。     

Parents' report of children's hospital care: what it means for your practice

PURPOSE: To determine the aspects of nursing practice that are predictive of parent satisfaction with their child's hospitalization. METHOD: A sample of 3,299 families whose children were hospitalized in a tertiary pediatric teaching hospital between 1995 and 1998 were surveyed. The survey covered their experiences during the child's hospitalization and their overall satisfaction with care. FINDINGS: Survey questions that were most strongly associated with overall satisfaction were questions about caring practices that are collaborations between nurses and parents. Satisfied parents reported nursing care that was tailored to their needs and preferences. CONCLUSIONS: These findings are consistent with Curley's model for nursing practice, which predicts better patient outcomes when nursing care is synergistic with patient characteristics.     

Parents' perceptions of support when a child has cancer: a longitudinal perspective

Previous research has shown perceived social support to be important for maintaining psychological well-being. However, severe stress may influence a person's perception of the availability and value of support from others. In this prospective study, we investigated changes in subjectively perceived social support among parents of children with cancer. Furthermore, we examined the role of parent gender and emotional distress (anxiety and depression) in predicting change in perceived support. Fifty-one parents (29 mothers and 22 fathers) participated. Perceived support, anxiety, and depression were assessed with self-report questionnaires. Parents were examined on 2 occasions. The initial assessment was completed within the first 6 months of the child's cancer treatment. At the time of the follow-up assessment 12 to 24 months later, cancer treatment was completed for all patients. On a group level, parents reported significantly poorer perceived support at the second assessment. However, further examination showed that for one fourth of the group, perceived support was improved. Depressive symptoms during the child's treatment predicted decline in perceived support. Anxiety and gender were not predictive of a change in perceived support.A comprehensive pediatric care model should pay particular attention to parents with a tottering perception of social support. Furthermore, the findings underscore the importance of early psychosocial attention to avoid negative long-term consequences of depression. Being in the frontline of patient care, the pediatric oncology nurse plays an important role in identifying early parents at risk and in shaping parents' perception of support.     

青少年强迫症患者父母心理状况调查及护理干预

目的:分析青少年强迫症患者父母存在的心理问题,了解其心理健康状况,实施及时有效的护理干预.方法:采用症状自评量表(SCL-90)、焦虑自评量表(SAS)和抑郁自评量表(SDS),对60名住院青少年强迫症患者的父母进行测评,对心理问题突出者给予相应的护理干预;干预后再次进行评定,将干预前的测评结果分别同全国常模、护理干预后的测评结果进行比较.结果:青少年强迫症患者父母干预前SCL-90、SAS、SDS得分均高于全国常模,差异具有显著性(P＜0.01);干预前后得分比较差异具有显著性(P＜0.01).结论:青少年强迫症患者父母普遍存在心理问题,及时有效的护理干预能改善其心理状况.     

Transitioning to survivorship: a pilot study.

There are no clear transition guidelines for adolescent and young adult cancer patients, their parents, and their primary care providers (PCPs) when completing active therapy and within the first few years after therapy. The purpose of this pilot study was to identify needs and concerns of recently treated adolescent cancer patients and their parents, young adult cancer survivors, and the community PCPs of adolescent patients. Four focus group interviews were conducted with survivors and parents, and 3 in-depth interviews were conducted with PCPs. All interviews were audiotaped and transcribed for content analysis. A range of needs were identified, including lack of adequate written and verbal information about their prior treatment, its potential side effects, and appropriate follow-up care. The best sources for education were identified as the primary oncologist, nurse practitioner, or nurse. At completion of treatment, parents and adult survivors felt a lack of psychosocial support. Suggestions from participants included use of informational videos for survivors, weekend education and support programs, ongoing support groups, use of the Internet, and educational newsletters. The PCPs reported a lack of general pediatric oncology knowledge and specific patient information, time constraints in their patient schedules, and having few survivors in their practices as barriers to optimal survivorship care. Further research is needed to look at the unmet educational and psychological needs of childhood cancer survivors and their parents during the critical time when they transition off treatment.