舒适护理在输尿管结石体外碎石术护理中的应用

目的:探讨舒适护理在输尿管结石体外碎石术护理中的应用效果。方法:将60例输尿管结石体外碎石术病人随机分为干预组和对照组,各30例。对照组采用传统护理,干预组除采用传统护理外还增加舒适护理。比较两组病人术后1周碎石清除率、平均结石排净时间、术后住院时间和术前、术后4周病人的焦虑水平以及病人的满意程度。结果:两组病人术后1周碎石清除情况无统计学意义(P=0.07),干预组病人平均结石排净时间及术后住院时间均明显少于对照组(P=0.00,P=0.00)。两组病人术前焦虑水平无统计学意义(P=0.922),但术后4周的焦虑水平有显著性差异(P=0.000)。两组病人的满意程度有显著性差异(P=0.00)。结论:舒适护理能有效减少输尿管结石体外碎石术病人平均结石排净时间及术后住院时间,减轻病人的焦虑程度并提高护理服务满意度。     

体外冲击波碎石术治疗340例肾结石患者的护理

我院自1998年6月－2000年12月用西德WOLF公司生产的PIEAZOLTH2501碎石机治疗肾结石患者340例，碎石率达100％，排净率达93.5%。本文总结了术前、术中、术后及并发症的护理，并介绍了治疗后常见的并发症产生机理及预防处理措施。     

体外震波碎石术的护理

体外震波碎石创伤小、安全、疗效显著，患者易接受，被广泛应用予泌尿系结石的治疗。体外震波碎石是不同于外科手术，将体内泌尿系统结石粉碎后从尿中排出。体外震波碎石的基本原理是利用水中放电，通过液电效应作为强大的震源，当冲击波到达结石部位时，由于结石密度与水相差悬殊，声波阻抗不同，会产生折射和反射现象，能量急剧释放，在结石内部产生相当高的拉伸内应力。既超过结石拉伸极限强度（大于98kg／cm）即可把结石粉碎。现将体外震波碎石治疗的术前、术后的观察与护理总结如下。．     

体外冲击波碎石术治疗926例尿路结石患者的护理体会

目的探讨体外冲击波碎石术治疗尿路结石患者的护理方法对提高碎石成功率的效果。方法选取本院2012年5月~2016年10月收治的尿路结石患者926例,全部患者给予体外冲击波碎石治疗并进行针对性护理干预,观察护理效果。结果 926例患者碎石有效率达96.3%,排净率为92.5%,术后随访未发现肾周血肿、肾破裂、肾功能衰竭。结论对体外冲击波碎石术治疗患者实施全程护理能够提高治疗成功率,减轻患者费用及痛苦,减少并发症发生。     

臂丛阻滞镇痛与自控镇静用于断指再植患者的护理

目的探讨臂丛阻滞镇痛及白控镇静（PCS）用于断指再植患者术后镇痛镇静处理的效果及护理管理方法。方法收集48例断指再植患者,术后行持续臂丛阻滞镇痛及静脉自控镇静,镇痛药物为0．2％罗哌卡因,镇静药物采用0．05％咪唑地西泮或0．05％咪唑地西泮与0．0005％芬太尼复合液,观察术前及术后6,12,24,48,72h时镇痛镇静评分、术后生命体征变化及不良反应。结果术后镇痛评分明显低于术前;PCS后各时间点的镇静评分均高于术前,无一例镇静不足或镇静过度发生。患者术后呼吸循环稳定,无明显不良反应发生。结论臂丛阻滞镇痛及自控镇静能为断指再植患者提供良好的镇痛镇静效果,镇痛镇静期间应加强生命体征的监测与护理,避免意外发生。     

臂丛阻滞镇痛与自控镇静用于断指再植患者的护理

目的 探讨臂从阻滞镇痛及自控镇静(PCS)用于断指再植患者术后镇痛镇静处理的效果及护理管理方法.方法 收集48例断指再植患者,术后行持续臂丛阻滞镇痛及静脉自控镇静,镇痛药物为0.2%罗哌卡囚,镇静药物采用0.05%咪唑地西泮或0.05%咪唑地西泮与0.0005%芬太尼复合液,观察术前及术后6,12,24,48,72 h时镇痛镇静评分、术后生命体征变化及不良反应.结果 术后镇痛评分明显低于术前;PCS后各时间点的镇静评分均高于术前,无一例镇静不足或镇静过度发生.患者术后呼吸循环稳定,无明显不良反应发生.结论 臂从阻滞镇痛及自控镇静能为断指再植患者提供良好的镇痛镇静效果,镇痛镇静期间应加强生命体征的监测与护理,避免意外发生.     

体外冲击波碎石患者的护理体会

20 0 2年 2月至 12月我院共收治泌尿系结石患者 138例 ,在体外碎石治疗过程中 ,对患者进行了术前指导和术后护理 ,取得了显著疗效 ,现报道如下。1　临床资料本组 138例中男 89例 ,女 49例 ,11～ 83岁。肾结石 45例 ,输尿管上、中、下段结石 81例 ,膀胱结石 8例 ,后尿道结石 4例。2　护　理2 1　术前指导及护理　多数患者对体外冲击波碎石不了解 ,有恐惧心理 ,担心是否会有出血、损伤脏器及其他并发症。根据患者的文化水平 ,采用不同的方法 ,讲述体外冲击波碎石术的治疗原理、方法及效果。并让患者把手伸到水囊表面体会冲击波的感觉 ,了解冲…     

体外冲击波碎石术治疗108例男性尿道结石患者的护理

我院用PIEZOLITH2300和PIEZOLITH2501型体外冲击波碎石机治疗原位尿道结石108例，改变了将结石推回膀胱内碎石，用膀胱镜钳夹取石或经会阴部开放式手术切开取石等传统治疗方法。这种治疗方法简单、患者痛苦小、治疗成功率100％，是治疗尿道结石的首选方法。该文总结了术前、术中、术后及并发症的护理，并介绍了治疗后常见并发症产生机理及预防措施。     

凯纷在老年患者体外冲击波碎石术中镇痛效果观察及护理

目的:探讨凯纷在老年患者体外冲击波碎石术中的镇痛效果及护理方法.方法:将80例行体外冲击波碎石术的老年患者随机分为观察组和对照组各40例,观察组术前10 min静脉滴注凯纷100 mg+生理盐水250 ml,对照组术前10 min肌内注射哌替啶50 mg.观察两组患者镇痛效果及不良反应.结果:观察组镇痛效果优于对照组、不良反应少于对照组(P＜0.01).结论:凯纷用于老年患者体外冲击波碎石术镇痛安全、有效,同时做好围术期护理也是治疗成功的关键.     

Satisfaction with medical rehabilitation in patients with orthopedic impairment

OBJECTIVE: To examine patient satisfaction after orthopedic impairment at 80 to 180 days after inpatient rehabilitation. DESIGN: Retrospective design examining records from facilities subscribing to the Uniform Data System for Medical Rehabilitation (UDSmr). SETTING: Information submitted to UDSmr from 1997 to 1998 by 177 hospital and rehabilitation facilities from 40 states. PARTICIPANTS: The sample (N=7781) was 72.63% female and 88.60% non-Hispanic white, with a mean age +/- standard deviation of 73.07+/-11.81 years, and average length of stay (LOS) of 13.84+/-10.48 days. INTERVENTION: Usual rehabilitation care.Main outcome measures Level of satisfaction 80 to 180 days after discharge as well as motor, cognitive, and subscale ratings for the FIM trade mark instrument. Predictor variables included gender, age, English language, marital status, discharge setting, LOS, rehospitalization, FIM gain, and primary payer. RESULTS: A logistic regression model was used to predict patient satisfaction at follow-up. Five statistically significant (P<.05) variables were found and correctly classified 94.9% of the patients. Discharge motor FIM rating, rehospitalization, age, patient's primary language, and discharge setting were associated with increased satisfaction. Discharge motor FIM ratings were significantly associated with increased satisfaction in patients with joint replacements and lower-extremity fractures. CONCLUSION: unctional and demographic variables were identified as predictors of satisfaction in patients with orthopedic impairments.     

精神分裂症患者医院社区一体化康复护理研究

目的 探讨医院社区一体化康复护理干预模式对精神分裂症患者的影响.方法 将240例精神分裂症住院患者随机分为观察组与对照组,各组120例,均予常规治疗和护理,随访1年.观察组制订个体化的康复训练计划,实施医院社区一体化康复护理干预.采用总体幸福感量表(GWS)、社会功能缺陷筛选量表(SDSS)和Morning Side康复状态量表(MRSS),分别于病人出院时和1年进行评估,比较两组患者1年复发率和服药依从性.结果 干预1年后,两组患者GWS、RSS及SDSS的评分相比,均有统计学意义(P＜0.01);观察组服药依从性较对照组高,复发率较对照组低(P＜0.01).结论 医院社区一体化康复护理干预可提高精神分裂症患者对精神病的认知水平和服药依从性,减少疾病复发,有效改善其受损的社会功能,提高病人的总体幸福感.

Abstract：

Objective To study on the impact of rehabilitation nursing intervention model for patients with schizophrenia in hospital community integration. Methods A total of 240 cases of schizophrenia inpatients were divided randomly into observation group and control group, each group of 120 patients, all given routine treatment and care, were followed up for 1 year. Observation group patients were designed individual rehabilitation plan and implemented rehabilitation nursing intervention in hospital community integration. The General Well Being Scale (GWS), Social Disability Screening Scale (SDSS) and the Morning Side Rehabilitation Status Scale (MRSS) were adopted to evaluate the effect when the patients discharged and after 1 year from hospital, relapse rate and medication compliance were compared between two groups after 1 year. Results After 1 year intervention, both groups GWS, MRSS and SDSS scores were statistically significant (P＜0. 01 ); The drug compliance in observation group were higher than in control group, the recurrence rate were lower than the control group (P ＜ 0. 01 ) . Conclusions Rehabilitation nursing intervention in hospital community integration can raise the cognitive level of mental illness and medication compliance of patients with schizophrenia, reduce disease recurrence and effectively improve their impaired social function, increase the patient's general well-being.     

The integration of the rehabilitation of psychiatric patients into the primary health care system

This study done in rural and semi-urban clinics examined the ability of primary health care nurses in providing rehabilitation of psychiatric patients in the Primary Health Care service. The objectives of the study were to train and evaluate registered nurses' ability to implement rehabilitation to psychiatric patients in the community. Registered nurses were trained over a period of 10 days. Each client who visited the clinic had a rehabilitation plan drawn with the client and family. Families participated in the training of clients while nurses were trained to identify target symptoms, draw a plan to be followed by the client and his family, set rehabilitation goals and the steps to achieve the goals. The project was implemented over a period of 12 months. Records were then reviewed 1 year after implementation and at 18 months to determine the performance of nurses. Evaluation was done per clinic. Each clinic was evaluated and differences were found and where performance was poor, re-education was done. Each clinic was seen as a case. A record review was done to determine the level of rehabilitation based on the following: identification of target symptoms plan for the patient plan for the family setting of rehabilitation goals steps to achieve goals level of vocational rehabilitation.     

连续性协同护理模式在COPD稳定期患者肺康复训练中的应用

目的探讨连续性协同护理模式在COPD稳定期患者肺康复训练中的应用。方法将201例病情稳定的患者采用随机数字表法分为观察组(100例)和对照组(101例)。观察组患者实施连续性协同护理模式,包括知识指导、康复训练、随访干预。对照组患者接受常规护理,出院后进行不定期随访。比较干预前后两组患者肺功能和自我护理行为情况。结果干预后观察组患者肺功能和自我护理行为明显优于对照组,差异具有统计学意义(P0.01或P0.05)。结论连续性协同护理模式有利于增强COPD患者肺康复依从性,改善其肺功能和自我护理行为,最终提高患者的生活质量。     

On uniform social medical evaluation of performance capacity in orthopedic rehabilitation

The need for standardized and unified performance capacity assessment in orthopedic rehabilitation has led to the attempt to use an existing standardized procedure. Graduated disease features have been defined which are relevant for work and their effects on performance capacity been formulated as rules. In this way so-called disease-conditioned performance capacities are obtained which help to identify problems in carrying out various activities. These activities can be directly assessed using tests. Appropriate tests are listed in a table.     

“双心医学”模式在CCU病人护理中的应用探讨

现阶段在"生理-社会-心理的综合模式"下,重点提出"以人为本"的服务理念。而"双心医学"模式的产生,既体现出人性化关怀,也兼并理性化的治疗。它提倡不仅关注病人心脏,更要关注病人心理,从而达到"心身"协调,真正体现了疾病诊治过程中"以人为本"的理念[1]。人性化护理是由美国人华生(Watson)首先提出的"人性照护"护理模式发展而来。所谓"人性照护"即护士必须有人性科学的认知,给予病人人性化照护。人性化护     

医护康一体化延续性护理在Pilon骨折术后病人功能康复中的应用研究

目的:探讨医护康一体化延续性护理对Pilon骨折术后病人功能康复的影响.方法:将2015年1月—2016年12月出院的84例Pilon骨折术后病人随机分组,对照组采用居家自我管理模式进行关节功能锻炼,观察组采用医护康一体化延续性护理模式指导关节功能锻炼,出院后12周比较两组病人踝关节功能、生活质量和满意度.结果:术后12周观察组病人踝关节功能优良率达83.33％,明显高于对照组的66.67％(P<0.05).观察组病人生理功能、精力、精神健康、生理职能、躯体疼痛、健康状况、社会功能和情感职能评分明显高于对照组(P<0.05).观察组病人满意度为73.81％,明显高于对照组的30.95％(P<0.05).结论:Pilon骨折术后病人实施医护康一体化延续性护理,可有效改善病人的关节功能和生活质量,明显提高病人的满意度.     

The process of hospital discharge for medical patients: a model

BACKGROUND: The 1990 NHS Community Care Act established a requirement for hospital discharge policies and procedures in the United Kingdom to be developed in collaboration with local government authorities in order to ensure supported discharge for those in need. AIMS: The aim of the study reported in this paper was to track decisions about hospital discharge in relation to outcomes for a sample of medical patients and their carers, identified as at risk of experiencing unsuccessful discharge processes. METHODS: Themed unstructured interviews were conducted in three different hospitals with 30 patients identified as at risk of unsuccessful discharge and their carers pre- and postdischarge. Hospital, community and social care staff involved in the care of the patient were also interviewed. FINDINGS: Patients and carers were constantly negotiating their social roles, seeking to juggle appropriate identities and limited resources to maintain their own and each others' dignity and quality of life. When the negotiation process was destabilized (for example, by exacerbation of chronic disease, withdrawal of some resource, or the experience of additional stressors - not necessarily health-related), then either or both parties sought a way out. In all the cases examined the result was admission to hospital - usually, but not always, mediated by community professionals. CONCLUSIONS: The effective discharge of patients from hospital needs to move from a functional focus on symptom management to a negotiation of quality of life that seeks to promote health for all parties involved.