护理干预对肿瘤经外周静脉置入中心静脉导管患者自我护理能力和健康行为的影响

目的探讨护理干预对肿瘤经外周静脉置入中心静脉导管（PICC）患者自我护理能力和健康行为的影响,以提高肿瘤PICC患者的生活质量。方法将218例肿瘤PICC患者随机分为干预组107例和对照组111例,对照组采用常规护理,干预组在对照组的基础上由PICC专科护士给予针对性的认知干预,内容包括健康知识水平、自我概念、自护责任感和自我护理技能等4个方面,干预时间为3个月。干预前后进行问卷调查。比较2组的自我护理能力和健康行为水平。结果干预后干预组自我护理能力及健康知识水平显著高对照组。结论有针对性的护理干预能有效地提高门诊肿瘤PICC患者的自我护理能力,改善健康行为。     

护理干预对肿瘤经外周静脉置入中心静脉导管患者自我护理能力和健康行为的影响

目的 探讨护理干预对肿瘤经外周静脉置入中心静脉导管(PICC)患者自我护理能力和健康行为的影响,以提高肿瘤PICC患者的生活质量.方法 将218例肿瘤PICC患者随机分为干预组107例和对照组111例,对照组采用常规护理,干预组在对照组的基础上由PICC专科护士给予针对性的认知干预,内容包括健康知识水平、自我概念、自护责任感和自我护理技能等4个方面,干预时间为3个月.干预前后进行问卷调查.比较2组的自我护理能力和健康行为水平.结果 干预后干预组自我护理能力及健康知识水平显著高对照组.结论 有针对性的护理干预能有效地提高门诊肿瘤PICC患者的自我护理能力,改善健康行为.     

协同护理模式对慢性阻塞性肺疾病出院患者自护能力的影响

目的探讨协同护理模式对慢性阻塞性肺疾病(chronic obstructive pulmo-nary disease,COPD)出院患者自护能力的影响。方法便利抽样选取2012年1-12月入住长沙市中心医院的COPD患者90例,按入院时间先后分为观察组和对照组各45例;对照组按COPD患者常规护理进行住院和出院后的指导,观察组在此基础上应用协同护理模式进行4个月的护理干预。比较两组患者不同时段自我护理行为评分情况。结果观察组干预后2、4个月的自我护理评分均显著高于对照组(均P0.01),且自我护理行为总分及各维度得分在干预方法和干预时间上有一定的交互作用(P0.01)。结论以协同护理模式为基础的护理干预能提高COPD患者自我护理能力,改善其生活质量。     

Costs associated with the primary prevention of type 2 diabetes mellitus in the diabetes prevention program

OBJECTIVE: To describe the costs of the Diabetes Prevention Program (DPP) interventions to prevent or delay type 2 diabetes. RESEARCH DESIGN AND METHODS: We describe the direct medical costs, direct nonmedical costs, and indirect costs of the placebo, metformin, and intensive lifestyle interventions over the 3-year study period of the DPP. Resource use and cost are summarized from the perspective of a large health system and society. Research costs are excluded. RESULTS: The direct medical cost of laboratory tests to identify one subject with impaired glucose tolerance (IGT) was $139. Over 3 years, the direct medical costs of the interventions were $79 per participant in the placebo group, $2,542 in the metformin group, and $2,780 in the lifestyle group. The direct medical costs of care outside the DPP were $272 less per participant in the metformin group and $432 less in the lifestyle group compared with the placebo group. Direct nonmedical costs were $9 less per participant in the metformin group and $1,445 greater in the lifestyle group compared with the placebo group. Indirect costs were $230 greater per participant in the metformin group and $174 less in the lifestyle group compared with the placebo group. From the perspective of a health system, the cost of the metformin intervention relative to the placebo intervention was $2,191 per participant and the cost of the lifestyle intervention was $2,269 per participant over 3 years. From the perspective of society, the cost of the metformin intervention relative to the placebo intervention was $2,412 per participant and the cost of the lifestyle intervention was $3,540 per participant over 3 years. CONCLUSIONS: The metformin and lifestyle interventions are associated with modest incremental costs compared with the placebo intervention. The evaluation of costs relative to health benefits will determine the value of these interventions to health systems and society.     

Effects of a motivational interviewing intervention to decrease prenatal alcohol use

This study determined the effectiveness of motivational interviewing (MI) to decrease prenatal alcohol use, while examining mechanisms of behavior change based on self-determination theory that may have evoked decreases in drinking behaviors. In all, 67 pregnant women who reported previous-year alcohol use were randomly assigned to an MI intervention or comparison group, with 56 women completing all study procedures. Both groups were assessed at baseline and 4- to 6-week follow-up for alcohol use and mechanisms of behavior change (basic psychological needs satisfaction and autonomous motivation). Only the MI group received the intervention after baseline assessments. Although MI was not found effective in decreasing prenatal drinking behaviors in this study, nonspecific factors were identified, such as treatment structures, participant motivation for improvement, and provider qualities, which may have influenced these results. More research is needed to determine theory-based specific and nonspecific factors that drive effective nursing interventions to decrease alcohol use during pregnancy.     

The Effectiveness of an Online Mind-Body Intervention for Older Adults With Chronic Pain

The Self-care Pain Management Project assessed the feasibility and efficacy of delivering online mind-body self-care techniques to 78 adults aged 55 and older with chronic pain. To assess feasibility, the study monitored use of the intervention and documented participant satisfaction. A randomized trial with intervention (n = 41) and waiting list comparison groups (n = 37) was used to assess changes in pain intensity, limitations due to pain, pain self-efficacy, depression, anxiety, and awareness of responses to pain from baseline to follow-up at 6 weeks. There were statistically significant results for between-group difference in awareness of responses to pain, improvements in pain intensity and pain interference for both groups, and increases in confidence with using nonmedical self-care techniques to manage pain for the intervention group. Reductions in mean pain scores reported by the intervention group at log on and log off also suggest that the intervention may have an immediate impact on reducing pain. Findings document the feasibility of a relatively short-term, online mind-body pain management intervention that can have benefits for participants. The characteristics of those who volunteered for an online self-care pain management intervention also have implications for identifying target populations for such interventions.PerspectiveThis article documents the outcomes of an Internet-based self-care pain management intervention that focused on mind-body exercises. The study suggests that the Internet can be an efficient mode for delivering self-care education to older adults with chronic pain and has potential benefits that complement clinical care.     

Investigation of the Effect of Web-Based Education on Self-Care Management and Family Support in Women With Type 2 Diabetes

This study is a randomized controlled trial to evaluate the effect of the web-based education given to female individuals who were using insulin with type 2 diabetes on self-care management and family support. The study was conducted between December 2019 and August 2020 using a sample of women (N = 61) with type 2 diabetes. For 6 months, web-based education was given to the intervention group. It was found that the diabetes self-care scores and family support scores were high, and there was also an improvement in the self-care behaviors. These findings show that web-based education models can be used by nurse practitioners to improve self-care in diabetes management.     

健康教育对2型糖尿病患者野外作业时的自护行为及生活质量的影响

目的探讨健康教育对2型糖尿病患者野外作业时的自护行为及生活质量的影响。方法对187例野外作业的2型糖尿病患者给予多种形式的健康教育,采用自护行为量表和生活质量综合评定问卷,调查分析患者干预前后的自护行为执行情况和生活质量。结果2型糖尿病患者野外工作时的自护行为执行情况干预前后差异具有统计学差异（P〈0．01）;生活质量的生理功能、心理功能、社会功能、独立性、环境适应能力方面,干预前后差异具有统计学差异（P〈0．05）。结论通过健康教育,可以增强2型糖尿病患者的自护行为能力,提高其生活质量。     

Writing therapy for the bereaved: evaluation of an intervention

Bereavement is a risk factor for a wide range of well-documented negative outcomes. As such, a range of sensitive and appropriate interventions are needed to support people adjusting to their new roles and change in identity. Writing has proven to be useful for people adjusting to traumatic experiences. Translating experiences into language and constructing a coherent narrative of the event enables thoughts and feelings to be integrated, leading to a sense of resolution and less negative feelings associated with the experience. Using a writing therapy intervention tailored specifically for bereaved individuals in Western Australia, this study asked: "Does a writing therapy intervention reduce grief, lead to greater health and wellbeing and lead to greater self care for bereaved individuals?" The results indicate that for grief and General Health Questionnaire-30 (GHQ-30) scores there was an overall improvement for all participants regardless of whether participants received the intervention or not. The results for the effect of writing therapy on self-care demonstrate that there is a greater increase in self-care for the intervention group than for the control group; however, this trend does not reach statistical significance. Writing therapy offers a useful, cost-effective, and private way of supporting bereaved individuals who may not practice self-care. The main limitation of the current research is the low number of participants, which limits the generalizability of the results. Future research could be directed toward evaluating the intervention for recently bereaved people or those identified by screening as being particularly vulnerable.     

院外延续宣教对糖尿病足中高危人群自护行为的影响研究

目的：探讨远程护理干预对2型糖尿病足中高危患者足部自护行为及血糖的影响。方法在2011年1～5月住院的糖尿病患者中,筛选出糖尿病足中高危患者60例为研究对象,随机分为对照组及干预组。对照组采取常规出院随访,干预组采取远程延续信函结合电话强化健康指导。比较两组患者在院时和出院2年后的足部自护行为、血糖值及糖尿病足危险因素评分。结果干预组患者干预前后的足部自护行为差异有显著意义（P＜0．05）,与对照组比较差异有显著意义（P＜0．05）。在血糖值、糖尿病足危险因素评分等方面比较两组差异无显著意义。结论针对性的远程宣教,可以提高糖尿病足中高危患者的足部自护行为,但宣教模式还可进一步完善。     

Self-care of young adolescents with type 1 diabetes

The purpose of this study was to describe the universal and health deviation self-care of adolescents with Type 1 diabetes and the associations of basic conditioning factors with universal and health deviation self-care. Subjects for this study were 152 adolescents aged between 11 and 15 years with a diagnosis of Type 1 diabetes. Data were collected in the home setting of each adolescent and his or her family. The mean universal self-care scores ranged from 66.62% to 90%. The overall mean for this sample was 75.37, indicating that these adolescents took care of their self-care needs 75% of the time. Health deviation self-care was a mean of 27.26, indicating more positive self-care behaviors and treatment adherence. Health deviation and universal self-care were significantly and positively related (r = .36, p < .001). Ethnicity and adolescent sex were statistically significant in predicting universal self-care. Adolescent age was statistically significant in predicting health deviation self-care. Health deviation self-care decreases with age, suggesting that early adolescence or late school age is an appropriate time for interventions to strengthen self-care behaviors. Furthermore, the interrelationship of the two types of self-care supports the potential for a synergistic effect of intervention.     

延续性康复护理路径对宫颈癌患者腹腔镜术后康复效果及自我护理效能的影响

目的:探讨延续性康复护理路径对宫颈癌患者腹腔镜术后自我护理效能及康复效果的影响。方法:选取2019年3月至2020年3月该院收治的宫颈癌患者70例,采用电脑数字法分为延续性康复护理路径组和常规护理组,每组35例。延续性康复护理路径组采用延续性康复护理路径,常规护理组使用常规护理模式。比较干预3个月、6个月后两组患者在健...     

Self-care behaviors for muscle pain

This investigation examined self-care behaviors for muscle pain because of the prevalence of musculoskeletal pain and the substitution of self-care for formal medical care. In Study 1, university students (N = 187) completed a retrospective questionnaire about self-care for muscle pain. In Study 2, muscle pain was experimentally induced in university students (N = 79) with subsequent measurement of self-care. In both studies, stretching and massaging were the most frequently performed behaviors, and consuming medication was the least frequently performed. In Study 1, the perceived effectiveness of behaviors and level of pain required to perform self-care accounted for 12% to 32% of the variance in behavior frequency. In Study 2, pain ratings and pain during activities were higher among those who performed self-care (ds = .59 to 1.00). These studies indicated that self-care behaviors are performed for both naturally occurring and experimentally induced muscle pain. However, both studies determined that the performance of self-care behaviors did not always correspond with current evidence of treatment effectiveness for muscle injuries. Unique opportunities for future investigations of self-care behavior models and interventions are permitted by muscle pain induction. PERSPECTIVE: Self-care for pain reduction is an understudied behavior. This report describes 2 studies of self-care behaviors for naturally occurring and experimentally induced muscle pain. The most frequent types of self-care behaviors are similar for the types of pain, and the perceived effectiveness of behaviors and pain level influence performance of the behaviors.     

Repetitive Behavior in Children with Down Syndrome: Functional Analysis and Intervention

Children with Down syndrome frequently display repetitive behavior including unusual routines, rituals, and stereotypy. Interventions for repetitive behavior in individuals with Down syndrome often include aversive procedures and are not informed by functional assessments despite effective function-based treatments for repetitive behavior with other populations. We used an analogue functional analysis to evaluate reinforcers maintaining repetitive behavior in three children with Down syndrome. Following identification of automatic functions, we used an ABAB design and a multiple-probe design to demonstrate the effectiveness of differential reinforcement of other behavior (DRO) in reducing repetitive behavior. DRO was effective in decreasing repetitive behavior and, for one participant, repetitive behavior remained low at 1, 2, and 3-month follow-up sessions. This study extends current functional analysis methodologies to decrease repetitive behavior for learners with Down syndrome.     

An Application of Differential Reinforcement of Other Behavior and Self-Monitoring to Address Repetitive Behavior

Differential reinforcement of other behavior (DRO) and self-monitoring was used to reduce repetitive challenging behavior in the form of eyelash, eyebrow, and hair pulling exhibited by a 19-year-old woman with an autism spectrum disorder. Treatment evaluation included DRO with competing and non-competing stimuli in a private therapy room. Once the DRO interval exceeded 10 min, treatment was conducted in the participant’s classroom. Results of the study suggested DRO was successful in both environments and across both stimulus types.     

以健康促进模式为基础的护理干预对麻风病足底溃疡患者自我护理行为及治疗效果的影响

目的 探讨以健康促进模式为基础的护理干预对麻风病足底溃疡患者自我护理行为及治疗效果的影响。 方法 采用随机数字表法将61例麻风病足溃疡患者分为2组,对照组31例给予常规健康教育护理干预,观察组30例实施以健康促进模式为基础的护理干预。6个月后比较2组患者的足部溃疡愈合情况及自我护理行为。 结果 观察组足部伤口愈合效果及肉芽覆盖率均好于对照组,护理行为各因子评分也均明显好于对照组。 结论 健康促进模式能有效提升麻风病足底溃疡患者的足部自我护理行为,促进足底溃疡愈合。     

Calming music and hand massage with agitated elderly

BACKGROUND: Agitated behavior is a widespread problem that adversely affects the health of nursing home residents and increases the cost of their care. OBJECTIVE: To examine whether modifying environmental stimuli by the use of calming music and hand massage affects agitated behavior in persons with dementia. METHOD: A four group, repeated measures experimental design was used to test the effect of a 10-minute exposure to either calming music, hand massage, or calming music and hand massage simultaneously, or no intervention (control) on the frequency and type of agitated behaviors in nursing home residents with dementia (N = 68). A modified version of the Cohen-Mansfield Agitation Inventory was used to record agitated behaviors. RESULTS: Each of the experimental interventions reduced agitation more than no intervention. The benefit was sustained and increased up to one hour following the intervention (F = 6.47, p<.01). The increase in benefit over time was similar for each intervention group. When types of agitated behaviors were examined separately, none of the interventions significantly reduced physically aggressive behaviors (F = 1.93, p=.09), while physically nonaggressive behaviors decreased during each of the interventions (F = 3.78, p< 01). No additive benefit resulted from simultaneous exposure to calming music and hand massage. At one hour following any intervention, verbally agitated behavior decreased more than no intervention. CONCLUSION: Calming music and hand massage alter the immediate environment of agitated nursing home residents to a calm structured surrounding, offsetting disturbing stimuli, but no additive benefit was found by combining interventions simultaneously.     

Observed behaviors of patients with probable Alzheimer's disease who are hospitalized for diagnostic tests

This study examines observed behaviors of hospitalized patients with probable Alzheimer's disease (AD) undergoing invasive diagnostic procedures. Data was obtained from nursing documentation in the medical records of 30 patients, 10 in each stage of AD (i.e., mild, moderate, severe). In general, analysis of the data revealed that changes in behavior occurred immediately prior to, during, and following these procedures. Specifically, the moderately impaired patients showed the most significant curve over the 5-day observation period, while patients in the mildly impaired group showed a high peak of behavioral change on the test day. The severely impaired group of patients had a higher sustained level of activity throughout the 5-day period. Routine assessment of the patients' usual behaviors, care-givers' knowledge of the stage of disease, and awareness of the potential impact that diagnostics may have on cognitively impaired patients could help care providers decide what interventions most likely would lead to successful outcomes.     

The management of diabetes in everyday life study: Design and methods for a pragmatic randomized controlled trial comparing the effectiveness of text messaging versus health coaching

BackgroundAfrican American patients with uncontrolled diabetes living in medically underserved areas need effective clinic-based interventions to improve self-care behaviors. Text messaging (TM) and health coaching (HC) are among the most promising low-cost population-based approaches, but little is known about their comparative effectiveness in real-world clinical settings.ObjectiveUse a pragmatic randomized controlled trial design to determine the comparative effectiveness of TM and HC with enhanced usual care (EC) in African American adults with uncontrolled diabetes and multiple chronic health conditions.Methods/designThe Management of Diabetes in Everyday Life (MODEL) study is randomizing 646 patients (n = 581with anticipated 90% retention) to 3 intervention arms: TM, HC, and EC. Participants are African American adults living in medically underserved areas of the Mid-South, age ≥ 18, with uncontrolled diabetes (A1c ≥ 8), one or more additional chronic conditions, and who have a phone with texting and voicemail capability. Primary outcome measures: the general diet, exercise, and medication adherence subscales of the revised Summary of Diabetes Self-Care Activities questionnaire assessed at one year. Secondary outcomes: diabetes-specific quality of life, primary care engagement, and average blood sugar (A1c). The study will also assess heterogeneity of treatment effects by six key baseline participant characteristics.ConclusionsWe describe the design and methods of the MODEL study along with design revisions required during implementation in a pragmatic setting. This trial, upon its conclusion, will allow us to compare the effectiveness of two promising low-cost primary care-based strategies for supporting self-care behaviors among African Americans individuals with uncontrolled diabetes.ClinicalTrials.gov registration number: NCT02957513     

行为转变理论在2型糖尿病患者足部自护行为中的应用

目的 探讨行为转变理论在帮助2型糖尿病患者建立足部自护行为中的作用.方法 选择广州某社区120例2型糖尿病患者作为研究对象,随机分为干预组和对照组.干预组接受行为转变理论与行为转变阶段匹配的护理干预,对照组接受单纯的糖尿病足部知识教育.结果 干预后两组患者足部自护行为比较有统计学意义(P<0.05).处理因素与随访时间存在交互效应,说明随着随访时间的推进,两组干预效果差异显著.两组足部皮肤干燥皲裂、甲沟炎、皮肤损伤干预组发生率低于对照组,两组比较有统计学意义(P<0.05).结论 行为转变理论对帮助2型糖尿病患者建立足部自护行为有促进作用,良好的足部自护行为能有效改善2型糖尿病患者足部皮肤情况.