依从性好与依从性差的抑郁症患者对抑郁症人群的外显与内隐刻板印象

目的：探讨依从性好与依从性差的抑郁症患者关于抑郁症人群的外显刻板印象与内隐刻板印象的特征及其关系。方法：选取符合入组条件的依从性好与依从性差的抑郁症患者各40人,所有被试均接受关于抑郁症人群的外显抑郁刻板印象与内隐抑郁刻板印象的测验。结果：①对于依从性好的抑郁症患者,积极外显的刻板印象强度显著高于依从性差的抑郁症患者（F＝6．77,P＜0．01）;消极的外显刻板印象显著低于依从性差的抑郁症患者（F＝10．08,P＜0．01）;②依从性好的抑郁症患者内隐刻板印象显著高于依从性差的抑郁症患者的内隐刻板印象（F＝11．73,P＜0．01）;③相关分析表明,依从性好的患者内隐刻板印象与其积极的外显刻板印象存在统计学差异（r＝0．38,P＝0．02）;依从性差的患者内隐刻板印象与其积极的外显刻板印象存在统计学差异（ r＝0．57,P＝0．00）。结论：依从性好的抑郁症患者存在积极的外显抑郁刻板印象与积极的内隐抑郁刻板印象,依从性差的抑郁症患者存在消极的外显抑郁刻板印象及消极内隐抑郁刻板印象。     

Rotavirus vaccination compliance and completion in a Medicaid infant population

We examined completion and compliance rates of rotavirus (RV) vaccination according to the recommendations of the Advisory Committee on Immunization Practices (ACIP) and the Food and Drug Administration approved Prescribing Information (PI) for Rotarix^® (RV1, GlaxoSmithKline Vaccines) and RotaTeq^® (RV5, Merck and Co.) among infants under one year of age covered by Medicaid programs. Healthcare claims data from state Medicaid programs that constituted the Truven Health MarketScan^® Multi-State Medicaid Database were retrieved from May 2008–June 2012. Infants were grouped under PI and ACIP cohorts based on the dosing regimens followed. The overall compliance per PI (n = 673,956) and ACIP (n = 695,612) recommendations were 24.5% and 28.2%, respectively; completion rates were 30.3% and 32.6%, respectively. In the PI cohort, infants who received RV1 had significantly higher compliance as compared with infants who received RV5 (65.2% vs. 31.3%; p < 0.0001); completion rates among infants receiving RV1 and RV5 were 65.3% and 46.4%, respectively (p < 0.0001). In the ACIP cohort, compliance with RV1 was significantly higher than RV5 (68.8% vs. 45.9%; p < 0.0001) as was the overall completion rate (73.5% vs. 48.8%; p < 0.0001). While compliance is increasing year over year, overall compliance of RV vaccines is suboptimal, with over 40% of eligible infants unvaccinated in both populations. The 2-dose RV vaccine showed better completion rates and higher compliance than the 3-dose RV vaccine in the United States. Public health initiatives focusing on suboptimal compliance and completion rates of RV vaccination in the Medicaid population could improve these metrics, thereby offering protection against RV infection.     

家庭教育-环境改良的延续性护理对小儿哮喘依从性、生活质量、复发率的影响

目的 探究基于家庭教育 环境改良的延续性护理应用于哮喘患儿对其依从性、生活质量、复发率的影响。方法 收集南京医科大学附属无锡第二医院儿科于2014年1月至2015年12月收治的接受常规护理干预的哮喘患儿62例作为对照组,2016年1月至2017年12月收治的接受基于家庭教育 环境改良的延续性护理的哮喘患儿62例作为观察组。对比两组患儿出院前以及出院3个月后依从性、生活质量以及复发率。结果 出院3个月后,观察组患儿依从性各指标均高于对照组,生活质量高于对照组,半年内哮喘复发率低于对照组,差异均有统计学意义（均P＜0.05）。结论 对哮喘患儿应用基于家庭教育 环境改良的延续性护理能有效提高患儿依从性,提升其生活质量并降低其哮喘复发率,值得推广。     

门诊输液室健康教育效果观察

目的 探讨在门诊输液室加强健康教育,提高输液患者的遵医行为,提高患者对疾病相关知识的知晓率,调高患者对护理服务质量的满意度,改善护患关系.方法 选择212例输液患者随机分为观察组和对照组各106例.对照组采用常规的输液护理,观察组在常规输液护理的基础上加强健康教育,二组患者对遵医行为的依从性,以及对疾病、药物、及输液知识的知晓率和对护理服务质量的满意度进行比较.结果 观察组的遵医行为,疾病、药物、输液相关知识的知晓率,以及对护理服务质量的满意度明显提高.结论 加强门诊输液室患者的健康教育可以提高患者的遵医行为及相关知识的知晓率,提高输液患者满意度,改善护患关系.     

松江区居民大肠癌筛查及检查顺应性的影响因素分析

目的研究居民大肠癌筛查结果及其检查顺应性的影响因素,为提高大肠癌的筛查效果提供依据。方法 2012—2013年选择上海市松江区40岁以上的大肠癌高危人群140 096人进行粪便潜血试验(FOBT),FOBT阳性者进行肠镜检查。同时对所有人群进行问卷调查,分析其对肠镜检查的应答情况,并分析对肠镜检查顺应性的影响因素。结果 FOBT阳性率为16.83%。肠镜检查8 566人,筛查率36.33%。诊断肠癌142例,检出率为1.66%。FOBT阳性率2013年15.78%与2012年18.16%比较,明显降低(P0.05),且肠镜检查率明显升高(45.66%,26.04%,P0.05)。多因素非条件Logistic回归分析显示,怕痛(OR=3.01)、认为没必要(OR=1.89)是肠镜检查顺应性的独立不利因素,而文化程度高(OR=0.92)、定期体检(OR=0.75)是肠镜检查顺应性的有利因素(P0.05)。结论松江区居民大肠癌筛查的顺应性不高,定期体检、文化程度高的高危人群更容易接受肠镜检查,怕痛、认为没必要是拒绝肠镜检查的主要原因。     

1例心脏病术后患者华法林抗凝治疗的用药分析

1例46岁男性患者,既往有房颤及脑梗塞病史,二尖瓣机械瓣膜置换术后予以华法林抗凝治疗。根据药物基因检测及合并用药情况,初始给予华法林2.5 mg po qd,监测INR值偏低,华法林调整至3.75 mg po qd后出院,一月后复查INR 1.64。在随访过程中,临床药师发现该患者出院后自2014年10月至2015年1月,华法林剂量上调,但抗凝效果不佳,有栓塞风险。经详细了解后,考虑与患者服药依从性差相关,建议家属严格监督患者每日按时按量服用华法林,在饮食上避免长期摄入大量含有维生素K的食物并戒酒,一周后复查INR为1.46,接近合适范围。     

Rectal compliance in females with obstructed defecation

PURPOSE: This study was designed to investigate whether rectal compliance is altered in females with obstructed defecation. METHODS: Eighty female patients with obstructed defecation and 60 control subjects were studied. Rectal compliance was measured with an infinitely compliant polyethylene bag. This bag was inserted in the rectum and inflated with air to selected pressure plateaus (range, 0–60 mmHg; cumulative steps of 2 mmHg with a duration of ten seconds) using a computer-controlled electromechanical barostat system. Volume changes at the levels of distending pressures were recorded. The distending pressures, needed to evoke first sensation of content in the rectum, earliest urge to defecate, and the maximum tolerable volume were noted. RESULTS: In all cases, the compliance curve had a characteristic triphasic (S-shaped) form. The mean compliance curve obtained from the patients was identical to that of the controls. However, the course of the compliance curve fell above the normal range (mean + 2 SD) in 14 patients. In ten (71 percent) of these patients, a large rectocele was seen at evacuation proctography. Such a rectocele was observed in only five patients (7.6 percent) with a normal compliance curve (P<0.001). Eighty percent of the controls experienced earliest urge to defecate during the second phase of the curve. In 75 percent of the patients, this occurred in the third phase. The mean pressure threshold for first sensation, earliest urge to defecate, and maximum tolerable volume were significantly higher in patients compared with control subjects. Ten of the patients experienced no sensation at all in the pressure range between 0 and 60 mmHg. CONCLUSION: In females with obstructed defection, the compliance of the rectal wall is normal.     

老年高血压患者药物治疗期间配合健康教育对患者遵医行为的影响

目的:分析老年高血压患者药物治疗期间配合健康教育对患者遵医行为的影响。方法:从本院2017年5月至2019年9月收治的患者中选取出60例患者作为本次研究的主要对象,并根据随机数字表法对患者进行分组,常规组30例,观察组30例。予以常规组患者药物治疗配合常规护理,予以观察组患者药物治疗配合健康教育。对两组患者治疗前后的血压控制情况,以及患者的生活质量评分和遵医行为进行对比。结果:两组患者治疗前,收缩压以及舒张压水平无显著差异(P>0.05);治疗后,与常规组患者相比,观察组患者的舒张压以及收缩压明显较低(P<0.05)。两组患者治疗前,生活质量评分无显著差异(P>0.05);治疗后,与常规组患者相比,观察组患者的生活质量评分明显较高(P<0.05)。观察组患者干预后的遵医行为明显优于常规组(P<0.05)。结论:通过给予老年高血压患者药物治疗并配合健康教育护理措施干预,能够使患者的血压水平得到明显控制,并提高患者生活质量,具有临床推广价值。