基于ADOPT问题解决模式下的个体化护理对口腔正畸患者自我 护理能力的影响

目的 探讨ADOPT问题解决模式下的个体化护理对口腔正畸患者自我护理能力的影响。方法 选 取2021年1月-12月我院正畸科收诊的80例正畸患者作为观察对象，采用自拟抽签法随机分为对照组与观察 组，各40例。对照组采用常规护理，观察组采用ADOPT问题解决模式下的个体化护理，比较两组干预前后 自我管理能力、生活质量以及社会心理适应能力。结果 两组干预后1个月生活质量以及自我管理能力评分 高于干预前，且观察组高于对照组，差异有统计学意义（P＜0.05）。观察组接受水平、持续担忧、积极 面对评分高于对照组，差异有统计学意义（P＜0.05）。结论 ADOPT问题解决模式下的个体化护理有助于 提升口腔正畸患者自我管理能力及社会心理适应能力，进而提高患者生活质量。     

永久性结肠造口患者自我护理能力的价值体会

目的探讨健康教育对永久性结肠造口患者自我护理能力改善的价值。方法选取2015年1月-2018年12月北京大学深圳医院收治的永久性结肠造口患者40例作为研究对象。所有患者均接受健康教育,评价患者健康知识及自我护理能力改善情况。结果护理前,患者健康知识评分及自我护理能力评分均较低。护理后,患者健康知识评分及自我护理能力评分明显高于护理前,差异均有统计学意义(P<0.05)。结论针对永久性结肠造口患者开展健康教育可进一步帮助患者增强自我护理能力,丰富其永久性结肠造口及护理相关知识,具有较高的护理价值,值得临床推广应用。     

Poor Nutritional Status among Low-Income Older Adults: Examining the Interconnection between Self-Care Capacity,Food Insecurity,and Depression

BackgroundUnderstanding of the mechanisms of how food insecurity and poor physical and mental health status are interrelated with nutritional status among older adults is needed due to their unique health and social needs.ObjectiveTo examine the complex relationships between self-care capacity, depressive symptoms, food insecurity, and nutritional status among low-income older adults.DesignThe cross-sectional study was conducted from February 2017 to May 2017.Participants/settingA total of 372 low-income older adults, 60 years of age and older, living in the state of Alabama participated.Main outcome measuresParticipants completed a validated survey measuring food insecurity (six-item US Food Security Survey Module), self-care capacity (Self-Care Capacity Scale), depressive symptoms (10-item Geriatric Depression Scale), and nutritional status (Mini Nutritional Assessment Short-Form).Statistical analyses performedGeneralized structural equation modeling was used to include the simultaneous equations and multiple mediators in one model. The Akaike Information Criterion, Bayesian Information Criterion, and likelihood ratio tests were conducted to compare the fit of competing model specifications.ResultsLower self-care capacity was associated with greater food insecurity (beta [b]=.11, odds ratio [OR]=1.11, P=0.03) and higher depressive symptoms (b=.08, P=0.005). Poorer self-care capacity and higher depressive symptoms were associated with poorer nutritional status (b=.24, OR=1.27, P<0.001; b=.13, OR=1.43, P=0.001, respectively). Higher food insecurity was associated with increased depressive symptoms (b=.40, P<0.001). Self-care capacity was associated with nutritional status directly and indirectly through depressive symptoms (b=.04, P=0.048). Although food insecurity was not significantly associated with nutritional status, a significant indirect association between food insecurity and nutritional status through depressive symptoms was observed (b=.02, P=0.04).ConclusionsStudy results indicate functionally impaired low-income older adults encounter greater food insecurity. Inability to afford food combined with limited ability to take care of oneself contributes to an increased self-report of depressive symptoms, resulting in less favorable nutritional status.     

延续性护理对老年糖尿病患者自护能力的影响

目的探讨对老年糖尿病患者实施延续性护理的临床效果,并研究其对患者自我护理能力的影响。方法选取我院2015年1月~2016年1月期间收治的89例老年糖尿病患者作为本次研究对象,将患者随机分组,行不同的护理方法。对照组(n=44)采取常规护理措施与宣传教育,研究组(n=45)出院后在对照组护理基础上行延续性护理干预措施,对比分析两组患者住院时和出院1年后的自我护理状况,采取自我护理能力测定量表进行调查。结果研究组患者出院时自我护理能力总分、护理技能、护理责任感、自我概念、健康理论等ESCA的各项指标与对照组相比,差异无统计学意义(P0.05),研究组出院1年后的自我护理能力总分、护理技能、护理责任感、自我概念、健康理论等ESCA的各项指标显著高于对照组,且研究组自我护理能力总分出院时为(104.32±9.93),出院1年后评分为(116.18±11.04);对照组自我护理能力总分出院时为(103.97±11.65),出院1年后评分为(101.91±10.14);两组比较有统计学意义(P0.05)。结论延续性护理应用在老年糖尿病患者中效果明显,能够有效提高患者的自我护理能力,值得临床应用推广。     

护理干预对2型糖尿病患者自我护理能力及生活质量的影响

目的探讨护理干预对2型糖尿病患者自我护理能力及生活质量的影响。方法选择2018年7～12月在我院诊断治疗的2型糖尿病患者60例为研究对象,随机分为干预组与对照组,各30例。对照组给予常规处理,干预组给予针对性护理干预。分别于干预前及干预后1个月采用自我管理量表对患者自我护理能力进行评价,采用SF-36量表对患者生活质量进行评价,比较两组干预前及干预后1个月自我护理能力、生活质量。结果干预后两组自我护理能力均显著提高,与干预前比较,差异有统计学意义(P0.05);干预后,干预组自我护理能力显著高于对照组,差异有统计学意义(P0.05)。干预后,两组SF-36各维度得分均显著高于干预前,差异有统计学意义(P0.05);干预后,干预组SF-36评分显著高于对照组,差异有统计学意义(P0.05)。结论护理干预能够显著提高2型糖尿病患者的自我护理能力,改善患者生活质量。     

Striving for Control: Cognitive, Self-Care, and Faith Strategies Employed by Vulnerable Black and White Older Adults with Multiple Chronic Conditions

The average older adult reaches age 65 with at least two chronic, co-occurring illnesses, or multiple morbidities (MM). We currently lack critical information about the specific strategies older adults use to attempt to control these MM. To increase our understanding of how older adults attempt to manage these MM and retain control of their health, in-depth interviews were conducted with 41 Black and White middle aged and older men and women with MM. We were particularly interested in representing the experience of those groups more vulnerable to adverse health outcomes due to greater disease prevalence and low income. During in-depth interviews, we asked open-ended questions on life and health history and open-ended and semi-structured questions about self-care for multiple morbidities. Participants expressed a strong desire to remain in control of their health; to do so they employed a wide range of strategies including cognitive structuring techniques (being health vigilant, normalizing, resignation/relinquishing control, and social comparison), self-care activities (emphasizing diet, exercise, medication taking, modifying existing activities, going to the doctor), and faith orientations (prayer as a constructive support strategy, gaining strength from God, church as a central part of life). With the exception of faith orientations, there were no race/ethnicity differences in the strategies participants use. Future studies should expand on this knowledge by exploring the contextual, cultural, and psychological backdrop and characteristics that shape the use of these coping strategies.

Diabetes Self-care among a Multiethnic Sample of Older Adults

Type 2 diabetes constitutes a leading and increasing cause of morbidity and mortality among older adults, particularly African Americans, Native Americans, Mexican Americans, and rural dwellers. To understand diabetes self-care, an essential determinant of diabetic and overall health outcomes, 80 middle aged and older adults from these four disproportionately affected racial/ethnic/residential groups engaged in in-depth interviews, focusing on approaches to and explanations for diabetes self-care. Certain self-care activities (medication-taking, diet, foot care) were performed regularly while others (blood glucose monitoring, exercise) were practiced less frequently. Despite research suggestions to the contrary, only one in four elders used unconventional diabetes therapies, and only one-third listed someone other than a health care provider as a primary information source. Few self-care differences emerged according to race/ethnicity/residence, perhaps because of the influential and common circumstance of low income. Thematic analyses suggest that inadequate resources, perceived efficacy of medication, great respect for biomedical authority, and lack of familiarity with and concerns about unconventional therapies are influential in establishing these patterns of self-care. We discuss the similarity of self-care practices and perspectives irrespective of race/ethnicity/residence and the predominance of biomedical acceptability.     

教育干预对小儿肾病综合征自我护理能力和治疗效果的影响

目的 探讨教育干预对小儿肾病综合征自我护理能力和治疗效果的影响.方法 选取2015年11月至2016年7月本院收治的小儿肾病综合征患者68例,给予对照组患儿常规肾病综合征护理措施,实验组患儿在对照组护理方案基础上施加教育干预.采用欧洲肾病综合征自我护理行为量表对患儿自我护理能力进行评价,对两组患儿的治疗效果进行评价并分析.结果 经过护理干预后,实验组患儿治疗有效率显著高于对照组(94.1％比2.4％,P＜0.05);护理干预前肾病综合征自我护理行为量表得分两组比较差异无统计学意义(P＞0.05),干预后实验组患儿量表得分降低明显(P＜0.05).结论 针对小儿肾病综合征患者治疗过程中采用健康教育进行干预,明显提高了患儿自我护理能力,提升了疾病治疗效果,对于缩短肾病综合征患儿的治疗时间,提高肾病综合征患儿的生活质量具有重要意义.     

Fall prevention intervention technologies: A conceptual framework and survey of the state of the art

In recent years, an ever increasing range of technology-based applications have been developed with the goal of assisting in the delivery of more effective and efficient fall prevention interventions. Whilst there have been a number of studies that have surveyed technologies for a particular sub-domain of fall prevention, there is no existing research which surveys the full spectrum of falls prevention interventions and characterises the range of technologies that have augmented this landscape. This study presents a conceptual framework and survey of the state of the art of technology-based fall prevention systems which is derived from a systematic template analysis of studies presented in contemporary research literature. The framework proposes four broad categories of fall prevention intervention system: Pre-fall prevention; Post-fall prevention; Fall injury prevention; Cross-fall prevention. Other categories include, Application type, Technology deployment platform, Information sources, Deployment environment, User interface type, and Collaborative function. After presenting the conceptual framework, a detailed survey of the state of the art is presented as a function of the proposed framework. A number of research challenges emerge as a result of surveying the research literature, which include a need for: new systems that focus on overcoming extrinsic falls risk factors; systems that support the environmental risk assessment process; systems that enable patients and practitioners to develop more collaborative relationships and engage in shared decision making during falls risk assessment and prevention activities. In response to these challenges, recommendations and future research directions are proposed to overcome each respective challenge.     

应用健康信念模式对乳腺癌术后患者自我护理能力的影响研究

目的:探讨应用健康信念模式对乳腺癌术后患者自我护理能力的临床效果。方法:将60例乳腺癌术后患者随机的分为试验组和对照组,每组各30例,试验组患者应用健康信念模式(HBM)的方法,对照组患者应用传统的健康教育模式,采用自我护理能力量表(ESCA)对两组患者的自我护理能力,自我护理技能,自我责任感,自我概念、健康知识水平进行评估。结果:试验组患者应用健康信念模式后,自我护理能力、自我护理技能、自护责任感、健康知识水平等方面得分明显高于对照组。结论:健康信念模式是乳腺癌术后患者健康教育最佳的指导理论。能够显著提高乳腺癌术后患者自我护理的能力,促进疾病的康复。