情景模拟训练对脑卒中患者日常生活自理能力的影响

目的 探讨情景模拟训练对脑卒中患者日常生活自理能力的影响.方法 入选我院2011年10月至2013年10月收治的116例脑中风患者.以数字法随机分成观察组（58例）和对照组（58例）.对照组采用临床上常用的治疗和护理方法;观察组在对照组基础上进行情景模拟训练,对比两组患者生活自理情况.结果 观察组疗效为优者占比例77.59％ （45/58）,优良率为91.38％ （53/58）,均高于对照组.差异具有统计学意义（P＜0.05）.发病后,缺血性脑卒中和出血性脑卒中Barthel指数较发病前均显著下降,差异均有统计学意义（均P＜0.05）.3个月及12个月后,除排尿和排便外,Barthel指数评分均显著提高,且观察组优于对照组,差异均具有统计学意义（均P ＜0.05）.结论 情景模拟训练对脑卒中患者日常生活自理能力有很好的效果,不仅可以减少患者的痛苦,还可以使患者家属提前准备,值得临床推荐.     

Effect of neighborhood factors on diabetes self-care behaviors in adults with type 2 diabetes

ObjectiveThe objective of this study was to identify latent variables for neighborhood factors and diabetes self-care and examine the effect of neighborhood factors on diabetes self-care in adults with type 2 diabetes.Research design and methods615 subjects were recruited from an academic medical center and a Veterans affairs medical center in the southeastern United States. Validated scales were used to assess neighborhood factors and diabetes-related self-care. Confirmatory factor analysis (CFA) was used to determine the latent constructs. Structural equation modeling (SEM) was then used to assess the relationship between neighborhood factors and diabetes self-care.ResultsBased on a theoretical framework, CFA yielded four latent variables for neighborhood factors (neighborhood violence, access to healthy food, social support, and neighborhood esthetics) and one latent variable diabetes self-care (including diet, exercise, foot care, blood sugar testing and medication adherence). SEM showed that social support (r = 0.28, p < 0.001) and access to healthy foods (r = −0.16, p = 0.003) were significantly associated with self-care behaviors, while neighborhood violence (r = −0.06, p < 0.001) and esthetics (r = −0.07, p = 0.278) were not χ² (180, N = 611) = 192, p = 0.26, RMSEA = 0.01, CFI = 0.999). In the final trimmed model, social support (r = 0.31, p < 0.001) and access to healthy foods (r = −0.20, p < 0.001) remained significantly associated with self-care behaviors χ² (76, N = 611) = 60, p = 0.91, RMSEA = 0.00, CFI = 1.0).ConclusionThis study developed latent factors for neighborhood characteristics and diabetes self-care and found that social support and access to healthy foods were significantly associated with diabetes self-care and should be considered as targets for future interventions.     

Tratamiento del paciente con artrosis

The therapeutic management of patients with osteoarthritis aims to decrease pain and inflammation, improve physical function, and to apply safe and effective treatments. A patient-centered approach implies the active participation of the patient in the design of the treatment plan and in timely and informed decision-making at all stages of the disease. The nucleus of treatment is patient education, physical activity and therapeutic exercise, together with weight control in overweight or obese patients. Self-care by the individual and by the family is fundamental in day-to-day patient management. The use of physical therapies, technical aids (walking sticks, etc.) and simple analgesics, opium alkaloids, and antiinflammatory drugs have demonstrated effectiveness in controlling pain, improving physical function and quality of life and their use is clearly indicated in the treatment of osteoarthritis. Conservative surgery and joint replacement is indicated when treatment goals are not achieved in specific patients.     

Self-management support activities in primary care: A qualitative study to compare provision across common health problems

ObjectiveTo explore the views of primary care teams about the provision of self-management support to patients with common health problems.MethodsSemi-structured interviews were conducted with twenty-one members of the primary care team from thirteen general practices. Interviews were transcribed verbatim, and analysed using the ‘Framework’ approach.ResultsThree categories and six sub-categories illustrating different self-management support activities across common health problems were identified from the analysis of interviews, and contributed to one major theme and one cross-cutting theme. Referral and signposting were frequently used to facilitate patient engagement with external services and resources. Practitioners faced some challenges in balancing medical management and psychosocial support and motivating patients to engage with self-management.ConclusionsPrimary care teams described providing a wide range of self-management support activities, but the pattern of use varied for different types of health problem. These patterns may have been influenced, in part, by general practices focusing upon achieving financially incentivised quality improvement goals.Practice implicationsTo improve self-management support, practitioners need a digital repository of services/resources, motivational interviewing skills, an understanding of the optimum duration and pattern of consultations, and incentivised targets that match a biopsychosocial model of care.     

基于行动研究实践理论的健康教育对直肠癌造口患者自我效能和自护能力的影响

目的探讨基于行动研究实践理论的健康教育对直肠癌造口患者自我效能和自护能力的影响。方法选择2017年1月至2019年1月我院收治的直肠癌造口患者80例,将其随机等分为对照组和观察组,对照组进行常规健康教育,观察组基于行动研究实践理论开展健康教育,3个月后比较两组患者自我效能调查量表以及自护能力量表(ESCA)评分。结果干预后3个月观察组患者造口照顾、饮食选择、社交、劳动信心、生活自理信心、性生活信心评分均高于对照组,差异具有统计学意义(P<0.05);护理技能、自我责任、健康知识水平、自我概念评分均高于对照组,差异具有统计学意义(P<0.05)。结论基于行动研究实践理论的健康教育通过观察、反思,不断改进行动干预,能够有效提升直肠癌造口患者自护能力与自我效能,值得临床推广应用。     

延续性护理对克罗恩病患者生存质量与自护能力的影响

目的探讨延续性护理对克罗恩病患者生存质量及自护能力的影响。方法选取我院2018年1—12月收治的克罗恩病患者50例作为研究对象,随机将其等分成对照组和观察组,对照组采用出院指导,观察组采用延续性护理,比较两组患者生存质量及自护能力。结果观察组生存质量各项评分、自护能力各项评分均高于对照组(P<0.05)。结论在克罗恩病患者中应用延续性护理能改善生存质量,增强自护能力。     

聚焦解决模式对基底节区脑出血患者术后自护能力的影响

目的探讨聚焦解决模式对基底节区脑出血患者术后自护能力的影响效果。方法选取2017年5月至2019年5月在我院接受治疗的脑出血患者98例作为研究对象,随机将其等分为对照组和观察组,对照组行常规护理,观察组在对照组基础上行聚焦解决模式护理,观察两组运动功能、日常生活能力及自护能力改善情况。结果观察组Barthel指数与Fugl-Meyer评分均高于对照组,差异有统计学意义(P<0.05);观察组自护信心、自护管理及自护维持得分均高于对照组,差异有统计学意义(P<0.05)。结论聚焦解决模式的实施可显著改善脑出血患者术后自护能力和日常生活能力,值得推广。     

护士自我关怀及其测量的研究进展

随着护理领域对关怀的深入研究,护士自我关怀的重要性逐渐凸显出来。近年来国内外对护士自我关怀进行了一系列的研究,本文通过对现有文献进行归纳、整理,就护士自我关怀的概念、内涵、理论基础、测量工具等进行综述,对护士自我关怀的现状进行了评价,旨在为进一步的研究提供参考。     

三维护理管理对胸腔镜食管癌切除术患者呼吸功能锻炼依从性及自护能力的影响

目的 探讨三维护理管理对胸腔镜食管癌切除术患者呼吸功能锻炼依从性及自护能力的影响.方法 选取0018年0月至0000年4月我院收治的胸腔镜食管癌切除术患者40例,随机分为两组各00例.对照组给予常规护理,观察组在对照组基础上给予三维护理管理.比较两组护理前后的呼吸功能锻炼依从性及自护能力.结果 护理后,观察组的呼吸功能...