Caring for the wounded healer—nurturing the self

Health professionals have to deal with a “wounded society”, for example, violence, natural disasters and displaced people. Shortage of health professional groups and the high use of complementary therapies may reflect professional wounds, such as stress and burnout. Self-care is an important aspect of health professionals’ lives, given modern-day work stressors that can affect an individual's physical, mental and spiritual health. Often people become healers through personal suffering. Each person wounded or not, needs to understand his or her own need to be nurtured, and develop and implement a self-care health programme. Personal and professional reflection are important to understanding the nature of events that lead to “wounds” and how they can be transcended and the experiences used in holistic care. Aromatherapy can be a useful addition to self-care especially in managing stress and minor self-limiting conditions.     

腹膜透析患者的自理能力和家庭辅助能力对临床预后的影响

目的探讨腹膜透析患者自理能力和家庭辅助能力对患者长期生存的影响.方法对155例腹膜透析患者进行随访,对其进入腹膜透析的情况,以及退出和死亡的情况予以记录,并对患者的自理能力和家庭辅助能力予以调查.结果患者的自理能力对患者生存率具有显著的影响作用(P《0.01),且具有完全自理能力和部分自理能力的患者,其患者生存率明显高于无自理能力的患者(P《0.01);而家庭辅助能力对患者生存率无显著的影响作用(P》0.05).结论患者的自理能力与临床预后相关,提示提高患者的自理能力可能有助于改善临床预后.     

Empowerment of patients with end-stage renal disease--a randomized controlled trial

The purpose of the study is to investigate the effectiveness of an empowerment program on empowerment level, self-care self-efficacy and depression in patients with end-stage renal disease. The study was a randomized controlled trial; qualified patients in two dialysis centers of major hospitals in southern Taiwan were randomly assigned into an empowerment group (n=25) and a control group (n=25). The empowerment program included identification of problem areas for self-management; exploration of emotions associated with these problems; development of a set of goals and strategies to overcome these problems to achieve these goals; creation and implementation of behavioral change plans; and stress management.The outcomes measured were the Empowerment Scale, the Strategies Used by People to Promote Health and the Beck Depression Inventory. Data were collected at baseline and 6 weeks following intervention. Primary statistical analysis was by means of t-test and analysis of covariance. The results indicated that scores of the empowerment (t(48)=6.54, p<0.001), self-care self-efficacy (F(1,47)=10.82, p=0.002) and depression (t(48)=2.49, p=0.03) in the empowerment group have a significantly greater improvement than the control group.     

The Effectiveness of Self-care Program on the Life Quality of Patients with Multiple Sclerosis in 2015

This study aimed to investigate the effectiveness of self-care plan on the life quality of patients with Multiple sclerosis (MS). The samples in this study included all the patients with MS under medical coverage of Iranian Association of supporting patients with MS in Tehran in 2015 who were studied as Convenience sampling and based on the inclusion and exclusion criteria. In this study, Dr. Madani's self-care program as an intervention and The World Health Organization Quality of Life (WHOQOL)-BREF for assessment of consequences were used. Spss software using Wilcoxon and ANOVA tests were used to analyze the data. Values are significant at P value less than 0.05. Before the intervention, the quality of life was 59.91 ± 13.39 and after the intervention, it was 69.37 ± 11.73 and there was a significant difference between them (P value < 0.001). Also, there was a significant difference between the items of life quality-including the physical, psychological and social relationships and living environment items-before and after the interventions. Self-care program has an effect on the quality of life and physical, psychological and social relationships and living environment items.     

心力衰竭患者心衰自理行为现状及影响因素研究

目的研究心力衰竭(心衰)患者心衰自理行为状况及其影响因素。方法以修订的心衰自理行为量表为研究工具对102例心衰患者进行调查分析。结果心衰患者对不吸烟、限制饮酒、出现呼吸困难时立即休息以及每天按时服药的自理行为最好,而对接种流感疫苗、监测体重以及疲劳乏力时应及时就医的自理行为最差。年龄、性别、婚姻状况及是否独身对心衰自理行为总分的影响无统计学差异(P>0.05),而教育程度、经济收入和病程对心衰自理行为总分的影响有统计学差异(P值分别为0.000、0.001和0.038),且与心衰自理行为总分之间均呈正相关(P值分别为0.000、0.000和0.019)。结论心衰患者自理行为能力总体上处于较低水平,对心衰患者应实施针对性健康教育,将每年接种流感疫苗、每天称体重以及疲劳乏力时应及时就医等作为重点内容,将教育程度低、经济收入低和病程较短的心衰患者作为重点对象,确保心衰自理行为的数量和质量适宜于患者的具体情况。     

健康信念模式教育矫正精神分裂症患者自理行为缺陷的研究

目的探讨健康信念模式教育对精神分裂症患者自理行为缺陷的矫正效果。方法将146例符合CCMD-2-R精神疾病诊断标准的精神分裂症患者随机分为研究组和对照组,对照组除不实施健康信念教育模式外,余同研究组。采用IPROS及自理行为缺陷标准对所有患者分别于教育前及教育后进行评定。结果通过健康信念模式教育矫正后,研究组患者的自理行为能力明显改善,教育4周末研究组IPROS及自理行为缺陷标准的评分与对照组有明显差别(均P<0.05)。结论对精神分裂症患者实施健康信念模式教育,可有助于患者自理行为缺陷的矫正。     

An Examination of Parenting Variables and Child Self-Care Behavior Across Disease Groups

The present study examined the relationship of three parent-related variables, namely, perceived child vulnerability, parental overprotection, and parenting stress to child self-care behaviors among 200 children with Type 1 diabetes, asthma, or cystic fibrosis. A related goal of the study was to examine for illness- and age-related differences among the same variables of interest. Results indicated that higher levels of parenting stress were associated with lower parent ratings of their child’s self-care behaviors. Additional analyses of individual illness groups demonstrated that age was significantly related to both child and parent ratings of self-care only for the diabetes group, with older children engaging in lower levels of self-care. Such results support continued investigation of parent behaviors and beliefs as they relate to child self-care outcomes at different ages in pediatric chronic illness populations.     

恢复期老年患者自我护理能力与家庭支持的相关性研究

目的了解恢复期老年患者的自我护理能力和家庭支持的关系,为切实提高其的自我护理能力提供参考依据。方法采用问卷调查法对本院144名住院恢复期老年患者的自我护理能力和家庭支持状况进行调查。结果恢复期老年患者的自我护理能力评分为(118.12±12.25)分,自护能力处于低、中、高水平者分别占0%、56%、88%。恢复期老年患者家庭支持得分为4～12(8.03±1.463)分;其家庭支持水平因文化程度、既往职业、经济收入、慢性疾病数的不同而存在显著差异(均P<0.01);恢复期老年患者的自我护理能力及其自我概念、自护动机、自护知识维度和家庭支持呈显著正相关(均P<0.01)。结论家庭支持的提高对恢复期老年患者自我护理能力有促进作用。作为护理工作者应充分利用一切家庭力量为老年人提供心理和信息支持,采取各种措施挖掘老年人的自我护理潜能,以全面提高老年人的自我护理能力。     

首次透析患者的健康教育

为了提高血液透析患者的生存质量,减少并发症,降低医疗费用,减轻家属负担,本文从首次透析患者的心理方面、饮食方面以及内瘘保护方面给予针对性指导,通过对首次透析患者实施健康教育,患者得到了更多的健康知识信息,提高了患者对自身相关疾病的认知程度,从而形成有利于自身健康的行为习惯,避免了许多影响透析的不利因素,使患者从有症状的被动透析变为无症状的主动透析,减少了并发症的发生。经过系统的健康教育,让患者饮食更科学,生活方式更健康,有效地提高了患者的生存质量。     

自我护理培训在血液透析患者中的运用与护理效果评价

目的探讨自我护理培训在持续性血液透析患者护理中的作用。方法选择本院2010年3月～2012年1月收治的血液透析患者120例,随机分为对照组60例,观察组60例,对照组采用常规宣讲,观察组在常规宣讲的同时实施自我护理培训,比较6个月后对照组和观察组护理知识掌握情况,肌酐、尿素氮、血红蛋白、清蛋白等血液生化指标变化情况及并发症发生率。结果观察组在嘱医行为、合理饮食、体重控制、情绪稳定方面显著优于对照组（P〈0.05）;观察组肌酐、尿素氮显著下降（P〈0.05）,清蛋白、血红蛋白显著上升（P〈0.05）;可有效减少并发症的发生。结论自我护理培训可提高患者自我护理管理能力,改善患者健康状态,提高生活质量,减少并发症发生。