病情及服药记录卡在家庭病床患者中应用的效果评价

目的 探讨病情及服药记录卡在家庭病床患者中的应用效果.方法 将126例家庭病床患者随机分为观察组和对照组各63例.对照组采用传统口头健康教育和服药指导;观察组由护士向每位患者发放病情及服药记录卡,指导实施方法 .用自行设计的调查表分别于患者住院时和住院后6个月调查患者自我保健知识掌握情况、医生和患者陪护对护理工作满意度及患者服药依从性.结果 观察组患者在使用病情及服药记录卡后患者自我保健知识掌握情况和医生及患者陪护满意度以及服药依从性方面明显高于对照组.结论 患者通过使用病情及服药记录卡,可有效改善其掌握自我保健知识,提高医生和患者陪护满意度及患者服药依从性.     

Regulating hospital use: length of stay, beds and whiteboards

This paper presents part of a larger study of contemporary nursing practice and the rationalisation of hospital length of stay. Informed by Michel Foucault's work on governmentality, length of hospital stay and the re-engineering of surgical services are examined, not in terms of numerical representations of hospital use, but as part of social and political processes through which certain concepts are made susceptible to measurement and practices are organised. Using data generated through fieldwork in a hospital surgical division this analysis offers understandings of how social practices around length of hospital stay are translated and how they pattern contemporary hospital nursing practice. Nursing practice is explored through the reconstitution of hospital beds and the demands of local administration of hospital length of stay.     

新型旋流降膜式洗涤冷却环的开发与研究

洗涤冷却环是水煤浆气化炉的关键部件之一，洗涤冷却水通过洗涤冷却环的分布，在洗涤冷却管内壁形成液膜，使高温合成气体迅速冷却，针对目前工业应用中的洗涤冷却环存在的液膜分布不均、抗堵塞能力差等缺点，开发了新型旋流降膜式洗涤冷却环。用激光多普勒测速仪（Dual PDA）研究了旋流降膜流动的速度及液膜厚度分布，得出降膜的轴径向速度与进水流量的均匀性及量值有关；液膜厚度在z=0．5m处趋于稳定；并比较了新型洗涤冷却环和普通洗涤冷却环的液膜分布，证明新型洗涤冷却环液膜分布均匀，能有效解决工业中存在的洗涤冷却管干壁现象。     

Characteristics associated with fear of falling and activity restriction in community-living older persons

OBJECTIVES: To identify the characteristics associated with restricting activity because of fear of falling (activity restriction) and to determine which characteristics distinguish older persons who restrict activity from those who have fear of falling but do not restrict their activities (fear of falling alone). DESIGN: Population-based cross-sectional study. SETTING: General community. PARTICIPANTS: One thousand sixty-four community-living persons aged 72 and older. MEASUREMENTS: Candidate predictors were identified from the following domains: demographic, health status, physical, psychosocial, and fall-related. The outcome measure was the report of no fear of falling, fear of falling alone,or activity restriction. RESULTS: Fifty-seven percent of the cohort reported no fear of falling, 24% reported fear of falling alone, and 19% reported restricting activity. The proportion of participants with poor health status, slow timed physical performance, activities of daily living disability, and poor psychosocial function was highest in those with activity restriction, intermediate in those with fear of falling alone, and lowest in those with no fear of falling. Of participants with fear of falling, characteristics independently associated with activity restriction were history of an injurious fall, slow timed physical performance, two or more chronic conditions, and depressive symptoms. CONCLUSION: Older persons who restrict activity are more physically frail and have a greater burden of chronic conditions and depressive symptoms than those who have fear of falling alone. These differences between persons with fear of falling may guide the refinement of clinical interventions and preventative programs.     

Homelessness and the use of acute psychiatric beds: findings from a one-day survey of adult acute and low-level secure psychiatric patients in North and South Thames regions

This paper describes the impact of homelessness on the use of adult acute and low-level secure psychiatric beds in North and South Thames regions. We specifically focus on those homeless patients who no longer required the acute psychiatric facilities in order to determine the complement of accommodation and alternative services necessary to enable them to be discharged. A point prevalence survey of all patients occupying adult acute and low-level secure psychiatric beds in North and South Thames regions was carried out on 15 June 1994. All patients occupying adult acute and low-level secure psychiatric beds in 54 mental health providers and seven private psychiatric units in North and South Thames regions were included in the survey. Demographic, admission, and diagnosis data were collected. Homeless patients were identified as those patients not living in permanent accommodation. Ward managers (nurses) were also asked to identify patients who, in their opinion, no longer required acute care and to identify more appropriate provision for these patients. Of the 3978 adult and low-level secure patients enumerated 20.5% (817) were recorded as homeless. A total of 306 homeless patients were identified by ward staff as inappropriately located, of whom 58.2% of were unsuitable to be discharged into the community but still required some form of alternative health provision, for example staffed-housing in the community and in-patient rehabilitation services based in hospitals. However, 51.8% of patients were suitable to be discharged back into the community and the majority required housing as a key component within their 'package of care'. Homeless psychiatric in-patients have contributed to the increasingly precarious state of mental health services provision and represent a failure to provide a sufficient level of community alternatives for those who can no longer access the long-stay hospital services, and for whom the pool of acute psychiatric beds is ever reducing.     

自适应平衡康复训练装置对老年脑卒中患者平衡功能及害怕跌倒的影响

目的观察自适应平衡康复训练装置对老年脑卒中患者平衡功能及害怕跌倒的影响,探讨其改善平衡功能,降低害怕跌倒,提高移动能力的作用。方法选取2018年3月至2020年10月在大连康复疗养中心接受康复治疗的老年脑卒中患者46例,采用随机数字表分为对照组和实验组,每组各23例。对照组给予常规康复训练,实验组在常规康复训练基础上,给予自行研制的自适应平衡康复训练装置治疗。于治疗前(M0)、治疗1个月(M1),治疗3个月(M3)后分别采用Berg平衡量表(BBS)、中文修订版跌倒效能量表(MFES)及起立-行走测试(TUGT)对两组患者进行疗效评定。结果在M0、M1两组各项评分比较,均差异无统计学意义(P>0.05)。M3,实验组BBS评分(39.48±2.35)分、MFES评分(87.47±11.67)分、TUGT计时(21.06±1.80)s较对照组BBS评分(38.09±1.13)分、MFES评分(80.76±10.45)分、TUGT计时(22.82±2.10)s均有改善,差异有统计学意义(P<0.05)。结论自适应平衡康复训练装置能够有效改善老年脑卒中后平衡功能,降低害怕跌倒,提...     

老年肌少症患者跌倒恐惧的研究进展

肌少症是一种增龄性疾病,在老年人中高发。老年肌少症患者由于肌肉质量、力量和躯体功能下降,跌倒风险增加,常常发生跌倒恐惧。而跌倒恐惧会导致患者刻意避免活动,反而增加跌倒风险,引起其他不良后果。本文对老年肌少症患者跌倒恐惧的发生现状、影响因素、评估工具和干预方法进行综述,以期为临床识别和干预跌倒恐惧提供参考。     

中医"治未病"说略

"治未病"是中医学先进和超前的医学思想,既是医疗保健的理想境界,也是衡量医者水平的重要标志。"未病"包括无疾之身、疾病隐而未发、发而未传三种状态;"治未病"具有三种境界,可概括为"未雨绸缪,保身长全""见微知著,救其萌芽""料在机先,阻截传变"。现代"治未病"切入点可以表达为:养生是基础,体质是根本,关注高危人群、发病先兆和干预亚健康状态是重点。中医"治未病"的意义主要体现于减轻医疗卫生负担、保障民众健康、发挥中医优势、实现中西医对话与交流等方面。     

The ABC Scale and Fall Risk: A Systematic Review

ABSTRACT

Objective: The aim of this systematic review was to assess the ability of the Activities-specific Balance Confidence (ABC) scale to predict the fall risk in older community-living adults. Methods: A systematic literature review was conducted from February 1, 2010, to October 8, 2010, through Pubmed, CINAHL and MEDLINE. Appraisal of full-text English articles, which were published from January 1996 to October 2010, provided the framework for this analysis. Results: On the basis of our inclusion/exclusion criteria, three studies qualified for inclusion in this review. Two of the three selected studies indicated a significant association between ABC scores and falls. The third study concluded that the ABC scale was unable to distinguish fallers from nonfallers. Conclusion: Despite the abundance of studies, which include the ABC scale, there is insufficient research that specifically examines the relationship between balance confidence scores with actual falls in community-dwelling older adults. In this population of adults, who live in the community and are aged at least 60 years, there is limited support for the hypothesis that the ABC scale can predict the fall risk.