The quantified patient: a patient participatory culture

The Quantified Self Movement, which aims to improve various aspects of life and health through recording and reviewing daily activities and biometrics, is a new and upcoming practice of self monitoring that holds much promise. Now, the most underutilized resource in ambulatory health care, the patient, can participate like never before, and the patient’s Quantified Self can be directly monitored and remotely accessed by health care professionals.     

Measurement of psychological adjustment to diabetes with the diabetes acceptance scale

Aims

To develop a psychometric measure of diabetes acceptance.

自我管理教育对吸毒伴胃、十二指肠溃疡穿孔患者生存质量的影响

目的探讨自我管理教育对吸毒伴胃、十二指肠溃疡穿孔患者生存质量的影响。方法对28例患者实施自我管理教育,6个月后比较干预前后患者药物成瘾者生存质量测定量表(QOL-DA)和自我护理能力测定量表(ESCA)得分情况。结果干预后患者心理功能、社会功能、戒断症状毒副作用及总分均比干预前明显提高(p<0.01),而躯体功能无明显改变(p>0.05);干预后患者ESCA各维度的得分显著提高(p<0.01)。结论自我管理教育不仅有利于吸毒伴胃、十二指肠溃疡穿孔患者的康复,而且能改善其生存质量。     

精神分裂症患者自我管理影响因素分析

目的了解精神分裂症患者自我管理现状,并分析其影响因素。方法采用一般资料调查表、精神分裂症患者自我管理量表,选取2013年12月²014年3月我院精神科出院的精神分裂症患者496例为研究对象,对其进行调查。结果精神分裂症患者的自我管理现状较差,平均得分(52.56±7.79),且其结果受患者性别、年龄、婚姻、受教育程度、是否首次发病等因素的影响,差异有统计学意义(p<0.05)。结论医务人员及其主要照顾者应教会患者掌握自我管理技能,提高患者的自我管理水平,稳定患者病情,促进患者的康复。     

自我管理教育对低位直肠癌保肛术后排便功能训练的效果评价

目的探讨自我管理教育对低位直肠癌保肛术后排便功能训练的效果。方法将已行低位直肠癌保肛术出院患者58例随机为干预组和对照组各29例,对照组患者给予常规护理,干预组患者采取自我管理教育进行护理。3个月后对两组的护理效果进行比较。结果干预组患者在缩短排便次数、提高肛门能力方面均优于对照组,两组比较有统计学意义(p<0.01)。结论自我管理教育可使患者排便次数缩短、控便能力增强,促进患者早日康复。     

同伴教育在维持性血液透析患者自我健康管理的影响研究

目的：研究同伴教育在维持性血液透析患者自我健康管理的影响效果。方法：选择参加医院＂血透患者之家＂的维持性血液透析（MHD）患者72例,采取自愿参加的原则分为两组,对照组通过对患者发放血液透析健康教育处方、随机教育、集中讲解授课等方式进行心理、内瘘自我护理、饮食、运动、透析并发症预防等进行护理指导,观察组在对照组的基础上开设同伴教育。6个月后比较两组患者依从性以及生活质量。结果：对照组回归社会就业7例,生活能自理20例,营养状况达标16例,负性情绪28例,依从性好21例;观察组分别为16例、30例、25例、8例、34例,与对照组相比,差异具有统计学意义（P〈0.05）。结论：同伴教育在维持性血液透析患者自我健康管理中有协同作用,明显的提高患者依从性及生活质量。     

高血压患者社区自我管理模式效果分析

目的探讨社区高血压患者建立自我管理小组开展健康自我管理的效果,为该地区建立科学、系统的高血压防治体系提供依据。方法2013年,在昆山市农村和城镇社区对220例高血压患者进行6个月的自我管理,并对管理效果进行分析。结果220例高血压患者,通过高血压自我管理活动,对高血压的诊断标准、理想血压值、危险因素、药物和非药物治疗等相关知识的知晓率分别较管理前显著提高,差异有统计学意义（P〈0．01）;每周进行规律性中等强度运动、每天坚持增加蔬菜和水果的摄入量、限盐饮食、规范测压、规范服药的患者比例管理前后分别为51．36％、54．55％、60．00％、76．36％、65．00％和79．55％、84．55％、98．64％、94．09％、88．64％,差异均有统计学意义（均P〈0．01）;吸烟的人数明显下降,管理前后患者吸烟比例分别为38．18％和11．82％（P〈0．01）;血压的控制率管理前后分别为71．36％和93．64％;居家购买血压计、每周测量血压者的比例显著增加,管理前后分别为26．36％和43．64％（P〈0．05）;对自我管理模式的认可比例管理前后分别为34．55％和98．18％（P〈0．01）。结论开展高血压自我管理,提高了高血压患者高血压相关知识的知晓率,促进了其不良生活行为方式的改变,提高了服药依从性和血压控制合格率,增强了高血压管理需求和患者自我效能,该方法是一种可行、有效、高效率的疾病管理模式。     

健康教育对提高2型糖尿病患者足部自护能力的效果评价

目的研究健康教育对提高2型糖尿病患者足部自护能力的效果。方法将120例具有糖尿病足高危因素的2型糖尿病患者纳入研究,随机分为给予强化健康教育的观察组和常规干预的对照组,观察糖尿病基础知识、足部自护能力以及下肢血管和神经功能。结果观察组患者与对照组相比,糖尿病基础知识（87.4±11.3 vs 75.4±9.6）及足部自护能力（79.4±10.4 vs 67.3±8.5）均高于对照组,差异有统计学意义（P〈0.05）;观察组患者的内膜中层厚度（0.11±0.01 vs 0.17±0.02 mm）、收缩期血管峰值血流速度（37.7±7.4 vs 46.20±7.01 cm/s）、运动潜伏期（3.1±0.6 vs 4.8±0.7 ms）均低于对照组,弹性程度（0.23±0.03 vs 0.17±0.01）、运动神经传导速度（51.3±8.9 vs 42.7±7.7 m/s）、感觉神经传导速度（53.2±6.9 vs 44.8±5.9 m/s）均高于对照组,差异有统计学意义（P〈0.05）;糖尿病基础知识及足部自护能力与内膜中层厚度、收缩期血管峰值血流速度、运动潜伏期呈负相关,与弹性程度、运动神经传导速度、感觉神经传导速度呈正相关。结论健康教育能够通过提高糖尿病基础知识及足部自护能力来改善下肢血管、神经功能,具有积极的临床价值。     

But do you think I’m cool?: Developmental differences in striatal recruitment during direct and reflected social self-evaluations

The current fMRI study investigates the neural foundations of evaluating oneself and others during early adolescence and young adulthood. Eighteen early adolescents (ages 11–14, M = 12.6) and 19 young adults (ages 22–31, M = 25.6) evaluated whether academic, physical, and social traits described themselves directly (direct self-evaluations), described their best friend directly (direct other-evaluations), described themselves from their best friend's perspective (reflected self-evaluations), or in general could change over time (control malleability-evaluations). Compared to control evaluations, both adolescents and adults recruited cortical midline structures during direct and reflected self-evaluations, as well as during direct other-evaluations, converging with previous research. However, unique to this study was a significant three-way interaction between age group, evaluative perspective, and domain within bilateral ventral striatum. Region of interest analyses demonstrated a significant evaluative perspective by domain interaction within the adolescent sample only. Adolescents recruited greatest bilateral ventral striatum during reflected social self-evaluations, which was positively correlated with age and pubertal development. These findings suggest that reflected social self-evaluations, made from the inferred perspective of a close peer, may be especially self-relevant, salient, or rewarding to adolescent self-processing – particularly during the progression through adolescence – and this feature persists into adulthood.     

Treatment of anastomotic stenosis and leakage after colorectal resection for cancer with self-expandable metal stents

Background

Self-expandable metallic stents can be used to treat patients with symptomatic anastomotic complications after colorectal resection.

Methods

Twenty patients with symptomatic anastomotic stricture after colorectal resection were treated with endoscopic placement of a self-expandable metal stent. Ten patients had “simple” anastomotic stricture. In the remaining 10 patients, a leak was associated with the stricture.

Results

The anastomotic leakage healed without evidence of residual stricture or major fecal incontinence in 8 of 10 patients. Overall, the anastomotic stricture was resolved in 14 of the 20 patients.

Conclusions

Self-expandable metal stents represent a valid adjunctive to treat patients with symptomatic anastomotic complications after colorectal resection for cancer. They have a complementary role to balloon dilatation in case of simple anastomotic stricture, and they improve the rate of healing when the stricture is associated with a leak.