Patients’ experiences of physical limitations in daily life activities when suffering from chronic heart failure; a phenomenographic analysis

Scand J Caring Sci; 2011; 25; 3–11
Patients’ experiences of physical limitations in daily life activities when suffering from chronic heart failure; a phenomenographic analysis The aim of the study was to describe how patients suffering from chronic heart failure conceived their physical limitations in daily life activities. An explorative and qualitative design with a phenomenographic approach was chosen, a total of 15 patients were interviewed. The findings indicate that participants perceived a variety of structural aspects pertaining to physical limitations in activities of daily life which resulted in four referential aspects. Need of finding practical solutions in daily life focused on how life had to be changed and other ways of performing activities of daily life had to be invented. Having realistic expectations about the future was characterised by belief that the future itself would be marked by change in physical functioning, but an incentive to maintain functions and activities ensured good quality of or even increased capacity in daily life. Not believing in one’s own ability included the perception of having no opportunity to improve ability to perform activities of daily life. There were perceptions of undesired passivity, undefined fear of straining themselves or performing activities that could endanger their health in addition to uncertainty about the future. In Losing one’s social role in daily life, participants described losing their social network and their position in society and family because of limited physical capacity. A lack of important issues, mental and physical, occurred when physical capacity was lost. In conclusion, patients suffering from chronic heart failure found new solutions to manage activities in daily life, including willingness to change focus and identify other ways of doing important things. Patients had an incentive to maintain functions and activities to ensure a good quality of and strengthen their physical capacity in daily life. Inability to trust in their physical capacity in combination with experienced limitations in daily life prevented patients from attempting to increase activities.     

延续护理对提高心脏瓣膜置换术后患者生存质量的研究

目的探讨延续护理对心脏瓣膜置换术患者出院后生活质量的影响。方法以2005年5月～2008年5月在我院心胸外科行人工机械瓣膜置换术的100名患者作为调查对象，随机分为实验组和对照组各50例。实验组行常规治疗和护理，患者出院后给予系统性延续护理2年。对照组按常规治疗和护理，患者出院后给予常规出院指导。两组患者分别于术后6个月、2年发放生存质量表进行问卷调查。比较两组患者的药物依从性、并发症发生率及生存质量。结果实验组术后6个月和2年的生存质量评分明显高于对照组，8项评价指标中差异有显著意义（P〈0．05）。结论延续护理可以促进心脏瓣膜置换术后病人早日康复，提高生存质量。     

综合康复护理在血管性痴呆患者中的应用

目的探讨综合康复护理在血管性痴呆患者中的应用效果。方法将60例血管性痴呆患者随机分为观察组和对照组。对照组给予血管性痴呆常规护理干预，观察组患者给予综合康复护理干预。采用简明精神状态量表（MMSE）对两组患者进行评分，采用巴氏指数（BI）对患者日常活动能力进行评定。结果观察组干预前MMSE评分、BI评分分别与对照组干预前比较，差异无显著意义（P〉0．05）；观察组和对照组干预后MMSE评分、BI评分与干预前比较，差异有显著意义（P〈0．05）；观察组干预后MMSE评分、BI评分与对照组干预后比较，差异有显著意义（P〈0．05）。结论综合康复护理干预能够显著改善血管性痴呆患者的认知功能，提高患者日常活动能力，护理效果显著，值得借鉴。     

肾母细胞瘤围术期的观察与护理

目的探讨家长教育对肾母细胞瘤围术期护理的临床效果。方法对照组16例患儿行常规护理,研究组16例患儿在对照组护理方法基础上,增加并强化对患儿家长的教育与护理指导。结果研究组患者问卷调查平均成绩和及格率均明显高于对照组,研究组患者病死率和并发症发生率明显低于对照组,平均住院时间明显短于对照组,数据经比较具有统计学差异（P〈0.05）。结论家长教育对肾母细胞瘤患儿有较好的临床护理疗效,可有效减少并发症和病死率,加快患儿康复。     

急诊观察室患者流行病学分析及对策

目的总结分析急诊观察室患者流行病学特点及临床疗效,为临床急诊治疗提供指导。方法以2007年1月-2010年12月收治的247 312例急诊观察室患者为研究对象,按年龄、性别、地域分布、疾病种类、发病时间、好转率、收入院百分率、死亡率等因素进行流行病学分析。结果各年度患者人数呈增加趋势,2010年减缓;城镇患者占91.5%;20～40岁患者占45.9%,40～60岁患者占27.2%,>60岁占21.3%;疾病种类分布中呼吸系统占42.4%,心血管疾病患者数量呈升高趋势,以老年人为主,中毒患者呈下降趋势。全年6、7、8月份因发热、上呼吸道感染患者较多,总数增加明显,其次11、12、1月份因慢性支气管炎急发患者较多,总数也有升高趋势;白天工作时间患者数量占66.2%;平均每天就诊人次为169.4人次,节假双休日平均每天就诊人次为191.1人次(P<0.01);各年度好转率呈升高趋势,收入院百分率无显著变化,死亡率无显著区别。结论近年急诊观察室患者以呼吸系统疾病为主,好转率呈升高趋势,但心血管疾病数量呈升高且有年轻化趋势,值得重视。     

多媒体教学结合PBL教学法在手术室临床教学的效果研究

多媒体教学和以问题为基础的学习(简称PBL)各有优、缺点.我院手术室2010年6月～2011年6月,在实习护生的临床教学中,应用"多媒体教学结合PBL教学法"的教学模式,并对教学效果进行评价,为手术室的临床教学提供了更为科学和合理的教学方法.现报告如下.     

Evaluation of a bibliotherapy manual for reducing psychological distress in people with depression: a randomized controlled trial

Aim. This article reports a study to evaluate the efficacy of a self‐help manual in reducing psychological distress in individuals with moderate depression. Background. The prevalence of depression in Thailand is increasing markedly (e.g. from 56–197 per 100,000 population between 1997–2007). Design. We conducted a randomized controlled trial with 54 outpatients with depression in Chiang Mai Province in Thailand. Method. Participants were assigned randomly to an intervention or control group. The intervention group participants were given a self‐help manual in addition to standard care and treatment while the control group received standard care and treatment. Psychological distress was measured with the Kessler Psychological Distress Scale. Data were collected between October 2007–April 2008. Results. The findings showed statistically significant differences between both groups in their levels of psychological distress (e.g. tiredness, hopelessness, restlessness). At post‐test, the distress scores of the intervention group were lower than those in the control group. Between post‐test and 1‐month follow‐up, distress scores continued to decrease steadily in the intervention group but only decreased slightly in the control group. Conclusion. The findings affirm the benefits of bibliotherapy or self‐help therapy in book form in helping to reduce psychological distress in people with moderate depression. The approach is easy to use and can be incorporated as an adjunct to standard care and treatment. Bibliotherapy can be used by community mental health nurses and other clinicians to reduce psychological distress and promote recovery in people with moderate depression.     

早期透析患者的生活指导

血透室护士能根据不同患者的年龄、病因和病情给予针对性的护理,对早期透析患者进行适宜的生活指导,提高患者对疾病的认识,在辅助治疗、延长生命上具有比较重要的意义。