基于Orem自理理论康复护理联合情志干预对脑梗死偏瘫患者神经功能、自护能力及生活质量的影响

目的:探究基于Orem自理理论康复护理联合情志干预对脑梗死偏瘫患者神经功能、自护能力及生活质量的影响。方法:选取2018年6月至2019年2月在雅安市中医医院进行脑梗死治疗的100例患者,根据患者入院时间将其分为常规组及研究组,对常规组患者行常规护理,对研究组患者行基于Orem自理理论康复护理联合情志干预,比较两组患者...     

Self-care in Heart Failure Hospital Discharge Instructions—Differences Between Nurse Practitioner and Physician Providers

Patients with heart failure (HF) are at risk for frequent readmission potentially due to self-care deficits. Medical doctors (MDs) and nurse practitioners (NPs) both provide discharge instructions. However, each type of provider may emphasize different elements of care. The aim of this study was to analyze and compare the content of the documentation of 50 discharge instructions of heart failure patients written by NPs and MDs. Compared with MDs, NPs placed greater emphasis on symptom identification, and were more likely to advise and schedule follow-up appointments with primary care and cardiology providers rather than advising an appointment was needed without scheduling one.     

An Automated Telephone Nutrition Support System for Spanish-Speaking Patients With Diabetes

In the United States, Spanish-speaking patients with diabetes often receive inadequate dietary counseling. Providing language and culture-concordant dietary counseling on an ongoing basis is critical to diabetes self-care. To determine if automated telephone nutrition support (ATNS) counseling could help patients improve glycemic control by duplicating a successful pilot in Mexico in a Spanish-speaking population in Oakland, California. A prospective randomized open-label trial with blinded endpoint assessment (PROBE) was performed. The participants were seventy-five adult patients with diabetes receiving care at a federally qualified health center in Oakland, California. ATNS, a computerized system that dialed patients on their phones, prompted them in Spanish to enter (via keypad) portions consumed in the prior 24 hours of various cultural-specific dietary items, and then provided dietary feedback based on proportion of high versus low glycemic index foods consumed. The control group received the same ATNS phone calls 14 weeks after enrollment. The primary outcome was hemoglobin A1c % (A1c) 12 weeks following enrollment. Participants had no significant improvement in A1c (–0.3% in the control arm, –0.1% in the intervention arm, P = .41 for any difference) or any secondary parameters. In our study, an ATNS system did not improve diabetes control in a Spanish-speaking population in Oakland.     

Ventricular Assist Devices: A Review of Psychosocial Risk Factors and Their Impact on Outcomes

BackgroundPsychosocial contraindications for ventricular assist devices (VADs) remain particularly nebulous and are driven by institution-specific practices. Our multi-institutional, multidisciplinary workgroup conducted a review with the goal of addressing the following research question: How are preoperative psychosocial domains predictive of or associated with postoperative VAD-related outcomes? Answers to this question could contribute to the development of treatment-specific (contra) indications for patients under consideration for mechanical devices.Methods and ResultsWe identified 5 studies that examined psychosocial factors and their relationship to postoperative VAD-related outcomes. Our results suggest that 3 psychosocial variables are possibly associated with VAD-related outcomes: depression, functional status, and self-care. Of the few studies that exist, the generalizability of findings is constrained by a lack of methodologic rigor, inconsistent terminology, and a lack of conceptual clarity.ConclusionsThis review should serve as a call for research. Efforts to minimize psychosocial risk before device placement can only be successful insofar as VAD programs can clearly identify who is at risk for suboptimal outcomes.     

Screening for determinants of self-care in patients with chronic heart failure

Heart failure self-care is vital to achieving clinical stability and improved health outcomes. Yet despite the attention it has been given, in both research and clinical practice, effective self-care remains elusive. It is recognised that there are many patient factors that impact on attaining effective self-care skills. Systematic research is warranted to resolve the knowledge gap of how patients process information and develop the necessary self-care skills. In addition, sound screening tools are needed to assess factors that hinder the development of effective heart failure self-care skills. In this manner, education and support strategies can be applied on an individualised needs basis to enhance health outcomes.     

Assessment of Problem-Solving: A Key to Successful Diabetes Self-Management

Problem-solving skill is important for chronic illness self-management. This project prospectively evaluated a measure of diabetes problem-solving skill for its reliability, convergent validity, sensitivity to intervention, and relationship to change in behavior. Postmenopausal women with type 2 diabetes (N = 279) participated in a RCT to evaluate a lifestyle modification program. The 9-item Diabetes Problem-Solving Inventory (DPSI) was used to assess how patients cope with challenges to diabetes self-care. The DPSI was found to have good inter-rater reliability and internal consistency for a brief scale, be moderately stable over time, and relate significantly to hypothesized variables. DPSI scores improved significantly more in the lifestyle change condition than in controls and were related to improved outcomes. Mediation analyses indicated that the increase in problem-solving was a partial mediator of outcomes. Results support the reliability, predictive ability, and sensitivity to change of the DPSI. Directions for future research on problem-solving and chronic illness are discussed.     

规范化自我护理方案在提升皮肤软组织扩张治疗患者护理质量中的应用

目的 探索运用规范化自护方案提升皮肤软组织扩张术患者护理质量的效果.方法 纳入于我科住院行皮肤软组织扩张术的患者120例,按照时间先后分为对照组60例和观察组60例.对照组进行回顾性分析.针对皮肤软组织扩张术患者的常见并发症(皮下血肿、感染、扩张器外露和皮瓣坏死),通过专家咨询和评议的方法并基于证据检索制订出相应的规范...     

尿路造口患者自护能力现状及其影响因素分析

目的 调查尿路造口患者出院后自护能力的现状并分析其影响因素,旨在为该类患者自护能力的干预性研究提供依据.方法 于2019年6—9月选取门诊就诊的尿路造口患者为调查对象,采用一般资料调查表、造口自我护理量表-早期版(SSCS-ESV)、中文版造口接受度问卷、自尊量表、社会影响量表(SIS)进行调查.结果 共收回有效问卷1...