Validity of Two Self-care Instruments for the Elderly

The aim of this study was to address concurrent and construct validity of two instruments, the Self-care Ability Scale for the Elderly (SASE) and the self-report form of the Appraisal of Self-care Agency Scale (ASA-A), by testing them with home-dwelling, elderly Swedish patients. The two self-report instruments, including some additional new questions, were mailed to an age-stratified random sample of 420 elderly subjects and were finally completed by 125 of them. Bivariate and multivariate statistical methods were used in the analyses. An analysis of the non-respondents revealed no significant differences between them and the respondents. Standardized regression coefficients for reported abilities/activities on the scores were 0.71 for SASE (p < 0.0001) and for ASA-A 0.51 (p < 0.0001). SASE and ASA-A were found to measure related but not identical concepts (r = 0.69). Sensitivity and specificity ratings for managing without any help from official and unofficial caregivers were 68% and 72% respectively for SASE, and 50% and 64% for ASA-A. Individuals of 80+ years of age had lower scores than younger respondents on the SASE (p < 0.001) and ASA-A (p < 0.05) scales. Respondents living independently had higher scores on both scales than those living in institutions (p < 0.001). Lower scores on both scales were found for respondents who were not in good health compared with those who were in good health (p < 0.001). A five-factor solution for SASE explained 70.2% of the variances, and an eight-factor solution explained 67.9% of the variances for ASA-A. The results of this study confirm that the SASE and ASA-A assessments substantially measured what they were intended to measure in the studied group of lucid, elderly subjects.     

奥伦自理模式对腹腔镜阑尾切除术患者早期生存质量的影响研究

目的 观察奥伦自理模式对腹腔镜阑尾切除术患者术后早期生存质量的影响.方法 选择本院2011年6~12月期间行腹腔镜阑尾切除术患者94例随机分为观察组和对照组各47例,观察组给予奥伦自理模式护理,对照组给予传统护理.观察患者Barthel指数及术后恢复情况.结果 观察组Barthel指数术前评分为（23.29±8.71）分,术后评分为（69.73±12.29）分,对照组术前评分为（22.34±9.43）分,术后评分为（43.01±12.10）分,两组术后与术前比较差异有统计学意义（t = 21.14,t = 9.24,P ＜ 0.05）,并且术后观察组患者自理能力明显优于对照组,差异有统计学意义（t = 10.62,P ＜ 0.05）;观察组术后排气时间为（20.12±6.12） h,住院时间为（3.13±0.76） d,对照组为（42.30±5.68） h、（6.72±1.68） d,两组比较差异有统计学意义（P ＜ 0.05）.结论 运用奥伦自理模式护理,能明显改善患者术后早期生存质量,值得临床进一步推广运用.     

治疗性沟通系统对永久性肠造口患者自我护理能力的影响

目的 探讨治疗性沟通系统对永久性肠造口患者自我护理能力的影响.方法 将64例永久性造口患者随机分为干预组和对照组（各32例）,干预组患者按照治疗性沟通系统模式进行护理干预;对照组患者采用常规健康教育方法.结果 干预前（术前）两组患者自我护理能力总分及各维度得分比较差异无统计学意义（P〉0.05）,干预后（术后、术后1个月、术后3个月）两组患者自我护理能力总分及各维度得分除自护责任感维度外差异均有统计学意义（P〈0.05）.干预组自我护理能力总分及各维度得分均随着干预时间的推移而升高.结论 治疗性沟通系统有利于提高永久性肠造口患者的自我护理能力.     

Orem自理模式应用于慢性精神分裂症患者的护理

目的研究Orem自理模式应用于慢性精神分裂症患者的护理效果。方法将120例住院慢性精神分裂症患者按住院号的单双号随机分为实验组60例和对照组60例,在药物治疗的基础上,对照组按传统进行常规护理,实验组则根据病人病情发展阶段自理能力的不同,按Orem自理模式给予完全补偿、部分补偿和支持-教育。两组分别在入组时、入组8周末、出院时采用日常生活能力量表(ADL)、护士用住院病人观察量表(NOSIE)进行评定,出院后随访半年。结果实验组在社会能力、社会兴趣、个人卫生等积极因素的提高,退缩、激惹、抑郁等消极因素的恢复方面显著优于对照组(p<0.05或p<0.01)。躯体生活自理及工具性自理能力评分显著高于对照组及干预前(p<0.05或p<0.01)。随访半年再住院率实验组为20%;对照组为30%。结论应用Orem自理模式对慢性精神分裂症患者进行护理干预,能发掘患者自身护理潜能,提高其自我护理能力,使患者由被动护理变为主动参与自身护理,从而提高患者日常生活质量,促进其社会功能恢复,同时也减轻了家庭和社会的负担。     

Orem自理模式对永久性结肠造口患者生存质量的影响

目的探讨Orem自理模式在永久性结肠造口患者自我护理中的应用。方法将82例造口患者随机分为两组,实验组接受Orem自理模式中的部份补偿系统、支持-教育系统的家庭护理干预,对照组接受常规护理服务。结果实验组患者在每日护理造口所需时间、造口自我护理能力及造口相关知识掌握程度,圴明显优于对照组,差异具有非常显著性意义（P〈0.01）。结论 Orem自理模式可提高患者对造口知识的掌握及日常生活能力,减少对他人的依赖,恢复自信和正常的社会功能,有效地提高生存质量。     

Critical analysis of everyday self-care decision making in chronic illness

AIMS OF THE PAPER: The purpose of the paper is to (1) identify prevalent assumptions that underlie the traditional conceptualization of everyday self-care decision making and (2) contrast these with the findings of relevant research. BACKGROUND/RATIONALE: Current understandings of self-care decision making in chronic illness tend to be extrapolated from knowledge gained in relation to one-time decisions, or decision making in contexts that are only superficially related to the complexity and pervasiveness of living with a chronic disease. FINDINGS: The authors challenge the assumptions with which current understandings represent self-care decision making in chronic illness, using evidence from their research on what it is like to live with and manage the implications of having a chronic disease on an everyday basis. CONCLUSIONS: The paper concludes with a call for a new conceptualization of self-care decision making in chronic illness which sufficiently addresses the unique and complex nature of such decisions.     

Potential validity of conducting research on headache in internet populations

OBJECTIVE: While it is technically feasible to conduct migraine research on the Internet, can one be sure that the subjects who participate actually have the disorder? We examined this issue in 109 sequential subjects in an Internet study of migraineurs' symptoms. BACKGROUND: The increasing use of the Internet by the US population provides an opportunity for using this medium in clinical research, but, to be useful, the results of such research must be valid and generalizable. METHODS: Using postings to Internet newsgroups of migraineurs, we recruited subjects to a migraine research site. We examined reported symptoms by comparing them with the International Headache Society's criteria for diagnosis of migraine and by subjective review by a neurologist. We also attempted to contact the subject's primary care physicians to confirm their diagnosis. RESULTS: We found considerable evidence for the validity of the participants' self-reported diagnoses. Most subjects with professed migraine reported quality of pain (97%) and associated symptoms (92%) consistent with that diagnosis, and review of their symptoms and questionnaire responses by the neurologist suggested that almost all subjects (97%) had migraine. Personal physicians confirmed a diagnosis of migraine in 90% of consenting subjects (n=49). CONCLUSIONS: The validity of self-reported diagnosis of migraine does not appear to be an obstacle to conducting research in subject populations on the Internet.     

慢性心力衰竭病人自我护理状况的调查

[目的 ]了解慢性心力衰竭病人自我护理状况。 [方法 ]应用慢性心力衰竭自我护理量表 ,对 90例慢性心力衰竭病人的自我护理维持、自我护理决策及自我护理评估状况进行调查。[结果 ]慢性心力衰竭病人自我护理维持较好的为遵医嘱服药 (70 .0 % ) ,但对症状识别率较差。 [结论 ]慢性心力衰竭病人自我护理状况在中等水平以上 ,健康教育时要教会病人识别心力衰竭症状 ,并采取综合措施。     

专科特色护理在轻中度老年性痴呆患者中的应用

目的探讨专科特色护理对提高轻中度老年性痴呆患者自理能力,减轻其抑郁程度的作用。方法选择本院住院的轻中度老年性痴呆患者52例,提供志愿者亲情服务、看图说话、音乐疗法、追忆往事、老年学习坊、益智游戏、手指操训练等。实施前及实施后9个月、分别采用Barthel指数(BI)评定量表评定其自理能力,抑郁自评量表(SDS)对其抑郁程度进行评定。结果轻度老年性痴呆患者实施9个月自理能力分级显著提高(P0.05);中度老年性痴呆患者实施前后自理能力分级虽无显著变化(P0.05),但亦未恶化;轻、中度老年性痴呆患者实施9个月后SDS均有显著下降(P0.05)。结论实施专科特色护理提高轻度老年性痴呆患者的自理能力,改善其生活质量。