An Analysis of the Nursing Diagnosis Ineffective Management of Therapeutic Regimen Compared to Noncompliance and Orem's Self-Care Deficit Theory of Nursing

The authors compare the nursing diagnosis ineffective management of therapeutic regimen with that of noncompliance and with Orem's concept of self-care deficit. The article describes how the diagnosis of ineffective management of therapeutic regimen is more comprehensive than noncompliance. A question of patient autonomy is raised considering how the patient manages his or her therapeutic regimen. The major conclusion is that the nursing diagnosis of ineffective management of therapeutic regimen is based on continuous interaction between patient and nurse. The authors recommend that noncompliance be eliminated as a nursing diagnosis.     

糖尿病患者社区家庭护理需求现状调查分析与对策

目的了解糖尿病家庭护理的需求现状,探讨糖尿病家庭护理的干预方向,为糖尿病患者自我管理提供指导。方法通过对住院患者的问卷调查方法,调查内容为患者家庭自我护理、对糖尿病基本知识掌握及患病后的心理感受情况。结果糖尿病患者家庭护理能力较低、心理压力很大、缺乏对糖尿病基本知识的掌握。结论加强糖尿病患者的家庭自我管理指导、建立医院社区糖尿病健康干预一体化,有助于预防糖尿病的各种并发症及提高患者的生活质量。     

Executing medical logic modules expressed in ArdenML using Drools

The Arden Syntax is an HL7 standard language for representing medical knowledge as logic statements. Despite nearly 2 decades of availability, Arden Syntax has not been widely used. This has been attributed to the lack of a generally available compiler to implement the logic, to Arden's complex syntax, to the challenges of mapping local data to data references in the Medical Logic Modules (MLMs), or, more globally, to the general absence of decision support in healthcare computing. An XML representation (ArdenML) may partially address the technical challenges. MLMs created in ArdenML can be converted into executable files using standard transforms written in the Extensible Stylesheet Language Transformation (XSLT) language. As an example, we have demonstrated an approach to executing MLMs written in ArdenML using the Drools business rule management system. Extensions to ArdenML make it possible to generate a user interface through which an MLM developer can test for logical errors.     

'The demented other': identity and difference in dementia

This paper explores the impact of the concepts of identity and difference on demented persons (especially on persons with Alzheimer's disease). The diagnosis of dementia is often synonymous with the assertion that demented individuals are no longer capable of making reasonable decisions. But rationality is an important aspect of characterizing a person's identity. Hence, this prevailing image of dementia as a loss of self and a change of identity leads to the situation that demented persons represent difference and otherness. Here, the brain and the mind act as the source for difference. The paper discusses several identity concepts with regard to demented persons and the relationship between identity and difference in dementia. This analysis is accompanied by an examination of the current biopolitics of dementia and ageing as biopolitics constitutes the socio-political-medical understanding of dementia. Challenges and possibilities for dementia care will be explored in the context of this complex relationship between theoretical concepts and political, medical, and health-care practices.     

患者自测腋温在临床运用的研究

目的：了解目前临床上患者自测腋温与护士按教科书规定的规范化测量腋温的测量结果是否有差异,讨论可否将自测腋温应用于临床。方法：对同一患者,在最接近的时问内先后采取让患者自测腋温与护士规范化测量腋温各-次,合计782例,采用统计描述及配对样本t检验的统计方法对结果进行处理。结果：临床患者自测腋温所测得的体温值与护士按教科书规定的规范化测量腋温所测得的体温值差异无统计学意义。结论：临床让患者自测体温的方法具有可行性、实用性。建议将体温测量作为临床护理健康教育内容之一,同时加强临床腋温操作的监督管理。     

Design and usability evaluation of a mobile-based-self-management application for caregivers of children with severe burns

Paediatric burns are a major public health issue because of long-term physical, psychological and social consequences and the high cost of treatment. The aim of this study was to design and evaluate a mobile-based self-management application for caregivers of children with severe burns. A participatory design technique was employed to develop the Burn application, which included three main phases: the determination of application requirements, the design and evaluation of the low-fidelity prototype, and the design and evaluation of the high-fidelity prototypes. In the first phase, application requirements were determined via validated paper questionnaires using the Delphi technique. In the second step, a low-fidelity prototype was prepared using conceptual models and evaluated through a focus group with specialists. Seven specialists reviewed the application and evaluated how this prototype meets functional requirements and objectives. The third phase was performed in three stages. First, the high-fidelity prototype was designed and developed by the JAVA programming language. Second, a cognitive walk-through was carried out to show how users can interact with the mobile application and how it works. Third, this program was installed on the mobile phones of 28 caregivers of burned children, eight IT experts, and two general surgeries, and the prototype's usability was evaluated. In the present study, most caregivers of children with burns stated that after discharge, they face problems regarding infection control and wound care (4.07) and how to perform physical activity (4.12). User registration, educational materials, caregiver-clinician communication, chat box, and appointment booking, safe login were the most important characteristic of the Burn application. Mean usability evaluation scores were in the range of 7.92 ± 0.238 to 8.10 ± 0.103, which is considered at a “good” level. From the Burn program design experience, it can be concluded that co-design with health care specialists can significantly support and meet the specialists' and patients' needs and ensure the program's usefulness. In addition, application evaluation by users involved and not involved in the application design process can help enhance usability.     

Eating as both coping and stressor in overweight control

AIM: The aim of this study was to test a conceptual model proposing that stress evokes eating as coping, that eating then becomes a stressor in itself, and that a coping repertoire specific for overeating is required to moderate its yield of negative mood states. BACKGROUND: It is known that stressors may evoke eating as a coping response, and that some persons respond to lapses in their dietary regimen with depression and self-criticism. These two findings are linked within the context of a stress and coping paradigm that has in the past been applied to the study of substance abuse. METHOD: A survey of 79 women who reported overeating was implemented, including the administration of five instruments and a telephone interview. FINDINGS: Over 43% of the variance in the dependent variable, negative mood states, was explained by hierarchical regression of the independent variables, entered sequentially as exemplars of: social stressors, coping, degree of required calorie consumption, use of overweight control strategies and the interaction between the degree of required weekly calorie consumption and use of overweight control strategies. Significant contributions were made by variables denoting stressors, coping, and the interaction between degree of required calorie consumption and use of overweight control strategies. Of particular interest was the suggestion that for individuals who frequently use strategies to control overeating and overweight, eating may produce negative mood states. Individuals intensively involved in efforts to control their weight may be vulnerable for dysphoria, may require unique nursing interventions, and thus deserve continued study in this context.     

老年痴呆患者认知功能训练效果观察

目的探讨老年痴呆患者认知功能训练的效果。方法随机抽取80例轻、中度老年痴呆患者,进行12～14周的认知功能训练。采用简易智能状态量表(MMSE)、日常生活活动能力量表(ADL)评估,自身前后对照观察。结果训练4～6周后本组患者认知功能及生活自理能力有一定的进步,但MMSE分数与ADL分数改善不明显;训练12～14周后认知功能明显进步,2个量表分数显著改善(P<0.05或P<0.01)。结论早期、有计划、持续地对患者进行认知功能训练和生活自理干预,能延缓老年痴呆患者各器官功能的衰退,改善自理能力,提高患者生活质量。