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991.
Penni Patricia Sadlon 《Nursing forum》2018,53(3):364-368
The purpose of this paper is to evaluate the concept reflection as a process using a principle‐based method of analysis that acknowledges the philosophical premises of formal cognitive operations (experiencing, understanding, judging, and deciding) espoused by Bernard Lonergan. The aim is to understand how we think and process cognitively in reflection while developing consciousness in knowing. Using Lonergan's formal cognitive operations adds a philosophical perspective and structure to the concept. Fostering the enactment of reflection is a complex process, but it is vital for nursing science and disciplinary advancement. 相似文献
992.
目的：探讨男性脑卒中患者勃起功能障碍（ED ）发生情况及影响因素。方法选取126例男性脑卒中患者,采用国际勃起功能指数‐5（IIEF‐5）量表判定入选患者有无ED ,根据评分结果将患者分为ED组和非ED组。采用NIHSS评分量表及改良Rankin （mRS）评分量表评估患者神经功能缺损情况;采用抑郁自评量表（HAMD）评估患者抑郁状态;采用简易智能状态检查量表（MMSE）评估患者认知功能。比较ED组与非ED组临床因素及心理因素组间的差异,应用Logistic回归模型分析ED的影响因素。结果共有38例（30．2％）患者患有ED。单因素分析显示高血压、糖尿病、血管紧张素转化酶抑制剂（ACEI）药物使用及抑郁与ED显著相关,而多因素分析提示ACEI药物使用及抑郁与ED独立相关。结论男性脑卒中患者的 ED较为常见,患者使用ACEI药物及抑郁是ED主要影响因素。 相似文献
993.
目的：探讨颈动脉支架置入术对无症状性颈动脉高度狭窄患者认知功能的影响。方法选择2009年9月至2012年12月期间在该科住院患者156例（狭窄程度大于或等于70％）,行颈动脉支架置入术。在支架置入术前1周内及置入术后3个月采用阿尔茨海默病评估量表认知部分（ADAS‐Cog）、简易智能量表（MMSE）、连线测验（TMTa、TMTb）对患者的认知功能进行评估。结果所有患者均安全、成功的置入颈动脉支架,其中1例患者术后失访。与术前相比,术后3个月患者的认知功能均有所改善,术前术后比较：ADAS‐Cog[（6．60±2．04）分vs．（5．16±1．63）分,P＜0．01],MMSE[（26．32±1．06）分vs．（27．05±1．46）分,P＜0．01],TMTa[（108．94±17．42）分vs．（94．70±20．27）分,P＜0．01],TMTb[（178．65±21．77）分vs．（148．92±23．65）分,P＜0．01],术后3个月内无新发脑梗死。结论颈动脉狭窄可能为认知功能减退的原因之一,颈动脉支架置入术可以改善无症状颈动脉狭窄患者认知功能。 相似文献
994.
目的 探讨影响急性胃肠功能障碍患儿预后的危险因素及防治措施.方法 回顾性分析78例急性胃肠功能障碍患儿的临床资料,比较死亡组与存活组患儿的临床特点,采用非条件Logistic回归分析方法,对可能影响预后的危险因素进行多因素分析.结果 78例患儿死亡36例(46.2％).多因素非条件Logistic回归分析显示,伴发心血管、脑、肝脏系统衰竭及循环不良或休克为死亡的危险因素,其相对危险度依次为19.17、10.28、10.09、10.07.结论 影响急性胃肠功能障碍患儿预后的因素有伴发心血管、脑、肝脏系统衰竭及循环不良或休克. 相似文献
995.
目的：探讨乌司他丁对老年胃癌患者术后认知功能障碍的影响。方法将符合标准的200例老年胃癌手术患者分成观察组（100例）和对照组（100例）,观察组患者在术前与术后均给予乌司他丁,对照组仅给予生理盐水。结果在术中,观察组的尿量为（441．7±78．5）mL,显著性低于对照组的（613．2±81．2）mL（P ＜0．05）。在治疗后,观察组的联想学习及对照组的简易精神状态检查（MMSE）、视觉再生、联想学习评分均低于治疗前（P ＜0．05）;治疗后观察组的 MMSE、视觉再生、联想记忆的评分分别为24．4±1．5、9．7±1．7、12．4±1．8,均显著高于对照组的21．1±1．0、8．7±1．5、11．3±1．7,差异有统计学意义（P ＜0．05）。在术毕、术后1 d、术后3 d,观察组患者的血清 S100β蛋白水平分别为（0．099±0．024）、（0．074±0．026）、（0．061±0．022）μg／L,均显著低于对照组的（0．138±0．042）、（0．110±0．034）、（0．075±0．031）μg／L（P ＜0．05）。结论乌司他丁不仅能够改善老年患者术后认知功能障碍,同时也能够降低术后血清 S100β蛋白的水平,对患者的脑组织起到保护作用。 相似文献
996.
Marcalee Alexander Khurram Bashir Craig Alexander Lesley Marson Raymond Rosen 《Archives of physical medicine and rehabilitation》2018,99(2):299-305
Objective
To examine the safety and efficacy of using a clitoral vacuum suction device (CVSD) versus vibratory stimulation (V) to treat orgasmic dysfunction in women with multiple sclerosis (MS) or spinal cord injury (SCI).Design
Randomized clinical trial.Setting
Two academic medical centers.Participants
Women (N=31) including 20 with MS and 11 with SCI.Intervention
A 12-week trial of the use of a CVSD versus V.Main Outcome Measures
Female Sexual Function Inventory (FSFI) and Female Sexual Distress Scale (FSDS).Results
Twenty-three women (18 MS, 5 SCI) completed the study including 13 of 16 randomized to CVSD and 10 of 15 randomized to V. There was a statistically significant increase in total FSFI score (P=.011), desire (P=.009), arousal (P=.009), lubrication (P=.008), orgasm (P=.012), and satisfaction (P=.049), and a significant decrease in distress as measured by FSDS (P=.020) in subjects using the CVSD. In subjects who used V, there was a statistically significant increase in the orgasm subscale of the FSFI (P=.028). Subjects using the CVSD maintained improvements 4 weeks after treatment.Conclusions
CVSD is safe and overall efficacious to treat female neurogenic sexual dysfunction related to MS and SCI. V is also safe and efficacious for female neurogenic orgasmic dysfunction; however, results were limited to the active treatment period. Because of ease of access and cost, clinicians can consider use of V for women with MS or SCI with orgasmic dysfunction. CVSD is recommended for women with multiple sexual dysfunctions or for whom V is ineffective. 相似文献997.
Marcas M. Bamman Gary R. Cutter David M. Brienza John Chae Daniel M. Corcos Stephanie DeLuca Edelle Field-Fote Mona N. Fouad Catherine E. Lang Anne Lindblad Robert W. Motl Carla G. Perna Darcy Reisman Kenneth M. Saag Sean I. Savitz Kathryn H Schmitz Jennifer Stevens-Lapsley John Whyte Mary E. Michel 《Archives of physical medicine and rehabilitation》2018,99(12):2637-2648
The purpose of this Special Communication is to summarize guidelines and recommendations stemming from an expert panel convened by the National Institutes of Health, National Center for Medical Rehabilitation Research (NCMRR) for a workshop entitled The Future of Medical Rehabilitation Clinical Trials, held September 29-30, 2016, at the NCMRR offices in Bethesda, Maryland. The ultimate goal of both the workshop and this summary is to offer guidance on clinical trials design and operations to the medical rehabilitation research community, with the intent of maximizing the effect of future trials. 相似文献
998.
Yael Goverover Nancy D. Chiaravalloti Amanda R. O&#x;Brien John DeLuca 《Archives of physical medicine and rehabilitation》2018,99(2):390-407
Objective
To update the clinical recommendations for cognitive rehabilitation of people with multiple sclerosis (MS), based on a systematic review of the literature from 2007 through 2016.Data Sources
Searches of MEDLINE, PsycINFO, and CINAHL were conducted with a combination of the following terms: attention, awareness, cognition, cognitive, communication, executive, executive function, language, learning, memory, perception, problem solving, reasoning, rehabilitation, remediation, training, processing speed, and working memory. One hundred twenty-nine articles were identified and underwent initial screening.Study Selection
Fifty-nine articles were selected for inclusion after initial screening. Nineteen studies were excluded after further detailed review. Forty studies were fully reviewed and evaluated.Data Extraction
Articles were assigned to 1 of 6 categories: attention, learning and memory, processing speed and working memory, executive functioning, metacognition, or nonspecified/combined cognitive domains. Articles were abstracted and levels of evidence were decided using specific criteria.Data Synthesis
The current review yielded 6 class I studies, 10 class II studies, and 24 class III studies. One intervention in the area of verbal learning and memory received support for a practice standard, 2 computer programs received support as practice guidelines (in the area of attention and multicognitive domains), and several studies provided support for 5 practice options in the domains of attention and learning and memory.Conclusions
Substantial progress has been made since our previous review regarding the identification of effective treatments for cognitive impairments in persons with MS. However, much work remains to be done to optimize rehabilitation potential by applying the most methodologically rigorous research designs to provide class I evidence in support of a given treatment strategy. 相似文献999.
Shelby Baez Matthew C. Hoch Johanna M. Hoch 《Archives of physical medicine and rehabilitation》2018,99(11):2287-2298
Objectives
To systematically locate, critically appraise, and synthesize the available evidence regarding the effectiveness of cognitive behavioral therapies (CBTs) and psychoeducation that can be implemented by rehabilitation specialists to treat fear-avoidance beliefs in patients with acute, subacute, and chronic low back pain (LBP).Data Sources
Electronic databases (CINAHL, PubMed, Psychology and Behavior Sciences Collection, SPORTDiscus, PsycINFO) were searched from inception to September 2017.Study Selection
Assessment of methodological quality was completed using the Physiotherapy Evidence Database (PEDro) scale. The Strength of Recommendation Taxonomy was used to evaluate the quality of evidence.Data Extraction
Study sample, subject demographics, CBT and/or psychoeducation intervention details, data collection time points, outcome assessments, statistical analysis, results, and conclusions were extracted from each study. In addition, effect sizes were calculated.Data Synthesis
Five high-quality studies (PEDro ≥6) were included. All included studies evaluated fear-avoidance beliefs. CBTs and psychoeducation strategies designed to target patient-specific fears demonstrated clinically meaningful results, while psychoeducation methodologies were not as effective.Conclusions
There is inconsistent, patient-oriented evidence (grade B) to support the use of CBTs and/or psychoeducation strategies by rehabilitation specialists to treat fear-avoidance beliefs. Patient-centered and personalized CBTs were most effective to treat these psychosocial factors in patients with LBP when compared with a control treatment. 相似文献1000.
