乳腺癌患者术后不同卧位及早期功能锻炼舒适程度的观察

目的探讨舒适护理在乳腺癌患者手术后早期的应用效果。方法对乳腺癌患者在手术后6b内给予舒适卧位及患侧上肢早期定时功能锻炼，并评价其效果。结果全身麻醉手术后非去枕平卧位及给予早期患侧上肢功能锻炼可以提高乳腺癌患者手术后的舒适程度，有利于患者术后机体功能的恢复。结论乳腺癌患者手术后早期实施舒适卧位及适度的患侧上肢功能锻炼可以促进功能恢复并提高舒适程度，减少术后并发症的发生。     

Posterodorsal Medial Amygdala Mediates Tail‐Pinch Induced Food Intake in Female Rats

Comfort eating during periods of stress is a common phenomenon observed in both animals and humans. However, the underlying mechanisms of stress‐induced food intake remain elusive. The amygdala plays a central role in higher‐order emotional processing and the posterodorsal subnucleus of the medial amygdala (MePD), in particular, is involved in food intake. Extra‐hypothalamic corticotrophin‐releasing factor (CRF) is well recognised for mediating behavioural responses to stress. To explore the possible role of amygdala CRF receptor activation in stress‐induced food intake, we evaluated whether a stressor such as tail‐pinch, which reliably induces food intake, would fail to do so in animals bearing bilateral neurotoxic lesions of the MePD. Our results showed that ibotenic acid induced lesions of the MePD markedly reduced tail‐pinch induced food intake in ovariectomised, 17β‐oestradiol replaced rats. In addition, intra‐MePD (right side only) administration of CRF (0.002 or 0.02 ng) via chronically implanted cannulae resulted in a dose‐dependent increase in food intake, although higher doses of 0.2 and 2 ng CRF had less effect, producing a bell shaped curve. Furthermore, intra‐MePD (bilateral) administration of the CRF receptor antagonist, astressin (0.3 μg per side) effectively blocked tail‐pinch induced food intake. These data suggest that the MePD is involved in stress‐induced food intake and that the amygdala CRF system may be a mediator of comfort eating.     

经皮冠状动脉成形术后卧位调整对患者舒适度影响的研究

目的改善经皮冠状动脉成形术后患者卧位舒适度。方法采用抽签随机分为两组,采取空白对照法,常规护理组60例病人按常规进行护理,伤口用弹性绷带压迫18h,期间保持平卧位。观察组60例病人采用护理干预,弹性绷带压迫2h后病人的卧位变动。运用自行设计的舒适程度评估表对两组病人进行评估。结果观察组穿刺点出血、血肿与常规护理组相比无显著性差异(P>0.05);干预组病人烦躁,排尿困难,腰酸背痛,失眠等不适情况与常规护理组相比明显减轻,有显著性差异P=0.000。护理干预组与常规护理组舒适程度比较有显著性差异,经Wilcoxon秩和检验P=0.000,护理干预组病人舒适度优于常规护理组病人。结论经皮冠状动脉成形术后的病人拔鞘管2h后,伤口在包扎弹性绷带下,可根据病人的需要给予适当调节卧位,提高病人的舒适度,减少并发症。     

妇科腹腔穿刺围术期舒适护理临床应用分析

目的探讨舒适护理在妇科腹腔穿刺围术期护理中的应用效果。方法选择本院行腹腔穿刺手术的564例患者,按照随机数字法分为实验组与对照组,各282例,对照组在腹腔穿刺围术期采取常规护理模式,实验组则在对照组的基础上采取舒适护理模式,比较2组患者护理干预后手术前、麻醉前血压、焦虑水平、心率,术中、术后疼痛水平、并发症发生率、健康知识水平评分、自我护理技能评分、护理满意度。结果 2组患者麻醉前收缩压、舒张压、焦虑水平、心率较手术前均有所升高(P0.05);实验组手术前、麻醉前的收缩压、舒张压、焦虑水平、心率均低于对照组(P0.05);实验组疼痛水平、并发症发生率显著低于对照组(P0.05);实验组在健康知识水平、自我护理技能及护理满意度均显著优于对照组(P0.05)。结论舒适护理模式在妇科腹腔穿刺围术期护理中可有效降低手术对患者血压、焦虑水平、心率的影响,减轻疼痛,降低并发症,提高患者的健康知识水平、自我护理技能及对护理满意度。     

Evaluation of ceiling lifts: Transfer time, patient comfort and staff perceptions

Mechanical lifting devices have been developed to reduce healthcare worker injuries related to patient handling. The purpose of this study was to evaluate ceiling lifts in comparison to floor lifts based on transfer time, patient comfort and staff perceptions in three long-term care facilities with varying ceiling lift coverage. The time required to transfer or reposition patients along with patient comfort levels were recorded for 119 transfers. Transfers performed with ceiling lifts required on average less time (bed to chair transfers: 156.9 seconds for ceiling lift, 273.6 seconds for floor lift) and were found to be more comfortable for patients. In the three facilities, 143 healthcare workers were surveyed on their perceptions of patient handling tasks and equipment. For both transferring and repositioning tasks, staff preferred to use ceiling lifts and also found them to be less physically demanding. Further investigation is needed on repositioning tasks to ensure safe practice.     

Quantifying the amount of padding improves the comfort and function of a fibreglass below-elbow cast

Aim

To determine the quantity of cotton underpadding needed for a comfortable, functional, below-elbow fibreglass cast.

Methods

In this randomised, prospective, crossover, clinical trial, 45 people with minimally displaced distal radial fractures were enrolled to randomly receive, 14 days after injury, a fibreglass below-elbow cast with either two or four layers of cotton underpadding. The characteristics of the recipients were recorded. After 2 weeks of immobilisation, participants completed a numerical survey evaluating parameters of comfort and underwent clinical and radiographic assessment. They then crossed over to receive the other fibreglass cast design, the process was repeated, and they indicated their cast preference, if any.

Results

Of 37 people who completed the study, 20 preferred the two-layer model, 13 the four-layer model and 4 had no preference. No significant trend for one design over the other was shown (p = 0.1), nor any statistical association between preference and participant characteristics or the order in which cast models were received.

Conclusions

Participants did state a preference, but this was not related to recipient characteristics. Neither cast design was significantly the more comfortable; and both models were safe and functionally satisfactory.     

Controlled Release of High Molecular Weight Hyaluronic Acid from Molecularly Imprinted Hydrogel Contact Lenses

Purpose  Current dry eye treatment includes delivering comfort agents to the eye via drops, but low bioavailability and multiple administration continues to be a barrier to effective treatment. There exists a significant unmet need for devices to treat dry eye and for more comfortable contact lenses. Methods  Using molecular imprinting strategies with an analysis of biology, we have rationally designed and synthesized hydrogel contact lenses that can release hyaluronic acid (HA) at a controlled rate. Results  Delayed release characteristics were significantly improved through biomimetic imprinting, as multiple functional monomers provided non-covalent complexation points within nelfilcon A gels without altering structural, mechanical, or optical properties. The diffusion coefficient of 1.2 million Dalton HA was controlled by varying the number and variety of functional monomers (increasing the variety lowered the HA diffusion coefficient 1.5 times more than single functional monomers, and 1.6 times more than nelfilcon A alone). Conclusions  HA can be delivered from a daily disposable lens at a therapeutic rate of approximately 6 μg/h for 24 h. This is the first demonstration of imprinting a large molecular weight polymer within a hydrogel and the effect of imprinting on the reptation of the long chain macromolecule from the structure. A research article submitted to Pharmaceutical Research for the Special Theme Section in Honor of NA Peppas.     

提高乳腺癌患者PICC置管舒适度的研究

目的提高乳腺癌PICC置管患者的舒适度。方法对应用PICC置管的乳腺癌患者进行系统护理干预,观察和评价PICC置管过程中患者舒适度。选取2007年8月-2008年12月行PICC置管的患者100例,按照置管先后顺序将患者随机分为实验组和对照组,每组50例,对照组采取常规护理,实验组制定一套舒适护理措施,评估两组患者在PICC置管前焦虑情绪和置管过程中的舒适度。结果经过一系列护理干预后,实验组患者在置管前焦虑情绪显著低于对照组,置管过程中,在疼痛、置管成功率上与对照组比较差异有显著性（P〈0.01）,舒适度高于对照组。结论一套有效的系统护理措施能提高乳腺癌PICC置管患者的舒适度。     

An evaluation of the use of an iPad for hospital orientation in a regional hospital

ProblemPatient orientation is a crucial point of information exchange, designed to support and enhance patient safety, comfort, and understanding during their hospital stay. Currently, most hospital patients receive face-to-face orientation with a nurse. The quality and content of orientation information can be affected by the nurse’s emotional state, job satisfaction, knowledge, and authenticity for the information conveyed, which can have a positive or negative impact on the patient.AimFocusing on key hospital policies and protocols, in a regional New South Wales hospital and compared to routine ward orientation, the objective was to assess the efficacy of digital video orientation.MethodsA two-group design was conducted utilising quantitative and qualitative approaches and drew on self-report, focusing on overall Understanding and Emotional Comfort. Participants (n = 35) were selected and randomly allocated into a digital orientation or face-to-face orientation group.FindingsEmotional Comfort scores for both groups were found to be similar (p < 0.05 level, t(33) = 0.27, p = 0.09), while the digital orientation group was found to have significantly higher understanding of key hospital policy (t(33) = −3.98, p < 0.001). Additionally, there was a negative correlation (r = −0.45, p = 0.006) between age and self-reported understanding, revealing that the lower age groups had scored higher.DiscussionThis research has demonstrated that key concepts can be effectively communicated using a digital format.ConclusionIt is recommended that this method of orientation be implemented and its efficacy continues to be evaluated.