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81.
Janet Fricke Carolyn Unsworth Diane Worrell 《Australian Occupational Therapy Journal》1993,40(1):7-15
This paper reports an inter-rater reliability study on the Functional Independence Measure (FIM). The FIM measures inpatient burden of care, as reflected in 18 self care items, rated on a seven point scale from dependent to independent. The subjects were 40 occupational therapists, divided according to experience with the FIM and randomly assigned to a FIM training or non-training group. Subjects rated video tapes of four stroke patients on transfers, bathing, dressing, grooming, toileting and eating items from the FIM. Rater consensus was calculated using the intraclass correlation coefficient (ICC), percentage agreement and a measure of disagreement. Rating accuracy was measured by comparisons with an expert rater. Ratings were most reliable when done by clinicians with no prior FIM experience, from the FIM training group. It is strongly recommended that all clinicians undergo FIM training before using this tool to ensure acceptable reliability. 相似文献
82.
笔者对13例良性小脑出血的患者,从起病、临床表现进行了具体分析.总结出中老年良性小脑出血的6个特点,供临床工作者参考. 相似文献
83.
先天性胆总管囊肿23例的术式及疗效分析 总被引:1,自引:0,他引:1
目的:探讨先天性胆总管囊肿的术式及疗效。方法:回顾分析手术治疗先天性胆总管囊肿23例,其中Roux-Y囊肿-空肠吻合8例;囊肿切除,Roux-Y肝总管-空肠吻合15例。结果:20例获得随访,Roux-Y囊肿-空肠吻合随访6例,仅2例无症状,另4例反复发作腹痛,发热或黄疸,其中1例再手术,囊肿切除,Roux-Y肝总管-空肠吻合随访14例。仅1例有腹痛,余13例无症状,结论:Roux-Y肝总管-空肠吻合是治疗先天性胆总管囊肿的首选术式。 相似文献
84.
妊娠合并肝内胆汁郁积症的围生儿结局57例分析 总被引:1,自引:0,他引:1
目的 探讨妊娠合并肝内胆汁郁积症(ICP)患者致围生儿不良结局的相关指标。方法 总结本院57例ICP患者的相关临床资料,将其与围生儿结局进行分组对照分析。结果 血清胆汁酸升高与围生儿不良结局关系不明显(P>0.05);血清转氨酶水平在产生围生儿不良结局组与未产生围生儿不良结局组之间有显著性差异(P>0.01);皮肤瘙痒持续时间大于3周组围生儿不良结局发生率与持续时间小于3周组有显著性差异(P<0.05);有、无NST基线变异消失组的围生儿不良结局发生率有极显著性差异(P<0.01)。结论 血清转氨酶水平、皮肤瘙痒持续时间及NST基线变异是否消失是预示围生儿不良结局的相关指标。 相似文献
85.
Jeffrey H. Coben MD 《Academic emergency medicine》2002,9(11):1176-1183
OBJECTIVE: To obtain consensus among a panel of experts on performance measures useful for evaluating the quality of hospital-based domestic violence (DV) programs. METHODS: The Delphi process of consensus development was used with a panel of 18 experts including DV researchers, program planners, and advocates. Three rounds were conducted over a period of six months, with each round involving the completion of a written questionnaire. Panelists were instructed to concentrate on structure and process measures of DV program performance. Health outcome measures were not considered. During each round, panelists rated (scale of 1-5) their level of agreement with each measure, in terms of the measure's usefulness for evaluating hospital-based DV programs. Data were entered into SPSS on a personal computer and frequency distributions, measures of central tendency, and variance were computed for each measure. Consensus development was defined as a reduction in the item-specific variance from one round to the next. RESULTS: A total of 37 performance measures were agreed upon. These measures fell within nine different domains of DV program activities, including: Policies and Procedures, Hospital Physical Environment, Hospital Cultural Environment, Training of Providers, Screening and Safety Assessment, Documentation, Intervention Services, Evaluation Activities, and Collaboration. CONCLUSIONS: A number of measures have been identified as useful for evaluating hospital-based DV programs. Use of these measures should assist researchers, program planners, and administrators in assessing the quality of hospital-based DV programs. 相似文献
86.
目的:分析T1期(肿瘤直径<2cm)原发性乳腺癌女性患者绝经前后在肿瘤大小、病理分类、淋巴结转移率和数目。方法:常规病理检验以及应用免疫组化、HE法分别测定绝经前乳腺癌患者和绝经后乳腺癌患者者的ER、PR。结果:两组患者在肿瘤大小上无明显差异,但绝经前乳腺癌患者浸润导管癌的百分比为 84. 7%,绝经后乳腺癌患者的浸润导管癌百分比为 62. 2%,经χ2 检验,P<0. 01。两组淋巴结转移率分别为 39. 3%和 25. 5%,经χ2 检验,P<0. 01。两组ER和PR阳性伴淋巴结转移的比例经χ2 检验,P<0. 05。结论:绝经前乳腺癌患者和绝经后乳腺癌患者在病理分类、淋巴结转移率及数目、ER、PR阳性伴淋巴结转移上有显著性差异。对于T1原发性乳腺癌患者不论有无淋巴结转移,均应行癌肿切除伴Ⅰ、Ⅱ级淋巴结清扫。 相似文献
87.
L. J. Jacobsson M. Westerberg S. Söderberg J. Lexell 《Acta neurologica Scandinavica》2009,120(6):389-395
Objectives – To assess long‐term functioning and disability after traumatic brain injury (TBI). Material and methods – Individuals (n = 88) in Norrbotten, northern Sweden, who had been transferred for neurosurgical care were assessed with internationally established TBI outcome measures 6–15 years post‐injury. Results – There was an improvement in overall outcome from discharge from inpatient rehabilitation to follow‐up. Many individuals had a high degree of motor and cognitive functioning, which enabled them to live independently in their own home without assistance, but there remained a disability related to community reintegration and social participation. This affected their productivity and to some degree their marital stability. The remaining disability and reduced productivity were related to the age at injury and the injury severity. Conclusions – Our data showed that individuals with a TBI can achieve and maintain a high degree of functioning many years after the injury. Increasing age and a greater injury severity contributed to their long‐term disability. 相似文献
88.
产科危重患者多器官功能障碍综合征的临床分析 总被引:4,自引:0,他引:4
目的 :分析产科危重患者多器官功能障碍综合征 (MODS)的发病特点及诱因 ,以及与急性生理与慢性健康状况评分II(APACHEII)的关系。方法 :回顾分析 2 0 0 0年1月至 2 0 0 4年 4月转入GICU产科危重患者中发生MODS 6 6例的临床资料 ,并计算其A PACHEII评分。结果 :产科MODS患者诱因主要是产科因素 ,共 4 8例 (72 .73% ) ,死亡 7例 (14 .5 8% ) ,以重度子痫前期或子痫及产后出血为主 ;诱因 18例妊娠合并内外科疾病 ,死亡 11例 ,死亡率为 6 1.11% ,以妊娠合并心脏病和妊娠合并重症肝炎为主。产科MODS患者死亡率随着器官损害数的增多而上升 ,差异有显著性 (P <0 .0 5 ) ;随着器官损害数的增多 ,APACHEII评分逐渐升高 ,差异有显著性 (P <0 .0 5 ) ;APACHEII评分用于预测MODS死亡阳性率 ,2 ,3,4 ,5个器官受损害 ,其阳性率分别为 33.4 5 % ,5 7.12 % ,97.0 9% ,10 0 %。结论 :产科多器官功能障碍 /衰竭的产科主要诱因是重度子痫前期 /子痫 ,产后出血 ;产科MODS患者死亡率也随着器官损害数的增多而上升 ;APACHEII评分可在一定程度上作为评定产科MODS患者病情危重程度和预测预后的指标。 相似文献
89.
90.
Potentially dangerous antibiotic resistant contaminants have permanently penetrated at least well-off western populations. The danger is so evident that some hospitals have started to refuse accepting patients who carry such bacteria. Sampling and enrichment measures in hygiene monitoring must be updated as they are corner stones in handling the problems and safeguarding the health care units. Their patients, when exposed to microorganisms are strenuous to treat. Sometimes even this fails, if the infections are spreading in weakened patients. The present review summarizes currently used technologies and the abilities of bacteria to avoid detection. Improved protocols on environmental monitoring in healthcare units are required. They should be comparable with contamination control in industries. Actually these measures in health care should be even stricter because human lives are directly endangered as the resistance of especially elderly patients is low. 相似文献