电话回访对糖尿病患者遵医行为的影响

目的:探讨电话回访对糖尿病患者遵医行为的影响。方法:将在我院经住院治疗后出院的糖尿病患者80例随机分为实验组与对照组,每组40例,对实验组进行电话回访,对照组不作任何干预,6个月后对两组患者遵医率及生活指标达标率进行调查。结果:实验组患者遵医率及生化指标达标率明显高于对照组(P<0.05,或P<0.01)。结论:对出院糖尿病患者进行电话回访密切了护患关系,提高了患者的遵医行为,对防止糖尿病并发症,提高生命质量有重要意义。     

社区糖尿病病人健康教育对治疗依从性的影响

目的了解社区糖尿病病人对治疗的依从性。方法由本科医生、护士对社区糖尿病病人进行糖尿病基础知识、饮食疗法、运动疗法、心理调节、自我监测有诊治方面的教育,并对病人的治疗依从性、空腹血糖、糖化血红蛋白进行教育前后比较。结果病人治疗依从率教育前明显提高,血糖控制良好。结论系统的社区糖尿病教育能有效提高糖尿病病人治疗依从性。     

老年性痴呆的研究进展

老年性痴呆是老年人最常见的神经退行性变性疾病之一,占全部痴呆的50%~80%,>65岁老年人群中患病率约5%。其临床特征为隐匿起病,进行性痴呆;发病机制目前尚不清楚,可能与老化基础上的遗传和环境因素有关。撰文就近年来老年性痴呆的分子病理学研究、神经化学变化及探索性药物治疗的进展简要综述。     

原发性高血压1490例服药依从性调查分析

目的探讨影响原发性高血压患者服药依从性的原因及提高服药依从性的方法。方法对我院1300例原发性高血压患者从一般情况、高血压知识得分和服药依从性进行问卷调查,分析影响服药依从性的相关因素。结果原发性高血压患者服药依从性与受教育程度和经济收入有关。结论医护人员应加强对高血压患者的健康指导。促进家庭和社会的支持,以提高患者的服药依从性。     

老年慢性病共病患者多重用药管理分析与评论

积极落实以老年慢性病共病患者为中心的多重用药管理策略,能够识别和纠正老年慢性病共病患者的用药差错,避免潜在用药错误的发生,减少并控制药源性疾病的发生与发展,进而有助于提高疾病临床治疗效果,延缓疾病发展进程,从而有利于疾病控制达标,提高老年慢性病共病患者的生活质量。本研究针对老年慢性病共病患者存在的多重用药问题,从强化顶层设计、组建老年多学科团队、革新患者药物管理产品技术、满足患者对药物信息的需求等方面对干预措施进行总结,旨在为今后我国老年慢性病共病患者的用药管理提供参考。本研究发现,老年慢性病共病患者多重用药问题突出。基于老年人的用药特点,积极探索多途径的多重用药管理策略是目前改善老年慢性病共病患者多重用药问题的重要突破点。     

Compliance with the recommendations of medical consultants

Compliance with the consultant’s recommendations is one measure of the effectiveness of a consultation. A previous study showed that compliance was better when fewer recommendations were made. In the subsequent year, consultants were encouraged to limit their recommendations to five or fewer. Despite a significant decrease in the number of recommendations, compliance rates remained essentially unchanged (72%). Multivariate analysis demonstrated that the clinical severity of the patient’s disease and the number of associated problems, as well as the types of recommendations, were significant predictors of compliance. Compliance was best for recommendations involving medications (84%) and worst for recommendations involving diagnostic tests (62%). Compliance was also evaluated in the context of a surgeon’s view of the appropriateness of the recommendations. For recommendations felt to be essential to patient care the compliance rate was 75%, but it was only 44% for recommendations judged non-essential (p<0.001). The consulting internist should be aware that the surgeon’s view of the relevance of the recommendations to patient care needs may have an important effect on compliance. Received from the Departments of Medicine and Surgery, Cornell University Medical College, New York, New York. Dr. Ballard was a Henry J. Kaiser Foundation Fellow in General Internal Medicine. Dr. Gold is a Fellow in Cardio-Thoracic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts. Dr. Charlson is a Henry J. Kaiser Family Foundation Faculty Scholar in General Internal Medicine.     

Medications and the Culture of Safety: Conference Title: At the Precipice of Quality Health Care: The Role of the Toxicologist in Enhancing Patient and Medication Safety Venue ACMT Pre-Meeting Symposium, 2014 North American Congress of Clinical Toxicology,New Orleans,LA

Medication mishaps are a common cause of morbidity and mortality both within and outside of hospitals. While the use of a variety of technologies and techniques have promised to improve these statistics, instead of eliminating errors, new ones have appeared as quickly as old ones have been improved. To truly improve safety across the entire enterprise, we must ensure that we create a culture that is willing to accept that errors occur in normal course of operation to the best of people. Focus must not be on punishment and shame, but rather building a fault tolerant system that maintains safety of both staff and patients.     

Transferability of Medication Administration Simulation Training to Clinical Settings

The study examines the impact of one-on-one simulation for medication administration (MA) on prelicensure student preparedness for and performance of MA in the clinical setting.We used a prospective quasi-experimental interventional study applying Kirkpatrick's model to the simulation experience addressing MA.Simulation increased student preparedness. Students' critical thinking and approach during the MA process were significantly higher in the clinical setting.One-on-one MA simulation is an effective educational method for improving student learning and performance in practice.