医学教育
本文系统探讨了人工智能(AI)技术在模拟医学培训中的应用现状、优势与挑战。AI通过虚拟患者系统、手术模拟评估、医学影像诊断培训及结构化报告优化四大核心场景,显著提升培训的智能化与个性化水平。研究表明,AI驱动的实时反馈机制(如手术技能评估系统)在随机对照试验中表现优于传统专家指导, 并具备大规模推广潜力, 可降低人力成本。然而,技术仍面临算法透明性、数据隐私伦理及临床转化效果验证等挑战。未来需深化跨学科合作, 结合增强现实(AR)等技术创新, 构建全球资源共享的智能认证体系, 推动医学教育范式转型。
This review summarizes and discusses the application status, advantages,and challenges of artificial intelligence(AI)technology in simulated medical training.AI significantly enhances the intelligence and personalization of training through four core scenarios:virtual patient systems, surgical simulation assessment, medical imaging diagnosis training, and structured reporting optimization.Researches demonstrates that AI-driven real-time feedback mechanisms(e.g., surgical skill assessment systems)outperform traditional expert guidance in randomized controlled trials(P<0.001)and exhibit potential for large-scale implementation to reduce labor costs.However, challenges remain regarding algorithmic transparency, data privacy ethics, and clinical translation validation.Future efforts require deepened interdisciplinary collaboration, integration with innovations like augmented reality, and the establishment of a globally shared intelligent certification system to advance the transformation of medical education paradigms.
护理研究
目的 分析共同照护模式联合回授法健康教育在2型糖尿病患者中的应用效果。方法 将2023年1月—2023年12月广州市第一人民医院收治 的114例2型糖尿病患者作为此次研究对象,分为研究组(n=57)和对照组(n=57),对照组患者给予常规护理结合健康教育,研究组患者给予共同照护模式联合回授法健康教育,评估两组在培训前及培训后1、3个月的血糖控制情况及糖尿病患者自我管理行为量表(SDSCA)等指标。结果 培训1、3个月后,两组患者的空腹血糖、餐后2 h血糖、糖化血红蛋白均低于培训前,且研究组空腹血糖、餐后2 h血糖、糖化血红蛋白水平均低于对照组(P<0.05)。培训1、3个月后,两组患者的糖尿病患者SDSCA评分高于培训前,且研究组各项评分高于对照组(P<0.05)。重复测量方差分析表明随着时间的推移,患者的血糖控制状况随着不同护理培训策略而得到改善。结论 使用共同照护模式联合回授法健康教育对2型糖尿病患者可以更显著改善血糖控制水平、提高自我管理效能。
Objective To analyze the effect of co-care mode and feedback health education on patients with type 2 diabetes.Methods From January 2023 to December 2023,114 patients with type 2 diabetes admitted to Guangzhou First People's Hospital were divided into two groups:experimental group(n=57)and control group(n=57).Patients in control group were given routine nursing combined with health education.Patients in study group were given co-care and feedback health education. Before intervention and 1,3 months after intervention,patients' blood glucose control and diabetic self-management behavior scale(SDSCA)were evaluated.Results After 1 and 3 months of intervention,the fasting blood glucose,2-hour blood glucose and HbA1c of the two groups were significantly lower than those before intervention,and the fasting blood glucose,2-hour blood glucose and HbA1c of the experimental group were significantly lower than those of the control group(P<0.05).After 1 month and 3 months of intervention,the SDSCA scores of diabetic patients in both groups were higher than those before intervention,and the scores of study group were higher than those of control group(P<0.05).Repeated measures analysis of variance indicating that glycemic control improved significantly over time with different nursing training strategies.Conclusions Co-care mode and feedback health education can significantly improve blood glucose control and self-management efficiency in patients with type 2 diabetes.
论著
目的 探讨情景模拟式健康教育对飞秒激光小切口角膜基质透镜取出手术(SMILE)患者的应用效果,提高手术患者术中的配合度。方法 随机选取2020年6月—12月于我院拟进行SMILE手术患者200例,随机分为观察组和对照组,各100例,其中对照组采用常规术前健康教育,观察组采用情景模拟宣教视频的方式实施术前健康教育。比较两组患者围术期依从性、焦虑自评量表(SAS)和SMILE手术知识知晓率。结果 观察组患者围术期依从性和SMILE手术围术期知识知晓率得分高于对照组、患者术前焦虑水平低于对照组,差异均有统计学意义(P<0.05)。结论 情景模拟式健康教育能有效提升SMILE手术患者围术期依从性,减轻患者手术紧张的情绪,提升患者SMILE手术围术期健康知识知晓率,提升就医体验及手术成功率。
Objective To explore the application effect of scenario simulation based health education on patients undergoing small incision lenticule extraction(SMILE),in order to improve the cooperation of surgical patients.Methods From June to December in 2020,200 patients who were scheduled to undergo SMILE in the hospital were randomly selected and divided into an observation group and a control group,with 100 patients in each group.The control group received routine preoperative health education,while the observation group received preoperative health education through scenario simulation educational videos.The perioperative adherence of patients,Self Rating Anxiety Scale(SAS),and SMILE surgical knowledge awareness rates were compared between patients of two groups.Results The observation group had higher scores in perioperative adherence of patients and perioperative knowledge awareness of SMILE surgery than the control group,and lower preoperative anxiety levels than the control group,with statistically significant differences(P<0.05).Conclusions Scenario simulation based health education can effectively improve the adherence of SMILE patients,alleviate their surgical anxiety,enhance their awareness of perioperative health knowledge,improve their medical experience,and increase the success rate of the surgery.
论著
目的 探讨基于态度-定义-开放思维-计划-实施(ADOPT)模式的健康教育联合情绪引导对消化内镜诊疗患者配合度的影响。方法 选取2020年1月—2023年1月在我院准备行消化内镜诊疗的80例住院患者,随机分为观察组与对照组各40例。对照组患者在检查前采取常规护理,观察组患者在常规护理基础上增加基于ADOPT模式的健康教育联合情绪引导,在护理前后应用简明心境量表(POMS-SF)分别评估两组患者负面情绪、诊疗配合度、基础值(T1)、入镜时(T2)、检查开始后5 min(T3)、检查结束时(T4)的Ramsay镇静评分和舒适度评分,并对比两组患者的护理满意度。结果 护理后两组患者的困惑、活力、疲劳、抑郁、生气和紧张方面的POMS-SF评分降低,且观察组低于对照组(P<0.05);观察组患者配合度为95.00%,高于对照组75.00%(P<0.05);两组患者T1时间Ramsay镇静评分与舒适度评分比较差异无统计学意义(P>0.05),观察组T2、T3、T4时间Ramsay镇静评分高于对照组,舒适度评分优于对照组(P<0.05);观察组患者的总满意度高于对照组(P<0.05)。结论 对消化内镜诊疗患者采取基于ADOPT模式的健康教育联合情绪引导可改善患者内镜诊疗过程前的负面情绪,提升患者配合度,同时能够改善患者诊疗过程中的镇静程度和舒适度,患者护理满意度较高。
Objective To explore the value of health education based on the ADOPT model combined with emotional guidance on the cooperation of patients undergoing digestive endoscopy diagnosis and treatment.Methods From January 2020 to January 2023,80 hospitalized patients who were going to have digestive endoscopy diagnosis and treatment in our hospital were selected as the research subjects.All patients were divided into observation group and control group,with 40 patients in each group.The control group patients received routine care before the examination,while the observation group patients added ADOPT based health education combined with emotional guidance on the basis of routine care.The Profile of Mood States-Short Form(POMS-SF)was used to evaluate the negative emotions of the two groups of patients before and after the examination.The diagnostic and treatment cooperation,basic value(T1),at the time of endoscopy(T2),and 5 minutes after the examination(T3),at the end of the examination(T4),the Ramsay sedation score and comfort score were compared between the two groups,and the nursing satisfaction of the two groups of patients was compared.Results After nursing,the POMS-SF scores of confusion,vitality,fatigue,depression,anger,and tension in the two groups of patients were significantly reduced,and the observation group was lower(P<0.05).The cooperation rate of 95.00% in the observation group was significantly higher than that of 75.00% in the control group(P<0.05).There was no significant difference in the Ramsay sedation score and comfort score between the two groups of patients at T1 time(P>0.05).The Ramsay sedation scores of the observation group at T2,T3,and T4 time were higher,while the comfort score was lower(P<0.05).The overall satisfaction of the observation group patients was higher(P<0.05).Conclusions Adopting ADOPT based health education combined with emotional guidance for patients undergoing endoscopic diagnosis and treatment can improve their negative emotions before the endoscopic diagnosis and treatment process,enhance their cooperation level,and improve their level of sedation and comfort during the process.Patients have a high level of nursing satisfaction.
论著
目的 分析多元化团体互动健康教育在初产妇女围产期的应用效果。方法 选取2019年6月—2021年6月在我院顺利分娩的168例孕产妇为研究对象,采用随机数字表法分为观察组和对照组,各组均84例,2组围产期均给予常规健康教育,观察组同时给予多元化团体互动健康教育,比较2组的应用效果。结果 观察组孕产妇的各产程和住院时间均短于对照组;观察组产褥期后母亲角色适应情况优于对照组;产后1周和产后1个月较干预前2组的母乳喂养自信量表评分均升高,且观察组较高;干预后较干预前2组的焦虑自评量表和抑郁自评量表评分均降低,且观察组较低;观察组的子宫复旧、恶露量及便秘、尿潴留、切口感染发生率均低于对照组,差异有统计学意义(P<0.05)。结论 初产妇女围产期给予多元化团体互动健康教育能够帮助其促进产后恢复,较快适应母亲角色,提高母乳喂养能力,缓解负性情绪,降低不良反应。
Objective To analyze the effect of diversified group interactive health education on perinatal period of primiparous women. Methods A total of 168 women who gave birth successfully in our hospital from June 2019 to June 2021 were selected as the research objects, and divided into an observation group and a control group by random number table method, with 84 cases in each group.Both groups were given routine health education during perinatal period, and the observation group was given diversified group interactive health education additionally, the effects of the two groups were compared. Results The duration of labor and hospital stay were shorter in the observation group than in the control group.The maternal role adaptation of observation group was better than control group after puerperium.The Breastfeeding Self-Efficacy Scale scores of 1 week postpartum and 1 month postpartum were higher than those of the two groups before intervention, and the observation group was higher.After intervention, Self-Rating Anxiety Scale and Self-Rating Depression Scale scores of the observation group were lower than those before intervention, and the observation group was lower.Uterine involution, lochia volume, incidence of constipation, urinary retention and incision infection rate in the observation group were lower than those in the control group, and the differences were significant (P<0.05). Conclusions Primiparous women given diversified group interactive health education during the perinatal period can help them to promote postpartum recovery, adapt to being a mother quickly, improve breastfeeding ability, relieve negative emotions, and reduce adverse reactions.
论著
目的 分析基于视觉传达理论的照顾者思维导图教育在宫颈环扎手术患者中的应用效果。方法 选取2018年1月—2020年1月在我院顺利完成宫颈环切手术的116例患者及主要照顾者为研究对象,采用简单随机法将其分为对照组和观察组,各58例。对照组照顾者给予常规健康教育,观察组照顾者给予基于视觉传达理论的照顾者思维导图教育。比较2组主要照顾者干预前后的照顾负担评分和家属照顾能力测量表(FCTI)评分,并比较2组患者干预前后的焦虑、抑郁水平和健康行为评分,比较2组患者的妊娠结局。结果 干预后较干预前2组主要照顾者的各项照顾负担评分、FCTI评分均降低,且观察组较低;干预后较干预前2组患者的焦虑自评量表、抑郁自评量表评分均降低,且观察组较低。干预后2组患者的各项健康行为评分较干预前均升高,且观察组较高,差异有统计学意义(P<0.05)。观察组患者的流产、感染的发生率低于对照组,观察组患者的足月分娩产的发生率高于对照组,差异有统计学意义(P<0.05)。结论 宫颈环扎手术患者的主要照顾者采用基于视觉传达理论的照顾者思维导图教育能够有效缓解其照顾负担,提升照顾能力,进而缓解患者的负性情绪,提高其健康行为,改善妊娠结局。
Objective To analyze the application effect of caregiver mind mapping education based on visual communication theory in patients undergoing cervical cerclage. Methods A total of 116 patients who successfully completed cervical cerclage in our hospital and their main caregivers from January 2018 to January 2020 were selected as the research objects.They were divided into control group and observation group by simple random method, with 58 cases in each group.The caregivers in the control group were given routine health education, and those in the observation group were given mind mapping education based on visual communication theory.The scores of care burden and family caregiver task inventory (FCTI score) of the two groups of main caregivers before and after intervention were compared, and the anxiety, depression levels and health behavior score of the two groups before and after the intervention were compared, and the pregnancy outcome of the two groups was also compared. Results After the intervention, the care burden score and FCTI score of the main caregivers of the two groups were lower than those before the intervention, and the observation group was lower; after intervention, the Self-Rating Depression Scale, Self-Rating Anxiety Scale scores of the two groups were lower than those before intervention, and the observation group was lower.The health behavior scores after intervention were higher than that before intervention, and the observation group were higher (P<0.05).The incidence of abortion and infection in the observation group was lower than that in the control group, and the incidence of full-term delivery in the observation group was higher than that in the control group (P<0.05). Conclusions The caregiver mind mapping education based on visual communication theory can effectively alleviate the care burden, improve the care ability, alleviate the negative emotion of patients, improve their health behavior and improve the pregnancy outcome.
论著
目的 调查眼科患者对荧光素眼底血管造影认知情况及健康教育需求,为眼底造影医护人员实施高效、个性化健康教育提供依据。方法 采用自制眼底造影认知及健康教育需求问卷,对本院2021年6月—8月的123例眼底血管造影患者进行问卷调查,使用Spearman相关性分析、非参数秩和检验及多元线性逐步回归分析患者眼底血管造影认知的影响因素。结果 患者荧光素眼底血管造影认知得分为(33.77±8.09)分,其中,患者对于检查中的相关知识认知最低,相对得分为0.59;患者健康教育需求的得分为(43.95±7.63)分,其中,检查后的相关知识需求度最高,相对得分为0.77;不同年龄、文化程度、主要照顾者、眼造影检查次数及是否合并全身病的患者的认知水平差异有统计学意义(P<0.05)。多元线性逐步回归分析表明,眼造影检查史是患者眼底血管造影认知的独立影响因素。结论 眼科患者对荧光素眼底血管造影认知水平较低,健康教育需求高,医护人员应重视健康教育的实施,结合FFA操作流程及患者特点,制定标准化健康教育流程,探索有效的线上+线下的健康教育模式,以提高造影患者认知水平,保障患者安全。
Objective To investigate fundus fluorescein angiography(FFA)cognition and health education needs in ophthalmic patients,and to provide basis for efficient and personalized health education for FFA medical staff.Methods A self-made questionnaire was used in a survey of 123 patients from June to August 2021.The influencing factors of FFA cognition were analyzed by Spearman correlation analysis,non parametric rank sum test and multiple linear stepwise regression.Results The score of FFA cognition was(33.77 ± 8.09).Patients had the lowest cognition of relevant knowledge during the examination,with a relative score of 0.59.The score of patient's health education needs was(43.95 ± 7.63),while the score of relevant knowledge needs after examination was the highest,with a relative score of 0.77.There were significant differences in cognitive level among patients with different ages,educational levels,main caregivers,angiographic times,and complication of systemic diseases(P<0.05).Multiple linear stepwise regression analysis showed that the number of ocular angiography was an independent factor affecting the cognition of FFA.Conclusions Patients with FFA have low cognitive level and high demand for health education.Medical staff should pay attention to the implementation of health education,formulate a standardized health education process with the combination of operation process and patient characteristics,and explore an effective online-to-offline health education mode,so as to improve the cognitive level of angiography patients and ensure the safety of patients.
论著
目的 探讨与观察思维导图教育模式对肠造口患者生活质量与心理情绪的影响。方法 选择2021年5月—2022年4月本院胃肠外科收治的低位直肠癌术后患者80例为研究对象,按入院顺序随机编号,对应随机数字为偶数的分到思维导图组(n=40),奇数的分到传统组(n=40)。传统组给予常规健康教育干预,思维导图组在传统组护理的基础上给予思维导图教育模式干预,思维导图组与传统组护理观察时间为3个月。结果 思维导图组护理期间的造口感染、坏死、水肿、出血、旁疝等并发症发生率与传统组相比都降低(P<0.05)。思维导图组与传统组护理后的焦虑与抑郁评分与护理前相比降低(P<0.05),护理后思维导图组评分与传统组相比降低(P<0.05)。思维导图组的术后住院时间、术后排气时间、术后下床活动时间与传统组相比均减少(P<0.05)。思维导图组护理后的副作用、共性症状、尿路症状、特异躯体症状、特异心理、性功能、尿袋问题等生活质量评分与传统组相比都减少(P<0.05)。结论 思维导图教育模式在肠造口患者的应用能促进缓解心理负面情绪,促进患者康复,提高患者的生活质量,减少术后造口并发症的发生。
Objective To explore and observe the effects of mind map education mode on the quality of life and psychological emotions of patients with enterostomy.Methods From May 2021 to April 2022, 80 cases of patients with postoperative low rectal cancer who were admitted to the Gastrointestinal Surgery Department of our hospital were selected as the research subjects, and all the cases were numbered according to the random admission sequence, and those with even random numbers were assigned to the mind map group(n=40), and odd numbers were assigned to the traditional group(n=40).The traditional group was given routine health education intervention, the mind map group was given mind map education mode intervention additionally, and the nursing observation time of both groups was 3 months.Results The incidences of complications such as stoma bleeding, parastomal hernia, stoma necrosis, stoma edema and stoma infection during nursing in the mind map group were lower than that in the traditional group(P<0.05).The anxiety and depression scores in both groups after nursing were significantly lower than those before nursing(P<0.05), and the scores in the mind map group after nursing were also significantly lower than those in the traditional group(P<0.05).The postoperative hospital stay, postoperative exhaust time, and postoperative ambulation time of the mind map group were significantly shorter than those of the traditional group(P<0.05).The quality of life scores of common symptoms, side effects, urinary tract symptoms, specific somatic symptoms, specific psychology, urine bag problems and sexual function in the mind map group after nursing were significantly lower than those in the traditional group(P<0.05).Conclusions The application of mind map education model in patients with enterostomy can promote the relief of psychological negative emotions, promote the recovery of patients, reduce the occurrence of postoperative complications, and improve the quality of life of patients.
论著
目的 探讨全程健康管理对糖尿病患者的血糖控制应用效果分析。方法 选择在我院门诊接受治疗的200例糖尿病患者作为研究对象,采用随机数表法分为对照组和观察组,各100例。对照组采用常规健康教育对患者进行健康指导,观察组在对照组基础上对患者行全程健康管理干预,建立糖尿病健康教育小组,对患者进行个体化的健康指导。比较2组患者干预后心理评估及空腹血糖、餐后2 h血糖的变化情况。结果 观察组患者予全程健康教育指导后,GAD-7焦虑量表及PHQ-9抑郁量表测试结果、空腹血糖及餐后2 h血糖控制效果优于对照组(P<0.05)。结论 行全程健康管理干预可有效改善糖尿病患者焦虑抑郁情绪,有效改善空腹血糖、餐后2 h血糖,增强患者自我保健意识。
Objective To explore the effect of whole process health management on blood glucose control in patients with diabetes.Methods A total of 200 patients with diabetes who were treated in the outpatient department of our hospital were studied and divided into control group and observation group,with 100 cases respectively.The patients in control group were given routine health guidance.The patients in observation group underwent whole-process health management intervention on the basis of control group,the diabetes health education group was established and individualized health coaching was given.Psychological assessment and fasting blood glucose and 2-hour postprandial blood glucose changes in the 2 groups of patients after the intervention were compared.Results After receiving whole course health education and guidance,the score GAD-7 anxity scale,PHQ-9 depression scale,pre-prandial blood glucose and 2 h postprandial blood glucose in observation group were better than those of control group(P<0.05).Conclusions The whole process of health management intervention can improve anxiety and depression of diabetes patients,lower blood glucose levels before meals and 2 h after meals,enhance patients’ self-awareness.
论著
目的 观察综合健康教育在门诊长期肌注黄体酮患者的应用效果。方法 选取2018年10月—2019年6月在本院门诊中心注射室进行黄体酮注射的先兆流产患者319例,按患者来门诊的注射顺序,采用随机分组方法,单数位为对照组,双数位为干预组。干预组在肌注黄体酮时实行综合健康教育,而对照组则进行基本指导。注射1个月后观察效果。结果 干预组发生硬结例数77例(48.4%),对照组147例(91.9%);而疼痛程度方面干预组为(1.34±2.125)分,而对照组则为(4.51±2.400)分;干预组的满意度平均分为(9.60±0.975)分,而对照组为(6.65±1.603)分,差异均有统计学意义(P<0.01)。结论 对门诊长期肌注黄体酮患者实行综合健康教育有助于减轻患者疼痛、降低硬结发生率,促进药物疗效,提高患者满意度。
Objective To observe the effect of comprehensive health education on outpatients with long-term intramuscular injection of progesterone. Methods 319 patients were enrolled from October 2018 to June 2019, and were divided into the observation group and control group according to the sequence of patients coming to the outpatient clinic. Comprehensive health education was applied in the intervention group, and general basic education was applied in the control group. Results There were 77 cases (48.4%) of callosity in the intervention group, 147 cases (91.9%) in the control group. In pain degree scores of (1.34±2.125) were in the intervention group, (4.51±2.400) in the control group. In degree of satisfaction, (9.60±0.975) were in the intervention group, and (6.65±1.603) in the control group, with statistically significant difference (P<0.01). Conclusion Comprehensive health education may alleviate pain and callosity in patients with long-term intramuscular injection of progesterone.