论著

罗伊适应模式对肺癌患者术后生活质量的影响

Effect of Roy adaptation model on quality of life in patients with lung cancer after surgery

:54-56
 
目的 探讨罗伊适应模式对肺癌患者术后生活质量的影响。方法 将2012年3月—2015年7月来我院就诊的178例肺癌术后患者,随机分为试验组85例和对照组93例;对照组患者按护理常规进行护理,试验组在常规护理基础上给予罗伊适应模式护理干预;出院时分别比较两组患者住院适应性、治疗依从性、病人满意度及患者生活质量评分。结果 试验组住院适应率为87.1%(74例),对照组住院适应率为66.7%(62例),两组差异有显著性(P<0.01);试验组治疗依从性优良率为88.2%(75例)、对照组治疗依从性优良率72.0%(67例),两组差异有显著性(P<0.01);试验组患者满意度为89.4%(76例),高于对照组患者满意度73.1%(68例),两组差异有显著性(P<0.01);试验组生活质量评分,总体健康得分(74.1±8.3)高于对照组(56.7±5.9),且差异有统计学意义(P<0.01)。结论 罗伊适应模式护理干预,可以提高肺癌患者手术后的住院适应性、治疗依从性及病人满意度,显著改善患者生活质量,在临床推广罗伊适应模式护理干预具有现实意义。
Objective To investigate the effect of Roy adaptation model on quality of life in patients for lung cancer after surgery. Methods 178 cases of patients with lung cancer after surgery operation were randomly divided into observation groups(85 cases) and control groups(93 cases). The control group was treated with routine nursing care and the observation group was treated on the basis of routine nursing care plus Roy adaptation model nursing interventions. When the two groups were compared in patients hospitalized and discharged adaptability, treatment compliance, patient satisfaction and patient quality of life score. Results Hospitalization adaptation in the observation group was 87.1%(74 cases) and control group was 66.7%(67 cases). There was statistically significant difference between two groups(P<0.01); Excellent treatment compliance of observation group was 88.2%(75 cases) and control group was 72.0%(67 cases). There was statistically significant difference between two groups(P<0.01); the observation group patient satisfaction were 89.4%(76 cases), it was higher than 73.1%(68 cases) of control group. There was statistically significant difference between two groups(P<0.01); quality of life in general health score(74.1±8.3) in the observation group was higher than that of control group(56.7±5.9),and there was statistically significant difference between two groups(P<0.01). Conclusion Roy adaptation model nursing intervention may improve the adaptability hospitalized the patients with lung cancer after surgery, treatment compliance and the patient satisfaction, and significantly improve the quality of life of patients. It is worthy of promotion clinically.
临床诊疗

心理健康干预对门诊复治肺结核患者生活质量的影响

Influence of mental health intervention to living quality in clinic retreating patients with tuberculosis

:83-85
 
目的 探讨心理健康干预对复治肺结核患者在整个治疗过程中生活质量影响,为加强结核病的宣教奠定坚实的基础。方法 选取广州市结核病防治所在治的复治肺结核病人72例,随机分成宣教组和普通组,选取2名有丰富经验的主管护师,经专业心理师培训指导,护长考核,负责宣教组的工作,而普通组则由轮班护士进行,无作特别要求。对比两组心理健康干预前后的变化。结果 两组症状自评量表(SCL-90)测评相比较,宣教组优于普通组,差异有统计学意义(P<0.05)。宣教组的生理健康总评及精神健康总评比对照组好,差异均有统计学意义(P<0.05)。结论 通过对门诊复治结核病患者进行心理健康干预,能有效改变复治病人的心理和生理健康,提高生活质量。
论著

急诊留观病历质量的调查分析与思考

Investigation and analysis of medical records from emergency observation room

:51-53
 
目的 对急诊留观病历中存在的质量问题予以分析,探索提高其书写质量的有效措施,优化管理流程。方法 根据卫生部《病历书写基本规范》、《医疗机构病历管理规定》和《广东省病历书写与管理规范》对2015年6月—12月某院1200份急诊留观病历进行质量检查,对其问题进行汇总分析。结果 发现存在质量缺陷的病历998份,缺陷数4478项,以缺权利义务告知书、授权委托书或填写漏项、出观记录入观情况简单复制、缺验单、病程记录过于简单等缺陷位居前四位,占78.67%。结论 急诊留观病历缺陷突出。临床医师及医院管理者需要就此进行针对性整改,以提高和控制急诊留观病历质量。
Objective To analyze deficiencies of medical records from emergency observation room and explore effective procedures to enhance writing quality of medical records and its management. Methods One thousand two hundred medical records from emergency observation room during June to December 2015 were analyzed according principles of medical records writing,regulations for medical records management in medical institutions by Ministry of Health and regulation for medical records writing and management in Guangdong province. Results 998/1200 medical records were found with deficiency and the total deficiencies were 4478 items. The prominent four types of deficiencies, occupying 78.67%, included absence or incompleteness of the notification of the rights and obligations and power of attorney, simple copy and paste of the medical records, absence of medical test results and too simplicity of the recording of the disease process. Conclusion Prominent deficiencies were found in medical records from emergency observation room. The clinical physicians and hospital administrators should take effective procedures to improve and control the quality of the medical records.
临床诊疗

机采双份血小板质量的影响因素研究

Study of Influence Factors in Quality by Mechanical Collecting Double Portion Blood Platelet

:78-81
 
目的 探讨影响机采双份血小板质量的因素,以提高机采血小板的制品质量。方法 收集本站2014年3月—9月机采双份血小板献血者资料,观察分析其一般情况,血细胞分离机运行参数及采前血常规对血小板采集质量的影响。结果 采集前血小板计数是影响机采双份血小板质量的重要因素,与血小板采集量成正相关(P<0.05)。而血小板平均体积、血小板体积分布宽度、大血小板比率则与血小板采集量成负相关(P<0.05)。结论 需正确分析献血者采前血常规,作出最优选择,保证机采双份血小板质量。
临床护理

持续质量改进在康复医学科护理质量管理中的作用

Effects of Continuous Quality Improvement in Nursing Quality Control in Department of Rehabilitation Medicine

:103-104
 
目的 探讨护理质量持续改进对康复医学科护理质量管理的影响。方法 制定康复医学科护理管理标准,比较改进前后护理专业基本技能评分和护患关系情况评分。结果 经过持续质量改进,康复医学科的护理质量显著提高。基础护理、护理文书和消毒隔离的评分显著提高,与改进前相比较,两组间的差异有统计学意义。护患关系融洽度和患者满意率提高,与改进前相比较,两组间差异有统计学意义;护理纠纷发生率降低,两组间差异有统计学意义。结论 在康复医学科护理管理中引进持续质量改进,可有效地提高护理质量,确保护理安全。
论著

压力管理对改善中年高血压患者生活质量的影响

Influence of stress management on the improvement of quality of life of middle-aged patients with hypertension

:56-57
 
目的 探讨压力管理对改善中年高血压患者生活质量的效果。方法 采用便利抽样法,把首次在我院住院的中年高血压患者115例按时间段分为实验组60例和对照组55例,对照组给予常规护理,实验组采用压力管理干预,分住院期和出院后康复期两阶段进行。使用抑郁自评量表和SF-36量表分别在出院前和出院后1个月进行测评。结果 干预后实验组患者抑郁标准分降低,SF-36量表各维度分及总分升高,与对照组比较差异均有统计学意义(P<0.05)。结论 对中年高血压患者实施有针对性、整体性、延续性和激励性的压力管理,可提高其生活质量。
Objective To explore the influence of stress management on the improvement of quality of life of middle-aged patients with hypertension. Methods According to convenience sampling, 115 middle-aged patients with hypertension who were the first time admitted to our hospital were divided, on the basis of different periods, into the test group (60 patients) and the control group (55 patients). The control group was accepted normal nursing, while the test group was accepted the stress management intervention that performed during hospitalization and after patients discharged from the hospital. Both groups were assessed, by using self-rating depression scale and SF-36 scale, before discharging from hospital and one month after discharging from hospital. Results After the intervention, the test group experienced reductions in depression standard score and increases in dimension scores and total scores of SF-36 scale.compared with those of the control group, these changes had statistical significant (P<0.05). Conclusion Selective, integrated, continuous and stimulating stress management can help middle-aged patients with hypertension to improve the quality of life.
论著

群组管理对儿童特应性皮炎患儿生活质量的影响

Influence of group management on quality of life of children with atopic dermatitis

:78-80
 
目的 探讨群组管理对儿童特应性皮炎患儿生活质量的影响。方法 采用随机数字法将72例患儿分为干预组和对照组各36例,对照组不给予任何干预,干预组实施1个月的群组管理活动。结果 干预后干预组的瘙痒程度显著好转、总疗效率达100%、生活质量评分改善,与对照组比较差异均有统计学意义(P<0.05)。结论 群组管理是一种有效的管理模式,增强了患儿的自我效能,降低了疾病严重程度,提高了患儿的生活质量。
Objective To explore the influence of group management on quality of life of children with atopic dermatitis. Methods According to random number table, 72 children with atopic dermatitis were randomly divided into the experiment group and the control group. While the control group was not accepted any intervention, the experiment group was accepted one-month group management. Results After the intervention, the pruritus of the intervention group was improved, the total effective rate was 100% and scores of life quality were improved obviously.compared with those in the control group, these changes had statistical significance (P<0.05). Conclusion Group management is an effective management mode, it improves children's self-efficacy, relieve the seriousness of illness and improve children's quality of life.
论著

连续护理在提高乳腺癌保乳患者生存质量中的应用效果分析

The effects of continuous nursing intervention on the quality of life for breast cancer patients after breast conserving therapy

:56-58
 
目的 探讨连续护理在提高乳腺癌保乳患者生存质量中的应用效果,号召我院为病人提供持续性、连续性护理开展APN排班。方法 随机抽取2011年1月—2014年1月我院收治的117例乳腺癌患者的临床资料。观察两组患者术后生存质量、焦虑情况、抑郁情况、术后上肢水肿情况。结果 两组患者术后1周生存质量比较,差异无统计学意义(P>0.05);观察组术后1个月、3个月、6个月、1年生存质量高于对照组,差异有统计学意义(P<0.05)。两组患者术后1周焦虑情况比较,差异无统计学意义(P>0.05);观察组术后1个月、3个月、6个月、1年忧郁情况优于对照组,差异有统计学意义(P<0.05)。观察组患者术后上肢水肿情况优于对照组,差异有统计学意义(P<0.05)。结论 连续护理在提高乳腺癌保乳患者生存质量中的应用效果较好,能够改善患者术后生存质量、焦虑抑郁情况、术后上肢水肿情况,值得临床推广。
Objective To explore the effects of continuous nursing intervention on the quality of life for breast cancer patients after breast conserving therapy. Methods 117 cases of patients with breast cancer were randomly divided into observation group(59 cases) and control group(58 cases). The control group were cared by routine postoperative care, including health education. On the basis of the control group, the observation group were cared by continuous nursing intervention, including cognitive intervention, psychological intervention, social support, life care, functional exercise, the prevention of complications and discharge instruction. The quality of life, anxiety situation, depression amd upper limb edema were compared in the two groups. Results There has no significant difference on the quality of life after 1 week in the two groups(P>0.05); The quality of life after 1 month, 3 months, 6 months, 1 year for the observation group were higher than the control group(P<0.05). There has no significant difference on the anxiety situation after 1 week in the two groups(P>0.05); The anxiety situation after 1 month, 3 months, 6 months, 1 year for the observation group were higher than the control group(P<0.05). The depression situation after 1 week, 1 month, 3 months, 6 months, 1 year for the observation group were higher than the control group(P<0.05). The upper limb edema situation for the observation group were better than the control group(P<0.05). Conclusion The effects of continuous nursing intervention on the quality of life for breast cancer patients after breast conserving therapy is good. It can improve the quality of life, situations of anxiety, depression and upper limb edema. It is worthy of clinical promotion.
论著

免疫联合化疗对晚期 NSCLC 患者淋巴细胞免疫及生活质量的影响

Effect of immunotherapy combined with chemotherapy on lymphocyte immunity and quality of life in patients with advanced NSCLC

:760-765
 
       目的   探讨免疫治疗联合化学治疗(化疗)对晚期非小细胞肺癌(NSCLC)患者淋巴免疫及生活质量的影响,为临床进一步治疗提供参考。  选择2021年6月—2023年6月天津市滨海新区大港医院收治的晚期NSCLC患者120例进行研究,按抽签法分为干预组及对照组,每组60例,对照组采取单纯化疗方案,干预组采取免疫联合化疗方案,对比两组临床疗效、药物不良反应,治疗前后免疫功能(CD3+ 、CD4+ 、CD8+ )、糖类抗原199(CA199)、糖类抗原 125(CA125)、血清癌胚抗原(CEA)水平及健康状态调查表(QOL)评分。结果  干预组患者治疗总有效率高于对照组(68.33%>41.67%,P<0.05);治疗后干预组患者CD3+ 、CD4+ 比例高于治疗前及对照组治疗后,CD8+ 比例低于治疗前及对照组治疗后(P<0.05);治疗后干预组血清CA199、CA125、CEA水平均低于治疗前及对照组治疗后(P<0.05);干预组药物不良反应发生率为16.67%,对照组为36.67%,干预组低于对照组(P<0.05);治疗后干预组QOL各维度评分高于对照组及治疗前(P<0.05)。结论  与单纯化疗相比,免疫联合化疗治疗晚期NSCLC患者,能有效降低肿瘤标志物水平,改善患者免疫指标,减轻药物不良反应,提高患者疗效及生活质量。
       Objective  To explore the effect of immunotherapy combined with chemotherapy on lymphatic immunity and quality of life of patients with advanced non-small cell lung cancer(NSCLC),and to provide reference for further clinical treatment.Methods  A total of 120 patients with NSCLC from June 2021 to June 2023 were selected and divided into observation group and control group evenly according to the method of drawing lots,control group was treated with chemotherapy,the observation group was treated with immunotherapy combined with chemotherapy,and the clinical efficacy and adverse drug reactions were compared between the two groups.Before and after treatment,immune function(CD3+ ,CD4+ ,CD8+ ),carbohydrate antigen 199(CA199),carbohydrate antigen 125(CA125),serum carcinoembryonic antigen(CEA)levels and health status questionnaire(QOL-RRB- scores)were measured.Results The total effective  rate in the observation group was significantly higher than that in the control group(68.33%>41.67%,P<0.05).After treatment,the ratios of CD3+  and CD4+  in the observation group were significantly higher than those before treatment and control group after treatment,and the ratio of CD8+  was significantly lower than that before and after treatment in the control group(P<0.05).After treatment,the serum levels of CA199,CA125 and CEA in the observation group were lower than those before and after treatment in the control group(P<0.05).The incidence of adverse drug  reactions was 16.67% in the observation group and 36.67% in the control group,which was significantly lower in the observation group than in the control group(P<0.05).After treatment,the QOL scores in the observation group were significantly higher than those in the control group and before treatment(P<0.05).Conclusions  Compared with chemotherapy alone,immunotherapy combined with chemotherapy can effectively reduce the levels of tumor markers,improve the immune indexes of patients,reduce the adverse drug reactions,and improve the efficacy and quality of life of patients with advanced NSCLC.
护理研究

医院 - 社区 - 家庭一体化康复护理模式干预对慢性创面患者生活质量及创面愈合的影响研究

Impact of hospital-community-home integrated rehabilitation nursing model on the quality of life and wound healing in patients with chronic wounds

:694-700
 
       目的   评估医院-社区-家庭一体化康复护理模式对慢性创面患者生活质量及创面愈合的潜在影响。   选择2023年1月—2024年6月在广州市第一人民医院接受治疗的慢性创面患者80例作为研究对象,所有患者在住院期间均接受基于溃疡面积、深度及是否合并感染等因素的综合治疗,包括彻底清创、创缘处理、负压治疗、感染控制等治疗,并接受常规护理。出院前,通过随机数字表法将患者分为两组,每组40例。两组患者在住院期间均接受常规护理,出院后,对照组接受延续护理并定期复查。干预组40例患者在出院后接受医院-社区-家庭一体化康复护理模式。入组时及护理3个月后,使用生活质量调查表(SF-36)对患者生活质量和创面愈合率进行评估。结果   干预组创面愈合率为(32.61±4.26)%,高于对照组(11.48±1.04)%,差异具有统计学意义(t=19.473,P<0.05)。两组患者在护理3个月后的数字评定量表评分和创面疼痛频率评分均较入组时降低(P<0.05)。其中干预组护理3个月后的创面VAS评分为(1.82±0.17)分,创面疼痛频率评分为(1.28±0.25)分;而对照组分别为(3.91±0.22)分和(2.63±0.37)分,干预组低于对照组(P<0.05)。此外,干预组在护理后3个月的总体健康、生理功能、生理职能、精神健康、情感功能、社会功能评分均高于对照组(P<0.05)。在居家3个月期间,干预组的感染发生率为5.00%,而对照组为17.50%,干预组感染发生率低于对照组(χ 2 =3.781,P<0.05)。结论   本研究表明,医院-社区-家庭一体化康复护理模式干预能够促进慢性创面患者的创面愈合,降低居家期间感染的风险,并提升患者的生活质量。
       Objective  To assess the potential impact of the integrated hospital-community-home  rehabilitation nursing model on the quality of life and wound healing in patients with chronic wounds.Methods  A total of 80 patients with chronic wounds treated at the Guangzhou First People’s Hospital from January 2023 to June 2024 were selected as the study subjects.All patients received comprehensive treatment during their hospital stay,including thorough debridement,edge treatment,vacuum therapy,infection control and routine nursing care.Prior to discharge,the patients were  randomly divided into two groups using a random number table,with 40 patients in each group.Both groups received routine nursing care during their hospital stay,and the control group received continuing nursing care and regular follow-up after discharge.Forty patients in the intervention group received the integrated hospital-community-home rehabilitation nursing model after discharge.Quality of life(QoL)and wound healing rates were assessed using the Short Form 36(SF-36)questionnaire at the time of enrollment and 3 months after nursing.Results  The wound healing rate in the intervention group was significantly higher than that in the control group ([32.61±4.26]% vs [11.48±1.04]%),with a statistical difference(t=19.473,P<0.05).The numerical rating scale(NRS)scores and frequency of wound pain scores decreased in both groups 3 months after nursing compared to the enrollment period(P<0.05).Specifically,the VAS score for wound pain in the intervention group 3 months after nursing was(1.82±0.17),and the frequency of wound pain was(1.28±0.25),in the control group,these scores were(3.91±0.22)and(2.63±0.37),respectively,with the intervention group scoring significantly lower than the control group(P<0.05).Furthermore,the scores for overall health,physical function,role physical,mental health,emotional function,and social function in the intervention group were higher than those in the control group 3 months after nursing(P<0.05).During the 3-month home recovery period,the incidence of infection in the intervention group was 5.00%,whereas it was 17.50% in the control group,with the intervention group  showing a lower incidence of infection(χ 2 =3.781,P<0.05).Conclusions  This study demonstrates that the hospital-community-home integrated rehabilitation care model intervention can promote wound healing in chronic wound patients,reduce the risk of infection during home care,and significantly improve patients’ quality of life.
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