论著

microRNA-29b对子宫内膜癌细胞增殖、迁移和侵袭的影响

Effect of microRNA-29b on proliferation,migration and invasion of endometrial cancer cells

:1002-1008
 
目的 探讨微RNA-29b(miR-29b)对子宫内膜癌细胞增殖、迁移和侵袭的影响。方法 子宫内膜癌HEC-1-B细胞分为miR-29b模拟物组(MM组)、miR-29b阻遏物组(MR组)和阴性对照物组(MNC组),分别转染miR-29b拟似物、miR-29b阻遏物和miR-29b阴性对照物,每组设置6个复孔。以实时定量逆转录PCR检测miR-29b表达,以水溶性四氮唑(WST-1)检测miR-29b对HEC-1-B子宫内膜癌细胞增殖的影响,以Transwell小室检测HEC-1-B子宫内膜癌细胞迁移和侵袭的影响,以Western blot法检测磷酸酶张力蛋白同源物(PTEN)-蛋白激酶 B(AKT)通路蛋白表达水平。结果 MNC组、MM组、MR组miR-29b相对表达量分别为(2 032.1±873.4)、(19 272.8±2 087.9)、(472.7±105.6),组间比较差异有统计学意义(P<0.05)。MM组0、3、5、7 d时OD值分别为(0.32±0.06)、(0.53±0.08)、(1.13±0.12)和(1.92±0.14),MNC组0、3、5、7 d时OD值分别为(0.34±0.09)、(0.71±0.08)、(1.67±0.21)和(3.49±0.24),MR组0、3、5、7 d时OD值分别为(0.38±0.09)、(0.84±0.18)、(2.43±0.24)和(5.67±0.15),3组0 d时OD值比较差异无统计学意义(P=0.216),三组3 d、5 d、7 d时OD值比较差异存在统计学意义(P<0.001)。MNC组、MM组和MR组迁移细胞数分别为(403.9±23.8)(102.6±15.7)和(685.7±46.8)个,上述3组侵袭细胞数分别为(82.1±12.7)(38.2±10.6)和(124.6±21.6)个,MM组和MNC组上述指标比较差异均有统计学意义(P<0.05),MR组和MM组上述指标比较差异均有统计学意义(P<0.05)。MNC组、MM组、MR组PTEN蛋白相对表达量分别为(0.25±0.08)、(0.69±0.11)、(0.11±0.05),上述3组p-AKT蛋白相对表达量分别为(0.58±0.10)、(0.13±0.06)和(0.79±0.08),上述3组AKT蛋白相对表达量分别为(0.38±0.09)、(0.37±0.11)和(0.37±0.08),MM组与MNC组PTEN、p-AKT水平比较差异有统计学意义(P<0.05),AKT水平比较差异无统计学意义(P>0.05);MR组与MNC组、MM组PTEN、p-AKT水平比较差异有统计学意义(P<0.05),AKT水平比较差异无统计学意义(P>0.05)。结论 过表达miR-29b对子宫内膜癌细胞增殖、迁移和侵袭具有抑制作用,靶向PTEN-AKT可能是其重要作用途径。
Objective To investigate the effects of microRNA-29b on proliferation,migration and invasion of endometrial cancer cells.Methods The endometrial cancer HEC-1-B cells were divided into micro29b mimetic group(MM group),micro29b repressor group(MR group)and negative control group(MNC group),and the micro29b mimetic,micro29b repressor and micro29b negative control were transfected into each group,six compound holes with each group.The real-time quantitative reverse transcription polymerase chain reaction(RT-PCR)was used to detect the expression of mi29b,WST-1 was used to detect the effect of mi29b on the proliferation of HEC-1-B endometrial cancer cells,Transwell chamber was used to detect the migration and invasion of HEC-1-B endometrial cancer cells,and Western blot was used to detect the expression level of PTEN-AKT pathway protein.Results The relative expression levels of microRNA-29b in MNC group,MM group and MR group were(2 032.1±873.4),(19 272.8±2 087.9)and(472.7±105.6),respectively,and there were significant differences between groups(P<0.05).OD values of MM group at 0 d,3 d,5 d and 7 d were(0.32±0.06),(0.53±0.08),(1.13±0.12)and(1.92±0.14)respectively.The OD values of MNC group at 0,3,5 and 7 days were(0.34±0.09),(0.71±0.08),(1.67±0.21)and(3.49±0.24)respectively.The OD values of MR group at 0 d,3 d,5 d and 7 d were(0.38±0.09),(0.84±0.18),(2.43±0.24)and(5.67±0.15)respectively.There was no significant difference in OD value between the three groups on day 0 (P=0.216).There were significant differences in OD value between the three groups on day 3,day 5 and day 7(P<0.001).The number of migrating cells in MNC group,MM group and MR group were(403.9±23.8)cells,(102.6±15.7)cells and(685.7±46.8)cells,respectively.The number of invasive cells in the above three groups were(82.1±12.7)cells,(38.2±10.6)cells and(124.6±21.6)cells.There were significant differences in the above indexes between MM group and MNC group(P<0.05),also between MR group and MM group(P<0.05).The relative expression levels of PTEN protein in MNC group,MM group and MR group were(0.25±0.08),(0.69±0.11)and(0.11±0.05).The relative expression levels of p-AKT protein in the above three groups were(0.58±0.10),(0.13±0.06)and(0.79±0.08).The relative expression levels of AKT protein in the above three groups were(0.38±0.09),(0.37±0.11)and(0.37±0.08),respectively.Compared with MNC group,the levels of PTEN and p-AKT in MM group had statistical significance(P<0.05),but there was no statistical difference in AKT level(P>0.05).Compared with MNC group and MM group,the levels of PTEN and p-AKT in MR group had statistical significance(P<0.05),and there was no statistical difference in AKT level(P>0.05).Conclusions Overexpression of microRNA-29b can inhibit the proliferation,migration and invasion of endometrial cancer cells,and targeting PTEN-AKT may be an important pathway.
论著

全面触发工具在新生儿医源性皮肤损伤不良事件中的应用研究

:997-1001
 
目的 研究探讨全面触发工具(GTT)在新生儿医源性皮肤损伤(ISI)不良事件监测中的应用,检验其有效性与适用性。方法 根据GTT白皮书中推荐的护理模块触发器,结合江西省妇幼保健院医院新生儿科ISI发生的特点和实际情况,建立科室审查团队,回顾性分析我院新生儿科重症监护室(NICU)2021年1月—2021年9月168例新生儿的病历。初级审查员负责审查病历;高级审查员负责对确定的ISI和伤害分级作最终决策,对ISI不良事件发生率进行综合的分析,制定符合科室的不良事件触发器,评价GTT在提高新生儿医源性不良事件检出率的优势。结果 168份病历中,设计的14项触发器中14项显示为阳性,触发器阳性检测率为100.00%,触发器阳性总频次为66次,阳性检出频次12例,阳性预测值为18.18%;168份病历GTT检出不良事件频次12次,涉及患儿8例,GTT检出率4.76%;GTT检出E级5例(2.98%),F级3例(1.79%);自愿上报E级3例(1.79%),F级2例(1.19%),均未发生G级、H级、I级事件;自愿上报事件5例,上报率为(2.98%)。结论 建立新生儿ISI不良事件触发器,并规范皮肤管理、规范和监督ISI医疗护理工作,可以最大限度保证患儿安全,提高新生儿综合救治能力,提升医疗护理服务水平。
论著

131I治疗儿童及青年格雷夫斯病疗效及影响因素分析

Efficacy and affecting factors in 131I therapy for children and young people with Graves' disease

:991-996
 
I')">131I,outcome" split="">Graves' diseaseI')">131I,outcome" split="">children and adolescentI')">131I,outcome" split="">131I')
目的 探讨131I治疗儿童及青年格雷夫斯病(GD)的疗效及其影响因素。方法 回顾性分析2013年—2022年在简阳市人民医院核医学科院接受131I治疗且年龄≤22岁的儿童及青年GD患者的临床资料。采用个体计算剂量法,每克甲状腺组织的计划用量为80~140 μCi,依据甲状腺吸碘率及甲状腺质量,确定131I的用量。依据131I治疗后3~6个月的甲状腺功能指标,进行疗效评价,甲状腺功能恢复正常或发生甲减视为治愈。统计分析治愈组与非治愈组间的临床疾病特征参数,评估可能影响疗效的因素。结果 纳入患者71例:男23例、女48例,年龄11~22岁。患儿甲状腺质量4.8~60.0 g,均值22.1 g。131I的用量在6~24 mCi,均值11.3 mCi。49例(69%)患者获得治愈,22例(31%)未获治愈。单因素分析显示年龄、性别、促甲状腺激素受体抗体的滴度、甲状腺吸碘率、甲状腺质量及131I用量等,治愈组与非治愈组间比较差异均无统计学意义(均P>0.05)。结论 以每克甲状腺组织80~140 μCi的计划用量,确定131I用量治疗儿童青年GD的疗效可达69%。
Objective To investigate the effect of 131I on Graves' disease(GD)in children and young adults and its influencing factors.Methods The clinical data of GD patients aged ≤22 who received 131I treatment in Nuclear Medicine Department of Jianyang People's Hospital from 2013 to 2022 were retrospectively analyzed.The planned dosage of 131I was 80~140 μCi per gram of thyroid tissue,and the dosage of 131I was determined according to the iodine uptake rate and thyroid mass.According to the thyroid function indicators of 3 to 6 months after 131I treatment,the curative effect was evaluated,and the thyroid function returned to normal or hypothyroidism occurred were considered as cured.The clinical characteristic parameters of the cured group and the non-cured group were analyzed to evaluate the factors that might affect the curative effect.Results Seventy-one patients were included:23 males and 48 females,aged 11-22.The thyroid mass of the children ranged from 4.8 to 60.0 g,with an average of 22.1 g.The dosage of 131I ranges from 6 to 24 mCi,with an average of 11.3 mCi.Forty-nine patients(69%)were cured and 22(31%)were not cured.Univariate analysis showed that there were no significant differences in age,sex,titer of thyrotropin receptor antibody,thyroid iodine uptake rate,thyroid mass and 131I dosage between the cured group and the non-cured group(all P>0.05).Conclusions With the planned dosage of 80~140 μCi per gram of thyroid tissue,the efficacy of 131I in the treatment of GD in children and young adults can reach 69%.
综述

全身免疫炎症指数与心血管疾病相关研究进展

Research progress on systemic immune inflammation index and cardiovascular disease

:985-990
 
慢性炎症是心血管疾病的常见发病机制,它主要通过损伤内皮细胞、氧化应激和刺激血栓形成影响疾病发展。全身免疫炎症指数(SII)作为一种新型炎症指标,最早用于肿瘤患者的预后评估,现已在多学科领域广泛使用,它由中性粒细胞、血小板、淋巴细胞计算得到,更加全面地反映机体炎症状态。SII已经在多项研究中被证实具有良好的预测价值,该文对SII的优势和在心血管疾病的临床研究进展进行综述,为研究的进一步开展提供参考。
Chronic inflammation is a common pathogenesis of cardiovascular disease,which mainly affects disease progression by damaging endothelial cells,oxidative stress and stimulating thrombosis.As a new type of inflammatory index,the systemic immune inflammatory index(SII)was first used to evaluate the prognosis of cancer patients,and has been widely used in multidisciplinary fields.SII has been confirmed to have good predictive value in a number of studies,and this article reviews the advantages of SII and the progress of clinical research in cardiovascular diseases,so as to provide reference for further research development.
专家述评

弥漫性大B细胞淋巴瘤的放射治疗进展

Recent progress in radiation therapy for diffuse large B-cell lymphoma

:974-984
 
弥漫性大B细胞淋巴瘤(DLBCL)是最常见的高度异质性非霍奇金淋巴瘤(NHL),不同的疾病阶段或临床亚型预后不尽相同。放射治疗作为无交叉耐药的理想局部治疗技术,应用于DLBCL可有效改善患者预后。初治DLBCL通过放射治疗联合化学治疗、免疫治疗等综合治疗可使约60%~70%患者疾病缓解。对于不同预后影响因素,如年龄、肿瘤体积、淋巴结外侵犯等,联合放射治疗也可取得更佳疗效。在复发性/难治性DLBCL的治疗中,自体造血干细胞移植(ASCT)和嵌合抗原受体T细胞免疫治疗(CAR-T)是目前的研究热点,而放射治疗无论是作为ASCT与CAR-T术前的桥接治疗或失败后的挽救性治疗均有助改善患者预后。随着放射治疗技术的日益优化,放射治疗在综合治疗方案中扮演着越来越重要的角色。
Diffuse large B-cell lymphoma(DLBCL)is a highly heterogeneous type of non-Hodgkin lymphoma(NHL)and its prognosis is different for different disease stages or clinical subtypes.Radiation therapy(RT)is a local treatment technique that does not cause cross-resistance and can effectively improve the prognosis of patients with DLBCL.When combined with chemotherapy and immunotherapy,RT can alleviate the disease in more than 60% of patients.Furthermore,RT can achieve better results for different prognostic factors such as age,tumor volume and external nodal invasion.For treating relapsed / refractory DLBCL,autologous stem cell transplantation(ASCT)and chimeric antigen receptor T cell immunotherapy(CAR-T)are currently being researched,while RT can help as bridging therapy before ASCT and CAR-T or salvage therapy after failure.With the increasing optimization of technology,radiotherapy plays an increasingly important role in combined treatment options.
专家述评

脊柱结核的外科治疗研究进展

The progress in surgical treatment research for spinal tuberculosis

:963-973
 
脊柱结核是脊柱感染性疾病中最为常见的类型。本文综述了脊柱结核外科治疗的现状及最新进展。在早期治疗阶段,规范化的抗结核药物治疗能够有效缓解疼痛,改善患者生活质量。但对于中后期,特别是椎旁脓肿较大,椎体骨质破坏较大而导致脊柱不稳定的患者,手术治疗往往是必要且必需的辅助手段,手术可以最大限度清除病变的椎间盘、椎体和脓肿,也应该最大限度保留健康的骨质。其主要原则包括病灶彻底清除、脊髓充分减压、脊柱稳定性重建等步骤。在手术治疗中,一期前路手术作为经典入路已经得到广泛应用,而单纯后路手术治疗也逐渐受到重视。近年来,随着微创手术技术的发展,其在脊柱结核治疗中的应用越来越广泛。微创手术的优势在于术中创伤更小、恢复更快,为患者带来了更好的治疗体验和临床效果。然而,对于手术的选择,临床医师需要综合考虑患者的个体差异性、临床表现及特征、影像学资料和手术适应证等多种因素,以确定最合适的治疗方案。只有充分考虑各种治疗手段的优劣,采取个性化、综合性的治疗方案,才能更好地提高患者的生活质量和治疗效果。
Spinal tuberculosis is the most common types of infectious diseases affecting the spine.This article reviews the current status and progress of surgical treatment for spinal tuberculosis.In the early and initial stages,standardized anti-tuberculosis drug therapy can effectively alleviate pain and improve patients' quality of life.However,for more complex cases in the middle and late stages,surgical treatment is needed,including thorough lesion clearance,adequate spinal cord decompression,and reconstruction of spinal stability.In surgical treatment,anterior approach surgery,as a classical method,has been widely applied,and posterior approach surgery alone has gradually gained attention.In recent years,with the development of minimally invasive surgical techniques,their application in the treatment of spinal tuberculosis has become increasingly widespread.The advantages of minimally invasive surgery lie in smaller intraoperative trauma and faster recovery,providing patients with better treatment experience and clinical outcomes.However,for the selection of surgery,clinicians need to consider multiple factors such as individual differences,clinical manifestations and characteristics,imaging data and surgical indications to determine the most suitable treatment plan.Only by fully considering the advantages and disadvantages of various treatment modalities and adopting personalized,comprehensive treatment plans can the quality of life and treatment outcomes of patients be effectively improved.
医学教育

错题析因在高校实验室安全管理中的意义

Analysis of the mistakes made in laboratory safety test provides hints for the critical control point in laboratory safety management

:1231-1236
 
目的 探讨学生实验室安全知识盲区,以提高高校实验室安全管理工作的成效。方法 考试人数192人,共计235次考试,根据考试系统的统计分析结果,观察各题目错误率和各选项构成比;结合统计描述和χ2检验,探讨影响学生实验室安全考试成绩的原因和所存在的知识盲区。结果 41%的考生身份为在读硕士研究生,59%的考生为在读本科生,男生占48%,女生占52%,且比较不同身份的性别构成比,差异无统计学意义;题目被归纳分为“行为规范”“应急自救技能”和“事故防范能力”三大部分,比较“行为规范”和“应急自救技能”类题目的错误率,差异存在统计学意义(χ2=7.570,P=0.006),“应急自救技能”类题目的错误率为3.14%,高于其余两类。结论 高校学生对应急自救技能类可能存在较多的知识盲区,应以之作为实验室安全管理工作关键控制点,加强应急自救技能培训可以极大地降低事故的严重程度。
Objective To enhance the efficiency of laboratory safety management in colleges,we analyzed the insufficiency of students in the knowledge about laboratory safety. Methods A total of 192 college students had attended the education tests of laboratory safety and totally 235 tests had been successfully recorded.According to the statistical analysis results,we observed the error ratio and the and the composition of the options for each question in the tests.With statistical description and Chi-square test,the impact of the test scores and the main insufficiency in the knowledge about laboratory safety were discussed. Results 41% of the students were pursuing master's degree,59% of them were pursuing bachelor's degree,48% are males and 52% are females,there was no significant difference in gender composition among different identities.All the questions had been categorized into three types,which were principle for conduct in laboratory,the skills of self rescue and the capability to prevent accidence.There was statistical significance between types of questions on principle for conduct in laboratory and the skills of self rescue(χ2=7.570,P=0.006),the error ratio of the question type of skills of self rescue was 3.14%,which was higher than the other types. Conclusions The insufficiency in the knowledge of skills of self rescue might probably be the critical control point in laboratory safety management,which should set as the key point of lab security,improve the self rescue skill of students may decrease thu severity accidence.
医学教育

理论授课后续PBL的阶梯教学法在临床技能混合教学中的效果

The effect of PBL step-by-step teaching method after theoretical teaching in the online and offline mixed teaching of clinical skills for medical students

:1226-1230
 
目的 探讨理论授课后续以问题为基础的学习(PBL)的阶梯教学法在临床技能混合教学中的效果。方法 选择福建医科大学附属南平第一医院2019级临床医学专业58名见习生为研究对象,将其通过单双号抽签的方式分为两组,即研究组与对照组各29例,研究组基于理论授课后续PBL的阶梯教学法,以“一对一”方式进行线上线下混合教学,对照组开展常规线下教学,对两组见习生教学效果进行比较。结果 研究组见习生参与消毒铺巾、气管插管、胸腔穿刺、腰椎穿刺及小儿腰椎穿刺等5项临床技能考核分别为(95.23±3.18)(95.19±3.26)(95.15±3.35)(95.28±3.17)(95.11±3.45)分,优于对照组(88.23±4.01)(87.89±4.59)(86.23±3.78)(87.22±3.89)(86.23±3.67)分(t=7.366、6.983、9.510、8.650、9.494,P<0.05);研究组见习生综合能力提升情况优于对照组(χ2=6.444,5.497、5.497、6.444、7.733,P<0.05);从教师培训态度(7项)、培训方法(15项)、培训时间(3项)、培训效果(11项)等方面进行评价,研究组临床技能培训教学效果各项评分及总分分别为(6.67±0.35)(12.23±2.23)(2.44±0.29)(9.23±2.56)(30.34±4.45)分,高于对照组的(4.12±1.45)(10.12±2.17)(9.23±2.56)(1.68±0.56)(7.23±2.12)分(24.34±3.45)分,(t=9.206、3.652、6.490、3.240、5.738,P<0.05)。结论 基于理论授课后续PBL的阶梯教学法,以“一对一”线上线下混合教学建立医学生临床技能的培训方法,见习生的综合能力明显提升,教学效果更好。
Objective To explore the effect of Problen-Based Learning(PBL)step-by-step teaching method in the online and offline mixed teaching of clinical skills for medical students. Methods Fifty-eight interns majoring in clinical medicine of grade 2019 in Nanping First Hospital affiliated to Fujian Medical University were selected as the research object,they were divided into two groups by drawing lots with even and odd numbers,namely,the study group and the control group,with 29 cases in each group.The study group conducted online and offline mixed teaching in a “one-on-one” way based on the step-by-step PBL teaching method after theoretical teaching,while the control group received regular offline teaching,and the teaching effects of the two groups were compared. Results The students of the study group participated in 5 clinical skills assessment,including disinfection towel(95.23±3.18),tracheal intubation(95.19±3.26),chest puncture(95.15±3.35),lumbar puncture(95.28±3.17)and pediatric lumbar puncture(95.11±3.45),were significantly better than those of control group(88.23±4.01),(87.89±4.59),(86.23±3.78),(87.22±3.89),(86.23±3.67)(t=7.366,6.983,9.510,8.650,9.494,P<0.05).The comprehensive ability improvement of students in study group was better than that in control group(χ2=6.444,5.497,5.497,6.444,7.733,P<0.05).The evaluation was made from the aspects of teacher training attitude(7 items),training method(15 items),training time(3 items)and training effect(11 items).The clinical skill training teaching effect scores of study group(6.67±0.35),(12.23±2.23),(2.44±0.29),(9.23±2.56),(30.34±4.45)were significantly higher than those of control group(4.12±1.45),(10.12±2.17),(9.23±2.56),(1.68±0.56),(7.23±2.12),(24.34±3.45)(t=9.206,3.652,6.490,3.240,5.738,P<0.05). Conclusions Based on PBL step-by-step teaching method after theoretical teaching,the training method of clinical skills for medical students is established by “one-to-one” online and offline mixed teaching,can improve the clinical skills and comprehensive ability of interns and get high evaluation from students.
护理研究

基于信息-动机-行为模型的护理干预对造口患者并发症及生活质量的影响

Effects of nursing intervention based on information-motivate-behavior model on complications and quality of life of patients with stoma

:1220-1225
 
目的 探讨与分析基于信息-动机-行为(IMB)模型的护理干预对造口患者并发症及生活质量的影响。方法 选择2021年5月—2023年4月本院进行结直肠癌行肠造口患者84例作为研究对象,根据1∶1随机电脑抽签分配原则把患者分为IMB组42例与常规组42例。常规组给予常规护理干预,IMB组在常规组护理的基础上给予基于IMB模型的护理干预,IMB组与常规组护理观察时间为3个月,观察与记录IMB组与常规组患者并发症、生活质量、心理状况、自我管理能力评分变化情况。结果 IMB组护理3个月期间的腹腔脓肿、肠梗阻、肺部感染、造口感染等并发症发生率为4.8%,与常规组的19.0%相比降低更多(P<0.05)。IMB组护理3个月期间的遵医依从性为100.0%,与常规组的90.5%相比提高更多(P<0.05)。护理3个月后IMB组的症状识别、症状处理、处理后评价等自我管理能力评分与常规组相比提高更多(P<0.05)。IMB组与常规组护理3个月后的焦虑评分与抑郁评分与护理前相比都有统计学意义的降低(P<0.05),护理3个月后IMB组的焦虑评分、抑郁评分与常规组对比降低(P<0.05)。护理3个月后IMB组的总生活质量量表、症状子量表、症状量表、功能量表评分都与常规组相比提高(P<0.05)。结论 基于IMB模型的护理干预在造口患者的应用能提高遵医依从性,缓解焦虑与抑郁情绪,提高患者自我管理能力,从而可有效减少患者并发症的发生,促进提高患者的预后生活质量。
Objective To explore and analysis the effects of nursing intervention based on Information-Motivation-Behavioral(IMB)model on complications and quality of life of patients with stoma. Methods Eighty-four cases of patients with colorectal cancer undergoing enterostomy in our hospital from May 2021 to Aprilt 2023 were selected as the study subjects.According to the principle of 1∶1 random computer lottery,the patients were divided into IMB group(42 cases)and traditional group(42 cases).The traditional group were given routine nursing intervention,and the IMB group were given nursing intervention based on the IMB model on the basis of the traditional group.The nursing observation time of the traditional group and IMB group were 3 months,the changes in complications,quality of life,psychological status,and self-management ability scores of patients were observed and recorded. Results The incidence of complications such as abdominal abscess,intestinal obstruction,pulmonary infection and stoma infection in IMB group during nursing were 4.8%,which were significantly lower than 19.0% in the traditional group(P<0.05).The compliance of IMB group during nursing were 100.0%,which were significantly higher than 90.5% in the traditional group(P<0.05).After nursing of 3 months,the scores of self-management ability such as symptom recognition,symptom treatment and post-treatment evaluation in IMB group were significantly higher than those in the traditional group(P<0.05).The scores of anxiety and depression in the traditional group and IMB group after nursing of 3 months were significantly lower than those before nursing(P<0.05),and the scores of anxiety and depression in the IMB group after nursing of 3 months were also significantly lower than those in the traditional group(P<0.05).After nursing of 3 months,the scores of IMB group on function scale,symptom scale,symptom subscale and total quality of life scale were significantly higher than those of the traditional group(P<0.05). Conclusions The application of nursing intervention based on the IMB model in patients with stoma can improve the compliance with medical treatment,reduce the occurrence of complications,improve the self-management ability of patients,relieve anxiety and depression,and continue to improve the prognosis and quality of life of patients.
护理研究

基于计划行为理论的妊娠期糖尿病患者自我管理行为意向的质性研究

A qualitative study of self-management behavior intention in patients with gestational diabetes mellitus based on the theory of planned behavior

:1215-1219
 
目的 基于计划行为理论探讨妊娠期糖尿病(GDM)孕妇自我管理行为意向,为促进其孕期良好的自我管理提供依据。方法 运用质性研究中的现象学研究方法,对12例GDM孕妇进行深度半结构式访谈,并用Colaizzi七步内容分析法对主题进行归纳。结果 根据计划行为理论对主题进行归纳,共提炼出3种类别:①行为态度:认知不足,积极态度,消极态度;②主观规范:家庭影响,医护压力,人际压力;③知觉行为控制:知识技能获取受限,客观条件束缚共8个主题。结论 GDM患者在自我管理过程中存在对疾病认知不足的问题GDM,自我管理行为受到家庭、医护人员、人际关系等外界压力对自我管理态度的影响,且存在知识技能欠缺,客观条件制约多方面阻碍。医护人员应加强对GDM孕妇的自我管理教育,适时提供支持,提高其自我管理效率。
Objective To explore the self-management behavior intention of pregnant women with gestational diabetes mellitus(GDM)based on the theory of planned behavior,and to provide a basis for promoting good self-management during pregnancy. Methods Using the phenomenological research method in qualitative research,12 pregnant women with GDM were interviewed in an in-depth semi-structured interview,and then the themes were summarized by Colaizzi's seven-step content analysis. Results According to the theory of planned behavior,the themes were summarized into three categories and eight themes including(1)Behavioral Attitudes:cognition deficiency,positive attitude,and negative attitude,(2)Subjective norms:family influence,medical pressure,interpersonal pressure,and(3)Perceptual behavior control:self-management knowledge acquisition limitations,self-management Objective conditions constraint. Conclusions Most of the respondents have insufficient awareness of self-management of gestational diabetes,different patients have different attitudes towards self-management,and self-management behavior is affected by external pressures such as family,medical staff,and interpersonal relationships,and there are many obstacles due to a lack of knowledge and skills,Objective conditions.Medical staff should strengthen the self-management education of pregnant women with gestational diabetes,provide timely support,and improve their self-management efficiency.
出版者信息








《广州医药》公众号