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西安某医院护士心理健康状况调查
西安某医院护士心理健康状况调查 摘 要 本文基于对西安某医院的护士心理健康状况的调查分析，旨在了解当前护士这个职业群体的心理抑郁情绪的现状,分析护士抑郁症状发生的影响因素，提出改进护士心理健康状况的建议。 我们使用的调查方法是调查问卷结合典型样本深入问询的方式。这里使用了自行设计的一般情况调查表，内容包括年龄、护龄、婚姻状况、受教育程度等。针对不同情况，分别采用了自评量表(SCL-90)对120名护士进行调查。调查结果显示，护士普遍存在不同程度的心理健康问题，心理焦虑的亚健康状况明显，其中有部分护士发生了抑郁症状。抑郁发生率为19% 。护士的心理健康的影响因素主要有受教育程度、健康状况、家庭关系[1]。基于调查分析，我们发现护士的心理健康状态问题突出，而且抑郁症状的发生率明显高于一般人群,应该引起有关护理管理人员的高度重视,减轻护士的压力及负担,提高护士的心理健康状况，促进医院的护理质量。 关 键 词：心理健康；护士；焦虑；抑郁症；人性化护理管理制度 目 录 摘 要3 目 录4 1.实习目的5 2.实习内容6 3.实习结果8 4.实习总结11 5.致 谢13 参考文献14 附 录15
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社区老年糖尿病患者生活质量的调查分析及护理干预
社区老年糖尿病患者生活质量的调查分析及护理干预 摘 要 研究目的 随着世界人口老龄化进程的加快,对老年人生活质量的研究正逐步成为世界关注的焦点。研究老年人的生活质量,首先要了解老年人生活质量的基本状况,并对其进行评价。老年人生活质量评价可揭示更深层次的健康问题,更灵敏地 反映其不断变化的情况,据此可准确地指导卫生服务。为临床护理人员及老年糖尿病患者家属及本人的护理干预提供指导，从而使老年糖尿病患者病情得到更好的控制及生活质量得到改善。 研究方法 采用目的抽样的方法，选择2010年9～2011年6月某社区2型糖尿病患者175例，平均年龄（58.99±11.92）岁，平均病程为（9.22±6.65）年。诊断均符合1999年WHO提出的糖尿病诊断标准。采用问卷调查的方法，面对面发放问卷。对于阅读困难者，笔者不加提示逐条阅读，让患者独立做出选择，逐一记录。 研究结果 结果显示女性患者在DSQL心理纬度分显著高于男性（P＜0.01），文化程度不同把患者分为三组，小学文化程度为Ⅰ组，共58例，初中高中及中专文化程度为Ⅱ组，共36例，大专本科及以上文化程度为Ⅲ组，共26例。应用方差分析结果显示三组不同年龄组别之间生理纬度分之间比较结果，有统计学意义。各文化程度组之间两两比较的结果，Ⅰ组和Ⅲ组在生理纬度的生活质量比较有显著差异（P＜0.05）。 研究结论 女性患者的生活质量比男性患者低，主要表现在心理纬度。这可能与女性的特点有关，文化程度高的患者要比文化程度低的患者生活质量高。 关 键 词：社区 ；糖尿病；SAS；SDS;生活质量 论文类型：调查报告 the community older adults with diabetes in the investigation and analysis of the quality of life and nursing intervention Abstract objective As the world's population aging process, the acceleration of old people life quality research is gradually becoming the focus of world attention. The old people's quality of life, and the first to understand the basic condition of old people life quality, and the evaluation on. Old people life quality evaluation can reveal a deeper level of health problems, the more sensitive to Reflect the changing situation, accordingly can accurately guidance and health services. For clinical nursing staff, and older adults with diabetes, families and I nursing provides guidance, so that older adults with diabetes illness get better control and the quality of life improved. Research methods The purpose of the sampling method, choose the 2010 9 ~ in June 2011, a community of 175 cases of patients with type 2 diabetes, with an average age of 58.99 + /-11.92 years, mean duration for (9.22 + /-6.65 years. Diagnosis which conform to the 1999 WHO proposed diabetes diagnosis standard. Using the method of questionnaire survey questionnaire, face to face. To read without difficulty, the author suggests headed reading, let patients independent make a choice, one by one to record. The results The results show that women in patients with DSQL psychological latitude points higher than male significantly (P < 0.01), cultural degree different divided the patients into three groups, primary education for Ⅰ group were 58 cases, junior high school, high school and technical secondary school culture for Ⅱ group, a total of degree of 36 cases, college degree or above level of culture, were Ⅲ group of 26 patients. Using the results of variance analysis showed three groups of different age group physiological latitude points between the comparison between a statistical significance. The cultural degree between group, the result of the comparison between two Ⅰ group and Ⅲ group physiological latitude in quality of life more significant difference (P < 0.05). Research conclusion The quality of life of patients with women than men with a low, main performance in psychological latitude. This may and women by the characteristics of the high degree of patients, culture than the low degree of cultural quality of life in patients with high. Key words: community; shut Diabetes; SAS; SDS; The quality of life Paper types: survey report 目 录 1 前言 …………………………………………………………………………………8 1.1 研究的背景 ……………………………………………………………………9 1.2 研究的意义及目标………………………………………………………………11 1.3 关键词及定义……………………………………………………………………11 1.3.1 社区……………………………………………………………………………11 1.3.2 糖尿病…………………………………………………………………………11 1.3.3 SAS…………………………………………………………………………… 12 1.3.4 SDS……………………………………………………………………………12 1.3.5生活质量………………………………………………………………………13 1.4文献回顾…………………………………………………………………………13 1.4.1社区老年人生活质量的研究现状……………………………………………13 1.4.2老年糖尿病人的生活及保健现状……………………………………………14 1.4.3生活质量的影响因素…………………………………………………………14 2 研究设计………………………………………………………………………………15 2.1 研究设计…………………………………………………………………………15 2.2 研究对象…………………………………………………………………………15 2.3研究步骤…………………………………………………………………………16 2.4研究工具…………………………………………………………………………17 2.5资料分析…………………………………………………………………………17 3 研究结果……………………………………………………………………………18 3.1不同性别之间2型糖尿病患者DSQL的比较…………………………………18 3.2不同年龄之间2型糖尿病患者DSQL的比较…………………………………19 3.3不同文化程度之间2型糖尿病患者DSQL的比较……………………………19 3.4不同婚姻状况之间2型糖尿病患者DSQL的比较……………………………19 4 讨论……………………………………………………………………………………20 5 结论…………………………………………………………………………………22 参考文献 ………………………………………………………………………………24
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泳疗对新生儿发育及代谢的影响研究
泳疗对新生儿发育及代谢的影响研究 摘 要 目的：探讨“新生儿游泳”（泳疗）与新生儿生长发育的关系，分析其促进新生儿部分代谢指标变化的临床价值。 方法：我院2008年1月至2010年3月我院新生儿随机分为两组，正常新生儿单纯沐浴组（对照组）1000例，其中顺产800例，剖宫产200例；正常新生儿游泳组（研究组）1200例，其中顺产950例、剖宫产250例。记录新生儿体重变化、胎便初排时间、低出生体重儿的体重及NBNA评分；测定新生儿胆红素及胃肠功能紊乱值。 结果：两组新生儿出生5d时体重，均有显著差异，P＜0.01；结果显示 ,两组间每天体重增加值 ,游泳前后 NBNA评分及胃肠功能紊乱 (便秘、 溢奶、 腹胀 )的发生率均有统计学意义 ( P < 0.05) ,两组新生儿脐部均无感染。两组新生儿TCG指数变化显著。 结论：新生儿游泳（泳疗）可促进新生儿的生长与发育，降低黄疸。 关键词：新生儿泳疗；早产儿；低体重儿；围生期；生长发育 论文类型：类实验研究 The study on the impact of swimming therapy to the newborn development and metabolism ABSTRACT Objective: Explore "the newborn swimming" (swimming therapy) and the growth and development of newborn babies, analyzes the relationship between promote metabolism indicators of the clinical value.Methods: From January 2008 to March 2010 from neonatal randomly divided into two groups, normal neonatal pure bath group (control group) patients, of whom 800 cases, and cesarean section natural labor 200 cases; Normal swim group (the team) newborn 1200 cases, of which 950 cases of natural labor 250 cases, cesarean section. Record neonatal weight change, tire and row time, early lower birth weight babies weight and NBNA score; Determination of neonatal bilirubin and gastrointestinal dysfunction value.Results: Two groups of birth weight 5 d, when significantly, P < 0.01; The results showed that between the two groups, the added value of weight every day before and after swimming NBNA score and the gastrointestinal dysfunction (constipation, overflowing with milk, the incidence of abdominal distension) are statistically significant (P < 0.05), two groups of neonatal infection. There are no umbilical plexus Two groups of neonatal trading card games (TCGS) are significant index change.Conclusion: Neonatal swimming (swimming) can promote the healing of the newborn growth and development, reduce jaundice.Keywords: Neonatal swimming function; Premature; Low birth weight; The perinatal period; growth Type: experimental research 目 录 摘 要IV 目 录V 1 绪论1 1.1研究背景及意义1 1.2研究目的及目标2 1.3关键词及定义2 1.4文献回顾2 2 研究设计9 2.1研究对象9 2.2研究方法9 2.4统计学方法9 3.结果10 3.1两组新生儿体重变化10 3.2两组新生儿体重变化TCB指数及胃肠功能变化10 4.讨论11 4.1 泳疗对新生儿发育的影响探讨11 4.2泳疗对新生儿代谢的作用探讨11 5.推论与建议13 参考文献14 致谢16
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动静脉内瘘闭塞原因分析与护理措施
动静脉内瘘闭塞原因分析与护理措施 摘 要 目的：随着患者透析龄的延长、人口老龄化以及糖尿病、高血压、周围血管疾病的发病率逐年增加，自体动静脉内瘘的建立愈加困难，其相关并发症也越来越多，部分内瘘吻合失败是长期透析病人面临的主要问题。本文通过总结我院15年来937例(1226次)血液透析患者自体动静脉内瘘术的临床资料，探讨影响动静脉内瘘术成功的因素，同时评估在不同时期手术方式、手术部位对动静脉内瘘术的影响。 方法：回顾性地对1994年1月-2008年10月我院住院行自体动静脉内瘘手术的937例患者的临床资料及辅助检查资料进行调查。每个患者的性别、年龄、原发病、透析时间等一般情况及手术时间、部位、方式、24小时内瘘通畅率、术后并发症等手术情况及辅助检查结果。计算手术的成功率，探讨不同阶段患者年龄、原发病、血压、血糖、血脂、血红蛋白、心功能状况及血管因素、血栓形成对内瘘成功的影响，比较自体内瘘在不同时期不同部位、不同方式对手术成功率的影响。 结果：1、自2005年1月-2009年10月第一、第二、第三阶段的手术成功率分别为93%、91%、90%，总成功率为90.29%，无统计学差异(P>0.05)。2、三个阶段鼻咽壶部、前臂动静脉内瘘术临床效果无显著差异(P>0.05)。3、血管端侧吻合术建立动静脉内瘘优于端端及侧侧吻合术,差异具有显著性(P
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剖宫产率的探讨
剖宫产率影响因素的探讨 摘 要 目的 探讨滁州市剖宫产率影响的主要因素,为降低剖宫产率提供依据 方法 采用问卷调查法，对100名已怀孕的育龄妇女进行问卷调查，问卷内容包括年龄、孕次、产次、文化程度、家庭收入、对剖宫产知识认识程度等，以了解影响剖宫产的普遍性因素。并对滁州市2005年-2009年剖宫产产妇进行回顾性分析，以了解剖宫产产妇手术指征构成及剖宫产率的变化。 结果 对100名孕妇的调查，此次剖宫产率为62%，明显高于WHO推荐的15%。本次调查当中明确的手术指征行剖宫产的为22%，有40名孕妇手术为不必要的，在这100名中有30%是在孕初期就选择的，有18%是在妊娠晚期决定剖宫产的，还有52%是在住院以后因各种原因而行剖宫产的。5年来剖宫产率明显上升，2009年达到57.6%，总结剖宫产指征主要是社会因素、胎儿宫内窘迫、巨大儿、胎位异常、头盆不称、脐带绕颈、中重度妊高征、疤痕子宫等。 结论 产时保健是孕产期中最重要的环节，同时分娩又是保健的重中之重。调查显示剖宫产率呈现不断上升的趋势，指征主要是社会因素、胎儿因素和产妇因素，不必要的剖宫产危害了妇女和儿童的健康。所以要加强产前保健，产前宣教，提高阴道分娩技术，加强医疗队伍道德建设和医疗卫生法制建设，严格掌握剖宫主指征，降低剖宫产率。 关 键 词 剖宫产率，手术指征 论文类型 研究报告 Explore the influence factors of cesarean section rate ABSTRACT Objectives Discusses the influence of ChuZhou cesarean section rate section rate,for reducing cesarean section rate Methods Using the method of questionnaire,100 already pregnant women of child-bearing age questionnaire,questionnaire includes at times,age, culture, and the family income,knowledge of cesarean section,In order to understand the influence factors of universality. Cesarean delivery.In chuzhou and 2005-2009cesarean delivery mothers were retrospectively analyzed,in order to understand the cesarean section puerpera surgical indications and cesarean section rate of change. Results The survey of 100 women,the cesarean section rate for 62 percent,Obviously higher than WHOthe recommended by 15%,This investigation clear operation indications for 22%. Do cesarean section,40 women as unnecessary surgery,in the 100 in early in pregnancy is 30% of choice,there are 18 in the late pregnancy decision cesarean section,there are 52 in hospital and after cesarean section for various reasons.5 years cesarean section rate increased obviously,2009 57.6% reach.Summarize cesarean section primarily social factors，intrauterine fetal distress，macrosomic，taiwei abnorma，head basin does not say, umbilical cord around the，severe al.pteeclampsia,scar uterine etc. Conclusion Health care is produced when were the most important link in,while the chongzhongzhi is health care delivery,Investigation shows cesarean section rate rising trend appears,indications mainly social factors,fetal factors and maternal factors.Unnecessary cesarean section endangers the health of women and children.Soto strengthen prenatal care,antenatal mission,improve vaginal delivery technology,strengthening medical ethics construction team and medical legal construction,strictly grasp the profile,reducing cesarean section rate. KEY WORDS Cesarean section rate,Surgical indications TYPE OF THESIS Investigating report 目 录 1、绪论7 1.1研究的背景和意义7 1.2研究的目的和目标7 1.2.1目的7 1.2.2目标7 1.3关键词·7 1.4文献回顾·8 2、研究设计·10 2.1研究对象10 2.2一般资料10 2.3研究方法10 2.4研究步骤10 3、研究结果·12 3.1孕妇的年龄、孕次、产次等与总分的相关性 ·12 3.2剖宫产率影响的因素·12 4、讨论·14 5、推论及建议16 5.1推论·16 5.2建议·16 6、致谢17 7、参考文献18 8、调查问卷19
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学龄前儿童的营养护理
学龄前儿童的营养护理 摘 要 研究背景 在最近的研究报告中，学龄前儿童营养性疾病案例比较多，常见的分为营养不良性疾病和过营养性疾病。营养不良性疾病常因营养缺乏程度不同而分为营养不足症和营养缺乏症，前者指亚临床性营养不良，后者指有明显临床表现的疾病。常见的过营养性疾病主要有：肥胖症、糖尿病等。发病虽有遗传、体质、神经及精神等多种因素，但脂质营养失调，脂肪在膳食中比例过高，特别是动物性脂肪、饱和脂肪酸摄取过多，是一个重要的致病原因。 研究目的 探讨对学龄前儿童营养不良性疾病、过营养性疾病的成因以及采用营养护理手段对学龄前儿童营养性疾病的干预效果。 研究方法 162例学龄前儿童随机分为实验组和对照组，实验组80例，根据学龄前儿童的身体现状采取合适的营养护理的方法和手段；对照组82例，不采取额外的营养护理的方法和手段。监测学龄前儿童的生理状况指标：血红蛋白、体重，采用统计学T检验法分析数据，得出相关结论。 研究结果 实验组中儿童缺铁性贫血只有2.5%,而对照组中儿童缺铁性贫血有17.1%；x2＝9.65，P
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人性化护理对于脑卒中康复相关因子影响的调查研究
人性化护理对于脑卒中康复相关因子影响的调查研究 摘 要 目的 探讨人性化护理，其本质就是“以病人为中心”，与现代医学模式的视病人为一个生物、心理、社会的完整的人相符合护理理念，稳定和调动患者积极有益的情绪，帮助患者从失落、痛苦、不安、孤独等消极情绪中解脱出来，缩短住院时间，提高患者的满意度。方法 将我科2008年10月至2009年4月住院患者，符合1995年第四届脑血管病学术会议通过的脑血管病诊断标准，并经头颅CT或MRI确诊。随机分为对照组和观察组各40例。分别给予常规护理方法及外加人性化护理方法，对两组护理前后有效率进行比较，并比较分析两组的住院时间及患者满意度,根据评分标准分型情况判断疗效，如分型减轻则为有效，分型不变甚或加重则为无效。结果 人性化护理，它让我们转变了“以我为中心”的惯性思维模式，将“以病人为中心”作为了我们整个护理工作的中心。它让我们改变了以往的护理工作程序，在细微之处来处处体现人性化护理对生命健康的关爱，体现人性化护理在我们临床护理工作中的真实意义。通过人性化护理使治疗的有效率达到85%，较对照组65%显著提高 (P＜0.05)、住院时间也比对照组明显缩短（30.9±3.7 VS 35.4±4.3,P＜0.05）;患者非常满意和满意的均高于对照组（30% vs 5%,47.5% vs 35%,P均＜0.05）。结论 我们要把“以人为本”的服务理念和实践贯穿于整个临床护理工作中，用爱心和责任心去关爱每一位患者，使患者感到了人性关怀的温暖与人性的回复，获得了满足感和安全感，通过人性化的护理服务，不断推进和提高整体护理质量，提高了患者的生存质量，促进患者恢复健康；有利于护患关系的协调与沟通，减少医疗纠纷。它让我们改变了以往的护理工作程序，在细微之处来处处体现人性化护理对生命健康的关爱。 【关键词】人性化护理；脑卒中; 调查研究 论文类型：应用研究 Human care and rehabilitation for stroke-related factors affect the investigation and research ABSTRACT Human care and rehabilitation for stroke-related factors affect the investigation and research Purpose: Expore the human care since that is the essence of “Patient-Centered”, with the morden medical model as the patient as a biological、psychological、social person with a complete ideal of the care。Stability and mobility in patients with positive and useful emotion, to help patients from the loss、pain、anxiety、loneliness and other negative emotions out to shorten the length of stay, improve the patient satisfaction。Methods：patients from October 2008 to April 2009，in line with the 1995 Fourth Symposium on Cerebrovascular disease through diagnostic criteria of Cerebrovascular disease，and by head CTor MRI confirmed。Divided into control group (n=40)and observation group(n=40)，randomly。40 cases were given in addition to conventional care and human care，care of the two groups before and after comparison of the efficiency and comparative analysis of two sets of in-patient time and patient satisfaction。According to criteria determine the effect of sub-type situations，such as sub-type to reduce the effective，or even add to the same type would be invalid。Results:Human care and let us change it a “self-centered” mode of thinking of inertia will be “patient-centered” as the care of our entire work.。It let us change the care of previous procedures, the subtleties of human nature to reflect on the life and health of nursing care in our work, the true significance。There are two sets of efficency、length of stay and patients satisfaction were significant differences exist。Conclusions：“People-Oriented”service philosophy and practice of clinical care throughout the work，the concept of love and sense of responsibility to love each and every patient，feeing the warmth of human caring and human response、satisfaction and a sense of security gained。through human care services，Promoting and improving the quality of care、life and the health of patients，continously。Nurse-Patient relationship conductive to communicateon and coordination，reducing medical disputes。Changing the care of working procedures of the part，the subtleties of human nature to reflect on the life and health of nursing care in our work。 [Key words]: humanistic nursing care； stroke；study Thesis Type: Applied Research
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气垫床预防晚期肺癌患者压疮的探讨
气垫床预防晚期肺癌患者压疮的探讨 摘 要 目的：通过对临床肺癌晚期病人使用气垫床压疮发生情况的观察，分析护理干预对压疮防治的效果。 方法：以铜陵有色职工总院呼吸内科为研究现场，以2009.1-2009.12月住院的临床肺癌晚期患者为研究对象，将使用气垫床、普通床的患者分别作为观察组、对照组进行压疮的发生和进展临床护理观察。其中，观察组31例，对照组30例。观察组、对照组均做好常规护理，如由护士协助翻身，白天1次／2h，夜晚1次/4h；观察受压部位皮肤颜色、温度、有无潮湿感，并做记录；保持床单整洁、干燥、无碎屑，保持患者正确、舒适的卧位；避免对局部发红部位进行按摩；给予患者富含营养、易消化的饮食，保证足够的营养支持；观察组气垫床使用雅博-Excel4000防压疮床垫。结合肺癌晚期病人疾病特点，调查项目包括患者姓名、住院号、年龄、性别、体重、临床诊断、受压部位2周后皮肤异常及处理情况等内容。 结果：对观察组、对照组两组病人在性别、年龄、体重等方面进行分析比较，两组病人差异无统计学意义（P＞0.05）。2周后观察组皮肤正常28人，皮肤异常3人，压疮发生率为9.68%；对照组皮肤正常16人，皮肤异常14人，压疮发生率为46.67%，观察组压疮发生率低于对照组，两组差异有统计学意义(P＜0.01)。 结论：预见性在压疮预防及护理中是第一位的，由于肺癌晚期病人营养状况一般较差，同时抵抗力下降，长期卧床活动受限等因素易导致压疮的发生。临床应用气垫床明显减轻肺癌晚期病人腰骶部皮肤所承的压力，起到预防压疮的作用，并能使病人增加舒适感，提高病人生命质量，减轻护理工作量，值得临床推广使用。 关 键 词：肺癌晚期；压疮；气垫床；护理 论文类型：分析性研究——病例对照研究 Study on Air Bed to Prevent Pressure Sores in Patients with Advanced Lung Cancer ABSTRACT Objectives To observe the effect of preventing pressure sores on advanced lung cancer patients using air cushion bed, and to analyze the effect of pressure sore prevention and treatment through nursing intervention. Methods Department of respiratory medicine of General workers’ hospital of Tongling nonferrous metals corporation was the research field and the patients with advanced lung cancer in hospital in 2009 were studied. The patients were randomly assigned to observe the occurrence and development of pressure sores through the observation of clinical nursing. 31 cases in the observation group which using air cushion bed and 30 cases in the control group which using ordinary mattresses. Both groups were doing routine care, such as by nurses to help turn for every 2 hours during the day time and once every 4 hours during the night.To keep observing the skin color, temperature, humidity sense of pressure parts and to keep recording.To keep sheets clean, dry, debris-free, maintaining the correct patient, a comfortable supine.To avoid the red part of the local massage and give the patients with nutrient-rich, easily digested diet to ensure adequate nutritional support. The air cushion bed was eqipped with Yabo-Excel4000 anti-bedsore mattress.Consider the characteristics of disease in patients with advanced lung cancer, survey included patient name, hospital number, age, sex, weight, clinical diagnosis, site 2 weeks after compression and treatment of skin disorders and so on. Results The observation group and the control group in sex, age, weight, etc. were analyzed and compared, there was no significant difference between the two groups of patients（P＞0.05）. The incidence of pressure sores of the observation group was significantly lower than that of the control group (P＜0.01). After 2 weeks, skin disorders was 3 in the observation group and 14 in the control group.The percentage of pressure sores occur 9.68% was in the observation group and 46.67% in the control group. The incidence of pressure sores of the observation group was less than that of the control group，the difference between the two groups was statistically significant (P＜0.01). Conclusion Predictability in pressure sore prevention and care is at the first situation. As the nutritional status of patients with advanced lung cancer in general poor, while resistance to decline, activity limitationin such as long-term bed rest and other factors easily lead to the occurrence of pressure sores. Air cushion bed can significantly reduce the pressure beared by lumbosacral skin of patients with advanced lung cancer, play the effective role of prevention of pressure sores, increase patient comfort,improve patient quality of life,reduce nursing workload, and is worthy of clinical use. Key words: Lung cancer later period；Control a sore；Air cushion bed；Nurse TYPE OF THESIS: Analytical study 目 录 1 前言 1 1.1研究背景及意义·1 1.2研究目标3 1.3 关键词及定义·3 1.4 文献回顾·3 2 研究设计·9 2.1 研究对象·9 2.2 一般资料·9 2.3 研究方法9 2.4 研究步骤10 2.5 统计学分析·10 3 结果11 3.1 两组病人的一般情况11 3.2 两组病人受压部位2周后压疮发生情况·11 4 讨论 ·13 4.1 肺癌晚期病人是压疮的高发人群13 4.2 卧床病人压疮易发部位及时间·13 4.3 气垫床可有效预防压疮·13 4.4 优质的护理可有效防止压疮发生14 5 结论及建议 ·15 5.1 研究结论15 5.2研究的局限性和不完善的地方15 致谢17 参考文献·19
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社区轻型老年高血压患者社区护理干预研究
社区老年轻度高血压患者社区护理干预研究 摘 要 研究背景 高血压是老年人最常见的心血管病,是全球范围内的重大公共卫生问题。原发性高血压是脑卒中、冠心病和心肾功能衰竭的主要发病因素（1）。国务院2004年公布资料显示，我国成人高血压患病率已达18.8%，高血压流行呈低知晓率、低治疗率、低控制率现状，因此，尽早发现，积极防治，力争使高血压患者的血压达到理想标准,是抗高血压治疗的基本要求，国内外的经验表明，控制高血压最有效的方法是社区综合防治（2）。社区综合防治是当前我国心脑血管疾病综合防治工作中的中心环节，是一项低投入、高产出、高效益的卫生保健事业，在社区中开展高血压健康教育可大大提高社区人群对高血压知晓率和控制率,延缓病情进展,降低复发率,减少并发症,减轻疾病负担,提高生活质量（3、4、5）。。社区轻型高血压，由于其主要是患者未受到心、脑、肾和眼底器质性损害,与正常血压和确诊高血压之间存在可转化型。轻型高血压是持续性高血压的前驱,并影响其发生和发展。 研究目的 探讨通过社区综合干预措施对轻型老年高血压患者进行干预从而控制血压，达到在社区居民中提倡和推广社区综合护理干预的目的。 研究方法 按随机原则选择248例社区轻型老年高血压患者，排除了糖尿病、冠心病、肥厚性心肌病、心力衰竭、主动脉瓣狭窄、过速性心律失及肾功能不全等疾病的人群，通过对人群建立居民健康档案，开展健康教育宣传、进行健康行为指导，合理膳食、低盐饮食、戒烟限酒、保持良好的情绪，并进行适量的体育锻炼，连续监测血压，与干预前后进行对比分析。 研究结果 1. 在老年高血压患者进行护理干预前，患者对高血压的知晓率、低盐低脂饮食率、适量运动率都比较低，通过我们对高血压患者有计划、有组织、有系统的综合干预后，患者对高血压知识均有很大程度的掌握，知晓率为90.8%，低盐低脂饮食率达53.2%，适量运动率为76.2%。 2. 选择的172轻度高血压老人经过干预发现1个月后血压正常者有41例(24.1%),干预2个月后血压正常者有61例(35.2%),干预3个月后血压正常者73例（42.5%） 结论 对社区老年轻度高血压患者进行社区综合护理干预，加强高血压基础、病因、临床症状知识等内容的健康教育十分必要，健康促进和健康教育可以通过影响人的知识、态度来改变人的行为, 同时进行运动锻炼、营养干预、放松训练等社区护理干预等可以有效的降低血压，降低患者服药的并发症和减少患者的经济负担。 关键词：高血压 社区护理 干预措施 论文类型：研究报告 Thesis subject:Community old-age light degree high blood pressure sufferer the community nursing interfere a search Abstract Study back ground The high blood pressure is old people's most familiar cardiovascular disease, the great public hygiene question in range in the world. The hair high blood pressure was a brain at first the soldier won, coronary and core kidney function crocked up of main outbreak factor.(1) State council releases data display in 2004, our country adult's high blood pressure fall ill rate already 18.8%, the high blood pressure fad presents low understand a rate and low treatment of rate, low control rate present condition, therefore, as early as possible discover, actively prevention and cure, work hard for the blood pressure of making the high blood pressure sufferer to hit ideal standard, is an anti- high blood pressure the fundamental request of treatment, domestic and international experience enunciation, controling the most useful method of high blood pressure is a community synthesis to prevent and cure.(2) Community's synthesizing prevention and cure is current our country the core link in the centre within cerebral disease synthesis preventing and curing is a low invest, high output - input ratio, efficiently the health care business of benefit, develop high blood pressure health education in the community can consumedly raise the community crowd understands rate and control rate to the high blood pressure and defers condition progress and lowers to relapse a rate and reduces complications and lightens disease burden, exaltation life mass.(3, 4, 5).Community light high blood pressure, because it mainly is a sufferer don't be injured by core, brain, kidney and the eye bed machine guilder, with normal blood pressure and confirm the existence of high blood pressure can conversion type.The light high blood pressure is the forerunner of continuity high blood pressure, and effect its occurrence and shape. Study a purpose Inquire into passing the community synthesis interruption measure to carry on an interruption to control blood pressure thus vs the light old-age high blood pressure sufferer and hit in the community to promote and expand community to synthesize the purpose of nursing interruption in the resident. Study a method According to random priniple select 248 community light old-age high blood pressure sufferer, expeled diabetes, coronary, fatty thick sex myocardial disease, the mental exertion crock up, the aorta petal is narrow, the overspeed core Lyu lose and renal insufficiency of etc. paroxysm crowd, pass vs crowd create resident healthy file, develop healthy education publicity and carry on healthy behavior instruction, reasonable meal, low salt food, quit smoking to limit wine and keep good emotion, and carry on just the right amount of athletics to toughen, continuous monitor blood pressure, contrast analysis with progress in the front and back of the interruption. Study a result Before the old-age high blood pressure sufferer carries on a nursing interruption, the sufferer understands rate and low salt and low fat food vs the high blood pressure rate and just the right amount of running rate is all lower, after passing us to having program to the sufferer of high blood pressure and have the organization, systematic synthesis the interruption, the sufferer has the keep in hand of very great degree to all the high blood pressure knowledge and understands to lead to 90.8%, the low salt and low fat food leads up to 53.2%, and just the right amount running leads to 76.2%. Choice 172 mild hypertension old person the intervention discovered 1 month later the blood pressure normal person has 41 examples (24.1%), intervenes 2 months later the blood pressure normal person has 61 examples (35.2%), intervenes 3 months later blood pressure normal person 73 examples (42.5%) Conclusion Carry on community synthesis vs the old-age light degree high blood pressure sufferer of community nursing interruption, intensify contents sc, such as high blood pressure foundation, cause of disease and clinical symptom knowledge...etc. of healthy education full a necessity, healthily accelerate and healthily education can pass the knowledge of effecting the person, attitude to transform the person's behavior, progress running toughens at the same time, nourishment interruption, relax training etc. community nursing interruption etc. can useful step - down blood pressure, lower the economic burden of complications and decrease sufferer that the sufferer takes a medicine. Keyword:High blood pressure Community nursing Interfere measure Thesis type:Research paper 目 录 1前言1 1.1研究背景及意义1 1.2研究目的及目标1 1.2.1研究目的1 1.2.2研究目标1 1.3关键词及意义2 1.3.1高血压2 1.3.2社区护理2 1.3.3干预2 1.4文献回顾2 1.4.1高血压病的病因和主要的发病机制2 1.4.1.1遗传因素2 1.4.1.2饮食3 1.4.1.3精神因素3 1.4.1.4体重因素3 1.4.1.5吸烟3 1.4.1.6血清游离脂肪酸3 1.4.1.7血管紧张素Ⅱ4 1.4.1.8阻塞性睡眠呼吸暂停综合征4 2研究设计与方法5 2.1研究设计5 2.2 研究对象5 2.2.1研究对象5 2.2.2纳入标准5 2.2.3排除标准5 2.3研究步骤5 2.4资料分析7 3结果9 3.1干预前后高血压知晓率比较9 3.2干预前后低盐低脂生活率比较9 3.3干预前后适量运动率比较9 3.4三个月降压控制率10 4讨论11 5结论13 5.1研究结论15 5.2不足和建议15 致谢15 参考文献17
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浅析建立产后出血预测评估系统对预后的影响
摘 要 目的：建立产后出血预后预测评估系统、评定病情的严重程度、早期判断预后，制定有效的护理方案，改善预后，并以回顾性资料对新建立的评估系统进行评估。 方法：根据产后出血的特点，参考产前及分娩期产后出血高危因素，参照以往“产后出血预测评分表”参数设置，设定了25项指标,并根据产科临床特点并进行赋值。2、回顾性收集2010年6月一2011年6月1年间我院产科重症监护病房375例资料完整可分析的产后出血患者资料，应用新建立的预测评估系统对患者进行量化评分，将产后出血量>1500毫升定义为严重产后出血，纪录患者各器官功能障碍、子宫切除及死亡情况。建立严重产后出血风险预测公式、多器官功能障碍风险预测公式、子宫切除风险预测公式。3．分析患者评分分值与严重产后出血、多器官功能障碍、子宫切除及死亡的关系。并从评分与预后的关系初步判断评分对临床治疗的指导意义。 结果：1．新建立了产后出血评分系统由25项指标；包括：分娩地点、年龄、产次、分娩孕周、刮宫次数、产检次数、疤痕子宫等。2．回顾性资料对产后出血评分系统的评价显示375例患者随着评分的升高母亲的器官功能障碍和并发症发生的阳性率增加。 结论：1．本课题组首次建立了产后出血预后预测评估系统及严重产后出血、多器官功能障碍、子宫切除的风险预测公式。2．预计该评估系统可以有效的预测产后出血患者的病情危重程度及预后，进一步评价需大样本量的研究。预期应用该评估系统指导临床处理能够早期判断预后，指导临床处理，制定有效的治疗方案，改善预后。 关键词：产后出血；预后；预测评估系统；护理对策 目 录 摘 要I 1实习目的3 2实习内容4 2.1研究设计4 2.2研究对象4 2.3研究工具4 2.4研究步骤4 2.5统计分析5 3实习结果6 3.1一般情况6 3.2 375例产后出血患者评分与预后的关系7 4实习总结或体会9 4.1总结9 4.2体会9 5 致 谢11 参考文献12
