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find Keyword "依从性" 81 results
  • 父母及家庭压力因素预测小儿新发癫痫患者的健康相关生活质量

    研究对人口学特征、疾病因素及抗癫痫药物(AEDs)依从性进行校正后,父母及家庭总体和健康相关压力对新发癫痫儿童的纵向通用和癫痫特异性健康相关生活质量(Health-related quality of life, HRQOL)的影响。此项前瞻性纵向研究纳入了124例新发癫痫儿童患者(平均年龄7.2岁, 标准差2.9岁)。患儿父母分别在诊断后1、13、25个月时完成关于父母压力、羞耻感、恐惧和担心以及HRQOL的调查问卷。AEDs的依从性应用电子监测装置进行评估。每次就诊均进行医疗过程回顾以获得发作和药物副作用的数据。高水平的总体及癫痫特异性父母及家庭压力、恐惧和担心以及羞耻感对儿童通用及癫痫特异性HRQOL存在负面影响,大于疾病及人口学因素。总体父母及家庭压力在疾病管理第1年对儿童通用及癫痫特异性HRQOL的影响大于疾病诊断2年后的影响。更大的恐惧和担心对于诊断后13个月更高的癫痫特异性HRQOL有预测作用,而在诊断后2年,更大的恐惧和担心则预示更低的癫痫特异性HRQOL。多个人口学(如年龄)及疾病相关变量(如副作用和AED依从性)影响儿童通用及癫痫特异性HRQOL。尽管一些发现在各项通用及癫痫特异性HRQOL指标中一致,但其它的都是独有的。可改进的父母因素(如总体及疾病特异性父母及家庭压力、羞耻感)对小儿新发癫痫患者诊断后前2年中的HRQOL的影响是不同的。在诊断后第1年内用以改善HRQOL的心理社会干预应当解决父母和家庭压力、总体应对和癫痫管理的预期指导。针对依从性、羞耻感、恐惧和担心的干预措施可改善HRQOL。推动压力、恐惧/担心和羞耻感的父母管理可改善儿童HRQOL结局。

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  • 肿瘤住院患者跌倒预防措施的依从性调查及分析

    目的 调查肿瘤住院患者对各预防跌倒措施的依从性。 方法 采用自行设计的《肿瘤患者跌倒预防措施的依从性调查表》,对2012年5月在肿瘤胸部病房进行治疗的139例患者进行问卷调查。 结果 本组患者对预防跌倒措施的依从性较低,夜间如厕有家属陪同的仅46例(33.09%)、床上或床边解便的50例(35.97%)、服用特殊药物遵循注意事项的57例(41.01%)、起床活动按三部曲要求执行的44例(31.65%)、卧床休息使用床档保护的62例(44.60%)。 结论 医护人员应重视肿瘤患者跌倒问题,做好防范跌倒的知识及行为健康教育,并采取有效的干预措施,降低跌倒发生率,为患者提供更优质、更安全的护理服务。

    Release date:2016-09-07 02:37 Export PDF Favorites Scan
  • 日间化学疗法留置经外围静脉置入中心静脉导管带管出院患者依从性调查分析

    【摘要】 目的 了解化学疗法中不同居住地点留置经外围静脉置入中心静脉导管(peripherally inserted central catheter,PICC)且带管出院患者的依从性问题。 方法 2009年5月-2010年4月采用自行设计的调查问卷,对100例行日间化学疗法的留置PICC患者,就影响带管出院依从性的各因素进行调查分析。 结果 本地化疗患者对PICC导管带管出院的依从性明显优于外地患者(Plt;0.05)。就影响因素而言,本地、异地化疗患者所担忧的问题不尽相同,异地化疗患者对带管出院的担忧主要集中在导管维护困难(81.8%)、并发症发生(67.3%)、导管维护质量(60.0%)等与治疗密切相关的几个因素。 结论 大力开展上臂PICC置管术即超声引导下的PICC置管术,以解决影响患者日常生活、美观、活动自如等问题。加大对区、县级医院护理人员PICC导管维护技能及并发症处理的培训,以提高外地患者PICC导管带管出院依从性。

    Release date:2016-09-08 09:26 Export PDF Favorites Scan
  • Effect of Evidence-based Nursing on Compliance with Schizophrenic Inpatients

    Objective To investigate the effect of nursing practice on the treatment compliance in schizophrenic inpatients.Methods A total of 196 inpatients with schizophrenia met the inclusion and exclusion criteria were randomly divided into two groups: the rountine nursing group (n=96) and the trial group (n=100). The trial group followed the paths of evidence-based nursing by confirming the affected facts of compliance, collecting the evidence, evaluating the evidence and incorporating this into nursing practice. The change of compliance was evaluated and two groups were scored by NOSIE-30 and BPRS at the beginning and 3 months later, respectively.Results The trial group had a significant improvement (Plt;0.05) on using the chosen treatment and had a lower relapse rate. Conclusions Implementing evidence-based nursing practice has a positive effect on the compliance with treatment of inpatients with schizophrenia.

    Release date:2016-08-25 03:35 Export PDF Favorites Scan
  • Influencing factors of medication adherence among patients with diabetes signing family doctor service contract in Beijing urban areas

    Objective To investigate the factors influencing the medication adherence among patients with diabetes signing family doctor service contract in Beijing urban areas, and provide the basis for improving the level of medication adherence. Methods A total of 320 patients with diabetes from four community health service centers in Beijing urban areas were selected to answer the questionnaires using convenient sampling from June to September 2015. Univariate analysis and binary logistic regression were used for the influencing factors analysis. Results A total of 320 questionnaires were distributed, and 317 valid questionnaires were recovered, in which the rate of high medication adherence was 54.6%. The results of logistic regression showed that the main impact factors on medication adherence were age [odds ratio (OR)=1.918, P=0.011)], degree of education (OR=2.462, P=0.008), knowledge related to diabetes (OR=1.773, P=0.027), adopting of family doctor service or not (OR=2.521, P=0.029) and social function status (P=0.003). Conclusions The family doctor service team should implement the practice of the family doctor service to ensure that the contracted residents can make full use of the family doctor services; and strengthen the follow-up and interventions for patients less aged or with low degree of education. For those with poor social function, more attention should be paid to their self-health management behavior to improve the level of patients’ compliance. As a result, the levels of blood glucose will be well controlled to reduce possibilities of complications and improve their health status and quality of life.

    Release date:2017-08-22 11:25 Export PDF Favorites Scan
  • Analysis of Factors Influencing Compliance of Antiviral Therapy in Patients with Chronic Hepatitis B in Sichuan Province

    目的 通过分析影响四川地区慢性乙型肝炎患者抗病毒治疗依从性的因素,探讨提高患者治疗依从性的策略。 方法 选择2011年4月-2012年4月在四川大学华西医院接受核苷(酸)类似物抗病毒治疗的324例慢性乙型肝炎患者作为研究对象。采用问卷调查的方法,对患者一般情况、心理状态、文化程度、经济情况、疾病认知情况、抗病毒疗效、服药持续性等相关因素进行分析,评估这些因素对患者治疗依从性的影响。 结果 324例患者中能够完全遵照医嘱者78例(24.07%),不能完全依从者246例(75.93%)。心理状态良好者132例(40.74%),其中依从性良好者54例;心理负担较重者192例(59.26%),其中依从性良好者24例。初中及以上学历204例(62.96%),依从性良好者72例;初中以下学历者120例(37.04%),依从性良好者仅6例。不同心理状态、文化程度的患者依从率差异有统计学意义。患者经济状况、年龄差异对于依从性也有一定影响。 结论 慢性乙型肝炎患者对抗病毒治疗的依从性与心理状态、文化程度者及经济状况密切相关。改善患者医疗费用偿付能力,对患者进行疾病认知教育以及减少社会歧视等措施有助于提高患者治疗依从性。

    Release date:2016-09-07 02:34 Export PDF Favorites Scan
  • Implementation of A Real-time Compliance Dashboard to Help Reduce Ventilator-Associated Pneumonia with Ventilator Bundle

    Objective To investigate the effect of a real-time compliance dashboard to help reduce ventilator-associated pneumonia ( VAP) with ventilator bundle. Methods 240 patients who were admitted into the intensive care unit ( ICU) of Shougang Hospital of Peking University and had received mechanical ventilation ( MV) for over 48 hours, between January 2010 and November 2011, were studied prospectively. The patients were divided into two groups by random number table, ie. a dashboard group ( n = 120) with implementation of a real-time compliance dashboard to help reduce VAP with ventilator bundle, and a control group ( n=120) with implementation of usually routine order to help reduce VAP with ventilator bundle. The success rate of ventilator bundle implementation, incidence of VAP, duration of MV, duration within ICU, mortality within 28 days, cost within ICU were compared between two groups. Results Compared with the control group, the success rate of ventilator bundle implementation obviously increased ( 81.6% vs. 52.5%) , incidence of VAP ( 14. 5/1000 days of MV vs. 36.2 /1000 days of MV) , duration of MV [ 5( 4,7) days vs. 8( 6,11) days] , duration within ICU [ 8( 6,12) days vs. 13( 8,16) days] , mortality of 28 days ( 12.6% vs. 28.6% ) , and cost within ICU ( 36,437 vs. 58,942) in the dashboard group obviously reduced ( Plt;0.05) . Conclusions Implementation of a real time compliance dashboard to help reduce VAP with ventilator bundle can obviously improve medical personnel compliance and reduce incidence of VAP, duration of MV, duration within ICU, mortality and cost in ICU than those of routine medical order to help reduce VAP with ventilator bundle.

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  • 霍桑效应对重症监护病房手卫生依从性的影响研究

    目的 探索霍桑效应对重症监护病房(Intensive Care Unit,ICU)医护人员手卫生依从性的影响。 方法 2014 年 10 月—12 月科室根据世界卫生组织手卫生调查方法,采用现场直接观察法和隐蔽式观察法,分别对 ICU 122 名护士、12 名医生、4 名保洁、14 名工人的手卫生情况进行明访和暗访,并将明访和暗访监测到的手卫生时机的洗手执行情况进行对比分析;2015 年 1 月研究者对中国知网数据库中所报道的手卫生依从性调查的文章进行了文献回顾,检索关键词为“手卫生”“依从性”,对搜索获取到的文献进行分析。 结果 ICU 医护人员手卫生依从性明访、暗访结果分别为 70.05%(1 275/1 820)和 57.28%(1 023/1 786),差异有统计学意义(P<0.001)。对中国知网数据库中检索到的 62 篇核心期刊的研究方法采用明访的居多,其中明访 36 篇,暗访 24 篇,明暗访相结合的 2 篇;仅有 3 篇提及霍桑效应,其中 2 篇采取了避免霍桑效应的措施;手卫生依从性<50% 的文献占总文献的 25.8%,依从性在 50%~80% 的文献占总文献的 46.8%,依从性在 80%~90% 的文献占总文献的 12.9%,依从性>90% 的文献占总文献的 14.5%。 结论 ICU 医护人员手卫生依从性可能受霍桑效应影响,因此在进行手卫生依从性的调查时要避免霍桑效应,以取得真实的调查结果。

    Release date:2017-06-22 02:01 Export PDF Favorites Scan
  • Practice of Quality Control Circle in Improving Hand Hygiene Compliance in Medical Staff

    ObjectiveTo improve the hand hygiene compliance in medical staff via quality control circle (QCC) activities. MethodsFrom January to May 2014, QCC activities were actualized throgh selecting the theme, ensuring the plans, confirming the target, investigating the actuality, validating the true reasons, finding out the countermeasure, ensuring the effect. ResultsHand hygiene compliance, accuracy rate handwashing, and awareness rate before the QCC activities was 53.02%, 65.51% , and 45.56%, respectively; while after the activities was 79.91%, 87.39%, 95.44%, respectively; the differences were significant (P<0.001). ConclusionQCC activities may improve hand hygiene compliance in the medical staff; at the same time, it can fully mobilize the enthusiasm of the medical staff , cultivate the spirit of teamwork , and promote quality improvement .

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  • Compliance improvement of rehabilitation exercise for patients after spine surgery

    Objective To explore the compliance improvement of rehabilitation exercise for patients after spine surgery. Methods Forty-nine in-patients who underwent spinal surgery between June 1st and July 14th 2016 were selected as the control group and 50 in-patients who underwent spinal surgery between July 15th and August 30th 2016 were selected as the trial group. The control group received conventional nursing for rehabilitation exercise, and the tiral group adopted a series of quality improvement measures for rehabilitation exercise. The compliance of functional exercise, the accuracy of patients’ exercise and the satisfaction with health education of the patients were compared between the two groups. Results The functional exercise compliance in the trial group (complete compliance in 45 cases, partial compliance in 4 cases, non-compliance in 1 case) was higher than that in the control group (complete compliance in 9 cases, partial compliance in 34 cases, non-compliance in 6 cases) with a statistical difference (Z=–6.910, P<0.001). The functional exercise accuracy rate of patients was higher in the trial group [84.00%(168/200)] than that in the control group [53.06% (104/196)] with a statistical difference (χ2=44.060, P<0.001). The patients’ satisfaction with health education in the trial group (4.64±0.49) was higher than that in the control group (4.20±0.89) with a statistical difference (t=3.084, P=0.003). Conclusion The implementation of nursing quality improvement intervention can improve the compliance and accuracy rate of rehabilitation functional exercise of patients undergoing spinal surgery, and improve the satisfaction of patients, which is worth promoting.

    Release date:2017-09-22 03:44 Export PDF Favorites Scan
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