目的 探讨康复护理日常生活活动（RNADL）评定在小儿脑性瘫痪（脑瘫）手术后护理的价值。 方法 选择2012年6月－10月200例脑瘫术后患儿为研究对象，随机分为观察组和对照组，每组100例，采用 RNADL对两组患儿进行功能障碍分型判断及障碍等级评定，并分别实施相应治疗方案及护理措施，并就2个月后的康复效果进行评价。 结果 与入组时比较，观察组患儿在2个月时的RNADL评分显著增高（P＜0.01），其2个月时重度障碍的患儿较对照组明显减少（P＜0.05）。 结论 RNADL评定是脑瘫患儿康复治疗的前提和基础，通过正规RNADL评定后采取合理有效的康复治疗方案能明显改善患儿的日常生活能力。
ObjectiveTo explore the effect of occupational therapy by stages on the activities of daily living (ADL) in spinal cord injury (SCI) patients during Wenchuan earthquake. MethodsTwenty-six SCI patients during Wenchuan earthquake admitted into the People's Hospital of Mianzhu City from July 2008 to June 2011 underwent two-stage occupational therapy. The first stage therapy continued for three months and the second continued for three weeks. ADL was measured using the modified barthel index (MBI). ResultsThe MBI in SCI patients after first-stage therapy was 65.71±19.30, and the MBI in SCI patients after the second-stage therapy was 76.93±16.82. All MBI item scores during the second-stage therapy were higher than in the first stage therapy, and the ability of stool and urine control, and walking increased significantly (P<0.05). ConclusionEarly and continuous occupational therapy by stages can increase the activities of daily living in spinal cord injury patients during Wenchuan earthquake.
ObjectiveTo evaluate the conditions of activity of daily living (ADL) and influence factors of ADL of hospitalized elderly (≥60 years old) patients. MethodsA cross-sectional study was conducted to investigate the health and ADL conditions of hospitalized elderly patients in the geriatric department of a tertiary hospital in Chongqing by ADL scale. The influence factors of ADL were analysed by using logistic regression analysis. ResultsA total of 375 hospitalized elderly patients were included. The ADL impairment rate of female was 59.60% (93/156), the one of male was 75.90% (166/219), and there was significant difference between different sex (χ2=11.169, P=0.001). The impairment rate by age were 95.40% at 60 to 69 years old, 91.40% at 70 to 79 years old, 87.20% at 80 to 89 years old, and 98.55% at above 90 years old, respectively; there was significant difference among different age groups (χ2=8.575, P=0.036). The result of logistic regression analysis showed that age was the individual risk factor of ADL (OR=0.188, 95%CI 0.085 to 0.416, P=0.000). The difficulty of walking up and down stairs occupied the highest proportion (68.80%) in 10 items of ADL scale. ConclusionHospitalized elderly patients should be equipped with specialized paramedics to minimize the difficulties of ADL, in order to improve their quality of life.
Objective To compare the effect of high-frequency chest wall oscillation (HFCWO) expectoration and mechanical vibration (MV) expectoration in elderly patients with pulmonary infection. Methods Thirty elderly patients with pulmonary infection were randomly divided into a HFCWO group and a MV group with 15 patients in each group. On the basis of routine treatment, the HFCWO group was treated with HFCWO vest to help expectoration, and the MV group underwent traditional mechanical vibration to help expectoration. The respiratory rate, peripheral oxygen saturation (SpO2), activities of daily living (ADL) score were measured before treatment (D1), 7 days (D7), and 14 days (D14) after treatment. Results Except ADL score had no difference between D7 and D14 in the MV group, there were significant differences in daily amount of sputum, respiratory rate, SpO2, ADL score between D1, D7, and D14 in both groups (P<0.05). There were no significant differences in daily amount of sputum between two groups on D1, D7, or D14. SpO2 and ADL score were significantly higher in the HFCWO group on D7 and D14 compared with the MV group (P<0.05). Conclusions Both high-frequency chest wall oscillation and mechanical vibration are effective in improving expectoration. The HFCWO vest is superior in improving blood oxygen and relieving shortness of breath than mechanical vibration expectoration.
ObjectivesTo investigate and analyze the activities of daily living status and influencing factors for the elderly of long-term care in Shangrao City of Jiangxi Province, and provide a basis for Shangrao City to carry out long-term care insurance for the elderly. MethodsCluster sampling was used to investigate the elderly aged 60 and over in 12 counties (cities, districts)of Shangrao, including the elderly general demographic characteristics and activity of daily living survey. ResultsA total of 1 087 elderly people were surveyed, with an average age of 77.75±8.12 and a total 70.6±21.4 score of activity of daily living. Comparing different age groups, the elder age group had a worse activity of daily living (P<0.001). Those with a higher education level had relatively poor activity of daily living (P<0.001), and those with spouse also had poor activity of daily living (P<0.05). Multiple linear regression analysis showed that age (P<0.001), education level (P<0.001), marital status (P<0.05) and income level (P<0.05) were important factors affecting the scores of activity of daily living of the elderly. ConclusionsAge, education level, marital status, low-income situation, chronic disease, and household registration are the main risk factors affecting the score of the long-term care of the elderly in daily life. The establishment of a long-term care insurance system should be based on chronic diseases, age, marital status and other factors to determine the corresponding long-term care standard scoring system and compensation standards.
Objective To evaluate whether respiratory training can improve motor function, exercise endurance, and activity of daily living (ADL) in stroke patients. Methods The randomized controlled trials of the effects of respiratory training on motor function, exercise endurance, and ADL in stroke patients were searched in PubMed, Embase, Google Scholar, China National Knowledge Infrastructure, Wanfang, and VIP Database. The search date was from the establishment of each database to December 2018. The control group received routine rehabilitation, medical treatment or other interventions, and the trial group added respiratory training on that basis. Outcome measures included the Fugl-Meyer Assessment (FMA), the 6-minute walk test (6MWT), and the modified Barthel Index (BI). The literature was independently screened by two investigators according to the inclusion and exclusion criteria, and the quality of the included articles was evaluated using the Physiotherapy Evidence Database scale and Cochrane Library systematic review criteria. Statistical analysis was performed using RevMan 5.3 software. Results A total of 11 articles with 741 stroke patients were included. Meta-analysis showed that in the trial group the exercise endurance [mean difference (MD)=41.50 m, 95% confidence interval (CI) (7.63, 75.37) m, P=0.02], ADL [MD=9.97, 95%CI (3.99, 15.96), P=0.001], and motor function [MD=8.00, 95%CI (1.29, 14.70), P=0.02] were improved compared with those in the control group. Subgroup analysis showed that after 8-10 weeks of intervention, BI of the trial group was higher than that of the control group [MD=25.37, 95%CI (16.49, 34.25), P<0.000 01]; after 8 weeks and 12 weeks to 3 months of intervention, FMA of the trial group was higher than that of the control group [ after 8 weeks: MD=20.40, 95%CI (9.72, 31.08), P=0.000 2; after 12 weeks to 3 months: MD=6.18, 95%CI (3.57, 8.79), P<0.000 01]. Conclusions The results of this study showed that respiratory training can improve exercise tolerance, ADL, and motor function in stroke patients. In consideration of the limited number of included articles as well as the heterogeneity among included articles in the current study, and the lack of long-term follow-up period, further studies could use more optimized respiratory training programs to conduct high-quality researches with bigger sample sizes.
Objective To explore the risk factors of nosocomial pulmonary infection in acute pesticide poisoning. Methods The clinical data of patients with acute pesticide poisoning hospitalized in the Emergency Department of the First Affiliated Hospital of Wannan Medical College and the Second Affiliated Hospital of Wannan Medical College between January 1, 2021 and September 30, 2023 were retrospectively analyzed. Patients were divided into pulmonary infection group and non-pulmonary infection group according to whether they had pulmonary infection during hospital. Multiple logistic regression was used to analyze the independent risk factors of nosocomial pulmonary infection in patients with acute pesticide poisoning, and a risk prediction model (nomogram) was constructed. The predictive efficacy of nomogram and independent predictors in nosocomial pulmonary infection were analyzed by using the receiver operating characteristic curve. Calibration curve and decision curve were used to evaluate the differentiation and clinical application value of the model. Results A total of 189 patients with acute pesticide poisoning were included in the study, with an average age of (58.12±18.45) years old, 98 males (51.85%) and 91 females (48.15%). There were 36 cases (19.05%) of pulmonary infection. Multiple logistic regression analysis showed that age [odds ratio (OR)=1.030, 95% confidence interval (CI) (1.001, 1.060), P=0.040], type 2 diabetes mellitus [OR=2.770, 95%CI (1.038, 7.393), P=0.042], ischemic cerebrovascular disease [OR=3.213, 95%CI (1.101, 9.376), P=0.033], white blood cell count [OR=1.080, 95%CI (1.013, 1.152), P=0.019], activities of daily living score [OR=0.981, 95%CI (0.965, 0.998), P=0.024] were independent predicting factors for nosocomial pulmonary infection in acute pesticide poisoning. The area under the curve of nosocomial pulmonary infection in patients with acute pesticide poisoning predicted by nomogram based on the above factors was 0.813 (P<0.001). The calibration curve showed that the prediction probability was consistent with the actual occurrence probability (P=0.912), and the decision curve showed that the nomogram had good clinical application value. Conclusions Age, activities of daily living score, type 2 diabetes mellitus, ischemic cerebrovascular disease, and white blood cell count are independent predictors of nosocomial pulmonary infection in acute pesticide poisoning. The nomogram constructed based on them has good differentiation and consistency, which can provide basis for early identification and intervention of clinical staff.