目的:为肿瘤骨转移患者压疮预防的方法进行总结评价以达到对临床肿瘤压疮进行指导。方法:采用改良后的诺顿评估表(信度0.80,效度0.84)作为压疮易患患者评估工具。评估内容包括患者年龄、身体状况、意识、活动能力、运动受限情况、疼痛、皮肤情况、大小便失禁、饮食、进食能力、口腔情况、牙齿及患者血色素、蛋白等资料。评估时间从患者入院开始,对30例肿瘤全身多处骨转移患者进行评估,有预见性、计划性,针对性及个体化对患者制订护理计划及措施,并督促实施,对效果进行评价分析。结果:≤25分高危险性患者(难以避免)发生率50%,26~29分中度危险性患者(可避免)发生率0,≥30分低危险性患者发生率14.2%。效果评价:压疮预防评估对肿瘤骨转移患者压疮的预防是有效的,压疮评估有助于规范护理行为和护理管理;通过分析找出护理过程中的薄弱环节,以利于指导临床工作。
Objective To investigate the influence of self-care and self-efficacy intervention on the quality of life of patients undergoing chemotherapy after surgery for gastric cancer. Methods Sixty-four patients undergoing chemotherapy after gastric cancer surgery between July 2014 and February 2015 were selected as the study subjects. According the sequence of admission, they were divided into intervention group (n=34) and control group (n=30). Patients in the control group accepted conventional care, while those in the intervention group received self-efficacy and self-care interventions. The scores of General Self-efficacy Scale (GCES), Exercise of Self-care Agency (ESCA), and Quality of Life Instruments for Cancer Patients-Stomach Cancer (QLICP-ST) were compared between the two groups before and after intervention. Results After intervention, GCES scores of the intervention group and the control group were respectively (30.08±4.21) and (20.78±4.58) points; the total scores of ESCA were respectively (132.30±14.81) and (92.45±13.23) points; and the total scores of QLICP-ST were respectively (75.96±9.41) and (56.77±10.32) points. All the above differences between the two groups were significant (P<0.05). Conclusion Self-care and self-efficacy intervention can improve self-care ability and self-efficacy, and improve the quality of life of patients undergoing chemotherapy after gastric cancer surgery.
Objective To study the catheter-related infection (CRI) in cancer patients treated with central venous catheterization. Methods A prospective study with 196 cancer patients was conducted to analyze the types of catheter-related infection and pathogen, as well as the relationship between CRI and the following factors: insert location, gender, age, remained time, or bone marrow suppression. Results Of the total 196 cases, 16 cases were diagnosed as CRI and the CRI rate was 8.2%. The types of CRI were five cases of pathogen colonization, four cases of insert location infection and seven cases of catheter-related bloodstream infection. Of the total 244 specimens, 20 were positive including 7 pathogenic bacteria in either Gram positive or Gram negative types, the dominating pathogens were staphylococcus aureus, staphylococcus epidermidis, acinetobacter baumannii and klebsiella pneumoniae. CRI was related to both insert location and age which were both the independent risk factors. Conclusion The concept of prevention should be set up, and the comprehensive measures should be taken to reduce CRI, such as choosing an appropriate insert location and complying with a strict catheter insert standard.