综合护理干预对慢性胃炎患者生活质量的影响

目的:观察分析并探讨综合护理干预对慢性胃炎患者生活质量的影响。方法:选取我院在2012年1月到2013年1月收治的慢性胃炎患者102例,随机分为两组,一组为观察组,一组为对照组,每组患者各51例。对照组采用常规的护理方法进行干预,观察组采用综合护理的方法进行干预,对两组患者的恢复情况以及各项指标进行对比,观察两组患者护理干预的总有效率和生活质量的改善情况评分。结果:观察组的总有效率比对照组的明显,并且该组患者生活质量的改善情况的评分也要明显比对照组患者的高,P<0.05,具有统计学意义。结论 综合护理干预对于改善慢性胃炎患者的生活质量有十分显著的作用,值得在临床上大力推广。     

舒适护理对乳腺癌化疗患者生活质量的影响

舒适护理是一种整体的、个性的、创造性的、有效的护理模式,其目的是使患者在生理、心理、社会上达到最愉快的状态,更注重患者的舒适感受和满意度[1]。乳腺癌是女性常见的恶性肿瘤之一,其治疗原则是以手术为主的综合治疗,单纯的手术治疗无法根治,因此全身治疗的化疗显得尤为重要。但在化疗的过程中,存在着不少的不良反应,直接影响     

综合性心理干预对冠心病介入治疗患者抑郁焦虑及生活质量的影响

目的:探究综合性心理干预对冠心病介入治疗患者焦虑、抑郁及生活质量的影响。方法:选择2014年6月~2015年6月期间我院收治冠心病性介入治疗患者3280例为研究对象,采用随机数字法将其分为观察组(1648例)和对照组(1632例),观察组患者给予常规治疗、抗抑郁治疗及综合心理干预,对照组给予常规治疗、抗抑郁治疗;采用焦虑自评量表(SAS)、抑郁自评量表(SDS)评价患者治疗前后焦虑、抑郁状态,生活质量评价量表QLQ-C30量表评价患者治疗前后生活质量的变化情况。结果:两组患者在入院时SAS和SDS得分不存在差异(P0.05);干预1月后两组组患者的SAS和SDS得分均出现显著降低(P0.05),且观察组患者的SAS和SDS评分均明显低于对照组(P0.05);干预前两组患者生存质量各维度的评分均不存在显著差异(P0.05);干预1个月后两组患者躯体功能、角色功能、社会功能、情绪功能及总体症状较干预前均出现明显改善(P0.05),且干预后观察组患者躯体功能、角色功能、社会功能、情绪功能及总体症状均显著优于对照组(P0.05)。结论:冠心病介入治疗患者进行综合性心理干预能够改善患者心理状态,降低患者焦虑、抑郁情绪,提高生活质量,对临床冠心病的治疗有重要的意义。     

心理护理干预对年轻宫颈癌患者生活质量的影响

目的探讨心理护理干预对年轻宫颈癌患者生活质量的影响。方法将我院收治疗的年轻宫颈癌患者70例随机分为观察组和对照组各35例,对照组给予常规妇科护理,观察组在对照组护理基础上强化心理护理,观察比较两组患者的生活质量以及术后6、9、12个月性生活情况、心理状况评分情况。结果观察组患者的生活质量评分及术后6、9、12个月性生活正常率均明显高于对照组,两组比较差异有统计学意义(P0.05);观察组患者的焦虑、抑郁及恐惧等不良情绪评分均明显低于对照组,两组比较差异有统计学意义(P0.05)。结论实施心理护理干预能明显改善年轻宫颈癌患者的心理状态,减轻焦虑、抑郁及恐惧情绪,提高生活质量。     

护理干预对女性乳腺癌患者生活质量的影响

目的探讨护理干预对年龄45岁以下女性乳腺癌患者生活质量的影响。方法采用汉密顿焦虑量表（HAMA）、汉密顿抑郁量表（HAMD）、乳腺癌特异量表（QLQ-BR23）和生活质量调查问卷（QLQ-30）进行问卷调查。结果与结论对不同治疗时期年轻女性乳腺癌患者予针对性的护理干预,可提高患者生活质量。     

出血性卒中后抑郁患者认知功能与生活质量的研究

目的:探讨不同时期出血性脑卒中后抑郁(Post-Stroke Depression,PSD)患者认知功能和生活质量的特征。方法:采用前瞻性队列研究,对57例PSD患者和91例非PSD(None PSD,NPSD)患者在基线期、6周和12周后分别进行临床神经功能缺损程度评分量表(China Stroke Scale,CSS)、汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)、蒙特利尔认知评估量表(Montreal Cognitive Assessment,Mo CA)和Barthel指数(Barthel Index,BI)的评估。结果:基线期PSD和NPSD患者Mo CA总分[分别为(11.6±2.9)分、(11.2±3.1)分]和BI总分[分别为(45.6±8.3)分、(46.2±7.2)分],差异无统计学意义(P0.05);治疗6周和12周后PSD组Mo CA总分[分别为(13.4±2.3)分、(18.2±3.2)分]和BI总分[分别为(63.8±6.5)分、(77.2±4.1)分]均低于NPSD组[分别为(15.8±2.8)分、(22.6±2.4)分;(72.2±7.5)分、(85.8±5.6)分],差异有统计学意义(P0.000)。结论:在卒中的康复后期,PSD患者较NPSD患者认知功能障碍损害更严重,生活质量更差。推测认知功能是PSD患者长期预后的独立预测因素,可为PSD患者康复策略的制定提供帮助。     

终末期肾脏病患者睡眠质量的影响因素及其与生活质量、焦虑抑郁的关系研究

目的:探讨终末期肾脏病(ESRD)患者睡眠质量的影响因素及其与生活质量、焦虑抑郁的关系.方法:选取2018年3月～2019年12月期间我院收治的ESRD患者198例为研究对象.患者睡眠质量采用匹兹堡睡眠指数量表(PSQI)评价.采用焦虑自评量表(SAS)与抑郁自评量表(SDS)评估患者焦虑、抑郁状态.采用肾病生活质量评...     

针对性护理对急性脑梗死患者神经功能及生活质量的影响

为探讨针对性护理干预对急性脑梗死(ACI)患者神经功能及生活质量的影响,本研究选取90例急性脑梗死患者作为研究对象,按照随机分组的方式,分为干预组和对照组,每组45例。其中,将常规治疗与护理方案应用于对照组,干预组在常规治疗与护理的基础上从入院第2天至第30天采用针对性护理干预,观察不同护理模式对患者的神经功能及生活质量影响。结果显示,采用针对性护理干预,干预组第30天FMA运动能力评分明显高于对照组,差异具有统计学意义(p<0.05)。干预组入院第30天的得分高于对照组,差异具有统计学意义(p<0.05)。本研究表明对急性脑梗死(ACI)患者进行针对性护理干预,可促进患者神经功能的恢复和生活质量的提高。     

综合护理对糖尿病足患者心理状态与生活质量的影响

目的：探讨综合护理对糖尿病足患者心理状态与生活质量的影响。方法：选取52例糖尿病足患者,随机分为照组和试验组,各26例,对照组给予常规护理,试验组采用综合护理进行干预。采用Zung焦虑自评量表（SAS）、抑郁自评量表（SDS）评价两纽患者心理状态,并用社会功能缺陷筛选量表（SDSS）和2型糖尿病生活质量量表（DMQI_,s）对两组患者生活质量进行评价。结果：两组患者干预前SAS、SDS、SDSS、DMQLS评分无差异,实施干预后,两组患者均有SAS、SDS、SDSS评分下降、DMQLS评分升高,但试验组患者SAS、SDS、SDSS评分下降及DMQLS评分升高更明显,与对照组比较,差异有统计学意义（P〈0．01）。结论：综合护理有助于改善糖尿病足患者焦虑、抑郁负性情绪,提高生活质量。     

胃癌术后患者施行饮食护理对患者生活质量的影响

目的：比较实施饮食护理和普通护理对胃癌术后患者生活质量的影响。方法：将选取的70例胃癌术后患者随机分为两组,饮食护理组通过结合营养评估结果与膳食习惯制定个性化食谱,普通护理组日常饮食不进行干预,观察并比较两组患者的营养状况、生活质量、并发症情况。结果：饮食护理组患者血清总蛋白（TP）、MNA评分显著高于普通护理组,差异具有统计学意义（P＜0.05）;两组患者血清白蛋白（ALB）差异没有统计学意义（P>0.05）;饮食护理组患者生活质量评分（QLQ-STO22）反流、焦虑、体型三个项目评分显著低于普通护理组,差异具有统计学意义（P＜0.05）;两组患者其他6项评分差异没有统计学意义（P>0.05）;饮食护理组反流性食管炎、肠梗阻、倾倒综合征发生率显著低于普通护理组,差异具有统计学意义（P＜0.05）;两组胃出血、胃瘫发生率差异没有统计学意义（P>0.05）。结论：对胃癌术后患者实施个性化饮食护理能够提高患者机体营养状态,降低患者术后并发症的发生,改善患者生活质量。     

Focus: Preventive Medicine: Postpartum Depression and Quality of Life: A Path Analysis

Purpose: The aim of this study was to model the relationship between risk factors of postpartum depression and quality of life in Iranian women. Methods: In this study, 306 women were included as a sample. The study tools of the Edinburgh Postpartum Depression Inventory included items such as socioeconomic characteristics, recent pregnancy history and outcome, and Quality of Life Questionnaire (SF-12). SPSS software was used for data analysis and a significance value of 0.05 was considered. Results: Most participants were homemakers with no instances of abortion, no stillbirth, no history of depression, no preterm delivery, no difficulties during pregnancy, no difficulties during delivery, no unplanned pregnancy, no smoking during pregnancy, had family support during pregnancy and after delivery, type of delivery was cesarean, had a healthy baby and satisfaction with neonatal sex, and never or rarely experienced partner violence. Their mean age, years of education, living arrangements, and breastfeeding of participants respectively were 29.73±5.42, 14.64±1.96, 1.09±0.53, and 5.61±2.98. The prevalence of postpartum depression was 5.6%. According to the path analysis, living arrangements with β=0.73 had the most direct effect and occupation with β=0.69 had the most indirect effect on postpartum depression. Conclusions: According to the path analysis model, postpartum depression is affected by many factors such as age, years of education, occupation, living arrangements, and quality of life.     

Multimorbidity and Quality of Preventive Care in Swiss University Primary Care Cohorts

Background

Caring for patients with multimorbidity is common for generalists, although such patients are often excluded from clinical trials, and thus such trials lack of generalizability. Data on the association between multimorbidity and preventive care are limited. We aimed to assess whether comorbidity number, severity and type were associated with preventive care among patients receiving care in Swiss University primary care settings.

Methods

We examined a retrospective cohort composed of a random sample of 1,002 patients aged 50–80 years attending four Swiss university primary care settings. Multimorbidity was defined according to the literature and the Charlson index. We assessed the quality of preventive care and cardiovascular preventive care with RAND’s Quality Assessment Tool indicators. Aggregate scores of quality of provided care were calculated by taking into account the number of eligible patients for each indicator.

Results

Participants (mean age 63.5 years, 44% women) had a mean of 2.6 (SD 1.9) comorbidities and 67.5% had 2 or more comorbidities. The mean Charlson index was 1.8 (SD 1.9). Overall, participants received 69% of recommended preventive care and 84% of cardiovascular preventive care. Quality of care was not associated with higher numbers of comorbidities, both for preventive care and for cardiovascular preventive care. Results were similar in analyses using the Charlson index and after adjusting for age, gender, occupation, center and number of visits. Some patients may receive less preventive care including those with dementia (47%) and those with schizophrenia (35%).

Conclusions

In Swiss university primary care settings, two thirds of patients had 2 or more comorbidities. The receipt of preventive and cardiovascular preventive care was not affected by comorbidity count or severity, although patients with certain comorbidities may receive lower levels of preventive care.     

The Effectiveness of Internet Cognitive Behavioural Therapy (iCBT) for Depression in Primary Care: A Quality Assurance Study

Background

Depression is a common, recurrent, and debilitating problem and Internet delivered cognitive behaviour therapy (iCBT) could offer one solution. There are at least 25 controlled trials that demonstrate the efficacy of iCBT. The aim of the current paper was to evaluate the effectiveness of an iCBT Program in primary care that had been demonstrated to be efficacious in two randomized controlled trials (RCTs).

Method

Quality assurance data from 359 patients prescribed the Sadness Program in Australia from October 2010 to November 2011 were included.

Results

Intent-to-treat marginal model analyses demonstrated significant reductions in depressive symptoms (PHQ9), distress (K10), and impairment (WHODAS-II) with medium-large effect sizes (Cohen''s d = .51–1.13.), even in severe and/or suicidal patients (Cohen''s d = .50–1.49.) Secondary analyses on patients who completed all 6 lessons showed levels of clinically significant change as indexed by established criteria for remission, recovery, and reliable change.

Conclusions

The Sadness Program is effective when prescribed by primary care practitioners and is consistent with a cost-effective stepped-care framework.     

Improving Quality of Preventive Care at a Student-Run Free Clinic

Student-run clinics increasingly serve as primary care providers for patients of lower socioeconomic status, but studies show that quality of care at student-run clinics has room for improvement.

Purpose

To examine change in provision of preventive services in a student-run free clinic after implementation of a student-led QI intervention involving prompting.

Method

Review of patient charts pre- and post-intervention, examining adherence to screening guidelines for diabetes, dyslipidemia, HIV, and cervical cancer.

Results

Adherence to guidelines among eligible patients increased after intervention in 3 of 4 services examined. Receipt of HIV testing increased from 33% (80/240) to 48% (74/154; p = 0.004), fasting lipid panel increased from 53% (46/86) to 72% (38/53; p = 0.033), and fasting blood glucose increased from 59% (27/46) to 82% (18/22; p = 0.059).

Conclusions

This student-run free clinic implemented a student-led QI intervention that increased provision of prevention. Such a model for QI could extend to other student-run clinics nationally.     

舍曲林对脑卒中后抑郁患者运动功能及生活质量的影响

目的：探讨舍曲林对卒中后抑郁患者运动功能的恢复及生活质量的影响。方法：将126例卒中后抑郁患者随机分入对照组与观察组,62例对照组患者接受常规脑血管病治疗及康复训练。64例观察组患者在常规治疗基础上加用舍曲林口服,治疗8周。采用汉密尔顿抑郁量表（HAMD）、Fugl-Meyer运动功能评分量表（FMA）及脑卒中影响量表（SIS 310）评估患者抑郁状况、肢体运动功能及生活质量。结果：治疗后8周观察组患者HAMD评分显著低于对照组（8.35±2.21vs 14.84±4.26,P〈0.05）;观察组FMA评分显著高于对照组（72.56±16.94 vs 51.29±10.22,P〈0.05）;SIS 310各项评分及总分显著优于对照组（P〈0.05）。结论：给予脑卒中后抑郁患者舍曲林治疗,可显著改善患者抑郁状况,改善肢体功能恢复和生活质量。     

协同护理干预对心肌梗死患者康复及照顾者的生活质量和照顾能力的影响

目的：探讨协同护理对心肌梗死患者康复及照顾着生活质量的护理效果。方法：选取60例心肌梗死患者,随机分为对照组和试验组,各30例。对照组采用常规护理,试验组在对照组的基础上采用协同护理进行干预,观察两组患者在死亡、再梗死、梗死后心绞痛、严重心律失常、心力衰竭等临床并症状及生活自理能力方面的差异,采用总体健康状况量表及照顾能力测量表评价干预前后照顾者生活质量与照顾能力。结果：两组患者生活自理能力无差异（P〉0．05）,试验组梗死后心绞痛的发生率低于对照组（P〈0．05）;试验组照顾者的照顾能力及生活质量显著优于对照组,差异有统计学意义（P〈0．01）。结论：协同护理能明显提高心肌梗死患者照顾者的照顾能力及生活质量,利于患者康复。     

Depression,Anxiety and Quality of Life in Long-Term Survivors of Malignant Melanoma: A Register-Based Cohort Study

Aim

The purpose of the study was to determine anxiety and depression, quality of life, and their determinants in long-term survivors of malignant melanoma.

Methods

In a state cancer registry a cohort of survivors of malignant melanoma was contacted via the physician registered. Of 1302 contactable patients, 689 (52.2%) completed a questionnaire including the Patient Health Questionnaire with generalized anxiety (GAD-7) and depression (PHQ-9) and the EORTC Quality of Life Questionnaire (EORTC QLQ 30). Based on multiple regression analysis, predictors of quality of life and distress were identified. Comparison data were assessed in two waves of representative face-to-face household surveys of the adult German population.

Results

An average of 8.4 (5.7 to 12.2) years after diagnosis, distress was higher in women compared to men and in middle adulthood (vs. older patients). Symptoms were higher in women than in men, and there was a decline of functioning and increase of symptoms across the age range of both genders. Compared to the general population, there were slightly increased depression and anxiety (only women), but no impaired global quality of life. Yet, survivors evidenced functional decline and more physical symptoms. Distress and reduced quality of life were consistently predicted by lack of social support, fear of recurrence, pessimism and self-blame. Distress was increased by a family history of melanoma, and additional mental and somatic diseases.

Conclusion

Overall, long-term survivors have adjusted well achieving a global quality of life comparable to the general population. Yet, compromised functional dimensions, physical symptoms and distress indicate the need for integrating psychooncological screening into oncological follow-up, which might be guided by predictors such as family history or social support. Further prospective study is needed to determine the course of adaptation to the disease and corroborate the risk factors identified.