CAPD患者家属的心理需求及护理对策

目的:分析CAPD患者家属的心理需求,并对其采取相应的护理对策。方法:采取自行设计问卷调查方法,对100例CAPD患者家属的心理需求调查分析。结果:患者家属的心理需求包括:能知道患者治疗方法,希望知道如何协助患者进行治疗,希望出院后遇到治疗操作中的问题能及时得到指导和解决,能定时家庭访问。结论:通过对患者家属的心理需求实施护理对策,满足其心理需求,使其主动参与协作患者治疗及护理,对提高患者的生活质量和生存率起至关重要的作用。     

ICU患者家属焦虑与心理需求的相关性研究

目的:调查ICU患者家属的焦虑和心理需求现状,并分析两者的相关性,以便对家属采取针对性的关爱措施,提高ICU的护理服务质量.方法:在患者入住ICU24～36个小时后,119名患者家属接受焦虑自评量表(SAS)、危重患者家属需求量表(CCFNI)的调查.结果:在所调查的患者家属中,焦虑的发生率达到59.7%,焦虑与获取信息、接近病人呈显著正相关(r=0.341,p＜0.01;r=0.363,p＜0.01),与自身舒适呈显著负相关(r=-0.217,p＜0.01).结论:ICU患者家属焦虑发生率极高,医护人员在护理患者的同时,需兼顾患者家属,提供多方面心理护理,体现以人为本的护理理念.     

护理关怀在ICU患者家属关爱中的应用价值

目的:探讨护理关怀在ICU患者家属护理中的应用及效果。方法:选取2011年1月至2012年3月间我院ICU收治100例患者的主要家属作为研究对象,共计200人。分为护理组和对照组,各100人。两组参与人员均采用临床常规措施,护理组人员护理过程中添加相关护理内容,对比两组患者家属的心理情况。结果:对患者家属进行SCL90以及FBS评估发现,护理组患者家属心理状态优于对照组患者家属,差异具有统计学意义,P0.05。结论:对ICU患者家属的护理行为能显著提高其心理将抗情况,为患者治疗和护理的开展提供相关保障。     

浅谈小儿外科中的心理护理

小儿是患者中的特殊群体,其生理与心理都还没完全成熟。在护理中不仅需要注意生理的变化,还需要对其心理进行特殊的护理,家属的心理状态对小儿外科患者有着直接的影响。本文分析了小儿外科患者与家属的心理特点,并就其提出相应的心理护理方法。     

慢性丙肝患者对抗病毒治疗的认知程度、心理需求及护理对策

目的:探讨慢性丙肝患者在抗病毒治疗时有效的护理干预方法。方法:采用自制问卷对接受干扰素抗病毒治疗的136例慢性丙型肝炎患者进行认知程度及心理需求的调查。结果:110患者例认知程度较高,依从性好,通过心理需求调查显示,所有患者均希望了解更多关于慢性丙型肝炎相关知识及干扰素的作用及副作用,希望得到护理人员具体的健康指导。结论:慢性丙型肝炎患者接受干扰素治疗时,加强护患沟通和心理护理,进行健康知识宣教并定期随访,可提高病人治疗的依从性,使治疗顺利进行。     

重症肝炎血浆置换术前护理问题分析与对策

目的：通过分析重症肝炎病人行血浆置换术的护理问题,提出相应的护理对策,减少手术的危险性。方法：通过沟通、观察、查阅病例。收集要钉血浆置换治疗的16例重症肝炎病人的资料,包括身体状况、心理、文化、社会、经济等。提出现存的或潜在的护理问题。寻求问题原因,经分析后进行护理帮助,做到了从生物一心理一社会医学模式的整体进行评估和护理。结果：10例重症肝炎病人在行血浆王换术前较以往病人情绪稳定,6例肝性脑病病人家属能周到的照顾病人,积极配合治疗。16例病人都能顺利完成血浆置换,提高了病人的治愈率。结论：重症肝炎病人行血浆置换前,实施积极有效的护理措施。较以前无护理措施者或肤浅的指导能降低手术危险性,使手术得以顺利进行。     

列车脱轨事件伤员36例心理分析及护理

目的 分析列车脱轨事件后伤员的心理特点,并采取相应的心理护理措施.方法 根据26例伤员的年龄、受伤程度等个体情况,对伤员的心理状态进行分析,并采取计划性的护理.结果 本组伤员未出现极端行为,均能积极配合治疗及康复锻炼.结论 针对列车脱轨事件伤后伤员的各种心理特点及时进行相应的心理护理,可有效地促迸伤员恢复心理平衡,避免其出现极端行为,并促使其配合治疗及康复计划顺利实施.     

老年心肌梗塞的护理体会

目的探析老年人急性心肌梗死(AMI)的急救护理对策与效果。方法选取2011年10月~2012年10月期间心内科收治的老年急性心肌梗死患者84例临床护理资料进行回顾性分析。严密观察患者生命体征和病情变化,实施心理护理及专科护理对策。结果本组84例患者有效75例,显效4例,无效2例,死亡3例,总有效率94.05%。出院随访12~24个月,未出现并发症。结论对老年急性心肌梗死患者实施有效的心理护理和专科护理干预,能明显提高治疗效果,值得临床推广应用。     

家属参与护理干预在脑卒中患者中的应用效果分析

目的针对脑卒中患者,在护理干预中使家属配合护理人员广泛参与其中,分析家属参与护理干预是否有良好的应用效果。方法选取2014年1-5月的178例脑卒中患者,平均分成对照组与观察组,对照组采取常规护理干预,观察组在与护理人员的配合下,从饮食、心理、康复训练等多个角度展开护理干预。结果通过两种护理干预方法对比可知,对照组的满意率为54%,观察组满意率为75%满意率差异明显,说明家属参与护理干预取得了良好的应用效果。结论通过对比观察可知,观察组的家属参与护理干预效果明显,值得在临床中推广。     

高血压患者脑出血的临床护理体会

目的探析高血压患者脑出血的临床护理对策与体会。方法选取本院2012年1月~2013年1月期间内科收治的高血压脑出血患者152例临床资料进行回顾性分析。在基础护理的基础上,给予患者心理护理、饮食调节、呼吸道护理及康复护理。结果152例患者治疗依从性提高,疗效确切,未出现并发症,病残率低。结论对高血压性脑出血患者实施科学有效的护理,能显著提高高血压性脑出血患者的治疗效果,降低病残率。     

Continuous ambulatory peritoneal dialysis: experience with 22 unselected patients with renal failure.

The present study describes our experience with CAPD in an unselected group of patients presenting with endstage renal failure. Twenty-three consecutive patients were offered CAPD, in-center, and home hemodialysis. Twenty-two patients selected CAPD, including 14 patients more than 60 years of age, four patients with diabetes, and one with multiple myeloma. CAPD training was performed in an out-of-hospital office facility. One patient returned to hemodialysis following the development of resistant Pseudomonas peritonitis, two patients died of a myocardial infarction, and one patient died with a GI bleed. The other 18 patients are doing well. Assessment of 17 patients maintained on therapy for four months or more revealed that the patients are less depressed, less organic, and have fewer physical symptoms than previously reported for a comparable group of patients maintained on hemodialysis for a similar period of time. In conclusion, CAPD can be successfully employed, at least for the initial months of therapy, to treat the vast majority of patients with endstage renal disease. CAPD training and follow-up care can be provided in an out-of-hospital office facility.     

Increased survival of mesothelial cells from the peritoneum in peritoneal dialysis fluid

Peritonitis remains the most important factor in patient morbidity and technical failure associated with continuous ambulatory peritoneal dialysis (CAPD). In vitro examination of bacterial infection of cultured human peritoneal mesothelial cells (HPMC) is an attractive approach to the study of peritonitis in CAPD, yet there are few reports on this subject. Previous studies have shown two limitations: (i) cell cultures of HPMC lasted for days only when incubated in culture medium and (ii) short-term studies of <30 min were done in HPMC when incubated with peritoneal dialysis fluid (PDF). Human peritoneal mesothelial cells, maintained in a conventional single chamber culture system with PDF alone, were unable to survive more than 40 min. The present study was designed to prolong the viability of HPMC cultured in PDF, with the object of using cells under different conditions, such as that of simulating CAPD. HPMC were cultured using plastic microtiter plates, where they were grown to confluence and growth was arrested. PDF containing different concentrations of NaHCO3and human serum albumin was added. Cell viability after exposure for up to 24 h was measured by trypan blue, Cell Death Detection ELISA and Annex-V flow cytometry. The data confirmed the 'toxic' effect of PDF, with cell viability being <40% after 2 h incubation in 4.25% glucose in PDF. However, the survival time of HPMC increased significantly in 4.25% glucose PDF at a physiological pH and even further after the addition of human albumin. These experimental conditions simulating CAPD may allow future in vitro studies of mesothelial physiology and peritonitis related to CAPD treatment.     

L'adolescence: une épreuve psychique particulière

The problematics of adolescence brings into play, through what we have termed the body circle, the family circle, and the social circle, a series of paradoxes conflicts/oppoisitions, where each time a conquest is possible but where also there is potential risk. This permanent conflictuality, is characteristic of adolescence. confronted with this conflictuality, the capacity to assume the psychic conflict is therefore an essential factor in the development of the adolescent. From this point of view, cathexis of the internal psychic space is an essential element of an adolescent's capacity to deal with this psychic working-through. It is this cathexis that allows a reinforcement of the internal working-through and a better tolerance to expectation and psychic conflictuality. On the other hand, anything that runs in the sence of a diminution of this psychic functioning: projection, acting out, etc … reduces the adolescent's capacities of adaptation with regard to his internal psychic world as well his environment.     

Continuous ambulatory peritoneal dialysis after the honeymoon: review of experience in Newcastle 1979-84.

Two hundred and twenty nine consecutive patients (129 men, mean age 45) were reviewed 12 to 65 months after starting treatment with continuous ambulatory peritoneal dialysis (CAPD) from January 1979 to December 1983. They received CAPD for a mean of 19.8 (range 0.5-62) months. Actuarial patient survival was 79% at 24 months and 72% at 36 months. Half of the 46 deaths were related to cardiovascular disease, while eight patients died of abdominal complications, including three patients with peritonitis. Peritonitis occurred at a rate of one episode per 35 patient weeks, and 88% of episodes were cleared by one or more courses of antibiotics. This still left peritonitis as the commonest cause of failure of CAPD, leading to a permanent change of treatment in 44 patients and temporary interruption in a further 25. CAPD remains a reasonable medium term treatment in chronic renal failure. Despite the persisting problem of peritonitis the results are comparable with those achieved by haemodialysis, and CAPD has become the treatment of first choice for end stage renal failure in Newcastle. In younger patients judged unsuitable for transplantation and facing long term dialysis, however, haemodialysis is preferred.     

MRI检查中发生幽闭恐惧症的心理疏导对策探讨

目的:探讨MRI检查中发生幽闭恐惧症患者的心理特征及其心理疏导对策。方法:根据Marks的4条诊断幽闭恐惧症的标准,选择2008年1月~2011年6月在我院磁共振室检查的102例出现不同程度幽闭恐惧症且MRI检查无法顺利完成的患者,分析其临床症状,查找检查失败发生的原因,并进行心理疏导、改善检查环境、家属陪同检查、优化扫描时间、程序以及口服镇静药物等方法保证检查的顺利完成。对干预前后患者的生命体征和检查中不适症状发生情况的差异进行比较。结果:102例发生幽闭恐惧症的患者通过心理疏导、改善检查环境、家属陪同检查、优化扫描时间、程序以及口服镇静药物等方法实施有效的护理干预,第二次检查成功87例,第三次成功10例,5例患者放弃检查,有效率达95.1%,干预后患者的生命体征:呼吸、脉搏、收缩压、舒张压等较干预前有明显的减轻;检查中不适症状:心悸、头晕、窒息感、压抑感等在干预后也明显减轻,各项指标的干预前后的变化有统计学差异,P0.05。结论:积极有效的心理疏导护理可缓解MRI检查中幽闭恐惧症的不适症状,使多数患者顺利完成MRI检查。     

Effect of continuous ambulatory peritoneal dialysis on a British renal unit.

Experience in the use of continuous ambulatory peritoneal dialysis (CAPD) for the treatment of end stage renal failure in Nottingham was reviewed. During six years 150 patients aged from 11 to 73 received this type of treatment. At three years patient actuarial survival was 69% and CAPD technique survival was 41%. Although CAPD was satisfactory as a first treatment for many patients, its long term use was possible in only a few. Actuarial survival of patients who changed to haemodialysis was 64% at one year after the change, suggesting that unsuccessful CAPD increased the risk of death. Hospital haemodialysis was the only suitable form of treatment for most patients in whom CAPD had been abandoned. British renal units have adopted CAPD to a much greater extent than those in Europe, but care in the selection of patients is necessary to reduce mortality, and many patients may eventually need hospital haemodialysis. Greater numbers of hospital haemodialysis places will probably have to be made available to meet this extra demand.     

Prevention of Mental Disorder—The Role of the General Practitioner

As prevention in psychiatry really refers to early detection and consequent prevention of complications and chronicity, the general practitioner is the most important person in the medical community in preventing mental disorders. As more postgraduate courses in psychiatry become available to practicing family physicians, the majority of patients with psychiatric disorders will be effectively managed by the general medical practitioner.The family physician is already doing this, although not as well as he could. In some instances, he may be unaware of the extent to which the disease with which he deals is psychic disease. As the number of community health centers increases, family physicians will play a vital role in their function. With the necessary knowledge to detect psychic disturbance and to treat emotional disorders effectively, the family physician will prevent many of the instances of progression to chronic psychiatric illness with which we are now plagued. The psychiatrist of the future will act as consultant, treating only patients with the more complicated mental disorders.     

Candida Parapsilosis peritonitis in patients on CAPD

Twenty-four episodes of C. parapsilosis peritonitis in 23 patients on continuous ambulatory peritoneal dialysis (CAPD) over 6 years were reviewed. Clinical manifestations and laboratory findings were similar to those of other pathogens. All started treatment with intravenous amphotericin B. In six cases it was attempted to maintain a peritoneal catheter in situ, but removal became essential to relieve fungal peritonitis. Of the patients who developed peritonitis, 15 episodes (62.5%) continued the CAPD program. Nine cases could not resume CAPD because of death in 4, patient preference in 2, and abdominal adhesion in 3. Antifungal treatment alone was ineffective in most cases. It was found that peritonitis developing after gram negative bacterial peritonitis and the use of fluconazole after catheter removal were associated with CAPD discontinuation. It was suggested that C. parapsilosis peritonitis in CAPD patients should be treated with rapid catheter removal, particularly those with fungal peritonitis who had prior gram negative peritonitis. This revised version was published online in June 2006 with corrections to the Cover Date.     

2型糖尿病家族史对患者及其同胞患病影响的分析

目的：分析明确的2型糖尿病家族史对患者及其同胞患病的影响。方法：收集我院内分泌门诊4年来就诊的具有明确糖尿病家族史的2型糖尿病患者143例,对患者的父母、同胞进行糖尿病患病情况调查,并对调查结果进行统计学分析。结果：（1）在143例糖尿病患者中,来自糖尿病母亲家族史的占55．6％,来自糖尿病父亲家族史的占31．0％,两者有显著差异（P〈0．01）。（2）具有糖尿病家族史的同胞兄弟姐妹中,二人或多人患病的比例高达52．4％。结论：（1）来自糖尿病母亲的家族史对子代糖尿病患病的影响超过父亲。（2）2型糖尿病具有明显的家族聚集性。