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。     

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。     

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。     

心理应激对策在治疗慢性盆腔炎护理中的应用

目的:研究并分析心理应激对策在治疗慢性盆腔炎护理中的应用。方法:将2014年1月~2014年8月在我院进行治疗的74例慢性盆腔炎患者纳入本研究,按照护理措施的不同将74例患者分为心理应激组(n=37)与对照组(n=37),两组患者均采用中药灌肠联合微波的治疗方式,对照组进行常规护理,心理应激组在常规护理基础上应用心理应激干预措施,对比两组疗效。结果:心理应激组治疗有效率为要远远好于对照组,差异有统计学意义。结论:慢性盆腔炎患者心理状态特殊,采用科学、细致的心理应激对策能够有效提升护理效果,缓解患者的负性心理,该种护理模式值得在临床中进行推广和使用。     

神经外科危重病患者家属心理状况调查研究

目的:通过对神经外科急危重患者的家属进行心理问卷调査,来了解家属的心理状态,为提供个体化的心理护理提供依据。方法:本研究随机选择近三年入住我院神经外科的急危重患者家属共159人,其中男性89人,女性70人,进行心理状况调查问卷,量表采用精神卫生焦虑自评量表和精神卫生抑郁自评量表,所得数据采用SPSS18.0软件软件进行分析,P0.05为有统计学差异。结果:(1)结果显示,在被调查的89名男性家属与70名女性家属中,女性的焦虑程度较男性严重,而男性的抑郁程度又较女性严重,二者比较均有统计学差异(P0.05)。(2)医疗费用支付类别不同的患者家属间焦虑、抑郁症状有显著性差异,自费患者家属焦虑、抑郁程度均明显高出医保患者家属(P0.05)。(3)以脑力劳动为主的患者家属其焦虑量表评分明显低于以体力劳动为主的患者家属,而在抑郁量表评分中,脑力劳动为主的患者家属抑郁评分则高于以体力劳动为主的患者家属,二者相比均有统计学差异(P0.05)。结论:女性、体力劳动者焦虑症状明显,男性、脑力劳动者抑郁症状突出。自费医疗的患者家属焦虑和抑郁程度均高于医保患者。作为护士应针对患者家属提供不同的有针对性的心理护理,帮助家属应对心理危机状态,维持患者家庭功能,促进患者康复。     

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,收集要行血浆置换治疗的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-心理-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置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。     

眼科手术等候期患者家属对健康教育需求的调查

目的:了解眼科手术等候期患者家属对健康教育的需求。方法:采用自行设计的调查问卷对100名在患者手术过程中等候的家属进行调查。调查内容包括手术等候中希望获得的相关信息及其需求程度,需要的健康教育方式及每种健康教育的需求程度。结果:1).眼科手术等候中,家属强烈需要的信息有手术效果(76%)、术后饮食指导(60.4%)、手术费用(57.3%)、患者目前病情(54.2%)、术后头位指导(51%)。2).最需要的健康教育方式是与医生护士交谈(66%)。结论:对手术等候期的患者家属应根据需求实施科学有效的健康教育,用恰当的方式及时提供家属想要了解的信息,使他们具有良好的应对能力和心理承受能力,在照顾患者的过程中为患者提供有效的支持系统。     

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.     

应用神经导航系统手术切除颅内肿瘤病人的整体护理临床效应

目的:探讨神经导航系统辅助下颅内微侵袭手术的整体护理临床效应。方法:神经导航系统因其能在术前制定最佳手术路径,术中准确快速地找到病灶,确定肿瘤切除范围,减少周围组织的损伤,术后并发症少,在临床已日渐推广。在临床护理中,为了确保达到预期疗效,对20例采用神经导航系统辅助下颅内肿瘤手术切除的病人从生理、心理、社会等各方面需求做出全面、有效的护理计划,制定出护理措施,进行健康指导。结果:全组无残疾或死亡,无1例术后因护理不当而出现并发症,15例患者4d左右下床活动,1例术前昏迷,术后15d清醒,2例术后出现尿崩症,经处理后恢复正常,1例术后脑水肿,给予脱水剂后症状消失,1例术后癫痫,药物控制后缓解。全组患者于术后平均20d左右痊愈出院。结论:在神经导航系统辅助下加强护理配合,严格操作规程,对提高手术成功率,减少并发症有重要意义。     

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: 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.     

Silicone foam sponge for pilonidal sinus: a new technique for dressing open granulating wounds.

A silicone foam sponge has been used to replace the daily packing of deep granulating wounds with moist sterile gauze. In the treatment of pilonidal sinus use of the sponge demands less nursing time and is more comfortable for the patient than the excision and open granulation technique. Patients can usually return to work soon after operation. The method has many applications in surgery, and widespread application of the technique to the management of granulating wounds could result in considerable savings to the NHS in money and skilled nursing time.     

Mimicking Natural Nursing Conditions Promotes Early Pup Survival in Domestic Rabbits

In the wild rabbit, Oryctolagus cuniculus, mother–young relationships are based on restricted, once-per-day nursing interactions. Correspondingly, pups have evolved an efficient strategy of energy saving. Here we investigate under breeding conditions, whether matching or not, the once-daily nursing visit by the rabbit females has an effect on pup survival and growth. Two nursing regimen were applied to 89 primiparous (P) and to 78 multiparous (M) does: (a) one that matched the once daily nursing pattern (closed nest-box during the whole day except for a few minutes devoted to nursing) and (b) one that did not match it (24 h free nest access). In P females, the controlled nest access resulted in lower mortality between birth and weaning (8.1%) as compared to the free nest-access (18%). This effect was recorded from postnatal d 3–4 onwards. Both treatments induced different death causes (starvation (63%) in controlled-access regimen, and wounds and nest-soiling (29%) in free-access regimen). While both experimental nest-access regimens differentially affected pup survival in P or M females, they were without influence on pup growth rate in does of either parity. It is concluded that repeated nest visits by the female increase risks of injury to pups, and of out-of-time pup activation or sucking, and that, more generally, it plays against the ethophysiologigal strategy of biomass conservation evolved by rabbit newborns. The fact that the nest-access regimen no longer affected pup survival from the second parity suggests that the behaviour of multiparous does more adequately models the offspring demands.     

A cross-cultural study of physician treatment decisions in relation to demented nursing home patients who develop pneumonia

This qualitative interview study in The Netherlands and North Carolina (US) found that physician treatment decisions are influenced by contextual differences in physician training and healthcare delivery in the US and The Netherlands. Dutch physicians treating nursing home residents with dementia and pneumonia assumed active, primary responsibility for treatment decisions while US physicians were more passive and deferential to family preferences, even in cases where they considered the families' wishes inappropriate. Dutch physicians knew their patients well and made treatment decisions based on what they perceived was in the best interest of the patient while US physicians reported limited knowledge of their nursing home patients due to a lack of contact time. Efforts to improve care for patients with poor quality of life who lack decision-making capacity must consider the context of societal values, physician training, and the processes by which physicians negotiate patient and family preferences.     

Een cultuurvergelijkend onderzoek naar behandelbesluiten van artsen met betrekking tot demente verpleeghuispatiënten met pneumonie

A cross-cultural study of physician treatment decisions for demented nursing home patients who develop pneumoniaThis qualitative interview study in the Netherlands and North Carolina (US) found that physician treatment decisions are influenced by contextual differences in physician training and healthcare delivery in the US and the Netherlands. Dutch physicians treating nursing home residents with dementia and pneumonia assumed active, primary responsibility for treatment decisions while US physicians were more passive and deferential to family preferences, even in cases where they considered the families’ wishes inappropriate. Dutch physicians knew their patients well and made treatment decisions based on what they perceived was in the best interest of the patient while US physicians reported limited knowledge of their nursing home patients due to a lack of contact time. Efforts to improve care for patients with poor quality of life who lack decision-making capacity must consider the context of societal values, physician training, and the processes by which physicians negotiate patient and family preferences.