Are the barriers to good oral hygiene in nursing homes within the nurses or the patients?

doi: 10.1111/j.1741‐2358.2011.00554.x
Are the barriers to good oral hygiene in nursing homes within the nurses or the patients? Objective: To explore nursing home patients’ oral hygiene and their nurses’ assessments of barriers to improvement. Background: In nursing homes, nurses are responsible for patients’ oral hygiene. Materials and methods: This study assessed the oral hygiene of 358 patients in 11 Norwegian nursing homes. 494 nurses in the same nursing homes participated in a questionnaire study. Results: More than 40% of patients had unacceptable oral hygiene. ‘More than 10 teeth’ gave OR = 2, 1 (p = 0.013) and ‘resist being helped’ OR = 2.5 (p = 0.018) for unacceptable oral hygiene. Eighty percent of the nurses believed knowledge of oral health was important, and 9.1% often considered taking care of patients’ teeth unpleasant. Half of the nurses reported lack of time to give regular oral care, and 97% experienced resistant behaviour in patients. Resistant behaviour often left oral care undone. Twenty‐one percent of the nurses had considered making legal decisions about use of force or restraints to overcome resistance to teeth cleaning. Conclusion: Oral hygiene in the nursing homes needed to be improved. Resistant behaviour is a major barrier. To overcome this barrier nurses’ education, organisational strategies to provide more time for oral care, and coping with resistant behaviour in patients are important factors.     

层级护理管理模式在临床护理中的应用

科室层级护理管理模式是护理质量控制的重要组成部分,对科室和全院的护理质量建设起到极大的推动作用。在立足医院科室层级管理模式的基础上,简单介绍临床层级护理模式,并探讨相应的管理对策和建议。     

心理护理在A 型性格上消化道出血患者的应用

目的:探讨心理护理应用于A型性格上消化道出血患者的影响。方法:将A型性格上消化道出血患者68例,随机分为观察组(n=34例)和对照组(n=34例)。观察组为实施心理护理组,对照组为非心理护理组。分别观察两组患者的住院时间、二次出血发生率、病死率等指标。结果:两组患者的临床疗效比较,观察组住院时间、二次出血发生率和病死率均明显少于对照组,差异具有统计学意义(P<0.05)。结论:心理护理应用于A型性格上消化道出血患者,能够明显较少患者的住院时间,并有效降低了患者二次出血发生率和病死率,其临床效果优于对照组。     

心理护理对腹腔镜胆囊切除术患者焦虑心理的影响

目的:探讨心理护理对腹腔镜胆囊切除术患者焦虑心理的影响。方法:将84例腹腔镜手术患者随机分为2组:对照组23例,给予常规护理;心理护理组61例,给予常规护理+心理护理,其中文化程度<高中的患者34例,文化程度≥高中的患者27例。采用焦虑自评量表(SAS)评价焦虑状态,采用疼痛视觉模拟标尺评估患者疼痛情况,以及评估患者情绪情感、恐惧程度及对治疗满意度。结果:与对照组比较,心理护理组患者焦虑程度、恐惧程度、疼痛评分、显著下降(P<0.05);与文化程度<高中比较,文化程度≥高中的患者焦虑评分显著降低(P<0.05),情绪情感的评分显著增加(P<0.05);术后第1-2天疼痛评分无显著差异(P>0.05),术后第3天疼痛评分有显著差异(P<0.05);心理护理组的满意度明显升高(P<0.05)。结论:腹腔镜手术患者存在明显的焦虑、恐惧症状,心理护理干预能有效缓解患者焦虑心理,减轻疼痛程度,减少疼痛时间,提高患者对医疗服务满意度,可有效提高临床护理质量与效率。     

康复护理对面瘫患者的影响

目的探讨面瘫患者实施康复护理的效果。方法选择2013年1月~2015年12月我院神经科收治的面瘫患者80例为研究对象,随机分为对照组和观察组各40例,对照组给予常规护理,观察组在常规护理基础上实施康复护理,观察比较两组患者的治疗效果。结果观察组临床总有效率明显高于对照组,差异有统计学意义(P0.05)。结论面瘫患者实施康复护理可提高临床效果,促进面神经的恢复,值得临床应用。     

Oral care training in the basic education of care professionals

doi:10.1111/j.1741‐2358.2009.00304.x
Oral care training in the basic education of care professionals Objective: To investigate the quantity and quality of oral care training in the basic education of future long‐term care (LTC) professionals in Norway. Background: The level of oral hygiene has often proved inadequate in LTC facilities. It has been maintained that this could be due to insufficient knowledge of oral care among care professionals. Materials and methods: A self‐administered questionnaire was sent to all 270 schools in Norway which offered basic education of LTC personnel in 2004/05. Information on theoretical and practical oral care training, scope of oral care in teaching material and curriculum, educational background of the teaching staff and schools opinion regarding adequacy of their training programme was collected. Results: Of the 203 respondents (75% response rate), 188 (participants) included oral care in their educational programme. Approximately two‐thirds of the participating schools provided 3 h or more of oral care training and many of the important themes were presented in the textbooks that were recommended. Moreover, the practical exercises performed in practice placement supplemented the knowledge. Conclusion: The results could not confirm that LTC professional’s basic education concerning oral care was inadequate. There may therefore be other explanations for the poor oral hygiene in many LTC facilities.     

对医护学生乙型肝炎病毒感染的定群研究

在调查687名医护学生课堂学习阶段的HBV感染率后,选出HBV易感者,连续观察了在校期、临床实习期、工作后1～2年时HBV易感者的年感染情况的变化,以比较医院内HBV感染的严重性。发现在参加工作1～2年后,人年HBV感染率和HBsAg阳转率均显著高于在校阶段和临床实习阶段,也显著高于做教师一年的师范学生(对照组)。医护学生在医院内的HBV感染与医院损伤次数有关,并与医院消毒管理的好坏有关。     

脑卒中偏瘫患者临床康复的护理效应

目的：通过脑卒中偏瘫患者4期的康复护理训练的疗效观察,探讨康复训练护理对脑卒中偏瘫患者的功能恢复的临床效果。方法：本贵料收集2004年1月至2004年12月共75例脑卒中偏瘫患者,随机分为两组,对照组和康复组,均采用内科常规护理,康复组接受康复护理训练;而对照组不进行康复护理训练。采用Banher指数评分法予以评定。结果：康复组功能改善程度明显高于对照姐（P〈0．05）。结论：脑卒中偏瘫患者日常生活活动能力改善在很大程度上取决于早期运动功能的恢复。对脑卒中偏瘫的早期功能恢复是必要的、有益的。     

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∞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,给予脱水荆后症状消失,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。