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目的:调查分析胃食管反流病患者自我管理行为依从性情况及其影响因素。方法:选取2010年2月-2012年6月来我院就诊治疗的胃食管反流患者150例,利用自我行为管理量表、自我效能量表、焦虑自评量表(SAs)及抑郁自评量表(SDS)进行调查,并采用单因素分析及多因素分析法分析其影响因素。结果:所有150例患者的自我行为管理平均得分为37.12+4.95分,处于中下游水平,其中治疗依从性较好而疾病知识认知方面较差;而从单因素及多因素分析中得知,胃食管反流病患者自我行为依从性的影响因素主要为自我效能、工作学习压力及文化程度(偏回顾系数=0.301、-2.264、1.403)。结论:胃食管返流病患者的自我管理行为依从性较差,这与其文化程度较低、工作学习压力较大有关,医务人员应指导患者减轻工作学习压力,改善生活方式以提高其自我管理行为依从性。 相似文献
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For studies with treatment noncompliance, analyses have been developed recently to better estimate treatment efficacy. However, the advantage and cost of measuring compliance data have implications on the study design that have not been as systematically explored. In order to estimate better treatment efficacy with lower cost, we propose a new class of compliance subsampling (CSS) designs where, after subjects are assigned treatment, compliance behavior is measured for only subgroups of subjects. The sizes of the subsamples are allowed to relate to the treatment assignment, the assignment probability, the total sample size, the anticipated distributions of outcome and compliance, and the cost parameters of the study. The CSS design methods relate to prior work (i) on two-phase designs in which a covariate is subsampled and (ii) on causal inference because the subsampled postrandomization compliance behavior is not the true covariate of interest. For each CSS design, we develop efficient estimation of treatment efficacy under binary outcome and all-or-none observed compliance. Then we derive a minimal cost CSS design that achieves a required precision for estimating treatment efficacy. We compare the properties of the CSS design to those of conventional protocols in a study of patient choices for medical care at the end of life. 相似文献
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目的:探讨骨质疏松防治综合干预对特需门诊原发性骨质疏松(POP)患者治疗依从性及生活质量的影响。方法:以2010年5月~2013年5月期间四川大学华西医院国际医疗中心收治的112例POP患者为研究对象,分为干预组和对照组,在药物治疗的同时给予不同的护理措施,6个月后比较两组干预前后POP知识掌握程度(OKT评分)、疼痛(VAS评分)、骨密度(BMD)以及生活质量(OQOLS评分)改善情况;随访1年后评价两组治疗依从性以及骨折发生率。结果:经过6个月的干预,干预组OKT评分、VAS评分以及BMD和治疗前比较差异均有统计学意义(P0.001),和对照组比较差异也均有统计学意义(P0.001)。干预组OQOLS评分的5个维度以及生活质量总评分和干预前比较差异均有统计学意义(P0.001),和对照组比较差异也均有统计学意义(P0.001),对照组心理维度和社会维度和干预前比较差异不大(P0.05)。两组随访1年,干预组完全依存比例明显高于对照组,不依从比例低于对照组(P0.001);干预组病理性骨折发生率低于对照组(P0.05)。结论:对特需门诊收治的原发性骨质疏松患者在药物治疗的基础上实施综合护理干预,能够明显提高患者的治疗依从性,提高骨密度增加比例,减少疼痛,降低骨折发生率,改善患者生活质量。 相似文献
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Nagatomi J DeMiguel F Torimoto K Chancellor MB Getzenberg RH Sacks MS 《Biochemical and biophysical research communications》2005,334(4):1159-1164
Previously, we demonstrated using a rat model of spinal cord injury (SCI) that bladder wall tissue compliance significantly increased within the first 2 weeks following injury. In order to explore the potential molecular-level mechanisms of this event, the present study quantified molecules pertinent to bladder tissue remodeling and changes in mechanical properties. An initial gene array analysis followed by real-time qPCR revealed that the message levels for tropoelastin and lysyl oxidase were as high as 8-fold in SCI rats compared to normal. Furthermore, both the message and protein levels of TGF-beta1 and IGF-1, known stimulators of elastin synthesis, in SCI rat bladders were significantly higher compared to those of normal rats. Taken together, it can be speculated that functional changes of the bladder associated with SCI induce release of select growth factors, which, in turn, stimulate elastogenesis that lead to alteration of biomechanical properties of the wall tissue. 相似文献
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R. D. Herbert J. Crosbie 《European journal of applied physiology and occupational physiology》1997,76(5):472-479
The first aim of this study was to measure the contributions of muscle and tendon to the total compliance of resting muscle-tendon
units. A second aim was to determine whether the decrease in muscle-tendon unit rest length produced by prolonged immobilisation
in a shortened position is mediated primarily by adaptations of the muscle or tendon. One ankle joint from each of five rabbits
was immobilised in a plantarflexed position for 14 days. The passive length-tension properties of soleus muscle fascicles
and tendons from both hindlimbs were measured using a video-based tensile-testing system. In non-immobilised muscles, muscle
fascicle strains exceeded tendon strains by up to four times. However, because the rest length of tendon was much greater
than that of muscle fascicles, changes in tendon length accounted for nearly half of the total change in muscle-tendon unit
length. The rest length of immobilised muscle-tendon units was less than that of non-immobilised muscle-tendon units from
contralateral limbs. Most of this difference was attributable to a change in the rest length of the tendon; there was little
change in the rest length of muscle fascicles. It is concluded that the tendon is responsible for a large part of the compliance
of rabbit soleus muscle-tendon units at physiological resting tensions, and that adaptation of tendon rest length is the primary
mechanism by which the rabbit soleus shortens in response to immobilisation at short lengths.
Accepted: 7 May 1997 相似文献
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F. Philipp Seib Marina Prewitz Martin Bornhäuser 《Biochemical and biophysical research communications》2009,389(4):663-199
The therapeutic efficacy of multipotent mesenchymal stromal cells (MSCs) is attributed to particular MSC-derived cytokines and growth factors. As MSCs are applied locally to target organs or home there after systemic administration, they experience diverse microenvironments that are biochemically and biophysically distinct. Here we use well-defined in vitro conditions to study the impact of substrate elasticity on MSC-derived trophic factors. By varying hydrogel compliance, the elasticity of brain and muscle tissue was mimicked. We screened >90 secreted factors at the protein level, finding a diverse elasticity-dependent expression pattern. In particular, IL-8 was up-regulated as much as 90-fold in MSCs cultured for 2 days on hard substrates, whereas levels were consistently low on soft substrates. In summary, we show substrate elasticity directly affects MSC paracrine expression, a relevant finding for therapies administering MSCs in vivo. 相似文献
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BackgroundCervical cancer screening, regardless of HPV vaccination, is a cornerstone of cancer prevention. This study evaluated associations between prior HPV vaccine doses and initiation and continued participation of screening by age at vaccination.MethodsUsing electronic medical records for a safety net healthcare system (Truman Medical Center), women aged 1426 y vaccinated (n = 1123) between 07/01/2006 and 10/1/2009 were randomly selected and matched on birth year and health campus to unvaccinated (n = 1123) women. Frequency of screening was determined through 07/01/2013. Hazard ratios (HR) for screening were estimated using Cox proportional hazards regression.ResultsScreening rates were higher after vaccination: unvaccinated (53%), first (62%), second (59%) or third (61%) doses. Women who initiated screening were less likely to complete the vaccine series, regardless of age. Women receiving one dose were more likely than unvaccinated women to initiate screening (HR = 2.98 95% Confidence Interval (CI):2.453.61) and were more likely to screen than those receiving two (1 vs. 2, HR = 2.94 95% CI:2.094.14) or three doses (1 vs. 3, HR = 3.15 95% CI:2.214.48). Compared to unvaccinated women, women <21 y who completed 3-doses were 1.8-times more likely to screen at 21 y, whereas vaccinated women 21 y were more likely to screen regardless of number of doses (p < 0.0001).ConclusionsWomen who were vaccinated were more likely to screen than unvaccinated women; screening rate was highest after and occurred closest to the first vaccine dose. Research evaluating the efficacy of a one-dose vaccine is warranted and may provide both higher vaccination and screening rates. 相似文献
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External fixators are standard devices to stabilize bone fractures and their compliance aims at producing an interfragmentary
motion that promotes rapid and successful healing. While evaluation of their axial compliance is a routine test, the quantification
and interpretation of their full 6 × 6 compliance matrix is an extensive and delicate task. In this context, the objective
of this study was to develop, validate and demonstrate the potential of a rigorous method to quantify their 6 × 6 compliance
matrix. An experimental system was developed to apply six independent static forces and moments to an external fixator in
the field of view of two infrared cameras quantifying the induced motion. The system was then tested with a calibration structure
which compliance could be calculated analytically and numerically. Finally, the system was applied to compare three configurations
of a commercial external wrist fixator. The results of the method proved to be reproducible and highly consistent with the
linear elasticity theory in the physiological range of small deformations. A rigorous method for evaluation of the 6D compliance
becomes therefore available for research in mechanobiology of fracture healing by external fixation. 相似文献
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