丹东地区朝鲜族骨质疏松症女性健康教育效果分析

目的探讨健康教育对朝鲜族骨质疏松症女性生活方式及对骨质疏松症认知的影响。方法 针对丹东地区体检发现的朝鲜族骨质疏松症女性83例,对其进行骨质疏松症健康教育。通过面对面 调查问卷及定期电话随访,3个月后了解健康教育对骨质疏松症患者生活方式及对骨质疏松症认知 率的影响。结果健康教育后朝鲜族骨质疏松症女性坚持喝牛（酸）奶、户外体育锻炼、晒太阳的人 数明显增多,素食、吸烟、饮酒人数减少（P<0.05 );对骨质疏松症认知率显著提高（P<0.05 )。结论健康教育有助于改善患者生活方式,提高患者对骨质疏松症的认知率与防治。     

全国中老年骨质疏松症分级健康管理平台的设计与应用

目的 搭建全国中老年骨质疏松症分级健康管理平台,加强骨质疏松症患者档案的数字化管理。方法 制定全国中老年骨质疏松症患者基础档案和规范化诊疗的业务流程和数据管理规范,采用企业级应用的技术架构研发由用户层、表示层、应用层、数据层和存储层构成的全国中老年骨质疏松症分级健康管理平台,并进行应用示范。结果 搭建了由患者管理、样本管理、统计管理、参数管理、用户管理、日志管理、信息发布等功能模块组成的全国中老年骨质疏松症分级健康管理平台,并在中心医院和社区医院的应用示范过程中升级完善,为全国中老年骨质疏松症患者的规范化管理提供了技术支持。结论 全国中老年骨质疏松症分级健康管理平台实现了骨质疏松症患者档案的信息化管理,建立了中心医院与社区医院之间的双向转诊模式,有助于提高骨质疏松症患者的诊疗率和依从性,促进我国医疗资源的合理配置。     

200例骨质疏松症患者健康知识、信念、行为的调查分析

目的 了解我院2011年6月-2013年3月骨伤科200例骨质疏松症患者健康知识、信念、行为的现状.方法 对骨质疏松症患者发放骨伤科自行编写的骨质疏松症健康知、信、行理论问卷,请患者自行完成或在护士的协助下完成问卷的患者基本信息、骨质疏松症的相关知识、健康信念评估和行为评估四方面的内容.所有问卷中的信息和各部分的得分均进行统计录入和分析.结果 不同年龄骨质疏松症患者健康知、信、行理论问卷的相关知识分值存在显著差异,健康信念评估和行为评估分值未见显著差异.不同工作状态和文化程度骨质疏松症患者健康知、信、行理论问卷的相关知识、健康信念评估和行为评估分值存在显著差异.结论 帮助更多的患者掌握卫生保健知识,树立健康观念,使他们自愿形成健康的行为和生活方式,预防骨质疏松的发生,进行有效的骨质疏松症健康管理.     

骨质疏松症健康教育效果评价的研究进展

回顾国内外骨质疏松症健康教育及效果评价现状,重点介绍了效果评价的标准和影响因素,为护士开展骨质疏松症健康教育效果评价工作提供参考。     

围绝经期妇女对骨质疏松症相关知识的需求调查

目的 了解围绝经期妇女对骨质疏松症相关知识的需求,加强针对性健康教育.方法 采用问卷调查法,对138例围绝经期妇女进行与骨质疏松症相关的生活习惯、相关知识需求及希望获得健康教育途径的调查.结果 在9项良好生活习惯中,仅有2项超过50.0%.她们最希望了解引起骨质疏松症的危险因素(92.8%)和骨质疏松症的症状(87.7%);就医咨询和电话咨询是围绝经期妇女希望获得的主要健康教育途径,分别占83.3%和70.3%.结论 需要通过多种形式对围绝经期妇女进行针对性的健康教育,使她们获得更多预防骨质疏松症的知识,建立健康行为和生活方式,促进健康,提高生活质量.     

社区骨质疏松症的综合防治

随着人口老龄化程度的加剧,骨质疏松症患者的数量逐年上升,由此导致老年人致残、致死的人数增加,给家庭和社会带来沉重的负担。目前,在大型综合医院对骨质疏松的治疗比较规范,但在社区医院对于骨质疏松症的诊治仍然存在认知上的差异。面对社区骨质疏松症认知诊治率偏低的问题,我们应积极强化对社区全科医生的培训,使其对骨质疏松症的认知和诊治水平得到提升,充分发挥社区全科医生的健康守门人作用,进一步普及防治骨质疏松症的健康知识,提高居民对骨质疏松症的防治意识,降低骨质疏松性骨折的发生率,提高其生存质量。     

骨质疏松症营养干预研究进展

随着人口老龄化加剧,骨质疏松症及骨质疏松性骨折的发生率和死亡率明显升高,给家庭和社会带来沉重负担。如何有效干预骨质疏松症的发生,减少骨质疏松症及其并发症带来的不良后果,不仅是有效提高骨质疏松症患者生活质量的关键,还可以减轻家庭和社会的经济负担。目前研究发现,饮食营养及营养素补充与骨质疏松症密切相关,早期营养及营养素补充改变有助于避免骨质疏松症的发生发展。在本文中,我们阐述了蛋白质、钙、维生素D及其他维生素和矿物质等营养素补充在预防骨质疏松症、维持骨骼健康中的作用,重点关注以骨密度或骨折作为结果的营养干预研究,探讨了近期关注的营养干预预防骨质疏松症的可能机制,强调了营养补充对预防骨质疏松和维持骨骼健康的重要性。     

南京市不同人群对骨质疏松症知晓情况调查

目的了解南京市一般人群、医护人员和骨质疏松症患者对骨质疏松症相关知识的知晓情况及其影响因素,为制定合理有效的骨质疏松症健康教育策略提供参考依据。方法采用自行设计的问卷对三类人群进行自填式问卷调查。结果医护人员正确认识骨质疏松症的知晓率83.1%,明显高于一般人群的49.1%和患者的44.8%(P=0.000)。关于骨质疏松健康危害的调查选项只有2名医护人员答案完全正确。预防骨质疏松的知识知晓率,医护人员为31.3%,明显高于一般人群10.2%和患者人群7.9%(P=0.000)。调查相关信息的获取和愿意接受的来源中,医护人员主要来自于医疗结构,一般人群和患者人群主要来自媒体机构。结论一般人群和骨质疏松症患者关于骨质疏松症的知识知晓率低,医疗机构在对社会人群的骨质疏松症健康教育中没有发挥应有的作用;而医护人员的骨质疏松症知识也仍然需要加强教育。     

肌少-骨质疏松症专家共识

肌少-骨质疏松症已成为全球性的公共健康问题和前沿研究难题。目前仍存在对肌少-骨质疏松症的临床知晓率低、重视不够、诊断治疗方法单一、管理不完善等实际问题。中国健康促进基金会组织专家编写《肌少-骨质疏松症专家共识》,为肌少-骨质疏松症的临床诊疗和科学研究提供参考。共识论述了肌少-骨质疏松症是肌少症和骨质疏松症并存的退行性代谢综合征,有共同的发病基础,诊断标准应是骨质疏松症与肌少症并存,预防比治疗更重要。肌少-骨质疏松症的治疗目标是改善肌量、肌力、身体平衡、骨量和骨质量,避免出现跌倒和骨折。肌少-骨质疏松症的管理应肌骨并重,综合诊断、规范治疗,医患合作,建立科学评估、定期随访机制。     

围绝经期妇女对骨质疏松症相关知识的需求调查

目的了解围绝经期妇女对骨质疏松症相关知识的需求，加强针对性健康教育。方法采用问卷调查法，对138例围绝经期妇女进行与骨质疏松症相关的生活习惯、相关知识需求及希望获得健康教育途径的调查。结果在9项良好生活习惯中，仅有2项超过50．0％。她们最希望了解引起骨质疏松症的危险因素（92．8％）和骨质疏松症的症状（87．7％）；就医咨询和电话咨询是围绝经期妇女希望获得的主要健康教育途径，分别占83．3%和70．3％。结论需要通过多种形式对围绝经期妇女进行针对性的健康教育，使她们获得更多预防骨质疏松症的知识，建立健康行为和生活方式，促进健康，提高生活质量。     

福州糖尿病性骨质疏松高骨折风险患者“知-信-行”调查研究

目的调查福州社区糖尿病性骨质疏松高骨折风险患者自我健康管理(知识-信念-行为)的现状,分析骨质疏松症知识水平的影响因素,为进行有针对性的健康教育提供理论依据。方法 2016年12月~2017年3月,应用FRAX中文版子模块筛选出191名DO高骨折风险患者,采用基本情况调查表、骨质疏松症知识问卷(OKT)、骨质疏松症自我效能量表(OSES)和自行设计的健康行为问卷进行统一问卷调查,分析骨质疏松症患者知识、自我效能、健康行为水平及其相关影响因素。结果骨质疏松症知识问卷每题平均得分为(0.44±0.16)分,钙知识维度得分最高,危险因素维度得分最低,性别、学历是骨质疏松症知识得分的影响因素,差异有统计学意义(P0.01),即男性的OKT得分高于女性,学历越高,OKT得分越高。自我效能平均分为(129.13±26.07)分,锻炼自我效能得分低于食钙自我效能。健康行为平均分为(31.74±6.88)分,摄钙健康行为维度得分最低。结论女性、低学历患者是骨质疏松健康教育的重点人群,应强化危险因素教育,提高"治未病"的意识和行为,提供多样化的运动方案和摄钙来源,以降低骨质疏松性骨折发生率。     

2型糖尿病伴骨质疏松患者健康素养状况及影响因素分析

目的了解2型糖尿病伴骨质疏松患者健康素养状况及影响因素,为制定提高2型糖尿病伴骨质疏松患者健康素养干预措施提供参考。方法采用自制的健康素养量表对268名2型糖尿病伴骨质疏松患者进行问卷调查,分析调查对象的健康素养状况及其影响因素。结果 268名2型糖尿病伴骨质疏松患者健康素养得分为144.68±62.81分,占满分的62.91%(满分230分),其中书面素养得分为124.82±58.74分,占该领域满分的75.65%(满分165分);运算能力得分为26.84±10.42分,占该领域满分的41.30%(满分65分)。其中有109例(40.71%)的患者得分150分,属于健康素养缺乏;有86例(32.10%)的患者得分为150~180分,属于临界健康素养;另有73例(27.20%)的患者得分180分,属于健康素养充足。多元线性回归分析结果显示,年龄、文化程度、病程、有无职业、月收入、住院次数、居住地是2型糖尿病伴骨质疏松患者健康素养的影响因素。结论 2型糖尿病伴骨质疏松患者存在较低健康素养现象,对其影响因素制定针对性的干预措施是提高患者健康素养的重要途径。     

Development of an integrated-care delivery model for post-fracture care in Ontario, Canada

Introduction The purpose of this study was to develop an integrated-care model for patients at highest risk for osteoporosis, those with a low-trauma fracture. Specific objectives were to describe the current processes and patterns of post-fracture care in hospitals in Ontario; to examine health-care professional and patient awareness of osteoporosis and the roles and responsibilities of various organizations and health care professionals; and to identify barriers and facilitators and obtain feedback on the model.Methods In 2002, questionnaires were completed for 178 eligible hospitals.Results Only 65% of hospitals inform primary-care physicians of a fracture for all patients and only 4% indicated that they provide information about osteoporosis. The main themes that emerged from the four patient focus groups (n=21) were lack of continuity of care, the absence of a link between the fracture and osteoporosis by both patients and health care providers, and need for information. Most participants agreed that something was needed to prompt their primary-care physician to investigate for osteoporosis. The four physician focus groups (n=26) identified a role for orthopaedic surgeons to flag cases.Conclusions From 34 key informant interviews with community-based organizations, we found a lack of integration between health care professionals who provide fracture care and those who provide osteoporosis management and fall prevention. Based on these data, we developed an integrated local-resource-based post-fracture care model, which we obtained feedback on at a stakeholder consultation workshop. The model focuses on improving emergency department/fracture clinic communication, emphasizes the need for follow-up investigation by family physicians for osteoporosis, and incorporates other health care professionals and a telemedicine multidisciplinary osteoporosis clinic. We are currently evaluating whether this model leads to an increase in appropriate investigation of and treatment for osteoporosis in patients with low-trauma fractures.     

Epidemiology and socio-economic aspects of osteoporosis in Finland

The public health problem of osteoporosis is assessed epidemiologically and economically. Osteoporosis is mainly a problem of old people. Ageing of the population will increase the number of osteoporotic fracture patients and the need of hospital and other services. It is possible to prevent osteoporosis and the goal of health planning activities should thus be directed more to the prevention of osteoporosis.     

Contemporary diagnostics and therapy of osteoporosis

Since the World Health Organisation's announcement of the "Bone and Joint Decade 2000-2010" diseases of the musculoskeletal system attract more and more attention throughout patients and professional health care providers. In an aging society especially osteoporosis represents a major public health concern. Fragility fractures are the most limiting condition in osteoporosis with the highest impact on both, life quality and health care systems worldwide. Orthopaedic surgeons play a key role in implementing primary diagnostics and therapy in patients with fragility fractures. Objective of this effort is the reduction of the common subsequent fractures in patients with osteoporosis. According to national and international guidelines implementation of contemporary clinical pathways to diagnose and treat patients with fractures due to diminished bone mineral density is fast, simple and proven to be effective.     

骨质疏松骨折患者的健康管理及效果分析

目的：通过对住院骨质疏松骨折患者进行全程健康管理,从而探索最佳的骨质疏松骨折健康管理。方法选择2012年1月－2013年12月在解放军第309医院住院的年龄在50岁～75岁的骨质疏松骨折200例患者为研究对象,分为对照组及干预组,运用前瞻性队列研究方法进行分析。同时采用SPSS12．0统计软件进行数据处理。结果干预后,患者骨质疏松相关知识掌握情况比干预前显著优于对照组;患者相关行为均明显改善,依从性提高;各部位骨密度均高于干预前;患者的疼痛程度较干预前均明显改善,生活质量大幅度提高。结论对骨质疏松骨折患者进行全程的健康管理,促进骨质疏松骨折愈合,提高生活质量,降低骨质疏松再骨折发生,从而为防治骨质疏松骨折提供理论依据。     

Multimodal intervention to improve osteoporosis care in home health settings: results from a cluster randomized trial

Summary

We conducted a cluster randomized trial testing the effectiveness of an intervention to increase the use of osteoporosis medications in high-risk patients receiving home health care. The trial did not find a significant difference in medication use in the intervention arm.

Introduction

This study aims to test an evidence implementation intervention to improve the quality of care in the home health care setting for patients at high risk for fractures.

Methods

We conducted a cluster randomized trial of a multimodal intervention targeted at home care for high-risk patients (prior fracture or physician-diagnosed osteoporosis) receiving care in a statewide home health agency in Alabama. Offices throughout the state were randomized to receive the intervention or to usual care. The primary outcome was the proportion of high-risk home health patients treated with osteoporosis medications. A t test of difference in proportions was conducted between intervention and control arms and constituted the primary analysis. Secondary analyses included logistic regression estimating the effect of individual patients being treated in an intervention arm office on the likelihood of a patient receiving osteoporosis medications. A follow-on analysis examined the effect of an automated alert built into the electronic medical record that prompted the home health care nurses to deploy the intervention for high-risk patients using a pre–post design.

Results

There were 11 offices randomized to each of the treatment and control arms; these offices treated 337 and 330 eligible patients, respectively. Among the offices in the intervention arm, the average proportion of eligible patients receiving osteoporosis medications post-intervention was 19.1 %, compared with 15.7 % in the usual care arm (difference in proportions 3.4 %, 95 % CI, ?2.6 to 9.5 %). The overall rates of osteoporosis medication use increased from 14.8 % prior to activation of the automated alert to 17.6 % afterward, a nonsignificant difference.

Conclusions

The home health intervention did not result in a significant improvement in use of osteoporosis medications in high-risk patients.     

绝经后患者焦虑、抑郁状态对骨质疏松和生活质量的影响

目的了解骨质疏松症与焦虑、抑郁状态的相关性。方法选取来我院门诊就诊和住院的绝经后骨质疏松患者74例和非骨质疏松患者76例,采用综合性医院焦虑抑郁量表和健康状况调查问卷对其焦虑、抑郁状态及生活质量进行评估,同时采用RIA方法测定雌二醇、睾酮、孕酮、促卵泡素和促黄体生成素水平。结果骨质疏松组患者血清E2水平较对照组降低,差异有显著性(P=0.020),而骨质疏松组FSH较对照组有所升高,差异有显著性(P=0.024),骨质疏松患者的焦虑分、抑郁分均显著高于对照组,差异均有显著性(P<0.01)。骨质疏松患者的生活质量显著低于对照组,8个纬度分值均显著高于对照组,差异均有显著性(P<0.01)。结论焦虑、抑郁状态也是绝经后骨质疏松的危险因素,对这部分患者进行有针对性的心理咨询和干预治疗也是非常必要的。