情景教学在尿路造口患者自我护理教育的应用

目的探讨情景教学模式对尿路造口患者自护能力的影响。方法将60例尿路造口患者按照入院时间分为对照组和干预组各30例。对照组给予常规造口知识健康教育,干预组在此基础上通过情景教学的模式指导患者自我护理,分别于指导前及出院3个月对两组造口患者的自护能力及生活质量进行调查。结果干预后干预组的自护能力及生活质量显著高于对照组(均P0.05)。结论情景教学模式应用于尿路造口患者自我护理教育,能够提高患者的自护能力及生活质量。     

健康教练教育对预防性肠造口患者自我护理能力的影响

目的 探讨健康教练教育对提升预防性肠造口患者自我护理能力的作用.方法 将110例直肠癌行预防性肠造口的患者随机分为干预组和对照组各55例.对照组采取个体宣教,每周2次集中授课,1次理论授课,1次实践操作,每月定期随访等常规健康教育;干预组在此基础上采取健康教练教育进行造口管理.比较两组手术前后的肠造口自我护理能力和术后造口并发症发生率.结果 术后第5天、术后1个月末、术后3个月末干预组自我护理能力总分优于同期的对照组(均P＜0.01).术后1个月、术后3个月干预组的刺激性皮炎发生率显著低于对照组(均P＜0.01).结论 健康教练教育能提高预防性肠造口患者的自我护理能力,降低造口并发症的发生.     

自我管理教育对尿路造口术后并发症的影响

目的 提高膀胱全切+尿路造口术后患者的自我护理能力,降低并发症发生率.方法 将60例尿路造口术后患者随机分为观察组和对照组各30例,观察组采用自我管理教育,对照组采用常规教育.结果 观察组出院第3、6、12个月自我管理能力得分显著高于对照组(均P＜0.01),出院第3个月并发症发生率低于对照组(P＜0.05).结论 自我管理教育可显著提高尿路造口术后患者的自我管理能力,减少出院近期造口并发症发生率.     

直肠癌Miles术患者造口护理的阶段式健康教育

目的探讨阶段式健康教育对减少直肠癌Miles术患者造口并发症的作用。方法将720例直肠癌Miles术造口患者,按入院时间分为观察组(370例)与对照组(350例)。对照组给予直肠癌常规护理。观察组在此基础上于术前、术后、出院时及出院后进行阶段式健康教育。结果观察组造口相关知识掌握率及相关操作达标率显著高于对照组,并发症发生率显著低于对照组(均P<0.01)。结论实施个性化阶段式健康教育,能提高健康教育效果,减少造口并发症,提高患者生存质量。     

基于造口工作坊的回授法用于肠造口患者健康教育的效果

目的探讨基于造口工作坊的回授法用于肠造口患者健康教育的效果。方法将80例肠造口患者按入院时间分为观察组和对照组各40例,对照组采用传统健康教育方法,观察组采用基于造口工作坊的回授法进行健康教育。结果观察组出院时造口自我护理能力评分显著高于对照组(P<0.01),但两组出院后3个月造口周围皮炎、造口狭窄、造口水肿、造口脱垂发生率比较,差异无统计学意义(均P>0.05)。结论基于造口工作坊的回授法用于肠造口患者健康教育有利于提高患者造口自我护理能力。     

膀胱癌术后双侧腹壁造口患者的延续护理

目的提高膀胱癌全膀胱切除双侧腹壁造口患者的自护技能与效果,以提高其生活质量。方法将46例膀胱癌行全膀胱切除并双侧腹壁造口患者随机分为两组各23例,对照组行常规治疗护理、健康教育、出院指导及随访;观察组建立"造口护理服务"微信平台并应用于上述护理中。术后6个月评价效果。结果干预后观察组造口知识及生活质量得分显著高于对照组,术后并发症发生率显著低于对照组(均P0.01)。结论基于微信平台的延续护理,可有效提高患者的造口知识,从而降低造口并发症发生率,提高生活质量。     

膀胱癌尿流改道腹壁造口患者健康素养与社会支持及健康信念的相关性

目的 了解膀胱癌尿流改道腹壁造口患者健康素养、社会支持和健康信念水平,并探讨三者之间的关系,为制订健康素养干预措施提供参考.方法 采用一般资料问卷、社会支持量表、Champion健康信念模式量表及慢性病患者健康素养量表对211例膀胱癌尿流改道腹壁造口患者进行横断面调查.结果 膀胱癌尿流改道腹壁造口患者健康素养总分为(86.83±12.19)分,4个维度得分从低至高依次为经济支持意愿、交流沟通能力、信息获取能力、改善意愿能力.社会支持及健康信念与健康素养呈正相关(P＜0.05,P＜0.01).结论 膀胱癌尿流改道腹壁造口患者健康素养处于中等水平,社会支持、健康信念与患者健康素养水平显著相关.护理人员可通过加强社会支持、提高患者健康信念,以提高尿路造口患者健康素养水平.     

形象化健康教育模式对肠造口患者自我护理能力的影响

目的:探讨形象化健康教育模式对肠造口患者自我护理能力的影响。方法:将我科2009年1月～2012年6月收治的97例直肠癌结肠造口患者随机分为两组,观察组48例、对照组49例。观察组采用形象化健康教育模式,对照组采用常规护理方法。采用问卷调查的方式,收集患者对造口知识的了解程度、对护理工作的满意度、造口自护能力及并发症发生率等,进行对比分析,了解患者对掌握肠造口自我护理能力的影响。结果:观察组患者自我护理能力优于对照组,P<0.01,差异有显著意义。结论:形象化健康教育模式较常规护理方法能快速提高肠造口患者自我护理能力,并能显著改善肠造口患者的生活质量。     

结直肠癌患者及照顾者造口护理的预警教育

目的探讨结直肠癌患者及照顾者进行造口护理预警教育的方法及效果。方法将98例肠造口患者随机分为干预组和对照组各49例。对照组给予常规造口健康教育,干预组在此基础上对患者及照顾者实施预警教育。比较干预后3个月两组造口护理依从性,患者焦虑水平及造口并发症发生率。结果干预后3个月后,干预组患者及照顾者造口依从性得分显著高于对照组(均P0.05);患者焦虑得分显著低于对照组,造口并发症(粪水性皮炎、造口黏膜出血及造口周围皮肤湿疹)发生率显著低于对照组(P0.05,P0.01)。结论预警教育可有效提高肠造口患者及照顾者造口护理依从性,降低患者焦虑水平及造口并发症发生率,提高患者的生活质量。     

微视频教育对永久性肠造口患者自我护理能力及生活质量的影响

目的 探讨微视频教育对永久性肠造口患者造口自我护理能力及生活质量的影响,为提高永久性肠造口患者的护理质量提供参考.方法 将低位直肠癌行永久性肠造口患者96例按住院时间分为对照组和观察组各48例,对照组采用常规肠造口护理,观察组在对照组的基础上实施微视频教育,录制肠造口患者初识肠造口、呵护玫瑰、口诀式造口袋更换技术、向阳而行四大版块13个健康教育微视频.结果 两组出院后1个月造口自我护理能力评分及出院后3个月生活质量评分的时间效应、干预效应及交互效应显著(P＜0.05,P＜0.01).结论 微视频教育有利于提高永久性肠造口患者造口自我护理能力及生活质量.     

Risk factors for insomnia and burnout: A longitudinal population-based cohort study

Insomnia and burnout are highly prevalent in the general population, calling for understanding of its causes. Taking a broad approach, the aim of this study was to determine various mental and somatic risk factors for development of insomnia and burnout and stratifying for sex and age group. Questionnaire data were used from a Swedish population-based sample aged 18–79 years, from which cohorts without insomnia (n = 1702) and without burnout (n = 1972) at baseline were followed-up after 3 years. Self-reports of eight mental and somatic conditions at baseline were used as independent variables in logistic regression analyses to predict development of insomnia and burnout at 3-year follow-up. All eight studied conditions were significant risk factors for development of both insomnia (odds ratio, OR = 1.62–2.73) and burnout (OR = 2.20–3.21). Burnout and poor self-rated health had the highest ORs for insomnia, and poor self-rated health, anxiety and somatic symptoms had the highest ORs for burnout. The ORs were generally similar between men and women, whereas age groups tended to differ in some of the risk factors. The study highlights the importance of a broad assessment of both mental and somatic conditions in the prevention of insomnia and burnout.     

Bringing to light the health needs of African-American men: the Overtown Men's Health Study

Background

The harsh intersections of racism and sexism in US society have contorted roles for African-American men and damaged their social ties, thereby contributing to excess morbidity and mortality in communities of color. The Overtown Men's Health Study is used here as a case study to examine the health needs of African-American men.

Methods

Men aged 18 years and older who resided in the neighborhood of Overtown within Miami, Florida, USA completed an in-person survey administered at 15 community sites: 3 housing complexes, 3 rooming houses, 3 commercial sites, 2 abandoned buildings, 1 large and 1 small public park, 1 union hall, and 1 community center.

Results

The vast majority of respondents (n = 129) were identified as Black/African-American (95.3%). Just 9.3% of the men surveyed were currently married, yet over half were fathers (59.7%). Nearly two-thirds (62.8%) of the men in Overtown reported drinking alcohol, and almost half (47.3%) reported smoking cigarettes. Only one of three (33.3%) Overtown men reported having a primary care physician or health practitioner, and only one of five (20.2%) had received dental care in the previous 12 months. A remarkable one of four (25.6%) Overtown men reported having been a victim of police violence, and nearly two-thirds (65.9%) reported having been incarcerated.

Conclusions

These findings are a call to action issuing from Overtown to other distressed neighborhoods of color within central cities through the USA. Urgent pursuit of measures for reducing social disparities in health for African-American men is ethically compulsory.     

Complementary and integrative health therapies in whole person resilience research

Complementary and integrative health approaches can improve health and well-being, as well as play an important role in disease prevention. The concept of whole person health builds on these concepts by empowering individuals, families, communities, and populations to improve their health in multiple interconnected domains: biological, behavioural, social, and environmental. Research on whole person health involves studies of interconnected biological systems and complex approaches to prevention and treatment. Some of these approaches may involve methods of diagnosis and therapy that differ from those used in conventional Western medicine. Of growing interest is how complementary, integrative, and whole person health approaches contribute to resilience. This brief commentary describes an integrated framework for mapping the connections between various complementary and integrative health therapeutic inputs onto aspects of resilience, including the ability to resist, recover (partially or fully), adapt, and/or grow in response to a following a stressor. The authors present selected examples of research studies supported by the National Institutes of Health that test whether complementary and integrative health approaches can promote some aspect of resilience. We conclude with a discussion of the challenges and opportunities in incorporating the study of resilience in complementary, integrative, and whole person health research.     

Men's health: impact on women, children and society

Men's health is often considered unimportant to the well-being of other demographic groups. However, men's health challenges may impact the health status of women and children profoundly, impairing family health, economics, and the stability of relationships. Society is adversely affected economically by preventable male illness and death through lost time from work, disability and diminished work productivity.Widowed women commonly experience financial hardship and increased death rates. Fathers’ age, alcohol/tobacco use, and military exposures are associated with specific birth defects in children. Infectious diseases such as human immunodeficiency virus (HIV), Herpes simplex virus (HSV), human papiloma virus (HPV) and Chlamydia among men are readily transmissible to women through sex, often with significant consequences for women and children.Males as a group are less likely to utilize preventive health care, less likely to have health insurance, and less likely to have seen a physician in the previous year than women. Studies show that many men do not respond to pain and illness by seeking health care. There is a pervasive lack of awareness concerning men's health issues. Men's work hours frequently eclipse the hours when health care is typically available. Depression in men is likely under-recognized significantly given a male suicide rate that is four times greater than that for women.Men's health is a vital but neglected component of community health. A tetrad approach is necessary to optimize public health outcomes, including children's health, women's health, men's health, and minority health as coequal partners. Addressing the health needs of males would very likely lead to overall improved health outcomes for communities and nations.     

Physical health complaints in combat-related post-traumatic stress disorder: A preliminary report

Research has detailed the psychosocial parameters of combat-related post-traumatic stress disorder (PTSD), but little information has been reported on it's physical health concomitants. Many aspects of the PTSD syndrome may interact to create chronic stress reactions that are related to the emergence of disease states. As part of an initial step in exploring the physical health risk associated with PTSD we examined self-reported health problems in two matched groups of treatment-seeking Vietnam combat veterans with and without PTSD. Overall, the PTSD group reported more current health problems, but no more physician diagnosed disorders than their non-PTSD cohort. Possible mechanisms responsible for the report of health complaints in PTSD are discussed.     

中国西部青海省农村妇女生殖健康需求的研究

目的　调查中国西部农村生殖健康现状 ,了解农村育龄妇女对生殖健康服务的需求 ,为制定有效的干预方案做准备。　方法　使用封闭式调查问卷 ,对青海省互助县农村 1 790名已婚育龄妇女进行调查。　结果　调查对象主要通过医生和计划生育服务人员的服务来获得生殖健康的知识 ( 3 8.8% ) ,通过婚前培训 ( 3 .8% )和学校教育( 1 .7% )获得的比例较低。 93 .65%的调查对象认同“生育一个孩子后放环 ,生育两个孩子后结扎”的避孕节育方法。但如果允许知情选择 ,44.7%选择放环 ,45.5%实行结扎。不知道避孕套有何作用者占 65.8% ,98.5%没有使用过避孕套。 58.5%的调查对象在怀孕期间没有产前检查 ,3 4.3 % 1 4次、0 .9%≥ 1 0次。 91 %的调查对象在家分娩。出现生殖道感染症状时 61 .9%的被调查者没有就诊 ,在就诊者中 79.5%的妇女认为症状未缓解。Logistic分析显示 :年纪越轻、受教育程度越高越重视孕产期保健。　 结论　该西部地区农村生殖健康现状较差 ,主要表现在 :生殖健康知识贫乏 ,通过婚前培训、学校教育来获得生殖健康知识的比例很小 ;男性避孕节育方法的宣传和使用以及孕产期保健、生殖道感染的诊断治疗严重不足。该地区农村育龄妇女对生殖健康服务的需求主要是 :加强婚前和学校生殖健康方面的教育 ,?     

Creating Musculoskeletal Programs for Culturally Diverse,Underserved Communities: a Community-Based Participatory Research Survey

Background

Arthritis and other musculoskeletal diseases are the most prevalent health conditions in the USA, causing enormous financial and social burdens, especially in underserved communities. Targeted care and prevention programs are urgently needed.

Questions/Purposes

Within an overall goal of revealing health disparities, the questionnaire explored (1) the use of and access to healthcare, (2) the factors affecting quality of life, and (3) the levels of provider–patient communication.

Methods

A New York City musculoskeletal hospital conducted a community health needs survey among its diverse ethnic/racial communities. A 39-item questionnaire was administered online, by mail, and in person (in English, Spanish, and Chinese). Answers were analyzed in terms of sociodemographics, to define health disparities within a total sample and two subsamples.

Results

In the total sample, respondents were 60% White, 16% Black, 14% Hispanic/Latino, and 11% Asian, mostly female, and aged 50 to 79. More than 17% of the total sample indicated they could not access a healthcare provider when needed. Poor nutrition and lack of physical activity were large areas of concern, as were falls and poor self-reported health status. Nearly all respondents said they took steps to communicate with their healthcare providers. Dramatic health disparities were found between Whites and non-Whites (e.g., non-Whites were most likely to rate their health poorly, consider their diet fair or poor, lack health insurance, and be unable to access a healthcare provider).

Conclusion

The findings are being used to further refine, develop, and expand the hospital’s community programs, especially for culturally diverse and underserved communities.

Electronic supplementary material

The online version of this article (doi:10.1007/s11420-014-9413-9) contains supplementary material, which is available to authorized users.     

健康营活动在糖尿病伴抑郁症患者中的应用

目的探讨健康营活动对糖尿病伴抑郁症患者心理状态、治疗效果的影响。方法将90例糖尿病伴抑郁症患者随机分为实验组和对照组各45例。实验组在常规治疗和护理基础上安排为期4周、每周3次的健康营活动，即郊外花卉园活动和专题健康教育讲座；对照组行常规治疗和护理。结果4周后实验组疾病相关知识知晓率，SDS、HAMD评分，空腹血糖和餐后2h血糖与对照组比较，差异有统计学意义（P〈0．05,P〈0．01）。结论健康营活动可提高患者疾病知识水平，有效改善糖尿病伴抑郁症患者的心理状态和糖代谢。     

Nocturia in relation to somatic health, mental health and pain in adult men and women

OBJECTIVE: To assess the relationship of nocturia to somatic health, mental health and bodily pain. SUBJECTS AND METHODS: A randomly selected group of men and women aged 20-64 years, living in three small municipalities in northern Sweden, or in the city of Ostersund or in Stockholm, were sent a postal questionnaire containing questions on somatic and mental health, satisfaction with life, pain, nocturnal voiding, work and sick-listing from work. RESULTS: Reports (from 1948 respondents) on poor somatic and mental health and on pain all increased in parallel with increasing frequency of nocturnal voids. In a multiple logistic regression analysis with sex, age, somatic health, mental health and bodily pain as the independent variables, significant independent correlates (odds ratios, confidence intervals) of nocturnal micturition (two or more episodes vs none or one) were: age 45-59 vs 20-44 years, 1.9 (1.3-2.7), > or =60 vs 20-44 years, 3.8 (2.4-6.0); somatic health, poor vs good, 2.3 (1.4-3.7); mental health, poor vs good, 1.9 (1.2-3.0); pain, rather mild vs very mild or none, 1.5 (1.0-2.3); rather severe vs very mild or none, 1.9 (1.1-3.2); and very severe vs very mild or none, 6.0 (2.5-14.0). Gender was deleted by the logistic model. Sick-listing for > or = 60 days during the past year was reported by 4.9%, 10.6%, 5.6% and 38.9% of the men with none, one, two or > or = three nocturnal voids, respectively, and by 10%, 12.4%, 23% and 46.7% (both P < 0.001) of the corresponding women, respectively. Life satisfaction decreased in parallel with increased nocturia. CONCLUSION: The impairment of both somatic and mental health was associated with increased nocturnal voiding. Pain was associated with a substantial increase in nocturia after adjusting for age and somatic and mental health. Sick-leave was more common in association with more nocturnal voids.