慢性乙型病毒性肝炎患者焦虑状况及影响因素

目的 了解慢性乙型病毒性肝炎(下称慢性乙肝)患者的焦虑状况及其影响因素,为实施针对性的心理护理提供依据.方法 应用自行设计的问卷及状态一特质焦虑量表对67例慢性乙肝患者进行调查.结果 慢性乙肝患者的状态焦虑和特质焦虑得分显著高于北京及长春地区的正常人(均P＜0.05);影响慢性乙肝患者状态焦虑的主要因素有年龄、职业、经济状况、文化程度(P＜0.05,P＜0.01),影响特质焦虑的主要因素有经济状况、婚姻状况和文化程度(P＜0.05,P＜0.01).结论 慢性乙肝患者焦虑水平较高,年龄、职业、经济状况、文化程度及婚姻状况是主要影响因素;护理人员应重视其人口学资料的收集及心理状况的评估,以实施针对性心理护理.     

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。     

老年良性前列腺增生患者生活质量及其影响因素分析

目的分析老年良性前列腺增生患者生活质量现状及其影响因素,以期为老年BPH患者进行有针对性的护理干预提供理论依据。方法采用整群抽样法,使用一般资料调查表、良性前列腺增生症患者生活质量量表和健康行为能力自评量表,对河南省11家三级综合医院住院的372名老年良性前列腺增生患者进行问卷调查。结果老年BPH患者生活质量的得分是(104.77±20.04)分,根据得分指标显示得分率是65.5%。年龄、文化程度、性生活次数、病程、婚姻状况、人均月收入和自我效能均是影响老年BPH患者生活质量的因素。结论老年BPH患者生活质量居中等水平,影响其生活质量的主要因素有年龄、文化程度、性生活次数、病程、婚姻状况、人均月收入及自我效能。     

慢性乙型病毒性肝炎患者焦虑状况及影响因素

目的了解慢性乙型病毒性肝炎（下称慢性乙肝）患者的焦虑状况及其影响因素，为实施针对性的心理护理提供依据。方法应用自行设计的问卷及状态一特质焦虑量表对67例慢性乙肝患者进行调查。结果慢性乙肝患者的状态焦虑和特质焦虑得分显著高于北京及长春地区的正常人（均P〈0．05）；影响慢性乙肝患者状态焦虑的主要因素有年龄、职业、经济状况、文化程度（P〈0．05，P〈0．01），影响特质焦虑的主要因素有经济状况、婚姻状况和文化程度（P〈0．05，P〈O．01）。结论慢性乙肝患者焦虑水平较高，年龄、职业、经济状况、文化程度及婚姻状况是主要影响因素；护理人员应重视其人口学资料的收集及心理状况的评估，以实施针对性心理护理。     

炎症性肠病患者对卫生保健服务期望水平的调查研究

目的了解炎症性肠病患者对卫生保健服务的期望水平,分析其影响因素。方法采用中文版炎症性肠病卫生保健质量问卷对303例炎症性肠病患者进行调查。结果炎症性肠病患者对卫生保健服务期望的平均得分为(7.79±0.97)分,其对医务人员职业素养和患方知情权利的期望水平较高,得分均8分。回归分析结果显示,性别、病种、病程、文化程度为影响期望的主要因素(P0.05,P0.01)。结论炎症性肠病患者对卫生保健服务的期望较高,尤其是对医务人员职业素养和患方知情权利。女性、溃疡性结肠炎患者对卫生保健服务的期望较高,病程较长的患者对医务人员的职业素养期望较高,文化程度较高的患者对医疗可及性的期望较高。     

稳定性冠心病患者健康素养对血循环重建决策冲突的影响

目的了解稳定性冠心病患者健康素养及血循环重建决策冲突现状,探讨健康素养对决策冲突的影响。方法对341例稳定性冠心病住院患者,采用慢性病患者健康素养量表及决策困境量表进行调查。结果稳定性冠心病患者健康素养总分为(90.97±17.18)分,191例(56.01%)健康素养充足;决策冲突得分为23.44(18.75,42.19)分,175例(51.32%)为决策有效。Logistic回归分析结果显示,年龄、文化程度、合并症数量及健康素养是稳定性冠心病患者决策冲突的主要影响因素(P0.05,P0.01)。结论稳定性冠心病患者的健康素养及血循环重建决策冲突水平有待改善,应采取措施提高患者的健康素养水平,以降低其决策冲突水平。     

肿瘤化疗患者心理韧性及其影响因素的研究

目的了解肿瘤化疗患者心理韧性状况并分析其影响因素,以期为肿瘤化疗患者的心理健康维护提供参考。方法选取2014年2~7月就诊于某三甲医院的200例肿瘤化疗患者,采用心理韧性量表、一般自我效能感量表、社会支持量表对患者进行问卷调查。结果肿瘤化疗患者心理韧性得分为(53.88±13.26)分;不同年龄、职业、婚姻状况、文化程度、家庭月收入、医疗费用支付形式及居住方式的患者心理韧性得分比较,差异有统计学意义(P0.05,P0.01)。文化程度、一般自我效能和社会支持对肿瘤化疗患者的心理韧性预测作用为40.90%。结论肿瘤化疗患者的心理韧性普遍较低,文化程度、一般自我效能感、社会支持是影响心理韧性的重要因素。护士需加强对肿瘤患者的心理行为干预,使患者保持良好的心理状态,使之积极配合治疗,以提高治疗效果。     

城市中老年人心理健康状况研究

目的了解城市中老年人心理健康状况,分析其影响因素,以探索维持和改善城市中老年人心理健康水平的有效策略。方法采用城市中老年人心理健康量表对山东省416名城市中老年人进行调查。结果城市中老年人心理健康问题得分均数较高的维度为强迫(24.80±6.70)、认知功能(23.01±8.14)、躯体化(19.72±7.36)。不同性别、年龄、职业、文化程度、婚姻状况、经济收入、医疗费用来源、接受健康教育频率与是否患慢性病中老年人的心理健康维度评分比较,差异有统计学意义(P0.05,P0.01)。结论城市中老年人心理健康主要问题为强迫、认知功能异常、躯体化;主要影响因素为性别、年龄、职业、文化程度、婚姻状况、经济收入、医疗费用来源、接受健康教育情况和慢性病等。中老年人要积极调整自身的心理状态,维持身心健康。     

育龄妇女避孕知识、态度、行为及影响因素的研究

目的了解育龄妇女的避孕知识、态度及行为状况,并分析其影响因素,为促进育龄妇女有效避孕提供依据。方法采用目的抽样方法对120例育龄妇女进行问卷调查。结果育龄妇女避孕知识得分为6.72±1.92,处于中等水平,获取避孕知识的前4位途径是报刊杂志(66.7%)、家人朋友(38.3%)、卫生保健人员(31.7%)和网络媒体(30.0%);育龄妇女避孕态度较积极,得分为21.97±2.91;其避孕行为得分为13.24±2.71,处于中等水平。育龄妇女的避孕知识和态度、避孕态度和行为、避孕知识和行为呈正相关(r分别为0.24、0.19、0.19,均P0.05);育龄妇女的避孕知识受其文化程度和性伴侣文化程度的影响(均P0.05);避孕态度受其年龄、文化程度、婚姻状况、职业、避孕工具的可及性的影响(P0.05,P0.01);而避孕行为受其年龄、婚姻状况、文化程度、性伴侣文化程度、流产次数及避孕工具的可及性的影响(P0.05,P0.01)。结论尚需通过多种途径促进育龄妇女对避孕知识的掌握,并充分调动性伴侣参与避孕的责任和意识,鼓励育龄妇女采取高效的避孕措施以提高避孕效果,减少意外妊娠和不必要的人工流产,促进妇女的身心健康。     

424例血液透析患者睡眠状况的人口学特征分析

目的：通过对424例血液透析患者睡眠状况的社会人口学特征分析,为临床治疗护理提供信息。方法：采用便利取样,使用匹兹堡睡眠质量指数量表及自设的一般情况调查表调查中山大学附属第一医院等7家医院424例维持性血液透析患者的人口学特征及睡眠状况。结果：有93.2%的患者PSQI总分≥5分,不同性别、婚姻状况的患者睡眠质量指数差异无统计学意义,而不同年龄、文化程度、经济收入及不同职业的患者得分差异有统计学意义。结论：血液透析患者睡眠质量指数得分比国外研究的水平高,不同的年龄、职业、文化程度、经济收入对患者的睡眠有一定的影响,应采取相应的措施。     

社区老年人用药安全认知、态度及自我效能调查分析

目的对社区老年人用药安全认知、态度及自我效能进行现况调查,为制定社区老年人用药安全健康教育干预提供参考。方法采用方便抽样,对泰安市某小区216名老年人实施问卷调查。结果调查对象用药安全认知、态度及自我效能得分率分别为56.00%、62.51%、61.91%。年龄、文化程度、参与用药安全讲座是老年人用药安全认知、态度及自我效能的影响因素(均P0.01)。结论社区老年人用药安全认知属于低等水平,用药安全态度及用药安全自我效能属于中等水平。年龄、文化程度、参与用药安全讲座为用药安全认知、态度及自我效能的预测因子,建议在后期制定健康教育干预方案时考虑到不同年龄和文化程度老年人的接受情况,给予针对性的健康教育指导。     

The Relationship Among Health Literacy, Health Knowledge, and Adherence to Treatment in Patients with Rheumatoid Arthritis

Background

Patients with poor health literacy often lack the knowledge needed to manage their treatment.

Objective

The aim of this cross-sectional study is to determine whether health literacy is a predictor of health knowledge and/or adherence to medication treatment in patients with rheumatoid arthritis.

Method

The study was completed in an urban, outpatient rheumatology setting. Health literacy was measured using the Test of Functional Health Literacy in Adults. The Arthritis Knowledge Questionnaire was modified to measure medication specific health knowledge, and the Morisky Medication Adherence scale was used to measure adherence. Researchers used regression analyses to determine if health literacy was a predicator of knowledge and/or adherence.

Results

Participants (N?=?125) had high mean health literacy scores. The average medication knowledge score was 0.73. Adherence to medication regimen was 0.84. Controlling for patient covariates, health literacy was positively associated with education, race, and age. In adjusted analyses, health literacy was a significant predictor of health knowledge but not adherence. Race, neighborhood income, and confidence with contacting provider about medications were predictors of adherence.

Conclusion

Study findings indicate that health literacy is independently associated with medication knowledge but not medication adherence in patients with rheumatoid arthritis. These results provide useful information for planning initiatives to support individuals with disease self-management.     

Investigation into factors that promote adherence to a mammography screening programme

The aim of the present research was to investigate the importance of different factors in promoting women's adherence to mammography screening programmes. The research was conducted during a mammography screening programme of the Emilia‐Romagna region addressed to all women aged 50–69 years. The programme was designed to maximize women's participation by increasing their knowledge of the benefits of breast screening (invitation letter and information campaign) and by reducing barriers (e.g. free test). The research was conducted on a sample of 200 women who adhered to the programme, 65 of whom never had a mammogram in the past, and on a sample of 95 women who did not adhere to the programme, 42 of whom never had a mammogram and 53 of whom had mammograms privately. A semi‐structured interview on demographic variables (e.g. age and marital status), an evaluation of mastery and self‐esteem and an evaluation of the influence of the different information channels used during the information campaign were asked to participants. Significant differences among groups were found as regards to age, marital status and education and as regards to objective and subjective vulnerability to breast cancer. Among the information channels, the invitation letter undersigned by the family physician had the most influence. Copyright © 2007 John Wiley & Sons, Ltd.     

Predictors of loud snoring in persons with spinal cord injury

BACKGROUND: Predictors of loud snoring were examined in a cohort of 197 persons with chronic spinal cord injury (SCI) recruited by advertisement and from a Veterans Affairs Medical Center SCI Service. METHODS: Data were collected on age, marital status, antispasticity medications, duration of injury, level and completeness of injury, stature, and weight. Body mass index (BMI) was calculated for all participants. A health questionnaire was used to collect data on snoring and respiratory history. Habitual snorers were defined as those who reported loud snoring more than 1 night per week. RESULTS: The mean age (+/- SD) was 51.2 +/- 14.8 years, and 84 of 197 (42.6%) were habitual snorers. The most obese research subjects, regardless of antispasticity medication use, were more likely to report snoring, but the risk of snoring was greatest among subjects who were obese and used antispasticity medication. Subjects who used antispasticity medication and had a BMI above the median (> or = 25.3 kg/m2) had a 7-fold risk of reporting snoring compared with subjects below the median who did not use antispasticity medication (P = .001). The greatest risk occurred in those who used diazepam alone or baclofen and diazepam together and had a BMI at or above the median. Subjects who used these medications and had a BMI below the median did not have a significantly increased risk. Neurological motor completeness, level of injury, age, and years since injury were not significant predictors of snoring. CONCLUSION: Because snoring is a marker for obstructive sleep apnea (OSA), the data suggest that in obese individuals with SCI, the use of antispasticity medications may be a risk factor for OSA.     

Pressure ulcers and acute risk factors in individuals with traumatic spinal fractures with or without spinal cord injuries: A prospective analysis of the National Spinal Column/Cord Injury Registry of Iran (NSCIR-IR) data

PurposeTo identify risk factors for developing pressure ulcers (PUs) in the acute care period of traumatic spinal fracture patients with or without spinal cord injuries (SCIs).MethodsData were collected prospectively in participating the National Spinal column/Cord Injury Registry of Iran (NSCIR-IR) from individuals with traumatic spinal fractures with or without SCIs, inclusive of the hospital stay from admission to discharge. Trained nursing staff examined the patients for the presence of PUs every 8 h during their hospital stay. The presence and grade of PUs were assessed according to the European Pressure Ulcer Advisory Panel classification. In addition to PU, following data were also extracted from the NSCIR-IR datasets during the period of 2015 – 2021: age, sex, Glasgow coma scale score at admission, having SCIs, marital status, surgery for a spinal fracture, American Spinal Injury Association impairment scale (AIS), urinary incontinence, level of education, admitted center, length of stay in the intensive care unit (ICU), hypertension, respiratory diseases, consumption of cigarettes, diabetes mellitus and length of stay in the hospital. Logistic regression models were used to estimate the unadjusted and adjusted odds ratio (OR) with 95% confidence intervals (CI).ResultsAltogether 2785 participants with traumatic spinal fractures were included. Among them, 87 (3.1%) developed PU during their hospital stay and 392 (14.1%) had SCIs. In the SCI population, 63 (16.1%) developed PU during hospital stay. Univariate logistic regression for the whole sample showed that marital status, having SCIs, urinary incontinence, level of education, treating center, number of days in the ICU, age, and Glasgow coma scale score were significant predictors for PUs. However, further analysis by multiple logistic regression only revealed the significant risk factors to be the treating center, marital status, having SCIs, and the number of days in the ICU. For the subgroup of individuals with SCIs, marital status, AIS, urinary incontinence, level of education, the treating center, the number of days in the ICU and the number of days in the hospital were significant predictors for PUs by univariate analysis. After adjustment in the multivariate model, the treating center, marital status (singles vs. marrieds, OR = 3.06, 95% CI: 1.55 – 6.03, p = 0.001), and number of days in the ICU (OR = 1.06, 95% CI: 1.04 – 1.09, p < 0.001) maintained significance.ConclusionsThese data confirm that individuals with traumatic spinal fractures and SCIs, especially single young patients who suffer from urinary incontinence, grades A-D by AIS, prolonged ICU stay, and more extended hospitalization are at increased risk for PUs; as a result strategies to minimize PU development need further refinement.     

A systematic review of caregivers' knowledge and related factors towards pressure ulcer prevention

This systematic review aimed to examine the knowledge of caregivers regarding pressure ulcer (PU) prevention. A thorough, methodical search was conducted from the earliest date to February 1, 2023 using keywords extracted from Medical Subject Headings such as “Caregivers”, “Knowledge”, and “Pressure ulcer” in various international electronic databases such as Scopus, PubMed, Web of Science, and Persian electronic databases such as Iranmedex and Scientific Information Database. The quality of the studies included in this systematic review was evaluated using an appraisal tool for cross-sectional studies (AXIS tool). In total, 927 caregivers participated in the eight studies. The average age of the participants was 40.50 (SD = 12.67). Among the participants, 61.87% were women. The average caregiver's knowledge of PU prevention was 53.70 (SD = 14.09) out of 100, which suggests a moderate level of knowledge. Factors such as level of education, age, occupation, information about PUs, attitude, and practice had a significant positive relationship with caregivers' knowledge related to the prevention of PUs. Knowledge had a significantly negative relationship with age. In addition, marital status, type of relationship, age, gender, occupation, level of education, and inpatient wards had a significant relationship with caregivers' knowledge regarding PUs prevention. Therefore, managers and policymakers in the medical field can help increase caregivers' knowledge by providing an online or in-person educational platform relevant to PU prevention.     

Medication understanding,non‐adherence,and clinical outcomes among adult kidney transplant recipients

We sought to evaluate the prevalence of medication understanding and non‐adherence of entire drug regimens among kidney transplantation (KT) recipients and to examine associations of these exposures with clinical outcomes. Structured, in‐person interviews were conducted with 99 adult KT recipients between 2011 and 2012 at two transplant centers in Chicago, IL; and Atlanta, GA. Nearly, one‐quarter (24%) of participants had limited literacy as measured by the Rapid Estimate of Adult Literacy in Medicine test; patients took a mean of 10 (SD=4) medications and 32% had a medication change within the last month. On average, patients knew what 91% of their medications were for (self‐report) and demonstrated proper dosing (via observed demonstration) for 83% of medications. Overall, 35% were non‐adherent based on either self‐report or tacrolimus level. In multivariable analyses, fewer months since transplant and limited literacy were associated with non‐adherence (all P<.05). Patients with minority race, a higher number of medications, and mild cognitive impairment had significantly lower treatment knowledge scores. Non‐white race and lower income were associated with higher rates of hospitalization within a year following the interview. The identification of factors that predispose KT recipients to medication misunderstanding, non‐adherence, and hospitalization could help target appropriate self‐care interventions.     

Canadian survey of postsurgical pain and pain medication experiences

PURPOSE: To assess the postoperative pain and pain medication experiences of Canadians. METHODS: Three hundred and five general population subjects from across Canada who had surgery in the previous three years were retrospectively questioned regarding pain experiences in the surgical facility and at home, pain medication efficacy and pain medication satisfaction. RESULTS: While in the surgical facility, pain was experienced by 68% of patients who expected overnight admission ("inpatients") and 49% of patients who expected same-day discharge ("outpatients"). Overall, 47% of inpatients and 15% of outpatients reported that their highest experience of pain was severe or extreme; 25% of inpatients and 9% of outpatients reported that their average pain was severe or extreme. In the two weeks post-discharge, 79% and 74% respectively of inpatients and outpatients experienced pain. Severe or extreme pain occurred at home in 25% of inpatients and 28% of outpatients; average pain was severe or extreme for 9% of inpatients and 12% of outpatients. Complete or a lot of pain relief was experienced by 54% to 72% patients who received pain medication; higher rates of pain medication satisfaction were reported than rates of pain relief from pain medication. CONCLUSION: Severe or extreme pain was experienced by many surgical patients. Improvements could be made to patients' postsurgical pain experience in Canada, both in the surgical facility and subsequent to discharge.     

Demographic,medical, and psychiatric factors in work and marital status after mild head injury

OBJECTIVE: To explore factors associated with long-term outcomes of work and marital status in individuals who had experienced a mild head injury (MHI), as well as those who had not. DESIGN: Population-based study using logistical regression analyses to investigate the impact of preinjury characteristics on work and marital status. PARTICIPANTS: Two groups of Vietnam-era Army veterans: 626 who had experienced a MHI an average of 8 years before examination, and 3,896 who had not. MAIN OUTCOME MEASURES: Demographic characteristics, concurrent medical conditions, early life psychiatric problems, loss of consciousness (LOC), and interactions among these variables were used to predict current work and marital status. RESULTS: Multiple variables were associated with work and marital status in the sample with MHI, accounting for approximately 23% and 17% of the variance in these two outcome variables, respectively. In contrast, the same factors accounted for significantly less variance in outcome in the sample without a head injury-13.3% and 9.4% for work and marital status, respectively. CONCLUSIONS: These findings suggest a more potent role for and increased vulnerability to the influence of demographic, medical, and psychiatric factors on outcomes after a MHI. That is, MHI itself moderates the influence of preinjury characteristics on work and marital status. In addition, in those who had a MHI, moderator relationships were found between education and LOC for both work and marital status. Similarly, complex moderator relationships among race, region of residence, and LOC were found for both work and marital status outcomes.