基于简易体能测试的健康教育对老年骨质疏松患者出院准备度及指导质量的影响研究

目的:探讨基于简易体能测试(SPPB)的健康教育对老年骨质疏松患者出院准备度及出院指导质量的影响。方法:选取骨质疏松症患者210例为研究对象,随机分为对照组和观察组各105例,对照组给予常规护理,观察组在此基础上进行运动锻炼、饮食、用药、疼痛、跌倒管理及随访,干预前后比较2组患者SPPB评分和干预后出院准备度量表(RHDS)及出院指导质量调查。结果:干预后,观察组SPPB各项评分及总分均高于干预前及对照组(均P<0.05);观察组RHDS量表4个维度及总分均较对照组明显提高(均P<0.05),且出院指导质量2个维度及总分均较对照组明显提高(均P<0.05)。结论:个性化的健康教育有利于改善老年骨质疏松患者的体能,也可提高患者的出院准备度和出院指导质量。     

Surgical patients’information needs on discharge: Are they being met?

Increasingly patients are being encouraged to participate more in their health care. Patients are being discharged earlier; therefore their need for information may potentially increase if they are to be involved in their care. This study explored the information that patients received prior to their discharge and, through follow-up interviews after their return home, investigated the usefulness of the information provided. Only 11 of a total 20 patients (55%) routinely received discharge information. This information was not solicited and its content was ad hoc . Nine patients (45%) did not routinely receive discharge information. If these patients needed information they had to ask for it. Despite the lack of comprehensive discharge information for the 20 surgical patients, the majority of patients (75%) did not access services after discharge. Only one of the five patients who did seek advice was in need of further medical intervention. The remaining four required further information so that they could be reassured. These findings emphasize the need for further research on the type and extent of information required by patients on their return home so that they can effectively participate in their recovery.     

Effect of hospital discharge plan for children with type 1 diabetes on discharge readiness,discharge education quality,and blood glucose control

BACKGROUNDType 1 diabetes is one of the most common chronic diseases in childhood. The number of type 1 diabetes patients in China still ranks fourth in the world. Therefore, children with type 1 diabetes in China are a group that needs attention. The management of type 1 diabetes mellitus (T1DM) involves many aspects of daily life. It is extremely challenging for children and their families. T1DM children have complex medical care needs. Despite the continuous development of therapeutic medicine and treatment technologies, blood glucose control in children with T1DM is still not ideal. They and their parents need to acquire more knowledge and skills before being discharged.AIMTo explore the influence of hospital discharge plan based on parental care needs of children with T1DM on discharge readiness, quality of discharge education and blood glucose control level.METHODSIn total, 102 parents of children with type 1 diabetes were divided into control group and intervention group according to admission time. Fifty cases from February to June 2019 were selected as the control group, and 52 cases from July to October 2019 were selected as the intervention group to implement the discharge plan. The Readiness for Hospital Discharge Scale, Hospital Discharged Education Quality Scale and children''s blood glucose metabolism indicators were used to compare the differences in discharge preparation, discharge education quality and blood glucose control between the two groups of children and their parents.RESULTSOn the day of discharge, the two groups of children had the following scores of readiness for discharge: The intervention group score was 225.34 ± 32.47, and the control group score was 208.68 ± 29.31. The P value was 0.007, and the difference was statistically significant. The discharge education quality scores were as follows: The intervention group score was 135.11 ± 19.86, the control group score was 124.13 ± 15.56, the P value was 0.002 and the difference was statistically significant. Three months after discharge, the blood glucose metabolism indicator showed that the glycosylated hemoglobin value of the two groups was (7.45% ± 1.04%), and that of the control group was (8.04% ± 1.27%), P = 0.012. Therefore, the improvement of parents'' readiness for discharge, quality of discharge education and blood glucose metabolism indicators (glycosylated hemoglobin, fasting blood glucose and postprandial blood glucose) in the intervention group were better than those in the control group (P < 0.05), and the difference was statistically significant.CONCLUSIONThe discharge plan for children with T1DM can help the children and their families realize the transition from hospital care to home self-management and improve the parents'' readiness for discharge, thereby improving children’s blood glucose control levels.     

农村初置管腹膜透析患者出院准备度的调查

目的 :调查农村初置管腹膜透析患者出院准备度现状及其影响因素。方法 :于2018年11月至2019年5月在郑州市某三级甲等综合医院肾脏内科,采用出院准备度量表、出院指导质量量表及社会支持评定量表对155名农村初置管腹膜透析患者于出院当天进行问卷调查。结果 :患者出院准备度条目均分为(6.33±0.85)分,处于中等偏下水平;相关性分析显示出院准备度与出院指导质量、社会支持均呈正相关;性别、年龄、文化程度、工作状况、合并症数量、血肌酐水平、出院指导质量及社会支持水平是出院准备度的影响因素(R2=0.842)。结论 :农村初置管腹膜透析患者出院准备度水平亟须提高。医护人员应对不同特征的农村初置管腹膜透析患者实施针对性健康教育,注重出院指导技巧及效果提升,努力为患者营造多元支持系统。     

腰椎间盘突出症患者出院准备度与疼痛程度的相关性分析

目的探讨腰椎间盘突出症患者出院准备度现状、疼痛程度及其相关性。方法对2019年3月—9月河南省某三甲医院收治的196例腰椎间盘突出症患者采用出院准备度量表(RHDS)和疼痛数字分级法(NRS)进行问卷调查,并用Pearson相关分析法进行分析。结果腰椎间盘突出症患者RHDS总分为(94.17±8.56)分,处于偏高水平,3个维度中得分最高的是个人状态,其次是预期性支持,最后是适应能力。腰椎间盘突出症患者入院时NRS评分为(6.10±0.30)分,为中度疼痛;出院前4 h NRS评分为(1.70±0.50)分,为轻度疼痛;出院前4 h患者疼痛评分明显降低,差异有统计学意义(t=1.892,P<0.05)。腰椎间盘突出症患者的RHDS总分及3个维度得分均与患者出院前4 h的NRS评分呈负相关(P<0.05)。结论腰椎间盘突出症患者出院准备度处于较高水平,出院前疼痛程度明显减轻处于较低水平,两者呈负相关。医护人员应积极关注腰椎间盘突出症患者的出院准备度,帮助其减轻疼痛,促进患者康复。     

肿瘤住院患者出院准备度现状及影响因素分析

目的：探讨肿瘤住院患者出院准备度现状及影响因素,为制定肿瘤住院患者出院指导计划提供依据。方法：采用一般资料调查表、出院准备度量表、出院指导质量量表对2020年6月至9月住院的274例初次手术、首次化疗和放疗的肿瘤住院患者进行调查。结果：肿瘤住院患者出院准备度总分为95.00(81.00,107.25)分,各维度得分由高到低依次为预期性支持、应对能力、个人状态;出院指导质量总分为208.50(180.50,226.00)分,各维度得分由高到低依次为护士健康指导技巧、患者须获得知识、患者实际获得知识;Spearman相关性分析显示出院准备度总分与出院指导质量总分呈正相关（r=0.436,P<0.01）;多元线性回归分析显示,疾病病种、家庭人均月收入、对疾病了解程度、治疗情况、住院次数、出院原因、出院指导质量是影响肿瘤住院患者出院准备度的主要因素。结论：肿瘤住院患者出院准备度有待提高,医护人员应借鉴国内外相关研究优势和相关理论,针对影响患者出现准备度的因素制定出满足患者需求的干预措施,确保患者获得高质量的出院指导,提高其生存质量。     

上海地区慢性病患者出院准备度现状及影响因素分析

目的调查上海市部分三级综合医院慢性病患者的出院准备度现状并探讨其影响因素,为提升慢性病患者出院准备度的干预性研究提供参考。方法 2018年8—10月,采用一般资料调查表、出院准备度量表及出院指导质量量表对上海市7所三级甲等综合医院的602例慢性病患者进行调查。结果 602例患者的出院准备度总均分为8.01±1.41,处于中高水平;出院准备度得分与出院指导质量呈正相关。多重线性回归分析结果显示,慢性病种类、住院天数、疾病知识知晓程度、有无其他慢性病或合并症、就医取药是否方便、感知自理能力下降、出院指导技巧及效果等是慢性病患者出院准备度的主要影响因素。结论医护人员应针对不同慢性病患者的特点进行合理评估,并结合患者需求给予个体化干预措施,以提升其出院准备度,改善出院后结局。     

骨髓炎患者出院准备度现状调查及影响因素分析

目的调查骨髓炎患者的出院准备度现状,并分析其影响因素。方法采用便利抽样的方法,选取2018年6—12月在四川大学华西医院骨科住院的120例骨髓炎患者,使用一般资料调查表中文版、出院准备度量表、出院指导质量量表、心理痛苦温度计评估患者出院准备度情况,分析出院指导质量、心理痛苦与出院准备度的相关性,采用多重线性回归分析出院准备度的影响因素。结果79.2%(95/120)的骨髓炎患者表示做好了出院准备;120例骨髓炎患者出院准备度总分为(144.66±35.50)分,条目均分为(6.58±1.61)分。多重线性回归分析结果显示,出院指导质量、病程、心理痛苦和是否合并有其他慢性疾病是脊髓炎患者出院准备度的主要影响因素(标准化回归系数分别为0.438、0.149、-0.229、0.198;P<0.05)。结论骨髓炎患者的出院准备度水平较低,急需改善。此外,针对出院指导质量不高、心理痛苦程度重、病程短以及合并有其他慢性疾病的患者应给予足够重视,并采取相应措施,以提高其出院准备度水平。