目的 探讨婚恋家庭取向心理干预对系统性红斑狼疮患者家庭功能和幸福感指数的效果。方法 将2012年6月1日—2014年5月31日就诊于东莞康华医院内分泌及风湿免疫中心的62名15~58岁的系统性红斑狼疮患者作为研究对象,根据随机化原则将其分成两组,其中30名为干预组,参加本研究设计的婚恋家庭取向的心理干预,余32名为对照组,采用家庭功能评定量表、幸福指数量表及狼疮活动指数量表,对两组进行干预前、干预后、干预后3月和干预后6月作问卷调查。采用重复测量的方差分析进行评估。结果 家庭功能中的问题解决、情感反应、情感介入、总的功能分量表和总分两组干预后重复测量的方差分析两两比较均有统计学差异(P<0.05)。幸福感指数总分两组重复测量的方差分析无统计学意义,但如扩大置信空间至P<0.1,则两组重复测量的方差分析两两比较中干预后3月及6月有一定统计学意义(P=0.08<0.1)。结论 本研究中婚恋家庭取向的心理干预对SLE患者即家庭功能中问题解决、情感反应、情感介入、总的功能及家庭功能总分均有显著的改善作用,对幸福感指数总分则有一定的增进作用,而对已通过心身疾病方式表达了的SLEDAI没有干预作用。

Objective To explore the effect of marital family-based psychological intervention in SLE patients on family assessment device FAD and index of well-being. Methods A total of 62 SLE patients, aged between 15 and 58, who were treated in out-patient of endocrine immune rheumatism center of Dongguan Kanghua hospital from June 1,2012 to May 31,2014. The experimental group was made up of 30 patients who, at random, volunteered to participate in an added marital family-based psychological intervention and the control group was composed of rest 32 cases. At the time of pre-intervention,post-intervention,3 months and 6 months after intervention, both groups were investigated with questionnaires of family assessment device, index of well-being, index of general affect, and systemic lupus erythematosus disease activity index. The results were analyzed with repeated measure variance analysis to explore the effect. Results There were significant multiple-comparison differences by repeated measure variance analysis in the score of FAD's total and sub-scale problem solving, affective responsiveness, affective involvement, general functioning(P<0.05) between experimental and control group after intervention. There were no significant repeated measure variance analysis differences in the score of index of well-being' total, but if enlarging confidence space to P<0.1, there were partial multiple-comparison differences between experimental and control group at the time of 3 months and 6 months after intervention(P=0.08<0.1). Conclusion Marital family-based psychological intervention may significantly improve FAD's problem solving, affective responsiveness, affective involvement, general functioning, and sum of FAD, and partially improve index of well-being, but can not improve SLEDAI which had developed by psychosomatic disease.

目的 通过研究4CH8的健康管理模式对社区更年期女性冠心病危险因素的干预效果,为制定慢病防控对策提供依据。方法 选择我社区,具有完整个人档案的更年期女性400例,经三甲医院确诊为冠心病患者为对照组134例,未患冠心病的266例为干预组,并进行危险因素分析。对未患冠心病的更年期女性进行4CH8健康管理模式干预,随访1年后对冠心病的危险因素进行前后对比分析。结果 对照组与干预组的BMI、高血压、糖尿病、低密度脂蛋白、高密度脂蛋白及空腹血糖相比较,差异有统计学意义(P<0.05)。年龄、尿酸及糖尿病两组相比较,差异无统计学意义。冠心病的危险因素与BMI、高血压、糖尿病、冠心病、低密度脂蛋白水平及空腹血糖呈正相关,与高密度脂蛋白呈负相关。干预组干预一年后BMI、高血压、低密度脂蛋白及空腹血糖水平与干预前相比较,差异有统计学意义(P<0.05),干预前各指标异常人数比干预后少。结论 4CH8模式对社区更年期女性冠心病危险因素管理效果较好,值得推广应用。

目的 探讨心理健康干预对复治肺结核患者在整个治疗过程中生活质量影响,为加强结核病的宣教奠定坚实的基础。方法 选取广州市结核病防治所在治的复治肺结核病人72例,随机分成宣教组和普通组,选取2名有丰富经验的主管护师,经专业心理师培训指导,护长考核,负责宣教组的工作,而普通组则由轮班护士进行,无作特别要求。对比两组心理健康干预前后的变化。结果 两组症状自评量表(SCL-90)测评相比较,宣教组优于普通组,差异有统计学意义(P<0.05)。宣教组的生理健康总评及精神健康总评比对照组好,差异均有统计学意义(P<0.05)。结论 通过对门诊复治结核病患者进行心理健康干预,能有效改变复治病人的心理和生理健康,提高生活质量。

目的 观察健康促进诊疗管理模式对社区慢性病的干预效果。方法 选取社区的慢性病患者268例,对他们实施慢性病健康促进诊疗管理,主要的方向有健康干预、诊疗管理、随访管理等。结果 干预后患者的体质指数、血压、血糖、血脂的达标率、健康知识、用药依从率等都比干预前有所提升。组间比较差异具有统计学意义(P＜0.05)。干预治疗后患者的满意度为87.3%,治疗有效率为85.8%,显著高于干预治疗前的70.1%和59.0%。结论 对社区慢性病患者采取健康促进诊疗管理模式进行干预,能够提高社区慢性病的综合防治效果,对提高患者的生活质量具有一定的促进作用。

目的 探讨早期干预对早产儿运动水平及技能的影响。方法 2013年3月—2014年3月在惠州市出生的283例有早产背景的高危儿,按照家长意愿分为两组,早产儿干预组143例及早产儿对照组140例。选择同时期出生的145例正常足月新生儿作为正常对照组。早产儿干预组根据评估结果制定干预训练方案,并按照评估—干预—评估的模式调整干预方案,早产儿对照组和正常对照组按健康检查的顺序进行体检并给予相关指导。在月龄3、6、9、12、18月时对三组婴儿行AIMS评估和神经系统相关检查。结果 早产儿干预组的运动发育水平明显高于早产儿对照组(P<0.01),神经系统异常率低于早产儿对照组(P<0.01),而早产儿干预组的神经系统异常率高于正常对照组(P<0.05)。但运动发育水平与正常对照组相比差异无统计学意义(P>0.05)。结论 早期干预能提升早产儿运动发育水平,改善运动技能,减少神经系统异常发生率,提高早产儿生存质量。

目的 探讨自我效能干预对于手术室护士的压力能够起到的调节效果。方法 通过对66名手术室护士的压力来源进行总结,并根据压力来源渠道分别进行自我效能护理干预一个月,并进行自我效能感以及工作倦怠方面对比评定,应用自我效能量表(USES量表)、工作倦怠量表( MBI量表)进行测算,将结果进行归纳总结。结果 经过自我效能护理干预的手术室护士的自我效能感评分显著提高,经过自我效能护理干预的手术室护士的MBI量表评分显著提高,干预前:手术室护士自我效能感以非常低的为主,占54.55%;干预后以非常高的为主,所占比例为48.48%;经过自我效能护理干预的手术室护士的MBI量表评分显著提高,干预前主要以中重度的工作倦怠护士为主,重度43例、中度21例;干预后主要以轻度和无倦怠的护士为主(P＜0.05)。结论 通过自我效能护理干预可以显著提高手术室护士的自我效能感、减少工作倦怠情绪,提高工作效率。

目的 研究并探讨产前优生筛查对出生缺陷的干预作用。方法 于2013年1月—2015年12月,选取69 183例孕产妇的临床资料进行回顾性研究,胎儿总数为69 262例,所有孕产妇在妊娠期均进行产前优生筛查,对产前筛查结果进行分析,统计胎儿异常例数,采取相应的产前干预措施,并对未检出胎儿异常的孕产妇进行跟踪随访,观察其妊娠结局,统计出生缺陷儿娩出例数及产前筛查漏检率。结果 69 262例胎儿中,共有7 470例胎儿检出异常,其胎儿异常率为10.79%,其中2013年检出1 910例,2014年检出2 569例,2015年检出2 991例,其检出率分别为9.15%、10.70%、12.17%,最终经产前诊断检查确定为出生缺陷的胎儿共98例,均采用引产术以终止妊娠。对未检出异常的61 792例胎儿进行跟踪随访后发现,其中17例胎儿在孕期流产,有9例出生缺陷儿娩出,其出生缺陷发生率为0.1 457‰,其产前筛查漏检率为0.1 456‰。结论 在产前对孕产妇进行产前优生筛查,并根据产前筛查结果进行相应的干预,可有效检出异常胎儿,及时终止异常妊娠,有利于减少缺陷儿的出生,促进优生优育。

Objective To study and discuss intervention effects of prenatal eugenic screening in birth defects. Methods From January 2013 to December 2015, we did retrospective study on the clinical data of 69 183 cases of pregnant in which there were 69 262 fetal cases, made prenatal eugenic screening for all pregnant women. Prenatal screening results were analyzed, fetal abnormal cases were calculated. We took appropriate prenatal intervention measures, and followed up pregnant women who had no detection of fetal abnormal. We observed the pregnancy outcome, and calculated the defected childbirth cases and prenatal screening miss rates. Results 69 262 cases of fetus, a total of 7 470 cases of fetal abnormalities were detected. The fetal abnormality rate was 10.79%, of which 1 910 cases were in 2013, 2 569 cases in 2014, 2 991 cases in 2015. The detection rates respectively were 9.15%, 10.70%, 12.17%. 98 cases were determined as fetal birth defects by the final prenatal diagnosis examination, in which all adopted induction of labor to terminate pregnancy. 61 792 cases who were not detected anomalies were followed up in which 17 cases of fetus were found and had abortion during pregnancy, and 9 cases of fetal birth defects were delivered . The incidence of birth defects was 0.1 457 ‰, the prenatal screening miss rate was 0.1 456 ‰. Conclusion Pregnant women were made prenatal eugenic screening and according to the result of prenatal screening we took corresponding intervention, which is effective detect abnormal fetus. We may have timely termination of abnormal pregnancy,and reduce birth defects. It may promote human eugenics.

目的 调查分析病案首页疾病诊断存在的问题,以提出针对性的干预对策。方法 由病案科编码员根据《卫生部关于修订下发住院病案首页的通知》相关规定,对抽取的4200份病案首页的疾病诊断进行检查,对疾病诊断问题分类记录,同时对其发生原因进行问卷调查,建立相应数据库,应用Excel统计工具进行统计分析。结果 共748份的疾病诊断存在问题,发生率高达17.8%,包括疾病诊断中主要诊断选择错误8.3%、疾病诊断的名称不规范7.6%,以及漏诊问题1.8%。疾病诊断存在问题发生率较高的临床科室为内分泌科38.0%,骨科科32.8%,肿瘤科31.6%。在读研究生最容易出现疾病诊断问题,发生率高达48.0%。结论 对疾病诊断存在问题的高发临床医师群体和临床科室进行针对性干预对策,有望降低病案首页疾病诊断问题的发生率。

Objective To investigate the defects analysis and targeted intervention on the diseases diagnosis in the home pages of medical records. Methods To conduct an inspection analysis on the four thousand and two hundred medical records according to the related requirements of “Notification on Standard writing in Home Pages of Hospitalization Medical Records announced by the Ministry of Health” by professional medical records staff.They found out and classified the defects on the diseases diagnosis in the home pages of medical records,at the same time,questionnaire survey were carried on to investigate the related causes,and the corresponding database establish ed.Excel statistical tools were applied for statistical analysis. Results There were defects on the diseases diagnosis in a total of seven hundred and forty-eight cases,the incidence of which was 17.8%,including 8.3% of mistakes of main diagnosis,7.6% of lack of standardization in diagnosis names,1.8% of missed diagnosis respectively.Defects on the diseases diagnosis occurred in a higher rate in the clinical departments,such as department of endocrine with 38.0%,department of orthopedics with 32.8%,and department of oncology with 31.6%.Graduate students most prone to make mistakes with defects on the diseases diagnosis,the incidence of which was 48.0%. Conclusion Targeted interventions to clinician groups and clinical departments with high incidence of defects on the diseases diagnosis,is expected to reduce the incidence of which in the home pages of medical records.

目的 研究低视力儿童“学校-社区-家庭”三位一体综合康复干预工作的具体效果。方法 2013年1月,选择广州市盲人学校新入学80名低视力儿童,随机分为两组,为期二年的跟踪研究。其中A组执行“学校-社区-家庭”三位一体综合康复干预,B组执行传统康复干预。就知识积累、心理健康、生活能力三个方面对两组儿童的具体数据收集,研究“学校-社区-家庭”三位一体综合康复干预与传统干预方式之间的区别。结果 A组低视力儿童较B组儿童的文化知识积累与生活能力训练成绩均有提高,两者差距在正常分布带内,A组低视力儿童的心理素质优于B组低视力儿童。A组低视力儿童的综合评价效果高于B组儿童。结论 低视力儿童“学校-社区-家庭”三位一体综合康复干预工作的具体效果优于传统康复干预方式。

目的 探讨综合中医护理措施在无痛人工流产术后调复中的效果。方法 将100例无痛人流病人随机分为观察组和对照组各50例,对照组手术前后予常规护理。观察组在对照组的基础上,采取综合中医护理措施。结果 观察组术后阴道出血量、出血时间、腹痛持续时间等少于对照组,月经按时复潮率高于对照组(P<0.05)。结论 综合中医护理干预对无痛人工流产病人具有良好的调复作用,可以有效地提高患者术后舒适度,促进患者早日康复,值得临床推广应用。