华生关怀理论联合缓和医疗理念照护服务在老年胃镜检查并发心律失常患者中的应用

目的 探究华生关怀理论联合缓和医疗理念照护服务在老年胃镜检查并发心律失常患者中的应用价值。方法 选取2020年6月—2023年6月厦门大学附属第一医院杏林分院收治的81例老年胃镜检查患者,采用随机信封法将患者分为对照组(40例)和观察组(41例)。对照组采用常规护理,观察组采用华生关怀理论联合缓和医疗理念照护服务,比较2组患者心律失常发生情况、生命体征和心功能。结果 观察组心律失常发生率为2.44%,相较于对照组的15.00%更低(P<0.05);干预前,2组患者的舒张压、收缩压、心率、血氧饱和度比较,差异无统计学意义(P>0.05);检查时,观察组舒张压、收缩压、心率均低于对照组(P<0.05);检查时,观察组血氧饱和度高于对照组(P<0.05);干预前,2组患者的左心室收缩末期内径(left ventricular end systolic diameter,LVESD)、左心室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、肌酸激酶(creatine kinase,CK)、左心室射血分数(left ventricular ejection fraction,LVEF)比较,差异无统计学意义(P>0.05);检查时,观察组LVESD、LVEDD、CK低于对照组(P<0.05);检查时,观察组LVEF高于对照组(P<0.05)。结论 华生关怀理论联合缓和医疗理念照护服务对于老年胃镜检查患者而言,能降低患者心律失常发生率,维持患者稳定的生命体征和心功能,提高老年胃镜检查患者的安全,适合推广使用。

利益相关者视角下放化疗宫颈癌患者病痛体验的质性研究

目的基于利益相关者理论探讨放化疗宫颈癌患者的病痛体验。方法采用描述性现象学研究方法对15例宫颈癌放化疗患者以及12名妇科肿瘤科医护人员进行叙事访谈以及半结构式访谈,运用Colaizzi七步分析法分析资料。结果提炼出3个主题及10个亚主题:身体完整性遭破坏(消化系统损伤、泌尿生殖系统改变、皮肤改变),身份序列被打乱(社会角色转变、家庭角色调整、自我认同危机),新的康复断裂与冲击(医疗照护服务断裂、饮食习惯改变、社会再融入障碍、癌症复发恐惧)。结论放化疗宫颈癌患者病痛体验复杂多样,医护人员应及时评估患者病情和感受,制定针对性的干预措施,缓解患者身心痛苦。

Quality indicators for the care of older adults with disabilities in longterm care facilities based on Maslow’s hierarchy of needs

Purpose:This study aimed to develop quality indicators for the care of older adults with disabilities in long-term care facilities(LTCFs)based on Maslow’s hierarchy of needs.Methods:The draft of the quality indicators was drawn up based on a literature review and research group discussion.The quality indicators were finalized by two rounds of expert consultation(involving 15 experts)using the Delphi method.The Analytic Hierarchy Process was applied to calculate the indicators’weight.Results:The response rates of the two rounds of consultation were 100%and 93%,and the expert authority coefficients were 0.86 and 0.87.After two rounds of consultation,the expert opinion coordination coefficients of the first-,second-and third-level indicators were 0.42,0.25,and 0.96,respectively(P<0.05),and the variation coefficient was0.25.The final quality indicators for the care of older adults with disabilities in LTCFs included 7 first-level,19 second-level,and 107 third-level indicators.Conclusion:The quality indicators for the care of older adults with disabilities in LTCFs are reliable,scientific,comprehensive,and practical and specify the content of person-centered care needs.This can provide a reference for evaluating and improving care quality in LTCFs.