Compliance of a Small Convenience Sample and Efficacy of Short Term Modified Carbohydrate Diet on Weight Loss in Overweight College Students: A Pilot Study

The purpose of this pilot study was to determine overweight students’ compliance on low and moderate carbohydrate diets and its influence on weight loss. The 28 day study was divided into two experimental periods of 14 days each. For the first 14 days, Group 1 (n = 6) received LC diet (30 grams carbohydrate/day with ad libitum intake of protein and fat), and group 2 (n = 8) received MC diet (60 grams carbohydrate/day with ad libitum intake of protein and fat). After 14 days, there was a crossover of the diets. Two random 24-hour diet records, urinary ketones, and daily emotional and physical well-being journals evaluated participants’ dietary compliance. Height, weight, body mass index, and urine ketones were assessed at baseline, days 14 and 28. A 2 × 2 ANOVA was conducted to examine the difference between groups and to determine if a difference existed from baseline to the end of the diet period. During the study period, ir- respective of carbohydrate levels, a vast majority of participants had above or below the recommended intake of carbo- hydrates, indicating non-compliance due to various reasons. During each experimental period, although weight loss differences between groups over time did not exist, there was a significant weight loss within subjects over time (p < 0.01). Presence of urinary ketones during the dietary interventions were not statistically significant. In conclusion, mod-ified carbohydrate diets were effective with weight loss;however participants were non-compliant with their de- fined dietary protocols.

Dietary compliance in celiac disease

Celiac disease is an immune-mediated disorder that causes severe architectural disturbance in the small intestinal mucosa of genetically-predisposed individuals.Impaired absorption of multiple nutrients results and diarrhea and weight loss develop.Evidence has accumulated that a strict gluten-free diet can result in resolution of diarrhea,weight gain and normalization of nutrient malabsorption.In addition,histopathological changes also normalize,but this histopathological res-ponse appears to be time-dependent,sex-dependent and age-dependent.Compliance to a gluten-free diet is difficult and costly resulting in poor compliance and only a limited clinical response.This poses a risk for later long-term complications,including malignancy.A major practical clinical problem is the assessment of compliance to the gluten-free diet.Although symptoms may resolve and serological antibody markers may improve,multiple studies have documented ongoing architectural disturbance and inflammatory change,and with these continued inflammatory changes,a persistent risk for long-term complications.Recent immunological studies have suggested that peptides can be detected in both urine and fecal specimens that may be indicative of limited compliance.At the same time,multiple biopsy studies have demonstrated that complete normalization of the mucosa may occur in some patients within 6 mo of initiation of a gluten-free diet,but more often,up to 2 years or more may be required before repeated biopsies eventually show mucosal recovery and mucosal healing.

Influence of transitional nursing on the compliance behavior and disease knowledge of children with purpura nephritis

BACKGROUND Purpura nephritis,also called Henoch-Schönlein purpura nephritis,is a systemic disease with small dead vasculitis as the main pathological change.AIM To observe the influence of transitional nursing activities on the compliance behaviors and disease knowledge of children with purpura nephritis.METHODS A total of 82 children with purpura nephritis were included and divided into a general nursing group(41 children)and transitional nursing group(41 children)using the envelope method.The general nursing group received routine nursing care,while the transitional nursing group received transitional nursing care.The behaviors,knowledge of the disease,and self-management ability of the two groups were evaluated after nursing care was provided.RESULTS The scores of four items(self-care ability,self-responsibility,health knowledge level,and self-concept)in the transitional nursing group were significantly higher than those in the general nursing group.CONCLUSION Transitional nursing can directly improve the disease knowledge level and selfmanagement ability of children with purpura nephritis and effectively reduce complications.

Self-Management of Type 2 Diabetes in Middle-Aged Population of Pakistan and Saudi Arabia

This research protocol design is aimed at exploring the qualitative health research in self-management of Type 2 diabetes and patient’s perceptions and experiences of undertaking physical activity and eating behaviour as part of their diabetes self-management. In addition, the study would analyze how the health issue related to diabetes is viewed and addressed in the community (Pakistan and Saudi Arabia) and would use the concepts of socio-ecological approach to self-management of Type 2 diabetes and explore the factors affecting the self-management practices in these countries. The other objective of this protocol is to examine the role of physical inactivity and obesity in the development of Type 2 diabetes and its self-management in middle-aged population living in rural area of Pakistan and to evaluate a lifestyle intervention (Physical Activity and Diet) in the management of Type 2 diabetes. The brief review conducted in this protocol design will identify the potential areas of health care which need attention including the overall functioning of community healthcare clinics to diabetes care in terms of recognizing the symptoms of diabetes to early detection and diagnosis, easy access to community doctors. This review will impress upon the need to recognize that in developing strategies and interventions to address diabetes, self-care, family support, community education and community ownership are important and it will be demonstrated by the comparison of two culturally diversified populations of Pakistan and Saudi Arabia in relation to the self-management of Type 2 diabetes.

高频浸润式控钾饮食教育对维持性血液透析患者血钾管理的效果研究

目的本研究旨在探讨高频浸润式饮食教育对维持性血液透析(maintenance hemodialysis,MHD)患者血钾管理的效果。方法通过便利抽样选取2023年1月至2023年8月于湖州市某三级甲等医院血液透析中心进行治疗的64例MHD高钾血症患者为研究对象,按照透析时间,将其分为对照组和观察组,各32例。对照组接受常规饮食教育,观察组在此基础上增加高频浸润式饮食教育,比较两组患者干预1个月后高血钾发生率和患者满意度,以及干预前后患者血钾知识掌握度、饮食行为依从性情况。结果干预后,观察组的高血钾发生率显著低于对照组(P<0.05)。与对照组相比,观察组患者满意度更高,且差异具有统计学意义(P<0.05)。观察组饮食行为依从性量表得分为(85.66±5.34)分,显著高于对照组(74.91±5.41)分(P<0.05)。观察组血钾知识掌握度得分为(9.47±0.72)分,明显高于对照组(8.47±1.19)分,两组比较,差异具有统计学意义(P<0.05)。结论高频浸润式控钾饮食教育能够有效帮助MHD患者减少高钾食物的摄入,并有助于更好地维持血钾水平,同时提升患者对饮食教育的满意度、饮食行为依从性。其临床价值显著,值得在实践中进一步推广和应用。

Ehealth monitoring in irritable bowel syndrome patients treated with low fermentable oligo-, di-, mono-saccharides and polyols diet

In the present study we report on changes in irritable bowel syndrome-severity scoring system (IBS-SSS) and irritable bowel syndrome-quality of life (IBS-QoL) in 19 IBS patients, aged 18 to 74 years (F/M: 14/5), during 12 wk registering their symptoms on the web-application (www.ibs.constant-care.dk). During a control period of the first 6-wk patients were asked to register their IBS-SSS and IBS-QoL on the web-application weekly without receiving any intervention. Thereafter, low fermentable oligo-, di-, mono-saccharides and polyols (FODMAP) diet (LFD) was introduced for the next 6 wk while continuing the registration. Though a small sample size a significant improvement in disease activity (IBS-SSS) was observed during both the control period, median: 278 (range: 122-377), P = 0.02, and subsequently during the LFD period, median: 151 (range: 29-334), P &#x0003c; 0.01. The IBS-QoL solely changed significantly during the LFD period, median: 67 (37-120), P &#x0003c; 0.01. The significant reduction in disease activity during the control period shows a positive effect of the web-application on IBS symptoms when presented as a &#x0201c;traffic light&#x0201d;. However adding the diet reduced IBS-SSS to &#x0003c; 150, inactive to mild symptoms. In the future results from larger scale trials are awaited.

Applying Snyder’s Hope Theory to Enhance Self-Management in Diabetic Patients

Objective: To explore the application effect of self-management based on Snyder’s hope theory in diabetic patients. Methods: A total of 260 patients with diabetes from a community were selected through convenient sampling and randomly divided into an experimental group and a control group using the random number table method, with 130 cases in each group. Five cases were lost in the experimental group, resulting in 125 effective cases, while all 130 cases in the control group were effective. The control group received standard lectures on diabetes self-management behavior and traditional approaches, such as the distribution of educational manuals. The experimental group underwent a self-management behavior intervention program for diabetic patients based on Snyder’s hope theory model, encompassing three components: goals, pathways, and motivational thinking. The levels of hope and self-management behavior were compared between the two groups. Results: After the intervention, the scores for hope levels and self-management behaviors in both groups were significantly higher than those recorded before the intervention (P < 0.05). Furthermore, the hope level and self-management behavior scores of the experimental group were significantly higher than those of the control group (P < 0.05). Conclusion: The application of Snyder’s hope theory model in diabetic patients demonstrates significant benefits, improving patients’ hope levels and, consequently, enhancing their self-management behaviors.

门冬胰岛素结合个体化饮食及运动指导控制GDM血糖效果

目的:观察门冬胰岛素结合个体化饮食及运动指导控制妊娠期糖尿病(GDM)孕妇血糖效果。方法:纳入2020年1月-2023年3月本院收治的GDM孕妇101例,随机数字表法分为观察组(50例)与对照组(51例),对照组采取常规胰岛素治疗,观察组采取门冬胰岛素结合个体化饮食及运动指导控制血糖,观察治疗前及治疗3个月后孕妇空腹血糖(FBG)及餐后2h血糖(2hPBC)、糖化血红蛋白(HbAlc)等血糖指标,空腹胰岛素(FINS)及稳态模型胰岛β细胞功能指数(HOMA-β)、稳态模型胰岛素抵抗指数(HOMA-IR)等胰岛功能指标,超氧化物歧化酶(SOD)与活性氧(ROS)水平、谷胱甘肽过氧化物酶(GSH-Px)等氧化应激指标变化,治疗依从性及治疗满意率,并观察不良结局发生率。结果:治疗3个月后观察组血糖FBG(4.75±0.46mmol/L)、2hPBC(5.84±0.60mmol/L)、HbAlc(6.05±0.41)%均低于对照组(5.61±0.70mmol/L、5.84±0.60mmol/L、6.47%±0.44%),胰岛功能指标、氧化应激指标均优于对照组,观察组依从率(98.0%)及治疗满意率(96.0%)均高于对照组(84.3%、82.4%),产妇不良结局(2.0%)及新生儿不良结局(4.0%)均低于对照组(13.7%、15.7%)(均P<0.05)。结论:门冬胰岛素结合个体化饮食及运动指导可较好帮助患者控制血糖水平,改善胰岛功能,患者依从性更好、满意率高,降低了不良结局发生。

互动式健康教育联合个体化饮食护理对慢性胃溃疡患者症状消失及遵医行为的影响

目的探讨互动式健康教育联合个体化饮食护理对慢性胃溃疡患者症状消失及遵医行为的影响.方法选取聊城市人民医院2021年8月—2023年8月收治的84例慢性胃溃疡为研究对象,按随机数字表法将其分为对照组与观察组,各42例.对照组采用常规护理,观察组采用互动式健康教育联合个体化饮食护理,随访观察1个月.对比两组症状消失时间、慢性胃溃疡相关知识掌握情况、遵医行为、护理满意度.结果观察组腹痛、反酸、胃灼烧感症状消失时间分别为(4.75±0.78)d、(5.25±1.20)d、(3.55±0.84)d,均短于对照组,组间差异有统计学意义(P<0.05).干预后,观察组慢性胃溃疡相关知识掌握度评分为(85.31±7.54)分,高于对照组的(74.09±10.22)分,差异有统计学意义(P<0.05).观察组总遵医率为92.86%,总满意度为95.24%,均高于对照组的76.19%、80.95%,组间差异有统计学意义(P<0.05).结论互动式健康教育联合个体化饮食护理可以提高患者的疾病认知度和遵医行为,加快慢性胃溃疡症状消失,提高患者满意度.

分期饮食护理联合人文关怀护理对消化性溃疡合并出血患者生活质量的影响

目的 分析消化性溃疡出血患者行分期饮食护理与人文关怀护理的作用。方法 简单随机选取2021年1月-2023年12月六盘水市人民医院收治的80例消化性溃疡合并出血患者为研究对象,按密闭信封法分为两组,各40例。对照组行常规护理,研究组行分期饮食与人文关怀护理。护理干预前及干预2个月,对比两组服药依从性、负性情绪[汉密尔顿焦虑量表(Hailton Anxiety Scale, HAMA)评分及汉密尔顿抑郁量表(Hailton Depression Scale, HAMD)评分]及生活质量评分。结果 干预后,研究组服药依从性高于对照组,差异有统计学意义(P<0.05)。干预后,研究组HAMA评分为(4.91±2.43)分,HAMD评分为(4.28±1.16)分,均低于对照组,差异有统计学意义(t=4.057、18.778,P均<0.05)。研究组生活质量高于对照组,差异有统计学意义(P<0.05)。结论 分期饮食护理与人文关怀护理有助于提高溃疡出血患者治疗依从性,改善负性情绪,从而提高生活质量。

医院-社区-家庭联动护理在难治性癫痫患儿中的应用效果

目的:观察医院-社区-家庭联动护理在难治性癫痫患儿中的应用效果。方法:选取2021年5月至2023年5月该院收治的94例难治性癫痫患儿进行前瞻性研究,采用随机数字表法将其分为观察组与对照组各47例。对照组采取常规护理,观察组采取医院-社区-家庭联动护理,比较两组护理前后家长癫痫知识掌握度评分、生酮饮食依从性评分、癫痫发作频率、癫痫发作持续时间、生命质量[癫痫儿童生活质量量表(QOLCE)]评分和家长满意度评分。结果:护理后,观察组发病原因、临床症状、应急处理、日常管理等家长癫痫知识掌握度评分均高于对照组,差异有统计学意义(P<0.05);护理后,观察组饮食比例、饮食量、按时进食等生酮饮食依从性评分均高于对照组,差异有统计学意义(P<0.05);护理后,观察组癫痫发作频率低于对照组,持续时间短于对照组,差异均有统计学意义(P<0.05);护理后,观察组社会功能、情感健康、行为、认知功能、躯体功能等QOLCE评分均高于对照组,差异有统计学意义(P<0.05);观察组沟通态度、需求满足、康复指导、操作技术、护理效果等家长满意度评分均高于对照组,差异有统计学意义(P<0.05)。结论:医院-社区-家庭联动护理应用于难治性癫痫患儿中可提高家长癫痫知识掌握度、家长满意度评分,提高患儿生酮饮食依从性和生命质量,降低癫痫发作频率,缩短癫痫发作持续时间,效果优于常规护理。

协同护理模式在提高慢性心力衰竭患者限钠饮食依从性中的作用分析

讨论协同护理模式在提高慢性心力衰竭患者限钠饮食依从性中的作用。通过选取2023年1月—2023年12月南宁市第三人民医院接收的154例慢性心力衰竭患者进行研究,按照随机数字表法将所有患者分为对照组和干预组,各77例,对照组患者使用常规护理模式,干预组患者使用协同护理模式;比较两组患者护理后限钠饮食依从性、心功能指标变化情况、生活质量评分。研究结果显示,护理后干预组患者限钠饮食治疗依从性显著高于对照组患者(P<0.05);护理后干预组患者心功能指标每搏排出量(SV)、心排血量(CO)及左室射血分数(LVEF)均显著优于对照组(P<0.05)。护理前两组患者的生活质量评分比较无明显差异(P>0.05),护理后干预组患者生活质量评分明显高于对照组患者(P<0.05)。研究发现对慢性心力衰竭患者使用协同护理模式,可显著提高患者限钠饮食依从性,逐渐恢复患者的心功能,提高患者的生活质量,加快患者的恢复速度,值得临床应用及推广。

三阶段全面延续性管理结合微信饮食指导对妊娠期糖尿病患者血糖控制情况及分娩结局的影响

目的探讨三阶段全面延续性管理结合微信饮食指导在妊娠期糖尿病(GDM)患者中的应用效果。方法选择2022年1—12月我院收治的80例GDM患者为研究对象,按随机数字表法将其分为对照组与观察组,各40例。对照组采用常规护理,观察组在对照组基础上采用三阶段全面延续性管理结合微信饮食指导,两组均持续随访至产妇分娩结束后。对比两组血糖控制情况、遵医行为、分娩结局。结果护理后,观察组血糖水平均低于对照组,组间差异有统计学意义(P<0.05)。护理后,观察组遵医行为评分均高于对照组,组间差异有统计学意义(P<0.05)。观察组不良分娩结局发生率为5.00%,低于对照组的20.00%,差异有统计学意义(P<0.05)。结论三阶段全面延续性管理结合微信饮食指导在GDM患者中具有较好的应用效果,利于改善其遵医行为,获得较好的血糖控制效果,减少不良分娩结局的发生。

生酮饮食治疗难治性癫癎的初步观察

目的观察生酮饮食治疗小儿难治性癫癎的疗效及其安全性。方法选择15例难治性癫癎患儿用合适中国人膳食习惯的生酮饮食方案进行治疗。随访其依从性、临床发作频率及不良反应。结果12例(80%)坚持治疗1个月,其中10例(87.5%)癫癎发作减少>50%;10例(66.6%)坚持治疗3个月,其中8例(80%)癫癎发作减少>50%;5例(33.3%)坚持治疗6个月以上,其中5例(100%)癫癎发作减少均>50%,4例(80%)癫癎发作减少>90%,3例(60%)癫癎发作完全控制。1例已随访2年以上,发作减少>90%。10例出现轻重不一的不良反应(恶心、呕吐、腹泻、便秘、低血糖、高血脂、肝功能受损),经对症治疗后均可缓解。结论适合中国人膳食习惯的生酮饮食方案治疗小儿难治性癫癎有效而安全。其疗效与发作类型无明显关系。

跨理论模式干预对老年2型糖尿病患者饮食控制依从性的影响研究

目的探讨跨理论模式干预对老年2型糖尿病(T2DM)患者饮食控制依从性的影响,为发展和完善糖尿病健康教育计划提供实践依据及实施方法。方法选取2014年3—9月在南通大学附属医院内分泌科住院治疗的老年T2DM患者159例,根据就诊的先后顺序进行编号排序,奇数进入干预组(n=80),偶数进入对照组(n=79),患者均不知晓其所在的组别。干预前对所有患者建立档案,并进行饮食控制依从性问卷调查。对照组采用传统教育方式,参加科室专题讲座;干预组在对照组的基础上,运用跨理论模式,根据患者所处的饮食控制行为改变阶段,针对饮食控制方面问题进行一对一个体化干预。出院后两组均给予电话随访,1次/月,连续6个月。比较两组干预前后糖尿病饮食控制依从性、饮食控制行为改变阶段及临床指标。结果两组干预前饮食控制知识、饮食疗法依从性得分间差异均无统计学意义(P>0.05);两组干预后饮食控制知识、饮食疗法依从性得分间差异均有统计学意义(P<0.05)。两组干预前饮食控制行为改变阶段间差异无统计学意义(P>0.05);两组干预后饮食控制行为改变阶段间差异有统计学意义(P<0.05)。两组干预前BMI、收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(Hb A1c)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)间差异无统计学意义(P>0.05);两组干预后BMI、SBP、FPG、2 h PG、Hb A1c、TG间差异有统计学意义(P<0.05),而DBP、TC、HDL、LDL间差异无统计学意义(P>0.05)。结论跨理论模式健康教育在改善老年T2DM患者饮食控制依从性、饮食控制行为改变阶段及临床指标方面,效果优于传统教育,是科学、可行、有效的。

妊娠期糖尿病患者治疗依从性与妊娠结局的关系

目的:探讨妊娠期糖尿病(GDM)患者对治疗的依从性与妊娠结局的关系。方法:回顾性分析49例GDM患者,其中28例接受系统饮食指导及治疗;另21例亦按上述方法确诊,但未服从系统饮食指导。分析妊娠并发症、围产儿并发症的发生情况。结果:两组分娩前体重指数、分娩时孕周及新生儿出生体重无明显差异(P>0.05),而接受系统饮食治疗者妊娠并发症的发生率明显低于未接受系统饮食治疗的GDM者(P<0.05)。两组巨大儿发生率无明显差异,而其他新生儿并发症如新生儿窒息、早产、吸入性肺炎、高胆红素血症等,经合理饮食治疗后,发生率明显低于未经系统饮食控制者(P<0.05)。结论:加强GDM临床管理,提高患者对治疗的依从性可以显著改善妊娠结局,提高母儿生活质量。

我国社区2型糖尿病患者治疗依从性对临床产出的短期影响研究

目的:为提高我国社区2型糖尿病患者的治疗依从性和治疗效果提供参考。方法:利用北京大学中国卫生经济研究中心"中国糖尿病药物经济学研究"课题组的随访数据,以随访终点糖化血红蛋白(HbA1c)水平作为临床产出指标,对终点HbA1c水平进行二分类变量和数值变量的单因素分析和多元回归分析,以评价治疗依从性对短期临床产出的影响。结果:本次研究共纳入2 236例社区2型糖尿病患者,用药依从性好和差的患者分别占23.48%和76.52%;血糖监测依从性好和差的患者分别占7.02%和93.98%;饮食控制依从性好、中和差的患者分别占66.3%、23.5%和10.2%。单因素分析结果表明,血糖"控制好"组与血糖"控制差"组在患者年龄、身体质量指数、文化程度、病程、是否锻炼、饮食习惯等方面存在显著性差异(P<0.05)。多元Logistic回归和多元对数线性回归模型的分析结果相似,即患者血糖监测依从性和饮食控制依从性对终点HbA1c水平有显著的积极影响(均P<0.05),但是用药依从性的影响不显著(P>0.05)。结论:我国2型糖尿病患者的治疗依从性总体上不理想。在控制其他变量的影响之后,患者治疗依从性对终点HbA1c水平有积极的影响,尤其是血糖监测依从性和饮食控制依从性的改善将有利于血糖控制,而用药依从性的影响则不明显。

基于行为转变理论的饮食教育对血液透析患者的作用

目的探讨基于行为转变理论的饮食教育对维持性血液透析患者的作用。方法将96例维持性血液透析患者随机分为观察组和对照组各48例。对照组给予门诊血液透析常规的饮食相关健康教育,观察组成立行为转变理论模式健康教育团队,实施以行为改变理论模式为指导的饮食健康教育。结果干预6个月后,观察组饮食依从性得分显著高于对照组(P<0.05),血钾、血磷水平显著低于对照组(均P<0.05)。结论基于行为转变理论的饮食教育可提高维持性血液透析患者饮食依从性,从而控制血钾、血磷,达到饮食管理的目的。

肝癌术后患者饮食治疗依从性量表的编制及信效度

目的编制适用于评估肝癌术后患者饮食治疗依从性量表,为临床护理提供实用型的评估工具。方法采用文献回顾法、半结构式访谈法、专家咨询法建立量表条目池,对量表进行信度、结构效度、内容效度检验。结果量表总体Cronbachα系数为0.761;因子分析法提取5个公因子,累计方差贡献率为75.479%,量表的回收率和有效率均为100%,完成量表的中位时间为3min,所有研究对象均表示能理解和接受量表。结论肝癌术后患者饮食治疗依从性量表具有良好的信效度和可行性,可应用于肝癌患者的饮食依从性测定。

结构—过程—结果三维质量评价模式在食管静脉曲张破裂出血行内镜套扎术后患者延续护理中的应用

目的探讨结构—过程—结果三维质量评价模式在肝硬化合并食管静脉曲张破裂出血行内镜套扎术后患者延续护理中的应用效果。方法选取2014年1月-2015年12月在本院住院治疗的肝硬化合并食管静脉曲张破裂出血行内镜套扎术患者100例,将2014年1月-12月住院治疗的50例患者设为对照组,住院期间实施常规的护理措施,出院前进行出院指导并嘱其按时复诊,出院后每个月由责任护士电话回访1次;将2015年1月-12月住院治疗的50例患者设为观察组,住院期间的健康教育与对照组一样,出院后以Donabedian的结构—过程—结果三维质量评价模式为理论框架,构建本研究的延续护理方案,将该方案应用于出院患者护理中。干预6个月后比较两组患者服药、饮食依从性的差异。结果干预后,观察组患者服药和饮食依从性优于对照组,两组比较,差异均有统计学意义(P<0.05)。结论结构—过程—结果三维质量评价模式可提升食管静脉曲张破裂出血行内镜套扎治疗术后患者的延续性护理质量,提高了患者服药和饮食依从性。