Impact of Nursing Interventions Based on Self- Efficacy Theory on HAMA and HAMD Scores in Patients with Hepatitis B Cirrhosis

Objective:To explore the effect of nursing interventions based on self-efficacy theory guidance on psychological stress indicators in patients with hepatitis B cirrhosis.Methods:70 patients with hepatitis B cirrhosis from October 2023 to May 2024 were selected and grouped by random number table.The observation group received nursing intervention based on self-efficacy theory,while the control group received routine nursing.The differences in psychological stress indicators,self-efficacy indicators,and nursing satisfaction were compared between the two groups.Results:Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD)scores of the observation group were significantly lower than those of the control group(P<0.05);Chronic Disease Self-Efficacy Scale(CDSES)scores of the observation group were significantly higher than those of the control group(P<0.05);and nursing satisfaction scores of the observation group were significantly higher than those of the control group(P<0.05).Conclusion:Hepatitis B cirrhosis patients receiving nursing care based on self-efficacy theory can stimulate patients'self-efficacy,calm their emotions,and their overall satisfaction is high.

Analysis of the Effects of Preoperative Hepatic Artery Chemoembolization and Quality Nursing Intervention on the Perioperative Safety and Short-term Prognosis of Liver Transplantation in Patients with Hepatocellular Carcinoma

Objective: To investigate the effects of preoperative hepatic artery chemoembolization (TACE) and quality nursing interventions on the perioperative safety and short-term prognosis in patients with hepatocellular carcinoma undergoing liver transplantation. Methods: The study period spanned from January 2021 to December 2023, and 125 patients with hepatocellular carcinoma admitted to our hospital were selected, all of whom underwent liver transplantation. They were randomly divided into an observation group (n = 63) and a control group (n = 62). The patients in the control group did not undergo TACE before the operation, and the patients in the observation group underwent TACE and quality nursing intervention before the operation. The operation time, intraoperative blood loss, length of hospitalization, liver- free period, complication rate, short-term prognosis, and liver function indexes between the two groups were compared. Results: There was no significant difference in operation time, intraoperative blood loss, and length of hospitalization between the two groups (P < 0.05). The liver-free period of patients in the observation group was longer than that of the control group (P < 0.05). The two groups had no significant difference in the incidence of biliary complications, vascular complications, and postoperative infections (P > 0.05). The rate of immune reactive complications in the observation group was lower than that of the control group (P < 0.05). There was no significant difference in the perioperative mortality rate, 1-year postoperative survival rate, and 2-year postoperative survival rate (P > 0.05). The two groups had no significant difference in postoperative liver function indexes (P > 0.05). Conclusion: Preoperative TACE and high-quality nursing intervention in patients with hepatocellular carcinoma had no adverse effect on the perioperative safety and short-term prognosis, prolonged the liver-free time, and reduced the incidence of immune-reactive complications.

Nursing Diagnosis in Patients with Liver Cirrhosis in Use of Feeding Tube

The objective was to identify the most frequent nursing diagnoses labels in patients with liver cirrhosis in use of feeding tube. A descriptive research was carried out in a Brazilian Hospital with 20 adult patients. Systematic data collection utilized the Conceptual Model of Wanda Horta, the first nurse to introduce the concept of Nursing Process in Brazil. The six phases of the nursing diagnostic reasoning proposed by Risner were used;nursing diagnoses were described according to NANDA-I taxonomy II. Patients were mainly male;half of them were middle age adults;they had an average of 12.8 nursing diagnoses labels;and the most frequent were: risk for aspiration and risk for infection. Nurses needed to develop effective skills to properly diagnose in order to provide safe care and improve patient outcomes.

Nursing of Artificial Liver Support System in the Treatment of Severe

Objective:Research on nursing method of artificial liver support system applied in severe hepatitis patients.Methods:Selected 50 severe hepatitis patients in our hospital during the period of January 2018 and January 2019,observed and analyzed the clinical intervention effect of all treated by artificial liver support system cooperating with related nursing methods.Results:After the treatment,the clinical symptoms and abdominal distension of the patients were relieved,whose spirit took a turn for the better and the jaundice subsided.Among these patients,68%got improved enough to be released,26.00%gave up for financial concerns and 6.00%died.Before and after treatment,the patients’PT and INR,APTT,TT improved obviously,and the difference were quite a lot(P<0.05),while ALT and ALB showed few without any statistical significance(P>0.05).Conclusion:During the treatment and intervention of severe hepatitis patients with artificial liver support system,effective nursing interventions are needed,mainly including completely preoperative,intraoperative and postoperative care so as to ensure the treatment effect and promote the recovery of intervention,which has remarkable significance to clinical development.

Effect of Foot Bath and Massage on Insomnia in Patients with Liver Cirrhosis and Investigation of Nursing Satisfaction

Objective: To observe the effect of foot bath and massage on insomnia in patients with liver cirrhosis. Methods: By control design of retrospective nonconcurrent cohort study, 100 insomnia patients with liver cirrhosis admitted and treated in our clinic between October 2011 and September 2012, were recruited in the control group and given routine nursing of internal medicine. A total of 105 insomnia patients with liver cirrhosis, admitted and treated between October 2012 and September 2013, were recruited in the intervention group and given foot bath and massage on the basis of routine nursing of internal medicine. After continuous intervention for 14 d, the clinical effects and the nursing satisfaction were evaluated. Results: There were statistically significant differences in clinical effects and sleeping quality between the two groups(P<0.05, P<0.01). The therapeutic effect was better in the intervention group than in the control group, and the nursing satisfaction was remarkably higher in the intervention group than in the control group(P<0.05). Conclusion: Foot bath and massage can obviously reduce insomnia in the patients with liver cirrhosis, improve the sleeping quality, and effectively elevate the nursing satisfaction of the patients, and are worthy of clinical popularization and application.

Care strategies for patients with severe drug-induced hepatitis

Objective: The aim of this study is to analyse the clinical characteristics of 32 patients with severe drug-induced hepatitis, reinforce the practice of unique nursing and holistic nursing, improve the therapeutic effect, reduce the patients’ mortality, and increase their quality of life. Methods: We give patients individualized dietary guidance, medication nursing, and psychological care according to the characteristics of severe hepatitis and its complications, using com- prehensive medical treatment and combined signs of Traditional Chinese Medicine. Results: Overall, 22 (68.8%) out of 32 cases were improved, 8 (25.0%) cases died, and 2 (6.2%) cases were discharged of free will. In addition, the average hospital stay was 28.75 days. Conclusion: This study indicates that dietary guidance for the patients with severe drug-induced hepatitis varies with the individual. The result embodies the concept of Traditional Chinese Medicine that different treatment for the same disease and different diet for the same disease. Special nursing enriches the connotation of holistic nursing. Both of them are vital for improving the survival rate and promoting rehabilitation of patients with severe drug-induced hepatitis.

基于质量三环理论构建肝硬化序贯治疗患者延续性护理评价指标体系

目的探讨质量三环理论构建肝硬化序贯治疗患者延续性护理的评价指标体系在临床评价肝硬化序贯治疗的应用价值。方法2020年2月至2021年4月中山大学附属第三医院消化内科以Donabedian提出的"结构-过程-结果"三环质量评价模式作为理论框架,通过文献研究、半结构访谈法初步构建延续性护理质量评价指标条目及初始专家咨询问卷,采用德尔菲法开展3轮专家咨询确定评价指标体系终稿。结果3轮专家问卷回收有效率均为100.0%,专家权威系数均为0.82,专家一致性系数Kendall’s W分别为0.158、0.161、0.224。最终形成一级指标3个,二级指标15个,三级指标49个的肝硬化序贯治疗患者延续性护理评价指标体系。结论基于质量三环理论构建肝硬化序贯治疗患者延续性护理的评价指标体系涵盖内容全面科学,专家对其意见高度集中,值得进一步深入临床研究。

隐匿性肝性脑病病人延续护理需求现状及影响因素

目的:调查隐匿性肝性脑病病人延续护理需求,分析其影响因素,为其延续护理实践方案提供参考。方法:采用便利抽样的方法,选取2022年2月—9月在山西省某三级甲等综合医院消化内科住院被诊断为肝硬化的病人69例,采用自行编制的病人延续护理需求调查表进行调查。结果:隐匿性肝性脑病病人延续护理需求得分为85~182分(173.34±25.71)分,需求内容中对信息的需求度最高。家庭平均月收入、工作状况、文化程度是隐匿性肝性脑病病人延续护理需求的影响因素。结论:隐匿性肝性脑病病人延续护理需求迫切,应研究以病人需求为导向的延续护理干预策略,实施精准化护理,提高病人的健康相关生活质量。

神经母细胞瘤扩增序列基因突变致急性肝功能衰竭患儿的护理

总结3例神经母细胞瘤扩增序列基因突变致儿童急性肝功能衰竭的护理体会。针对本组患儿高氨血症引发肝性脑病、感染引起高热、分解代谢增加及出院后护理等问题,采取严密监测意识评估肝性脑病发展,及时采取合适的血液净化方式快速降血氨;预防与控制感染,尤其是体温管理;加强营养支持;定期跟踪随访,避免再次发生急性肝功能衰竭。经过快速救治及精心护理,3例患儿病情稳定出院,出院后3个月随访恢复良好。

前馈控制理论护理在乙型肝炎肝硬化患者遵医行为及生存质量中的应用效果

目的探究前馈控制理论护理对乙型肝炎肝硬化患者遵医行为及生存质量的应用效果。方法选取2022年2月至2023年10月南通大学附属南通第三医院的110例乙型肝炎肝硬化患者作为研究对象,按照随机数字表法将其分为对照组和观察组,各55例。对照组采用常规护理,观察组采用前馈控制理论护理,干预2个月后比较两组遵医行为、心理状态评分及生存质量。结果干预后,两组遵医行为评分指标高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05);干预后,两组90项症状自评量表评分低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05)。干预后,两组肝病生存质量调查表评分高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论乙型肝炎肝硬化患者护理中接受前馈控制护理,提高遵医行为,改善患者心理状态的同时,患者生存质量有所提升,预后效果更佳,可广泛应用于临床中。

基于奥马哈系统理论的护理在病毒性肝炎肝硬化患者中的应用效果

目的:观察基于奥马哈系统理论的护理在病毒性肝炎肝硬化患者中的应用效果。方法:选取2020年4月至2022年4月该院收治的88例病毒性肝炎肝硬化患者进行前瞻性研究,依照随机数字表法将其分为对照组和观察组各44例。对照组采取常规护理,观察组采取基于奥马哈系统理论的护理,比较两组护理前后自我管理能力评分、生命质量[生命质量综合评定问卷-74(GQOLI-74)]评分和护理满意度。结果:护理后,观察组饮食管理、日常生活管理、病情监测管理和用药管理等自我管理能力评分均高于对照组,差异有统计学意义(P<0.05);观察组社会功能、躯体功能、心理状态和物质生活状态等GQOLI-74评分均高于对照组,差异有统计学意义(P<0.05);观察组护理满意度为95.45%(42/44),高于对照组的81.82%(36/44),差异有统计学意义(P<0.05)。结论:基于奥马哈系统理论的护理应用于病毒性肝炎肝硬化患者可提高自我管理能力评分、生命质量评分和护理满意度,效果优于常规护理。

以需求为导向的阶段护理方案对肝硬化患者的影响

目的探讨以需求为导向的阶段护理方案对肝硬化患者的影响。方法采取便利抽样法,选取2019年2月至2021年12月江苏省淮安市第四人民医院收治的118例肝硬化患者,按随机数字表法将其分为对照组和研究组,每组59例。对照组给予常规护理,研究组给予以需求为导向的阶段护理方案。比较两组护理前后疾病相关知识掌握程度、自我效能和健康行为。结果118例患者中,2例患者自愿放弃本次调查,1例患者中途转入其他科治疗。对照组最终纳入58例,研究组最终纳入57例。护理前,两组慢性肝病问卷(CLDQ)各维度评分比较,差异无统计学意义(P>0.05);护理后,两组CLDQ各维度评分均高于护理前,且研究组高于对照组,差异有统计学意义(P<0.05)。护理前,两组一般自我效能感量表(CDSES)各维度评分比较,差异无统计学意义(P>0.05);护理后,两组CDSES各维度评分均高于护理前,且研究组高于对照组,差异有统计学意义(P<0.05)。护理前,两组健康促进生活方式量表Ⅱ(HPLP-Ⅱ)各维度评分比较,差异无统计学意义(P>0.05);护理后,两组HPLP-Ⅱ各维度评分均高于护理前,且研究组高于对照组,差异有统计学意义(P<0.05)。结论以需求为导向的阶段护理方案可有效改善肝硬化患者的疾病相关知识掌握程度、自我效能及健康行为。

互联网+5E康复护理模式在肝硬化主要照护者中的应用

目的分析互联网+5E康复护理模式在肝硬化主要照护者中的应用。方法选取2020年12月至2023年12月于笔者医院收治的120例肝硬化患者为研究对象,采用随机数字表法分为对照组、研究组每组60例,对照组采用常规干预措施,研究组采用互联网+5E康复护理模式,观察两组主要照护者照顾负担、自我效能感,分析患者肝功能、负性情绪、生活质量、自我管理水平、应对方式。结果干预后两组主要照护者照顾负担评分降低,自我效能感评分升高,且研究组低于/高于对照组(P<0.05)。干预后两组患者总胆红素(total bilirubin,TBIL)、天冬氨酸转移酶(aspartate transferase,AST)水平、肝功能Child-Pugh评分、焦虑、抑郁、回避、屈服评分降低,且研究组低于对照组,差异有统计学意义(P<0.05)。干预后两组患者生活质量、自我管理水平评分升高,且研究组高于对照组,差异有统计学意义(P<0.05)。结论肝硬化患者与主要照护者采用基于互联网+5E康复护理模式干预,可改善患者应对方式,使患者自我管理能力、生活质量提高降低主要照护者的负担。

以奥马哈系统为指导的延续护理对肝硬化出院患者治疗依从性的影响

目的探析以奥马哈系统为指导的延续护理在肝硬化出院患者中的实施效果和价值。方法按随机数字表法将2020年1月至2022年1月福建省三明市第一医院收治的100例肝硬化患者分入对照组和观察组,各50例。对照组实施常规护理及门诊随访,观察组采用以奥马哈系统为指导的延续护理。比较2组治疗依从性、肝功能指标及生活质量。结果出院3个月和6个月后,观察组的Frankl依从量表评分、慢性肝病生活质量问卷评分,以及天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转氨酶(ALT)、总胆汁酸(TBA)和总胆红素(TBIL)水平均较同一时间的对照组更优,且2组均优于同组出院前,均有统计学差异(P均<0.05)。结论对肝硬化出院患者实施以奥马哈系统为指导的延续护理,对其治疗依从性提升、肝功能和生活质量改善等均可产生积极影响。

分级护理在乙型肝炎肝硬化失代偿患者中的应用效果

目的:探讨分级护理在乙型肝炎肝硬化失代偿患者中的应用效果.方法:选取2020年7月至2023年7月本院收治的102例乙型肝炎肝硬化失代偿患者为研究对象.依据护理模式将其分为观察组(n=52,给予常规护理联合分级护理)和对照组(n=50,给予常规护理).采取统计学分析方法,对两组患者依从性行为,肝功能[丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)]及并发症总发生率进行比较.结果:干预后,观察组患者检查配合、饮食、护理配合、心理调节、遵医用药各项评分均高于对照组,差异均有统计学意义(P<0.05);干预后,观察组患者ALT、AST水平均低于对照组,差异均有统计学意义(P<0.05);观察组并发症总发生率(3/52,5.77%)低于对照组(10/50,20.00%),差异有统计学意义(P<0.05).结论:在乙型肝炎肝硬化失代偿患者中实施分级护理可有效提高治疗依从性,改善患者肝功能水平,促进病情恢复.

基于智谋理论的心理教育课程结合个体化饮食护理对乙型肝炎患者疾病自我感受负担及病情控制的影响

目的探讨基于智谋理论的心理教育课程结合个体化饮食护理对乙型肝炎患者疾病自我感受负担及病情控制的影响。方法择取2020年1月至2023年1月于我院就诊的100例乙型肝炎患者为研究对象,随机将其分为对照组(50例)和观察组(50例)。对照组采用常规护理干预,观察组在对照组基础上增加基于智谋理论的心理教育课程结合个体化饮食护理。比较两组的干预效果。结果干预后,观察组的自我感受负担量表(SPBS)各维度评分低于对照组(P<0.05)。观察组的乙型肝炎病毒e抗原(HBeAg)、乙型肝炎病毒-脱氧核糖核酸(HBV-DNA)、乙型肝炎表面抗原(HBsAg)转阴率及丙氨酸氨基转移酶(ALT)正常率高于对照组(P<0.05)。干预后,观察组的ALT、谷草转氨酶(AST)、碱性磷酸酶(ALP)、总胆汁酸(TBA)水平低于对照组(P<0.05)。结论基于智谋理论的心理教育课程结合个体化饮食护理不仅能够有效减轻乙型肝炎患者的疾病自我感受负担,提升病情控制效果,还能促进肝功能恢复,值得推广。

IMB技巧模型的健康教育对肝硬化患者自我护理能力的影响评价

目的分析信息-动机-行为技巧模型(information-motivation-behavioral skills model,IMB)的健康教育对肝硬化患者自我护理能力及并发症发生率的影响。方法随机选取2022年1月—2023年10月单县中心医院收治的130例肝硬化患者作为观察对象,以不同护理方法分为参照组(常规健康教育)和研究组(IMB技巧模型的健康教育),每组65例。比较两组患者自我护理能力及护理满意度。结果干预前,两组患者自我护理能力评分比较,差异无统计学意义(P>0.05);干预后,研究组自我护理能力高于参照组,差异有统计学意义(P<0.05)。研究组护理总满意度为98.46%(64/65),高于参照组的83.08%(54/65),差异有统计学意义(χ^(2)=9.181,P=0.002)。结论肝硬化患者实施IMB技巧模型的健康教育护理,可以大幅度的提升患者自我护理能力,有助于提高患者护理满意度。

肝硬化患者肌少症的管理研究进展

肝硬化常常导致机体能量代谢、激素分泌和免疫稳态发生异常,这些代谢过程的紊乱会导致肌少症或病理性肌肉萎缩。肌少症是肝硬化患者常见并发症之一,常常预示患者预后不佳,包括住院时间、感染性并发症和死亡率等。准确评估、早期营养支持和及时治疗对于肝硬化并肌少症患者具有重要意义。本文综述了肝硬化患者肌少症的发生机制、肌少症评估工具和干预措施。

自我效能理论指导下的护理干预在乙型肝炎后肝硬化患者护理中的应用分析

目的探讨自我效能理论指导下的护理干预在乙型肝炎后肝硬化患者护理中的应用。方法随机选取2018年5月—2023年5月东台市人民医院收治的100例乙型肝炎后肝硬化患者作为研究对象,采用随机编号的方法将患者分为观察组50例和对照组50例,对照组采取常规护理,观察组应用自我效能理论指导下的护理干预,对比两组干预结果。结果干预后两组自我效能感评分均得到提升,且观察组自我效能感评分均显著高于对照组,差异有统计学意义(P均<0.05)。观察组总满意度为96.00%,显著高于对照组,差异有统计学意义(χ^(2)=6.061,P<0.05)。观察组焦虑和抑郁各指标得分均低于对照组,差异有统计学意义(P均<0.05)。结论对于乙型肝炎后肝硬化患者实施自我效能理论指导下的护理干预,具有显著价值,不但能够提升患者的自我照护能力,同时也能缓解负面情绪,满意度良好。

护士主导的多学科协助护理模式对肝硬化病人自我管理的影响研究

目的:探讨护士主导的多学科协作护理模式对肝硬化病人自我管理的效果。方法:根据便利抽样法纳入119例符合标准的肝硬化病人,在入院24 h内接受护士主导的多学科协作护理模式干预方案,并在病人出院前、出院后1个月、出院后3个月分别对病人的自我管理水平进行评价。结果:出院后3个月病人满意度高于出院前,且病人出院后1个月、出院后3个月自我管理行为、用药依从性、自我效能水平均高于入院时(P<0.05)。结论:护士主导的多学科协作护理模式有助于改善肝硬化病人自我管理水平、提高病人满意度。