目的 探讨妇科化学治疗（化疗）患者自我管理效能感与焦虑抑郁的关系。 方法 2011年10月－2012年1月采用中文版癌症自我管理效能感量表和医院焦虑抑郁量表对110例妇科化疗患者进行问卷调查。 结果 共收回有效问卷106份。33例（31.70%） 患者焦虑阳性，43例（41.30%） 抑郁阳性，35例（33.70%） 焦虑抑郁均为阳性；自我管理效能感得分为（86.31 ± 27.06）分，并与焦虑呈负相关（r = −0.793，P = 0.000），与抑郁呈负相关（r = −0.753，P = 0.000）。 结论 妇科化疗患者自我管理效能感与焦虑抑郁密切相关，在以后的护理工作中应该重视妇科肿瘤患者自我管理项目的构建，提高患者的自我效能，从而改善其心理状况。
ObjectiveTo investigate the status of quality of life and influencing factors among newly diagnosed epilepsy patients with co-morbid anxiety and depression. MethodsA total of 180 newly diagnosed epilepsy patients from June 2022 to December 2022 in a district of Shanghai were selected as the study subjects. The Quality of Life in Epilepsy-31 (QOLIE-31), Hamilton Depression Rating Scale (HAMD-24), Hamilton Anxiety Rating Scale (HAMA), and Epilepsy Self-Management Scale (ESMS) were used to assess patients' quality of life, depression levels, anxiety levels, and self-management abilities, respectively. Patients were divided into the co-morbid depression group (HAMA≥14 and HAMD>17) and the control group (HAMA<14 and HAMD≤17), and their general characteristics and scale scores were compared. Spearman correlation, Pearson correlation, and multiple linear regression analysis were used to identify influencing factors of quality of life in epilepsy patients with co-morbid depression. ResultsCompared to the control group, the anxiety comorbid with depression group of older adults had a higher proportion, higher unemployment rate, lower personal and family annual income in the past year, higher frequency of epileptic seizures, and lower medication adherence (P<0.05). The correlational analysis revealed a negative correlation between the quality of life abilities of epilepsy patients with comorbid anxiety and depression and the severity of anxiety and depression. (r=−0.589, −0.620, P<0.05). The results of multiple linear regression analysis showed that the frequency of seizures in the past year (β=−1.379, P<0.05), severity of anxiety (β=−0.279, P<0.05), and severity of depression (β=−0.361, P<0.05) have an impact on the ability to quality of life in epilepsy patients with co-morbid anxiety and depression. These factors account for 44.1% of the total variability in quality of life (R2=0.4411, P<0.05). ConclusionThe frequency of seizures in the past year, as well as the severity of anxiety and depression, are important factors that influence the ability to quality of life in epilepsy patients with comorbid anxiety and depression. For these patients, it is crucial to take into account these factors and provide appropriate support and interventions.
ObjectiveTo compare home blood pressure monitoring (HBPM) versus ambulatory blood pressure monitoring (ABPM) versus office blood pressure monitoring (OBPM) in diagnosis and management of hypertension, and to find the optimal blood pressure measurement and management.MethodsThe following were compared among three BP monitoring, such as cost-effectiveness, prognostic value of target organ damage (TOD), predictive value of the progress in chronic kidney disease (CKD) and blood pressure variety (BPV). ResultsCompared to OBPM, ABPM was the most cost-effective method in the primary diagnosis of hypertension, but HBPM was the optimal method in long-term and self-management in hypertension. In hypertensives, compared to OBPM, HBPM and ABPM, especially HBPM, had a stronger predictive value for cardiovascular events, stroke, end-stage renal dysfunction (ESRD) and all-cause mortality. In hypertensives with renal dysfunction, controlling HBPM and ABPM, especially controlling ABPM, was an effective way to slow the progress in renal dysfunction, to decrease cardiovascular events, and to decrease the need of dialysis. All BPV derived from OBPM, ABPM and HBPM had a predictive significance of cardiovascular events, and HBPM BPV performed the best.ConclusionCompared to OBPM, ABPM is the best method in primary diagnosis of hypertension and BP control in CKD patients, while HBPM is the best method in predicting and in evaluating BPV, as well as in long-term and self-management in hypertension.
ObjectiveTo investigate the level and influencing factors of self-management behaviors among maintenance hemodialysis patients.MethodsPatients undergoing maintenance hemodialysis were recruited from 4 tertiary hospitals in Chengdu from October 2016 to October 2017. Convenient sampling method was used to select patients. The instruments used in the study included General Information Questionnaire, Hemodialysis Self-management Instrument, Hemodialysis-related Knowledge Questionnaire, Herth Hope Index, Multidimensional Health Locus of Control Scale, and Chronic Illness Resources Survey.ResultsA total of 360 patients were investigated, and 343 patients were finally included. The mean score of self-management behavior was 54.87±9.65. The results of multiple linear stepwise regression showed that gender, age, ethnic, monthly family income, chronic illness resources, knowledge and internal health locus of control were the significant influencing factors of self-management behaviors (P<0.05).ConclusionThe self-management behavior among patients undergoing maintenance hemodialysis can be promoted by improving the level of knowledge and internal health locus of control, and making effective use of chronic illness resources.
ObjectiveThis article aims to comprehensively retrieve and summarize the best evidence for the self-management of epilepsy in adolescents, so as to provide a reference for clinical medical staff and relevant decision makers. MethodsWe systematically searched Cochrane, Global Guidelines Collaboration (GIN), Scottish Interhospital Guidelines Network (SIGN), Joanna Briggs Institute (JBI), NICE, RANO (Nurses' Association of Ontario, Canada), UpToDate, BMJ, Medical Maitong, PubMed, International League Against Epilepsy, China National Knowledge Infrastructure, Wanfang Database and other databases and websites. All kinds of literature related to the self-management of epilepsy in adolescents were collected from the establishment of the database to April 18, 2023, including clinical decision-making, clinical guidelines,. Evidence summary, expert consensus, systematic review, etc. Four researchers were invited to evaluate the quality of the retrieved guidelines, and two researchers independently screened and evaluated the quality of the remaining literature. According to the opinions of professionals, data extraction and analysis were performed on the literature that met the inclusion criteria. ResultsA total of 9 articles were included, including 3 clinical guidelines, 3 expert consensus and 3 systematic reviews. We summarized the evidence in the literature in the following 8 aspects: Self-management initiation timing, monitoring management, psychological management, innovative self-management mode, information and support, medication management, daily life management and follow-up management. We identified 34 best pieces of evidence. ConclusionsThis article provides health care providers with the best evidence for the self-management of adolescents with epilepsy, guiding them to provide self-management education and counseling for adolescents with epilepsy through evidence-based methods, helping them to improve self-management ability, reduce seizures, reduce health services and healthcare costs, and improve quality of life.
Objective We aimed to develop a self-management assessment scale for children with epilepsy and test its reliability and validity. Methods A research group was established, and the items were revised through literature review, group discussion and pre-investigation, and 280 patients with epilepsy in children were included, and the reliability and validity of the scale were tested. Results 28 items in 4 dimensions were developed to form the scale, namely, knowledge and belief of diseases and medication, compliance of medication and treatment, self-efficacy of medication and obstacles of medication. Confirmatory factor analysis extracted four common factors with characteristic roots greater than 1, and the cumulative variance explanation rate was 65.639%. The factor load of all items is > 0.5. The overall Cronbach’s alpha is 0.880, and the coefficients in seven measurement dimensions are all greater than 0.8. Conclusion The self-management assessment scale for children’s epilepsy drugs has good reliability and validity, and can provide a measuring tool for the drug management of children’s epilepsy diseases.
ObjectiveTo investigate the efficacy of follow-up continuous nursing intervention on the self-management ability and medication compliance of patients undergoing maintenance hemodialysis. MethodsBetween June and December 2013, 157 maintenance hemodialysis patients were randomly divided into control group (n=76) and study group (n=81). The control group was given conventional nursing, while the study group received continuous nursing intervention program as well as conventional nursing. Six months later, the self-management ability and medication compliance of the patients were assessed by using self-made Patient Self-management Scale and Morisky Medication Compliance Scale. ResultsSix months later, self-management ability in patients of the study group was significantly better than that in the control group (P<0.05). Medication compliance rate in the study group reached a highest of 45.7%, while it was only 18.4% in the control group, and the difference between the two groups was significant (χ2=13.283, P<0.001). ConclusionFollow-up continuous nursing intervention can obviously improve maintenance hemodialysis patients' ability of self management and compliance behavior, so as to improve the quality of life of these patients.
Objective To observe the effectiveness of IMPACT management mode on self-care and management abilities of breast cancer patients undergoing chemotherapy with implantable venous access port (VAP). Methods Breast cancer patients who underwent chemotherapy with VAP at Shangjin Hospital, West China Hospital, Sichuan University between March 2020 and June 2021 were prospectively included. IMPACT mode was used for self-management training guidance. The patient self-care abilities before training and at 1 month, 2 months, and 3 months of training were compared, and the patient self-management abilities at 1 month and 3 months of training were compared. Results A total of 74 patients with breast cancer undergoing chemotherapy with VAP were included. The total score of self-care ability of patients before training and at 1 month, 2 months, and 3 months of training was 112.11±14.63, 123.20±15.73, 127.95±13.89, and 131.92±13.60, respectively, and all the between-time-point differences were statistically significant (P<0.05). In terms of self-concept score, all the between-time-point differences were statistically significant (P<0.05) with increasing score over time, except the difference between the score at 3 months of training and that at 2 months of training (P>0.05). In terms of self-responsibility and self-care skill scores, all the between-time-point differences were statistically significant (P<0.05) with increasing scores over time, except the difference between the score at 2 months of training and that at 1 month of training (P>0.05). In terms of health knowledge level, the scores at 1 month, 2 months, and 3 months of training were higher than that before training (P<0.05), and the score at 3 months of training was higher than that at 1 month of training (P<0.05). The self-management ability scores in all dimensions at 3 months of training were higher than those at 1 month of training, and the differences were statistically significant (P<0.05). Conclusion The IMPACT management mode can effectively improve the self-care and management abilities of breast cancer patients undergoing chemotherapy with VAP, thereby ensuring the normal use of VAP, reducing the occurrence of complications, and reducing the burden on families and society.
Objective To investigate the current status of self-management knowledge, attitude and behavior and influencing factors in patients with chronic obstructive pulmonary disease (COPD) in Qianbei area, and to analyze the influencing factors. Methods A total of 329 COPD patients were recruited and investigated with self-compiled questionnaire for self-management knowledge, attitude and behavior of chronic obstructive pulmonary disease, and SPSS 17.0 software was used to analyze the data. Results The mean score of self-management knowledge, attitude and behavior in COPD patients was 132.6±17.0, in which the scores of each dimension from high to low were as follows: smoking, medication treatment, exercise and family oxygen therapy. The analysis of stepwise regression indicated that the main influencing factors of self-management of COPD patients were age, sex, address, degree of education, course of disease and smoking. Conclusions The self-management level of the disease recognition, attitude and behavior in COPD patients should be improved, in which the knowledge is key factor to promote the health behavior of patients. So the healthy workers should pay close attention to the influence factors and apply the new thinking pattern and methods to improve the self-management ability and the quality of life of patients.