Objective To analyze the application effect of health management program for young and middle-aged hypertensive patients based on transtheoretical model(TTM).Methods A total of 240 young and middle-aged(aged 19-60)patients with primary hypertension who were registered at representative community health service centers in the urban area of Zhenjiang City(selected based on the scope and quantity of services within the jurisdiction,including Jiankanglu Community Health Service Center,Dashikou Community Health Service Center of Jingkou District,Liming Community Health Service Center)from July 2021 to January 2022 were selected as the research subjects.The patients were divided into control group and observation group using a random number table method,with 120 cases in each group.The control group was intervened with the conventional community health management plan,while the observation group was intervened with health management program for young and middle-aged hypertensive patients based on TTM on the basis of the control group.The intervention lasted for a total of 6 months.The general data,Hypertension Knowledge-Level Scale(HK-LS)scores,Self-efficiency Assessment Scale for Hypertensives scores and hypertension control rate before intervention and after 6 months of intervention were compared between the two groups.Results During the intervention process,5 patients in the control group were lost to follow-up,4 patients in the observation group were lost to follow-up,and finally,115 patients were included in the control group and 116 patients were included in the observation group.After 6 months of intervention,the HK-LS score of the observation group was higher than that of the control group(P<0.05).The HK-LS scores of the control group and the observation group after 6 months of intervention were higher than those before intervention respectively(P<0.05).After 6 months of intervention,the Self-efficiency Assessment Scale for Hypertensives scores in observation group were higher than those in control group(P<0.05).After 6 months of intervention,the Self-efficiency Assessment Scale for Hypertensives scores in control group and observation group were higher than those before intervention respectively(P<0.05).After 6 months of intervention,the hypertension control rate in the observation group was higher than that in the control group(P<0.05).The hypertension control rate of control group and observation group after 6 months of intervention was higher than that before intervention respectively(P<0.05).Conclusion The health management program for young and middle-aged hypertensive patients based on TTM can effectively improve the knowledge level of hypertension,self-efficacy level and hypertension control rate of young and middle-aged hypertension patients.

目的 构建基于跨理论模型(TTM)的中青年高血压患者健康管理方案.方法 本研究时间为2021年1—7月.通过文献回顾法,结合社区中青年高血压患者健康管理实际情况,根据TTM及小组讨论结果,形成基于TTM的中青年高血压患者健康管理方案初稿.采用德尔菲法构建基于TTM的中青年高血压患者健康管理方案,并评价专家积极程度、专家意见百分比、专家协调程度、专家权威度,统计基于TTM的中青年高血压患者健康管理方案的重要性评分.结果 两轮专家函询的有效回收率均为100.0％.两轮专家函询的专家意见百分比分别为53.3％(8/15)、20.0％(3/15).第一轮专家函询的变异系数(CV)为0.064～0.218,肯德尔协调系数为0.204(P<0.05);第二轮专家函询的CV为0.051～0.179,肯德尔协调系数为0.336(P<0.05).两轮专家函询的权威系数(Cr)分别为0.850和0.835.第一轮专家函询后,修改了5个一级条目、2个二级条目,增加了5个二级条目;第二轮专家函询后删除了5个二级条目,修改了5个二级条目.专家函询结束后,意见趋向统一,最终确定了基于TTM的中青年高血压患者健康管理方案,共包含无意图阶段(5个二级条目)、意图阶段(5个二级条目)、准备阶段(5个二级条目)、行动阶段(5个二级条目)、维持阶段(5个二级条目)5个一级条目、25个二级条目,各条目的重要性评分均>3.5分、CV均<0.25.结论 本研究构建的基于TTM的中青年高血压患者健康管理方案的科学性较好,其可评估中青年高血压患者健康行为改变的阶段,进而实施精准干预,也可采用动态评估策略,促进连续管理,为后续社区开展有效规范的健康管理提供了参考.

目的:探讨由护士主导的专病一体化管理模式对居家进行腹膜透析(PD)患者的自我护理能力、疾病知信行水平及生活质量的影响。方法:对2018年1月至2020年12月在江苏大学附属医院进行PD治疗的50例慢性肾脏病5期随访患者实施护士主导的专病一体化管理模式，利用专项程度调查表掌握并比较患者在出院前1 d、出院后1个月、3个月及6个月后自我护理能力、疾病知信行水平及生活质量的变化情况。结果:在护士主导的专病一体化管理模式下，与患者出院前1 d比较，患者在出院后1个月、3个月和6个月对疾病知识的掌握及自我护理能力均有明显提升(均 P<0.001)；且患者在出院后1个月、3个月和6个月，对疾病的知信行水平和生活质量也有明显提升，差异均有统计学意义(均 P<0.001)。 结论:护士主导的专病一体化管理模式可以提高PD患者的自我护理能力，提升患者的疾病知信行水平，改善患者的生活质量，值得临床推广。

目的:探讨分组分层排班法在提高心内科护士护理能力中的应用效果.方法:选择2018年1月1日～2019年5月31日对25名心内科护士实行分组分层排班法作为观察组,选择2017年1月1日～2018年5月31日对25名心内科护士实行传统排班法作为对照组;比较两组护士共情能力[采用临床医务人员共情能力调查表(JES-HP)]、患者对护理工作满意度、护士对工作满意度,并统计两组护理不良事件发生率.结果:观察组护士JES-HP中观点采纳、换位思考、情感护理评分高于对照组(P<0.05,P<0.01);患者对观察组护士在质量设施、护士服务、健康教育及人文关怀方面评分高于对照组(P<0.01,P<0.05);观察组护理过程中不良事件总发生率低于对照组(P<0.05);观察组护士对上班时间、晋升福利及同事交流满意度评分均高于对照组(P<0.05,P<0.01).结论:分组分层排班法可有效提高护士的护理能力及工作积极性,减少不良事件,同时患者对护理工作满意度和护士对工作满意度.

目的 探讨PDCA循环管理对腹膜透析置管患者护理质量及并发症发生率的影响.方法 选取2016年6月至2018年12月在我院接受腹膜透析置管患者48例作为研究对象,随机将其等分为对照组和观察组,对照组给予常规护理,观察组给予PDCA循环管理.比较两组患者的护理质量和并发症发生率.结果 观察组患者的护理质量评分明显高于对照组,差异具有统计学意义(P<0.05);观察组患者的并发症发生率明显低于对照组,差异具有统计学意义(P<0.05).结论 将PDCA循环管理应用于腹膜透析置管患者的临床护理中,能提高护理质量,减少并发症发生率,值得临床推广应用.

目的 研究优质护理干预对慢性肾脏病5期腹膜透析患者的临床效果.方法 选择2015年1月~2016年12月在我院进行诊治的慢性肾脏病5期腹膜透析患者40例,随机分为对照组和观察组,各20例.对照组采用常规护理干预,观察组采用优质护理干预.比较两组的腹膜炎发生率,以及两组患者的心理功能、躯体功能、物质生活以及社会功能等方面的生活质量评分.结果 护理前,两组腹膜炎发生率相比,差异无统计学意义(P>0.05),护理后,观察组腹膜炎发生率明显低于对照组,差异有统计学意义(P<0.05);观察组心理功能、躯体功能、物质生活以及社会功能等方面的生活质量评分均明显高于对照组,差异有统计学意义(P<0.05).结论 对慢性肾脏病5期腹膜透析患者采用优质护理干预不仅可以明显降低腹膜炎发生率,还可以改善患者的生活质量.

[目的]分析强化式健康教育对持续非卧床腹膜透析病人生存质量的干预效果。[方法]将83例持续非卧床腹膜透析病人随机分为观察组(42例)和对照组(41例)，对照组病人采取常规式健康教育模式进行干预，观察组则采取强化式健康教育模式进行干预，待干预90 d后评价并比较两组病人的生存质量和并发症发生率。[结果]干预后观察组病人生存质量明显优于对照组(P<0.05)。[结论]强化式健康教育可有效改善持续非卧床腹膜透析病人的生存质量。

目的：探讨血必净注射液治疗脓毒症，对患者血和肽素（Copeptin）、降钙素原（PCT）及白细胞介素6（IL-6）水平的影响。方法125例脓毒症患者随机分为对照组和血必净组，记录两组治疗前、后第4、8天APACHEⅡ评分和SOFA评分，检测治疗前及治疗8 d后两组Copeptin、PCT及IL-6水平。结果治疗后第8天两组血Copeptin、PCT及IL-6水平均较治疗前下降，血必净组血较对照组下降明显，差别有统计学意义（P＜0.05）；两组APACHEⅡ评分和SOFA评分均有改善，血必净组较对照组改善明显，差别有统计学意义（P＜0.05）。结论血必净注射液抑制炎性因子释放，降低血Copeptin、PCT及IL-6水平，抑制体内炎性反应，改善APACHEⅡ评分和SOFA评分，降低脓毒症患者的预计病死率。

2010年全国护理工作会议提出了以“夯实基础护理，提供患者满意度”为主题的“优质护理服务示范工程”[1]，本科作为全院优质护理服务示范工程的A类病区，为进一步加强和改善临床护理服务，丰富护理服务内涵，推动护理服务整体水平，为患者提供安全而满意的护理服务，结合本科的实际情况不断转变护理服务理念，改革临床护理模式和护理管理方式，坚持一切以患者为中心，力求责任护士对所负责的患者提供连续、全程的护理服务，全面推行整体护理责任小组包干制模式，取得了满意效果，现总结如下。

目的：对探讨 PDCA 循环管理在降低腹膜透析相关性腹膜炎感染率中的应用。方法对60例腹膜透析患者进行随机分组，分为常规护理组和 PDCA 组。比较两组的感染率的差异。结果常规护理组发生腹膜炎患者12例（40.00%），PDCA 组发生腹膜炎患者4例（13.33%）。PDCA 组腹膜透析相关腹膜炎发生率低于常规护理组腹膜透析相关腹膜炎发生率（P<0.05）。结论 PDCA 循环管理能有效的降低了腹膜透析相关性腹膜炎的发生率，延长了患者的透析时间，提高了患者的生活质量。

Objective To explore the role of head nurse in the management of high quality nursing. Method Effectively providing high quality nursing service by renewing ideas, changing nursing mode, focusing on construction of high quality nursing connotation, and strengthening nurse team consciousness. Result The nursing service quality and patient satisfaction was improved, and the nursing safety was effectively guaranteed. Conclusion Head nurse plays a crucial role in the management of high quality nursing.

为全面提高有创机械通气患者的护理质量,降低呼吸机相关性肺炎的发生率,我们将1998年2月～2003年4月41例机械通气患者随机分为常规护理组和PDCA组,将PDCA循环管理法运用于护理工作中,对降低呼吸机相关性肺炎的发生率取得了一定的效果,提高了抢救的成功率,现报告如下.

Objective: To evaluate the clinical effect of NPPV for respiratory failure in the patients with chronic obstructive pulmonary disease(COPD). Methods:Fifty one patients with COPD and type II respiratory failure were randomly divided into two groups: conventional therapy(CT) group and noninvasive positive pressure ventilation(NPPV) group. The arterial blood gases were observed before and after the treatment. Prognosis was analyzed in the two groups. Results:Compared with pre-treatment, the level of PaO 2 was apparently increased and the PaCO 2 decreased after 24 hour by NPPV (P0.01). In CT group the level of PaO 2 was increased, PaO 2 was unchanged after treatment. The degree of increase or decrease has significant differences between the two groups (P0.05). The failure rate of treatment in CT group(34.6%) was higher than the NPPV group(16.0%,P0.05). The average hospitalization day of the NPPV group was significantly shorter than the CT group. Conclusion: NPPV can effectively improve the gas ventilation with correcting hypoxia and hypercapnia, and to increase the successful rescue rate in the patients with COPD and type II respiratory failure.