目的 了解中国多囊卵巢综合征(PCOS)患者焦虑抑郁情况.方法 检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献服务系统、PubMed、EMbase、The Cochrane Library、Web of Science核心合集数据库,检索时间为建库至2021年9月,收集关于中国PCOS患者焦虑抑郁患病情况的调查研究.采用Stata 12.0软件对焦虑抑郁患病率进行meta分析.结果 共纳入9篇文献,meta分析显示,我国PCOS患者焦虑患病率为22％(95％CI:20％～24％),抑郁的患病率为30％(95％CI:28％～32％).亚组分析显示,近5年内PCOS焦虑患病率为 24％(95％CI:21％～27％),抑郁患病率为 28％(95％CI:26％～31％);近 5～10年 PCOS 焦虑患病率为 16％(95％CI:11％～21％),抑郁患病率为 30％(95％CI:24％～36％);10 年以上 PCOS 焦虑患病率为 23％(95％CI:19％～27％),抑郁患病率为37％(95％CI:32％～42％).华南地区焦虑患病率为30％(95％CI:25％～36％),抑郁患病率为29％(95％Cl:23％～34％);华北地区焦虑患病率为 27％(95％CI:22％～32％),抑郁患病率为 38％(95％CI:33％～42％);华东地区焦虑患病率为16％(95％CI:13％～20％),抑郁患病率为33％(95％CI:29％～38％);西南地区焦虑患病率为22％(95％CI:19％～26％),抑郁患病率为24％(95％CI:21％～28％).结论 我国PCOS患者焦虑抑郁呈高发趋势,应加强对PCOS患者不良情绪的管理,预防和干预并行,探寻有效情绪管理手段.

目的 系统评价生活管理对多囊卵巢综合征(PCOS)的影响.方法 遵循Cochrane的建议和指南进行系统检索,检索PubMed、Embase、Cochrane Library、Web of Science、中国生物医学文献数据库、知网、万方、维普数据库,纳入生活管理干预PCOS的临床随机对照研究(RCT),检索时间截止到2021年5月.在筛选文献、数据提取和质量评价后,使用RevMan5.4软件进行Meta分析.结果 共纳入18篇RCT,总计1 875例PCOS患者.Meta分析显示,生活管理后干预组与空白对照组相比,胰岛素抵抗指数(HOMA-IR)[MD=-0.27,95％CI(-0.30,-0.25),P＜0.000 1]、空腹胰岛素(FINS)[MD=-3.27,95％CI(-4.02,-2.35),P＜0.000 1]、空腹血糖(FPG)[MD=-0.11,95％CI(-0.17,-0.05),P=0.000 2]、低密度脂蛋白(LDL)[MD=-0.50,95％CI(-0.67,-0.34),P＜0.000 1]、高密度脂蛋白(HDL)[MD=-0.33,95％CI(-0.46,-0.20),P＜0.000 1]、三酰甘油(TG)[MD=-0.39,95％CJ(-0.46,-0.32),P＜0.000 1]、腰围[MD=-3.09,95％CI(-5.46,-0.73),P=0.01]、收缩压(SBP)[MD=-3.76,95％CI(-6.29,-1.23),P=0.004]、舒张压(DBP)[MD=-1.34,95％CI(-2.36,-0.33),P=0.009]等均有改善.结论 生活管理能够显著改善PCOS患者核心病因及代谢谱,预防心血管疾病(CVD)危险因素的增加,还能够在一定程度上提高患者生活质量,促进PCOS患者自觉采取有利健康的生活管理.

目的:系统评价多囊卵巢综合征患者的患病体验.方法:检索PubMed、Web of Science、Embase、中国生物医学文献库、中国知网、万方数据库、维普中文期刊全文数据库.采用澳大利亚JBI循证卫生保健中心质性研究质量评价标准对文献进行评价,并采用汇集性整合方法对结果进行整合.结果:共纳入10篇文献,提炼了50个主题,归纳出10个类别,最终形成3个整合结果,即疾病造成的影响、疾病意识与应对方式、疾病相关需求.结论:医护人员应充分了解多囊卵巢综合征患者的患病体验,在治疗与护理中给予帮助和支持,鼓励其积极应对疾病,同时构建支持系统,以提高患者生活质量.

目的:探讨不同心理干预方式对围绝经期女性焦虑、抑郁症状的改善效果.方法:计算机检索Pubmed、Embase、Cochrane、Web of Science、中国生物医学文献数据库(CBM)、万方数据库、中国知网数据库(CNKI)、维普数据库(VIP)关于心理干预对围绝经期女性影响的随机对照试验,并筛检纳入研究的参考文献,检索时间为建库至2020年11月.2名研究人员完成文献筛选、数据提取、质量评价后,采用RevMan 5.4软件进行Meta分析.结果:纳入10篇文献,共计1278例病人.Meta分析显示:不同心理干预方式中,认知行为疗法能有效减轻围绝经期女性焦虑[SMD=-0.41,95％CI(-0.75,-0.06),P=0.02]、抑郁[SMD=-0.55,95％CI(-0.82,-0.27),P<0.0001];综合心理干预能减轻围绝经期女性焦虑[SMD=-3.86,95％CI(-4.13,-3.59),P<0.00001]、抑郁[SMD=-2.88,95％CI(-3.41,-2.35),P<0.00001];而正念疗法对围绝经期女性焦虑、抑郁改善效果不明显.结论:认知行为疗法、综合心理干预能够有效缓解围绝经期女性的焦虑和抑郁,正念干预对围绝经期女性焦虑、抑郁的改善效果尚需一些试验支撑.

Objective:To analyze effects of dietary intervention on health outcome in patients with polycystic ovary syndrome.Methods:PubMed, Cochrane Library, Web of Science, Embase, China Biology Medicine disc, CNKI and WanFang Data were searched by the computer, and clinical RCTs about dietary intervention in patients with polycystic ovary syndrome were included. The retrieval time was up to August 2020. Two trained researchers independently screened the literature, extracted data and evaluated the quality. Meta-analysis was performed using RevMan 5.3 software.Results:A total of 9 clinical RCTs were included, including 697 patients with polycystic ovary syndrome. The results of Meta-analysis showed that compared with the control group, dietary intervention could reduce the body weight ( MD=-2.22, 95% CI -2.75--1.68, P<0.001) , body mass index ( MD=-1.05, 95% CI -1.24--0.87, P<0.001) , waist circumference ( MD=-2.35, 95% CI -4.17--0.53, P=0.01) , fasting blood glucose ( MD=-0.12, 95% CI -0.18--0.05, P<0.001) , fasting insulin ( MD=-4.77, 95% CI -5.59--3.96, P<0.001) , insulin resistance index assessed by steady-state model ( MD=-0.93, 95% CI -1.29--0.57, P<0.001) , luteinizing hormone ( MD=-0.46, 95% CI -0.90--0.03, P=0.040) , follicle-stimulating hormone ( MD=-0.16, 95% CI -0.31--0.01, P=0.030) , total testosterone ( MD=-0.33, 95% CI -0.53--0.13, P<0.001) , increase sex hormone-binding globulin ( MD=8.02, 95% CI 5.55-10.49, P<0.001) and pregnancy rate ( RR=18.38, 95% CI 4.47-75.55, P<0.001) of patients with polycystic ovary syndrome. Conclusions:Dietary intervention can improve the pregnancy rate of patients with polycystic ovary syndrome, improve the endocrine and metabolic status and reduce the level of insulin resistance and human measurable indicators.

目的 探讨动机性访谈在COPD稳定期患者健康行为及生活质量中的应用效果,为开展相关临床工作提供参考.方法 采用简单随机抽样法,选取2015年10月至2016年3月从遵义医学院附属医院呼吸内科出院的COPD患者102例作为研究对象.采用随机数字表法将研究对象分为对照组(n=51)和观察组(n=51).对照组给予常规的出院后随访及护理,观察组在此基础上采用动机性访谈进行干预.采用慢性阻塞性肺疾病患者自我管理量表、生活质量问卷、肺功能指标及6 min步行试验于干预前、干预结束、干预后3个月及6个月时对两组患者进行评估.结果 干预结束、干预后3个月及6个月,观察组患者自我管理水平及运动耐力得分均高于对照组(P<0.05),生活质量得分低于对照组(P<0.05);不同时间点两组患者肺功能指标比较均无统计学意义(P>0.05).结论 动机性访谈能帮助COPD稳定期患者建立良好的健康行为,并能提高及维持患者的自我管理能力、生活质量及运动耐力.

综述饮食构成和运动类型对多囊卵巢综合征(PCOS)病人临床作用的影响,以及心理干预、行为疗法的研究现状,为我国治疗PCOS提供参考.

With the increasing prevalence of chronic obstructive pulmonary disease (COPD) and the extremely high mortality, disability, symptom burden and dysfunction, as well as the need for continuous drug management and care and increased rehospitalization rate, it brings patients, families and even society huge economic burden. The transitional care model provides non-drug treatment method to help patients get through the transition period safely and steadily, it also improves patients' self-care ability, quality of life and reduce hospital readmission. This review will start from the concept of disease management in transitional period, elaborate on the problems and core elements of transitional caring, then discuss the application of advanced practice nurse-dominated transitional caring mode in COPD, so as to provide theoretical and practical basis for improving the quality of chronic diseases management in China.

Objective To reconcile previous studies on the impact of transitional nursing intervention on quality of life in patients with chronic obstructive pulmonary disease (COPD) after discharge from the Chinese population. Methods PubMed, EMBASE, Cochrane Library, Clinical Trial, CBM, Joanna Briggs Institute Library, MEDLINE, Wanfang database and CNKI database, Vip database were searched by computer. The literatures about the influence of transitional nursing on the quality of life of COPD patients were searched until January 1, 2018. the data were analyzed by Rev Man 5.3 software. The results showed that P<0.05 on both sides was statistically significant. Results Five clinical studies were included, and the data were combined according to the symptom, activity, social psychology and St.George's Respiratory Questionnaire (SGRQ) total score in the SGRQ scale. Mean difference and its 95％confidence interval of symptoms, activities, social psychology and SGRQ score were-13.09 (-18.71,-7.48), 12.05 (-14.55,-9.45),-17.87 (-22.27,-13.46) and-15.42 (-19.74,-11.10) (Z=4.57-9.42, all P <0.05). Conclusions The transitional nursing has a significant positive effect on improving the quality of life among patients with COPD, which can effectively improve the psychosocial status of patients, and make the patients respond more actively to the problems in the process of treatment and rehabilitation.

目的 调查肝癌患者营养状态,并对肝癌患者营养风险的影响因素进行分析.方法 选取216例肝癌患者,采用营养风险筛查-2002(NRS-2002)量表对患者的营养风险状况进行了评估,216例肝癌患者的营养风险状况影响因素采用多元Logistic回归模型进行分析.结果 NRS-2002量表调查结果显示,NRS-2002评分≥3分124例,存在营养风险;NRS-2002评分﹤3分92例,无营养风险.单因素分析结果显示,存在营养风险肝癌患者和无营养风险肝癌患者年龄、婚姻状况、医疗费用来源、肿瘤直径、TNM分期、贫血情况和乙型病毒性肝炎情况比较,差异均有统计学意义(P﹤0.05).Logistic回归分析结果显示,年龄越大、医疗费用来源为自费、TNM分期为Ⅲ期、合并贫血和患有乙型病毒性肝炎均是肝癌患者营养风险的独立危险因素.结论 临床应重点关注年龄较大、医疗费用为自费、TNM分期为Ⅲ期、合并贫血和患有乙型病毒性肝炎的肝癌患者的营养风险状况,预防营养不良发生.

目的 了解黔北地区老年慢性阻塞性肺疾病患者自我管理知识、态度及行为现状,并对其影响因素进行分析.方法 采用自行编制的《慢性阻塞性肺疾病自我管理知识、态度及行为调查表》,对329例慢阻肺患者进行调查,采用SPSS17.0软件进行数据统计分析.结果 慢阻肺患者的自我管理知识、态度及行为总得分为(132.6±17.0)分,各维度得分高低依次为吸烟状况、用药治疗、运动锻炼、家庭氧疗.多元逐步回归分析显示年龄、性别、居住地、文化程度、病程及吸烟等是慢阻肺患者自我管理的主要影响因素.结论 老年慢阻肺患者对慢阻肺认知、态度及行为的自我管理水平亟待提高.知识的掌握是促进患者健康行为的关键因素.医务人员进行健康宣教时,应重点关注其影响因素,以患者为中心,运用新的思维与方法提高患者的自我管理能力,改善其生活质量.

目的 通过分析引起慢性乙肝患者抗病毒治疗疗效不好或病情加重的原因,探讨提高慢乙肝患者对治疗依从性,建立遵医行为的方法,提高抗病毒治疗效果,促进康复及预后.方法 选取2015年6月—2016年12月出院的120例慢性乙肝抗病毒治疗患者进行电话随访.其中,应用拉米夫定62例,阿德福韦35例,恩替卡韦37例,分析其对治疗依从性差的原因并进行相应指导.结果 97例按医嘱用药,23例自主停药,3例因重症肝炎抢救无效死亡.23例停药者中,最长者用药1年,最短者仅为1个月.结论 抗病毒治疗是抗乙肝治疗的关键,患者的依从性直接影响治疗效果.

[目的]系统评价循证护理在慢性阻塞性肺疾病病人健康状况中的应用效果.[方法]计算机检索PubMed、The Cochrane Li-brary、CNKI、WanFang Data、CBM、VIP、谷粉学术等数据库,收集循证护理对慢性阻塞性肺疾病病人健康状况影响的随机对照试验,采用RevMan 5.0软件最终纳入RCT进行系统评价.[结果]最终纳入12个RCT,总例数为1278例.结果显示:循证护理比常规护理更能有效提高肺功能、住院满意度、治疗依从性,改善缺氧状况、焦虑和抑郁情绪,差异均具有统计学意义(P<0.05);采取描述性分析6个RCT,各个研究结果分别显示循证护理的生存质量高于常规护理(P<0.05),差异有统计学意义(P<0.05).[结论]循证护理能有效提高COPD病人的肺功能、住院满意度、治疗依从性,改善缺氧状况、焦虑和抑郁情绪.

Objective To explore the effect of home care nursing model for children with hand foot and mouth disease. Methods A total of 84 patients with mild symptoms of HFMD were randomly divided into observation group and control group according to the order of visiting, 42 cases in each group. The patients of the observation group re-ceived home care after discharge, including health education, telephone follow-up and visit and other nursing meas-ures. The patients of the control group were not given the home care after discharge. The treatment compliance, quality of life, the mastery of self-management knowledge at home and the symptom relief time were compared. Results The treatment compliance, quality of life, the mastery of family self-management knowledge and patients' symptom remis-sion time of the observation group were shorter than that of the control group; the treatment compliance, quality of life, the mastery of family self-management knowledge and patients' symptom relief time of the observation group were better than that of the control group, and the differences were statistically significant (P <0. 05) . Conclusions Home care model has a positive influence on the life and treatment status of children with hand, foot and mouth disease, at the same time it can effectively improve the mastery of the related knowledge in terms of the hand, foot and mouth disease for the children's families, and can promote the patients' recovery, it is worth a clinical popularization and application.

目的 评价基于护士执业考试与岗位胜任能力培养相衔接的护理主干课程教学改革的效果.方法 2009级护理本科生418人设为对照组,沿用以往的护理主干课程体系,采用传统分课程考核模式、课堂理论讲授与临床实践教学法;2010级护理本科生341人设为实验组,以护士执业考试与岗位胜任能力为导向进行护理主干课程设置,增加实践教学比重,改革考核模式,并应用多形式教学法.结果 实验组执业资格考试成绩及初次就业率显著高于对照组(均P＜0.01).结论 以护士执业考试与岗位胜任能力为导向改革护理本科教学,有利于实现学校教育与国家行业标准的对接,为社会输送更多高素质护理应用型人才.

护理学科正经历着迅速发展阶段,研究生教育逐渐成为护理高等教育体系的重要组成部分。2010年,国务院学位委员会审议通过了护理学硕士专业学位(master of nursing specialist,MNS)设置方案[1]。这体现出我国的护理学高等教育逐渐与国际接轨,开始注重培养实用型人才。学术学位所要培养的是临床护理专家、高级实践护士,是“高层次、应用型、专科型”的护理人才。护理学硕士专业学位设置方案的实施,顺应了护理专科化的发展趋势,也将有利于护理学科的可持续发展,但是,由于专业学位硕士研究生教育培养还处在一个起始阶段,在该类型研究生的培养方向、课程设置、临床实践模式、考核评价等方面存在很大的空缺,有的甚至是零起点。但如何建立科学的培养方案,实现护理学专业学位教育的稳步发展,是各院校面临的共同问题。结合我院具体情况,通过查阅文献、访谈法和问卷调查法,建立了护理学专业学位硕士研究生培养模式。

据报道，美国每年有6万病人死于压力性溃疡引起的并发症，每年压力性溃疡治疗费用高达110亿，占医疗总花费的4％〔1〕。压力性溃疡的发生率是衡量护理质量的核心指标。本文就压力性溃疡的评估、预防与治疗进展进行综述。

为了解我国慢性阻塞性肺疾病（COPD）患者疾病经济费用的现状，制定相关的卫生经济政策和疾病防治策略提供基线数据，笔者对遵义地区COPD患者的疾病经济费用进行了分析。

Objective To evaluate the application effect of clinical pathway for patients with chronic obstructive pulmonary disease (COPD) in China .Method The application effect of clinical pathway for patients with chronic ob‐structive pulmonary disease was collected using computer to search CNKI ,CBM ,Wanfang data base and manual in‐spection .Cochrane systematic review's manual 5 .1 .0 quality evaluation criteria are included to evaluate the study by RevMan5 .0 Meta‐analysis software .Result There were 9 references included eventually ,a total of 930 patients inclu‐ding 474 cases of observation group and 456 control group .(1) Randomized model for COPD patients in hospital costs [MD= -0 .38 ,95% CI (-0 .50 , -0 .26),Z= 6 .23 ,P< 0 .00001] and length of hospital stay [MD=-4 .52 ,95% CI (-6 .20 ,-2 .84) ,Z=5 .28 ,P<0 .00001] clinical pathway of the application to statistical analy‐sis .There was significant difference .(2) Descriptive analysis was used in clinical pathway for COPD patients'hospi‐talized satisfaction and related knowledge of the effect of the application ,five studies showed clinically effective way to increase domestic COPD patients hospitalized satisfaction (P<0 .05) ,one study showed no significant difference (P>0 .05);5 clinical studies showed a statistically significant way (P< 0 .05) for patients with COPD related&nbsp;knowledge mastery domestic applications .(3) Fixed model of clinical pathways for reducing complications in pa‐tients with COPD application analysis ,the results show :[MD= 0 .31 ,95% CI (0 .15 ,0 .66) , Z= 3 .07 , P=0 .002] ,there was significant difference (P<0 .01) .Conclusion Studies have shown that the clinical pathway as a standardized model of health care services used for COPD in China can reduce hospital costs ,the length of stay and complications ,and can improve patient satisfaction and related knowledge degree to a certain extent .The depth and breadth of its application in the clinical work of medical institutions in the country should be further promoted .