ObjectiveTo examine the feasibility of the Body Function component in the International Classification of Functioning, Disability and Health Rehabilitation Set (ICF-RS) as a functional assessment instrument for orthopedic patients by using Rasch analysis.MethodsA total of 119 orthopedic inpatients hospitalized in Shenzhen Longcheng Hospital were recruited from July 2018 to November 2019 through convenient sampling method. The component of Body Function (9 categories) of the ICF-RS was used to assess the patients. Rasch analysis was performed using the RUMM 2030 software. The psychometric properties were reported including overall goodness of fit, goodness of fit for each item, person separation index, differential item functioning, and person-item threshold distribution map.ResultsThe first-round Rasch analysis found that the overall goodness of fit for the Body Function component of the ICF-RS was poor （χ2=39.01, P=0.002 8, the significance level after Bonferroni correction was 0.05/9=0.005 6), the item-fit and individual-fit residuals were (0.36±1.34) and (-0.24±0.62), respectively. The person separation index was 0.55. The residuals of the category b130 Energy and Drive Function was 3.642, more than 2.5, and it fit the Rasch model poorly. After deleting the category b130 Energy and Drive Function, the second-round Rasch analysis found that the overall goodness of fit for the Body Function component of the ICF-RS was satisfied (χ2=25.60, P=0.059 9, the significance level after Bonferroni correction was 0.05/8=0.006 3), the item-fit and individual-fit residuals were (0.40±0.90) and (-0.27±0.59), respectively. The person separation index was 0.58. The residuals of the remaining items were all within ±2.5 with a nonsignificant P value. The results showed no differential item functioning in terms of age, gender, course of disease, and marital status. The person-item threshold distribution map showed that the categories basically covered the patient coordinates. The patients performed the worst in the category b280 Pain Sensation and the best in the category b640 Sexual Function.ConclusionAfter deleting the category b130 Energy and Drive Function, the remaining 8 categories of Body Function component in the ICF-RS fit well with the Rasch model, and could be used as a functional assessment instrument for orthopedic patients.

目的:探讨间歇导尿在控制脊髓损伤排尿功能障碍患者尿路感染的效果.方法:将符合纳入标准的30例脊髓损伤患者随机分为对照组和观察组各15例,对照组采用留置导尿管的方法进行护理,观察组采用间歇导尿的方法进行干预护理,2组分别在干预的第1周和第2周行尿常规和中段尿培养检查,了解尿路感染的情况,并观察其对生存质量的影响.结果:间歇导尿患者尿路感染率明显低于留置尿管的患者,生存质量明显改善(P<0.05).结论:采用间歇导尿的方法进行干预护理,能更好的降低脊髓损伤排尿障碍的尿路感染发生率,从而更好的提高其生存质量.

目的:探讨膀胱扫描仪在神经源性膀胱患者残余尿测定的相关性.方法: 25例神经源性膀胱患者自行排尿后间歇导尿前采用膀胱扫描仪进行残余尿测定,随即间歇导尿测量实际尿量,比较二者之间的相关性与差异性.结果:128次膀胱扫描仪测得的尿量与间歇导尿测得的实际尿量成线性相关分析,相关系数为0.97,其中103次(80.4％)的测量误差在实际值的上下20％范围之间.结论:膀胱扫描仪测定残余尿存在相关性,膀胱扫描仪对于神经源性膀胱患者的间歇导尿具有指导意义,可减少盲目间歇导尿的次数,减轻尿路损伤和感染.

目的：探讨实施激励理论护理干预方式，对改善脊髓损伤患者的心理状态、日常生活能力的干预效果。方法：50例脊髓损伤患者，分为对照组25例，干预组25例，对照组给予常规护理，干预组在常规护理过程中应用激励理论进行护理。两组在入院第1天、出院前1天分别用焦虑自评量表、抑郁自评量表，改良的 Barthel指数（MBI）评定日常生活活动能力进行评价。结果：干预组在干预后焦虑情绪、抑郁情绪、日常生活活动能力较对照组有显著改善（P＜0．05）。结论：在护理过程中应用激励理论可明显改善脊髓损伤患者的焦虑和抑郁情绪，提高日常生活活动能力，从而促进疾病的康复，提高生活质量。

目的:总结老年鼻饲患者误吸的原因,并提出护理对策.方法:回顾性分析我科2011 年1 月-2012年12 月收治的老年鼻饲患者发生误吸20 例的临床护理资料.结果:13 例在家中发生误吸,出现肺部感染;7 例在医院发生,出现呼吸困难2 例,清理呼吸道分泌物后好转,肺部感染加重4 例,呼吸机辅助呼吸1 例.结论:根据病情判断患者可能发生误吸的机会,提高急救意识,可降低老年患者误吸的发生率.

目的观察旋转振动扫痰仪预防长期卧床老年患者坠积性肺炎的临床效果。方法将182例老年脑卒中偏瘫患者(年龄56～91岁)分为治疗组(117例)和对照组(65例)。治疗组采用旋转振动扫痰仪治疗,每次10min,1～2次/d;对照组采用传统护理方法预防坠积性肺炎。结果对照组发生坠积性肺炎5例,治疗组无1例发生,治疗组治疗效果优于对照组(P<0.05)。结论旋转振动扫痰仪对预防长期卧床老年患者坠积性肺炎有良好效果。