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Objective:To analyze the mediating role of self-esteem and control sources in readmission frequency and self-perceived burden of elderly patients with chronic heart failure(CHF).Methods:A total of 346 cases of elderly patients with CHF were included, using self-perceived burden scale(SPBS), self-esteem scale(SES) and multidimensional health locus of control scale(MHLC) to investigate.SPSS 20.0 software was employed to coduct Pearson and Spearman correlation analysis and multiple linear stepwise regression to construct the structural equation model.Process 2.13.2 plug-in was used to test the intermediate effect of Bootstrap.AMOS 23.0 was used for structural equation model and path analysis verification.Results:(1) The readmission frequency during the recent years of the elderly patients with CHF was 0-8, and M( P25, P75) was 1(1, 3). The mean score of self-esteem scale was (29.25±3.67), and the score of internal control in psychological control source was (22.67±3.85). The score of influential others was (26.45±3.38). The opportunity score was (19.84±3.82). The mean SPBS score was (22.19±9.49). (2) SPBS total score was significantly negatively correlated with self-esteem ( r=-0.359, P<0.01), positively correlated with opportunity control source ( r=0.169, P<0.01). Self-esteem was positively correlated with internal control( r=0.237, P<0.01), control of influential others( r=0.225, P<0.01). The readmission frequencies of CHF were significantly negatively correlated with self-esteem( r=-0.119, P<0.05) and internal control( r=-0.173, P<0.01), positively correlated with SPBS( r=0.219, P<0.01). (3) Multiple regression and structural equation model results showed that readmission, self-esteem and psychological control sources could account for 18.0% of the total variables of self-perceived burden.The relationship between readmission and self-perceived burden was mediated by self-esteem and locus of control, accounting for 20.00% of the total effect. Conclusion:Self-esteem and control sources are partially mediating the effect between readmission and self-perceived burden.By nursing intervention to improve the self-esteem level, positive coping strategies of internal control of elderly patients with CHF, the burden of self-perception may possibly be alleviated.
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This article reports the successful experience of integration of burn treatment and rehabilitation for a child suffering from 91% TBSA flame burn injury (with 60% TBSA full-thickness injury, 30% TBSA deep partial-thickness injury, and 1% TBSA superficial partial-thickness injury), severe inhalation injury, severe burn shock, stress ulcer, gastrointestinal bleeding and atelectasis of the right upper lung. The patient was given effective fluid infusion against shock, treatment for gastrointestinal bleeding, and other effective supportive treatment for functions of various organs after being admitted to our burn ward. When vital signs became stable at 30 hours post injury, bedside rehabilitation was begun. On post injury day (PID) 4, escharectomy was performed for both lower limbs, followed by microskin grafting and allogeneic skin covering. On PID 10, invasive infection of multi-drug resistant bacteria was found with accompanied high fever, and at the same time allograft began to disintegrate, with dissolution of large area of eschar, leading to a raw surface reaching 86% TBSA. Following debridement, dressing, application of compound polymyxin B ointment, temporary covering of wounds with porcine acellular dermal matrix, adjustment of antibiotics, patient's condition was finally stabilized. From PID 28 on, split-thickness skin grafting was conducted 7 times, and the raw surface of 75% TBSA involving the upper and lower limbs and trunk was successfully covered. At the same time, our rehabilitation team launched comprehensive rehabilitation measures comprising active exercise, occupational therapy, prevention of scar formation, organ function training and psychological intervention. Finally, the patient was able to walk unaided and fed herself when the wounds were almost entirely healed in 3 months after injury. Oriented forwards functional rehabilitation, strong cooperation between team members, and synchronous effective implementation of burn treatment and rehabilitation in the whole process are the keys to achieve successful integration of burn treatment and rehabilitation of this child.
Subject(s)
Animals , Humans , Acellular Dermis , Anti-Bacterial Agents , Therapeutic Uses , Burns , Rehabilitation , Therapeutics , Cicatrix , Debridement , Shock , Skin , Skin Transplantation , Swine , Trauma Severity Indices , Treatment Outcome , Wound HealingABSTRACT
Objective To analyse effect of berberine combined with levofloxacin on myocardial enzymes, isozymes and serum inflammatory factors in children with diarrhea.Methods 58 patients who were diagnosed with pediatric infectious diarrhea in our hospital were collected.All patients were randomly divided into experimental group and control group, 29 cases in each group.two groups of patients were given routine treatment, including infusion, maintaining water and electrolyte balance, supplemental calories etc.On the basis of routine treatment, control group was intravenous dripped with levofloxacin injection 200mL,one times per day,and experimental group was treated with berberine hydrochloride tables 0.2 g orally on the basis of control group.The treatment period was one week of two group.After one week of treatment, the serum levels of myocardial enzymes, isozymes, inflammatory factors and clinical curative effect were detected in all patients.Results Compared with control group post-treatment,the serum AST,ALT and LDH levels were lower than that of experimental group(P<0.05);the serum CK and CK-MB levels were lower than that of experimental group(P<0.05);the serum TNF-α,IL-6 and IL-10 levels were lower than that of experimental group(P<0.05);the total effective rate was higher in experimental group(P<0.05).Conclusion The berberine combined with levofloxacin can significantly reduce the serum myocardial enzymes, isozymes and serum inflammatory factors in children with diarrhea, improve clinical curative effect.
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Gynecologic personnel training is an important part of traditional Chinese medicine(TCM) of qualified personnel in the new century. With the opportunities and challenges in these years, improving the quality of TCM Gynecologic personnel training to adapt to economic and social development has great significance. For the situation of Gynecologic students difficult to word, and poor ability to adapt clinical reasons, we propose a five complex combination of moral, intellectual, research, economics, thinking education model, training Gynecologic compound talents, educating more skilled talents for medical practice.
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As a pilot program of teaching reform,some excellent undergraduates majoring in nursing were selected to take specialized courses in ICU in order to cultivate the intensive care specialized nurses.The teaching team of specialized courses in ICU was established to guarantee the teaching quality.The team was in charge of the ICU specialized curriculum building,textbooks selection and teaching content examination.The high leveled teaching team of specialized courses in ICU was organized by taking teaching and researching section as a unit to improve theoretical teaching level,using clinical department as training base to enhance practice skill and participating in special subject classes and in-service study to promote specialized quality.
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Objective: To explore the burden of spouse caregivers of patients with dementia at home and factors having influence.Methods:Forty-two patients with dementia were collected from psychiatric out-clinic consecutively. Trained investigators did home visit to collect data on severity of the disease (CDR, MMSE), pathological behavior (BEHAVE-AD), activity of daily living (ADCS-ADL) and burdens of their spouse as caregiver (CBI). The caregivers' anxiety, depression (Zung's Anxiety Scale and Depression Scale) and knowledge about dementia were also collected.Results:The caregivers felt big burden (BDI total score: 30.7?15.1). Nearly half of them (42.9%) were in depression and one quarter (23.8%) were anxious. They were lack of knowledge about dementia and unskillful in care-giving. 26.2% caregivers thought dementia is curable or equal to normal aging, 57.1% of them did not believe it is an improving disease. The burden of caregivers was correlated positively with pathological behavior of patients (r=0.40, P