ABSTRACT
Objective To investigate the effect of cluster interventions for prevention of ventilator-associated pneumonia (VAP)on mechanical ventilation.Methods A total of 110 patients with mechanical ventilation more than 48 hours at the intensive care unit(ICU)between April 2011 and June 2012 were randomly divided into three groups:control group(n=36),subglottic secre-tion drainage(SSD)group(n=37),cluster(CL)group(n=37).At the end of study,VAP incidence rate,VAP related death rate, duration of mechanical ventilation,ICU length of stay(LOS)were investigated and compared among the three groups.Results The morbidities of VAP between control group and SSD group were significantly different in the third day,the 7th day of mechanical ventilation.The morbidity of VAP of CL group was lower than that of control group,The morbidity of VAP of CL group was lower than that SSD group in the over 9 day.and its duration of mechanical ventilation and ICU LOS were significantly lower than those of SSD group and control group.However,there was no significant difference of VAP related death rate among the three groups. Conclusion Strictly implement semi-supine position and oropharynx intervention strategies of each link in mechanical ventilation that has important significance to preventing ventilator-associated pneumonia.
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Objective To observe the effects of rehabilitation training combined with health education on quality of life and psychological state of elderly patients with chronic obstructive pulmonary disease (COPD).Methods A total of 108 elderly inpatients with moderate to severe COPD in stable conditions were randomly divided into an intervention group and a control group,with 54 patients in each group.The patients in both groups received general respiratory medical therapy.The patients in intervention group also received additional comprehensive rehabilitation training consisting of individualized exercise instructions and health education,while the patients in control group only received online telephone health education and rehabilitation training instruction.Patients in both groups were assessed by using St.George's respiratory questionnaire (SGRQ) and symptom checklist 90 (SCL-90) before and after one year of treatment.Results After treatment,the control group's scores for various SGRQ items were similar to the scores within the group before treatment (P ＞ 0.05).The intervention group's SGRQ scores for symptoms,mobility and impact on life and the total score were (42.12 ± 11.32),(45.17 ± 10.23),(29.98 ± 6.54) and (41.02±9.92),respectively,significantly different from their baseline values and those of the control group after treatment (P ＜ 0.01).After treatment,the intervention group's SCL-90 scores were significantly improved from baseline values and were also significantly different from the control group (P ＜ 0.05).Comparison between the two groups showed that throughout the treatment period,the number of patients with acute attacks and the number of patients' hospitalization due to acute attacks were statistically significantly lower in the intervention group (P ＜ 0.05).Conclusions Rehabilitation training combined with health education can significantly improve quality of life and psychological health of COPD patients.
ABSTRACT
<p><b>OBJECTIVE</b>To explore the effect of rehabilitation exercise combined with encouragement on the quality of life of patients with chronic obstructive pulmonary disease (COPD).</p><p><b>METHODS</b>A total of 120 inpatients with moderate or severe COPD in stable conditions were randomized equally into experimental and control groups. The patients in both groups received routine treatment for 1 year, and those in the experimental group had additional respiratory muscle and limb exercises with encouragement. The quality of life, 6-min walking distance, lung function, anxiety and depression levels were compared between the two groups before and after the treatments.</p><p><b>RESULTS</b>The quality of life was improved significantly in the experimental group after the treatments (P<0.01) with obviously increased 6-min walking distance and lowered levels of anxiety and depression in comparison with those in the control group (P<0.05). Compared with the control group, the patients in the experimental group showed also significantly improved lung functions.</p><p><b>CONCLUSION</b>Comprehensive pulmonary rehabilitation training program with exercise combined with encouragement can improve the physical and emotional state, social adapt ability and the quality of life of patients with COPD.</p>