RÉSUMÉ
Objective To explore the influence of acupuncture point massage combined with limb function exercise on ankle brachial index (ABI) and pulse wave velocity (PWV) in patients with coronary heart disease (CHD). Methods According to scores by grace score scale, 180 CHD patients were divided into three groups: low risk group (n=58), moderate risk group (n=68) and high risk group (n=54). Within the three groups, the patients were divided into the experiment group and the control group by using the random digital table. The control group was treated with routine nursing intervention , while the experiment groups accepted acupuncture point massage and limb function exercise training on the basis of control groups. We collected the values of ABI and PWV at four points-in-time: before intervention, 7 days after intervention, 30 days after intervention and 90 days after intervention. Results Repeated measurement data analysis of the experiment group and control group suggested that:in the moderate and high risk groups, there was statistically significant difference (P 0.05) in time and group interaction effect. The difference between the experiment group and control group was statistically significant (P0.05) in ABI&PWV interaction effect at the four time points between the experiment group and control group. In the low-risk group,the differences in time points compared with the main effect were insignificant (all P>0.05). In comparison of main effect at all the four time points, there was significant different in the moderate and high risk group (P0.05) of ABI&PWV before and 90-days after intervention. Conclusion Acupuncture point massage combined with limb function exercise can effectively improve the peripheral artery blood supply in CHD patients, lower ABI and promote PWV.
RÉSUMÉ
Objective We sought to evaluate the effect of structured health education on quality of life and the end point of patients with coronary disease with evidence-based method.Methods The Cochrane Library,Cochrane Database of Systematic Reviews (CDSR),Medline (OVID),Pubmed and Web of Science were searched to collect the randomized controlled trials (RCT) which mentioned the structured health education to CHD patients,the quality of the RCTs was evaluated by Jadad Score,then effective data were extracted and analyzed by Meta-analysis with RevMan 5.2 software.Results A total of 12 eligible studies of RCT were included in the study with Jadad Score evaluations at B level or above.There were 20 476 cases in the intervention group,14 522 cases in the control group.Meta-analysis showed that the quality of life scores of the intervention group were significantly higher than those of the control group,weighted mean difference was 3.29,95％ CI (0.49-6.09).No significant difference was found in cardiac morbidity outcomes,re-hospitalization and the mortality rate,relative risk,95％ confidence interval were respectively 0.72(0.50-1.04),0.98(0.86-1.11),0.77(0.58-1.03).Conclusions The structured health education can improve the quality of life of patients with coronary disease,but has no obvious effect on the cardiac morbidity outcomes,re-hospitalization and mortality rate.We suggest transitional care to be carried out in future research to decrease the incidence rates of them.
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Objective To establish a scientific and feasible evaluation index system of the quality of health education among the elderly in the community.Methods Based on the results of literature review,theory analysis,cross-sectional study and interviews,a draft evaluation index system was formulated.Then Delphi method was conducted on 28 specialists around the country,the weight of each index was determined by hierarchy analysis.Results After three rounds of Delphi procedure,the response rates of the three round consultation were all above 85％,and the authority coefficient and coordination coefficients was 0.858,0.210,respectively.An evaluation index system which covered three first-level items,7 second-level items and 35 third-level items was formulated.Conclusions Based on survey of the elderly and interviews of health education staffs in the community,and using the method of Delphi to collect experts' suggestion,a strong maneuverability and high reliability quality evaluation index system was formulated,which provided guidance for community health education of the elderly,and promoted its development towards scientization and standardization.
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Objective To parse the concept of self-management in the context of coronary heart disease based on the content analysis,to clarify the connotation of the concept of self-management.Methods Thirty-four references were recruited through the databases of CNKI,VIP journals knowledge service platform,Wanfang Data Services Platform and Pubmed.We broke the concept of self-management in the context of coronary heart disease into such three aspects as implementing body,major behavior,and facilitators.Results The most common indicators were symptom management(which was mentioned by 78.57％ of domestic literature and 66.67％ of foreign literature),and protect and promote healthcame second,the person with the chronic diseasewas 42.85％,other indicators' frequency existed differences.The major body of coronary artery disease self-management was the patient itself,with the help of assist staff and using lifestyle management,symptom management,rehabilitation and exercise,environmental control,emotional awareness behavior management and medication to maintain patients' satisfactory functional status.Conclusions To parse the concept of self-management in the context of coronary heart disease can be applied as the basis for clinical nursing research and build an effective reference and guidance for future coronary heart disease self-management model building.
RÉSUMÉ
In nursing teaching,it is necessary to adopt the idea of developmental teaching,innovate the traditional teaching method,make the students be active and learn autonomously and in the meantime make the exploration of developmental evaluation,in order to improve the students' integrative quality and promote their individual development and strengthen their competence of autonomous learning.