Relationship between therapeutic compliance and complications in children with severeβ-thalassemia / 现代临床护理

Objective To explore the relationship of therapeutic compliance and complications in children with severeβ-thalassemia.Method One hundred and eight children with severeβ-thalassemia involved in the survey using convenient sampling to investigate the relationships between compliances with blood transfusion and iron removal treatment and complications.Results Of all the patients,66 complied with blood transfusion and the rest 42 did not;73 complied with the therapy and the rest 35 did not. Those complying with the blood transfusion had significant lower rates of developmental retardation,unusual faces,hepatosplenomegaly(P<0.01). Those complying with the therapy had significant lower rates of injuries in liver,heart and endocrinal system(P<0.01).Conclusion Therapeutic compliance in children with severeβ-thalassemia is at lower level so that the incidence of complications in them is higher.

Primoimplante de marcapaso definitivo: caracterización de pacientes y adherencia a seguimiento / Primoinplant permanet pacemaker characterization of patients and monitoring adherence

La implantación de marcapaso definitivo (MPD) se realiza en portadores de alteraciones en la generación del impulso eléctrico del corazón y/o con trastornos de la conducción. Las guías clínicas para su manejo proponen un seguimiento precoz, regular y de por vida, posterior al implante de MPD, con el fin de pesquisar alteraciones. Objetivo: caracterizar y evaluar adherencia a seguimiento en pacientes con primoimplante de MPD del Hospital Gustavo Fricke (HGF) en el período 2007. Pacientes y método: estudio descriptivo y retrospectivo, cuyo universo fueron los pacientes con primoimplante de MPD del HGF en el año 2007. Se caracterizaron los pacientes de acuerdo a sexo, edad y diagnóstico de indicación de MPD; se describió el porcentaje de inasistencia al primer, segundo y tercer control post-implante del MPD (correspondiente por garantías explícitas en salud) y finalmente se buscaron causas de inasistencia a estos controles. Resultados: el universo fue de 181 pacientes, 101 hombres. El grupo etáreo predominante fueron mayores de 70 años (56,9 por ciento). Los diagnósticos más frecuentes fueron: bloqueo auriculoventricular completo (31,4 por ciento) y enfermedad del nodo sinusal (30,9 por ciento). De los 181 pacientes del universo, 110 faltaron al menos a un control con una curva de insistencia ascendente en el tiempo, observándose que a los 6 meses (tercer control) más de la mitad estuvo inasistente. De estos 110 pacientes, 60 pudieron ser contactados telefónicamente para aplicarles una encuesta de causas de inasistencia, encontrándose que 37 de ellos no asistieron a control por falta de citación. La caracterización de pacientes respecto a sexo, edad y diagnóstico de indicación de MPD coincidió con la literatura. Conclusiones: el importante ascenso de las inasistencias a controles post-implante de MPD contrasta con las recomendaciones de seguimiento.

The difinitive pacemaker (DPM) implantation is performed in patients with alterations in the generation of electrical impulse from heart and / or conduction disturbances. Clinical guidelines for management proposed early tracking, regular and for life, post DPM implantation in order to detect alterations. Aim: characterize and assess adherence to monitoring in patients with first DPM implantation at the Hospital Gustavo Fricke (HGF) during 2007. Method and patients: retrospective and descriptive study. The universe were patients with first DPM implantation at HGF during 2007. Patients were characterized according to sex, age and diagnosis of DPM indication; percentage of absence at the first, second and third control post DPM implantation (corresponding to clinical guidelines in Chile) was described and finally causes of absences to the controls were investigated. Results: the universe was 181 patients; 101 men. The most frequent age group were older than 70 years (56.9 percent). The most common diagnoses were: complete atrioventricular block (31.4 percent) and sinus node disease (30.9 percent). Of 181 patients of the universe, 110 missed at least one control in an ascending curve in time so that at 6 months (third control) more of 50 percent did not attend the medical control. Of these 110 patients, 60 could be contacted to make a telephone poll to know the causes of the absence and it was found that 37 of them did not attend due to lack of appointment. Characterization of patients regarding sex, age and diagnosis of DPM indication coincided broadly with those reported in the literature. Conclusions: the significant rise in absences to post implantation DPM controls contrasts sharply with the follow-up recommendations.

Influence of self nursing education on the therapeutic compliance and life quality of patients with infectious tuberculosis / 中国实用护理杂志

Objective We discussed the application and clinical effect of serf nursing education in patients with infectious tuberculosis. Methods We divided 140 patients with infectious tuberculosis into the test group and the control group with 70 cases in each group. The control group adopted health education. The test group received individual and selective self nursing education, including serf mastering of tuberculosis, self monitoring of illness, completion of ther therapeutic process by oneself, serf management of diet, self regulation andf control of motion and education of self nursing technique. The intervention continued for 3 months. Pulmonary tuberculosis specific knowledge inventory, therapeutic compliance investigation inventory and general questionnaire on living (GQOL) were adopted in the two groups and the results were compared. Results The therapeutic compliance and life quality of the test group were evidently higher than those of the control group after self nursing education (P<0.01). The mastering of tuberculosis knowledge of the test group was also superior than that of the control group (P<0.01). Conclusions Self nursing education could increase the therapeutic compliance as well as the life quality of patients.

Determinantes da adesão ao tratamento anti-retroviral em Brasília, DF: um estudo de caso-controle / Determinants of antiretroviral treatment adherence in Brasília, Federal District: a case-control study

Buscou-se avaliar os fatores relacionados à adesão ao tratamento anti-retroviral no Distrito Federal. De 150 pacientes entrevistados em sete centros de referência, 35 não aderentes foram definidos como casos, sendo selecionados 70 controles aderentes, pareados por idade. Avaliaram-se variáveis sócio-demográficas, hábitos, suporte social, qualidade de vida, questões relacionadas a doença, estado clínico, tratamento e serviço. Na análise bivariada, houve associação da adesão com raça/cor, escolaridade, centros de referência em que faz acompanhamento e renda familiar. Após ajuste, cor parda, centros de referência localizado no Plano Piloto, escolaridade alta e receber apoio dos amigos quanto às necessidades permaneceram associados com adesão. Retirando raça/cor do modelo, mantiveram-se centros de referência, escolaridade, profissão, renda, apoio (contar com alguém que demonstre gostar de você) e satisfação com o atendimento na farmácia de dispensação. Além dos fatores já consolidados na literatura, questões relacionadas ao apoio no âmbito micro-social e aos serviços de assistência mostraram-se associados à observância terapêutica.

We sought to evaluate factors relating to adherence to antiretroviral treatment in the Federal District. Out of 150 patients interviewed at seven reference centers; 35 non-adherent subjects were considered to be cases; we selected 70 age-matched adherent individuals as controls. Variables relating to sociodemographics, habits, social support, quality of life, disease-related issues, clinical conditions, treatment and healthcare services were evaluated. Bivariate analysis showed that adherence was associated with race/color, educational level, the reference center where the patient was followed up and familial income. After adjustments, mixed race (parda), reference center location in central Brasília, high educational level and friends’ support for needs remained associated with adherence. After excluding race/color from the model, the reference center location, educational level, profession, income, support (being able to count on someone who demonstrably likes you) and satisfaction with the service at the pharmacy remained related to adherence. In addition to the factors already established in the literature, questions relating to support within the microsocial environment and the healthcare services were shown to be associated with therapeutic compliance.

The Effects of Programs Using Strategies for Promoting Self Efficacy in Patients with Lung Cancer / 성인간호학회지

PURPOSE: This study investigated the effects of a 'overcoming cancer program' on knowledge, self efficacy, and quality of life, therapeutic compliance for patients with lung cancer. METHOD: Research design of this study was a nonequivalent control group quasi-experimental study. Subjects for this study were 16 lung cancer patients for the control group, and 12 lung cancer patients for the experimental group. The experimental group participated in the program once a week for 4 weeks. Data were collected before and after the program. Nonparametric statistics were used to analyze the data. RESULTS: The results of this study were as follows: In the pretest, there were no significant differences in general characteristics, knowledge, self efficacy and quality of life between the two groups. In the posttest, there were significant differences in knowledge, self efficacy between the experimental and the control groups. But there were no significant differences in therapeutic compliance and quality of life between the two groups. CONCLUSION: From the results above, it can be concluded that program was effective to improve knowledge and self-efficacy for patients with lung cancer.

Therapeutic Compliance with Hypertension in Rural Elderly

BACKGROUND: The purpose of the research was to find significant factors that were related to the therapeutic compliance of hyper- tension(HT). METHODS: Hypertensive 354 patients from 932 rural elderly were measured blood pressure and administered the questionnaire during August 2003. Operational definition of therapeutic compliance was the state of care and management of HT. The data were analysed by univariate analysis and multivariate regression model. RESULTS: Results of univariate analysis, the seriousness, the barriers, the benefits, and the patients who have family members or friends suffering from HT, the motive of the behavior were significant variables for acceptance rate of the caring HT(p<0.01). Result of multiple logistic regression on participating caring process in HT, significant prediction variable were the subjects who had spouses, long ongoing caring process, no drinking habits, mind set that considers the high blood pressure as a serious disease, families and friends who had complications, didn't feel that taking the medication is not uncomfortable if they haven't experienced the side effect during the caring process. CONCLUSION: According to this result, we should consider major prediction variables to increasing the therapeutic compliance of hypertensive patients and developing the program for controlling hypertensive patients.

Therapeutic Compliance with Hypertension in Rural Elderly

BACKGROUND: The purpose of the research was to find significant factors that were related to the therapeutic compliance of hyper- tension(HT). METHODS: Hypertensive 354 patients from 932 rural elderly were measured blood pressure and administered the questionnaire during August 2003. Operational definition of therapeutic compliance was the state of care and management of HT. The data were analysed by univariate analysis and multivariate regression model. RESULTS: Results of univariate analysis, the seriousness, the barriers, the benefits, and the patients who have family members or friends suffering from HT, the motive of the behavior were significant variables for acceptance rate of the caring HT(p<0.01). Result of multiple logistic regression on participating caring process in HT, significant prediction variable were the subjects who had spouses, long ongoing caring process, no drinking habits, mind set that considers the high blood pressure as a serious disease, families and friends who had complications, didn't feel that taking the medication is not uncomfortable if they haven't experienced the side effect during the caring process. CONCLUSION: According to this result, we should consider major prediction variables to increasing the therapeutic compliance of hypertensive patients and developing the program for controlling hypertensive patients.