Aims: The purpose of this study was to clarify the thought processes of nurses in performing nursing assessment. Methods: The participants comprised 20 nurses working in a surgery ward. Patient information on a case, ...Aims: The purpose of this study was to clarify the thought processes of nurses in performing nursing assessment. Methods: The participants comprised 20 nurses working in a surgery ward. Patient information on a case, including presenting illness, vital signs, and other findings from admission until 09:00 on the day after surgery, was shown to the participants. After reading the case report, the nurses presented their assessments. Based on these assessments, nursing problems, patient strengths, and patient information were identified. Nursing problems and patient strengths were described by various words and sentences, and were classified according to similar content. Results: The number of nursing problems ranged from 1 to 8 and patient strengths from 0 to 6 for each nurse. The mean number of nursing problems was 4.7 ± 1.8, and the mean number of patient strengths was 2.2 ± 1.4. The main nursing problems were respiratory complications, postoperative wound pain, and anxiety, and the main patient strength was family cooperation. Patient information as evidence of respiratory complications included history of smoking, chest radiography results, postoperative vital signs, sputum color and properties. Patient information as evidence of postoperative wound pain included complaints of pain, epidural anesthesia, use of patient-controlled anesthesia and its effect. Patient information indicating family cooperation included family structure, preoperative visits by family, and presence of family while providing informed consent. Significant differences were seen in the number of nursing problems and patient strengths according to cognitive style. Conclusions: Postoperative complications were the nursing problems most commonly extracted by nurses. To clarify nursing problems and patient strengths, the nurses made assessments on the basis of information such as patient complaints, vital signs, and test results. However, extracted nursing problems and patient strengths were diverse, suggesting that nursing problems and patient strengths as determined by nurses differed between individual nurses.展开更多
BACKGROUND ： Functional magnetic resonance imaging （fMRI） studies have disclosed the changes of the motor function in the motor cortex of ipsilateral and contralateral hemispheres of tumor, which have special signi...BACKGROUND ： Functional magnetic resonance imaging （fMRI） studies have disclosed the changes of the motor function in the motor cortex of ipsilateral and contralateral hemispheres of tumor, which have special significance for making the surgical planning and most greatly minimizing the postoperative functional damages. OBJECTIVE： To analyze the association between the manifestation characteristics of hand functional area and motor dysfunction using fMRI in patients with space-occupying lesions of tumor in motor cortex. DESIGN ： A case-controlled observation SETTING： Department of Radiology, Second Affiliated Hospital, Shantou University Medical College .PARTICIPANTS： Twenty-three patients （13 males and 10 females） with space-occupying lesions of central sulcus area, aged 21-53 years with a mean age of （47±1） years were selected from the Second Affiliated Hospital of Shantou University Medical College. All the patients were diagnosed by MR scanning as space-occupying lesions of motor area, and pathologically confirmed that the lesions involved central sulcus and central Iobule; Lesions occurred in left and right hemispheres in 13 and 10 cases respectively. The tumor types were astrocytoma （n =8）, metastatic tumours （n =7）, meningiomas （n =5） and oligodendroglioma （n =3）. The muscle strength was normal in 11 cases （grade 5） and obviously decreased in 12 cases （grade 2-3 in 3 cases and grade 4 in 9 cases）; muscle strengths of both upper and lower limbs were decreased in 7 cases, and only that of upper limbs was decreased in 5 cases. Informed consents were obtained from all the subjects. Meanwhile, 9 healthy physical examinees （5 males and 4 females） of 20-56 years old with an average of （34±1） years were taken as controls. All the patients and healthy subjects were right-handed. METHODS： All the enrolled subjects were examined with MR scanning and functional imaging. Twenty cases whose clinical symptoms were mild in the patient group and 9 healthy volunteers adopted simple active finger-tapping movements, and for the 3 cases whose clinical symptoms were severe in the patient group, the simple passive finger-tapping movements were used. The manifestations in the activated brain areas were analyzed in the patients with brain tumor of different muscle strength and the controls. The motor deficit and activation of contralateral primary motor cortex （M1） in simple finger-tapping movements were observed in the patient group. MAIN OUTCOME MEASURES： （1） Brain areas activated by finger-tapping movements in each group： （2） Activated volumes in hemisphere by finger-tapping movements between groups. RESULTS： The contralateral M1 area could not be activated in 1 case in the patient group,, all the other 22 patients and 9 healthy subjects were involved in the analysis of results. （1） In the control group, unilateral finger tapping movement activated the contralateral primary motor cortex （M1）, bilateral SMA and bilateral PMC. The activation volume was the largest in contralateral primary motor cortex （M1）, smaller in the SMA, and the smallest in PMC. The finger tapping movement in healthy subjects could activate contralateral primary motor cortex （M1）, bilateral SMA and bilateral PMC, which had no obvious differences from the manifestations of brain functional area activated by active finger tapping. There was no significant difference in the volume of activated functional areas between right and left hands. In the patient group, the central sulcos around the tumor in the activated M1 area displaced towards dorsal or ventral side, also extended. The distance of displacement in the functional area was determined as compared with the contralateral central sulcus, and the results suggested the M1 displacement, including that there were 10 cases with the M1 displacement larger than 10 mm in the patients with motor deficit, which were obviously more than in those without motor deficit （n =1, P 〈 0.01）, and the activated volume in contralateral M1 area was obvious smaller in the patients with motor deficit than in those without motor deficit （P 〈 0.01）. （2） The M1 activation and changes were observed in contralateral hemisphere in the patient group, and the activated volume was obviously larger than that in the control group （P 〈 0.01）. The activated volumes of M1 and PMC in ipsilateral hemisphere were obviously larger than those in the control group （P 〈 0.05）, but that of SMA had no obvious difference between the two groups （P 〉 0.05）. CONCLUSION： fMRI can be used to observe the activation of the brain motor functional areas of patient with space-occupying lesions in motor area, and evaluate the state of their motor function. The larger the distance of displacement of M1 compressed by tumor, the more obviously the muscle strength decreases in the patients.展开更多
目的:探究等速肌力训练联合镜像疗法对脑卒中偏瘫病人平衡能力及自理能力的影响。方法:选取2020年1月—2022年12月在医院治疗的100例早期脑卒中偏瘫病人作为研究对象,按随机数字表法将其分为联合组与对照组,每组50例。对照组采用等速肌...目的:探究等速肌力训练联合镜像疗法对脑卒中偏瘫病人平衡能力及自理能力的影响。方法:选取2020年1月—2022年12月在医院治疗的100例早期脑卒中偏瘫病人作为研究对象,按随机数字表法将其分为联合组与对照组,每组50例。对照组采用等速肌力训练,联合组在对照组的基础上联合镜像疗法,观察两组平衡功能[Berg平衡量表(Berg Balance Scale,BBS)]、躯干控制能力[躯干控制测试量表(Trunk Control Test,TCT)]、骨骼肌指数(SMI)、步行能力[Holden功能性步行量表(FAC)]、自理能力(Barthel量表)。结果:干预2、4周后,两组BBS得分均高于干预前(P<0.05),且联合组干预2、4周后BBS得分均高于对照组(P<0.05);干预2、4周后,两组TCT得分均高于干预前,且联合组干预2、4周后TCT得分均高于对照组(P<0.05);干预2、4周后,两组SMI均高于干预前(P<0.05),且联合组干预2、4周后SMI均高于对照组(P<0.05);干预2、4周后,两组FAC分级均高于干预前(P<0.05),且联合组干预2、4周后FAC分级均高于对照组(P<0.05);干预2、4周后,两组Barthel量表得分均高于干预前(P<0.05),且联合组干预2、4周后Barthel量表得分均高于对照组(P<0.05)。结论:等速肌力训练联合镜像疗法可改善脑卒中偏瘫病人的平衡功能、躯干控制能力、步行能力,提高其骨骼肌指数和自理能力。展开更多
目的探讨应用等速肌力训练加强踝关节屈伸肌群的肌力,对老年脑卒中患者平衡功能的影响。方法选取40例老年脑卒中患者随机分为对照组(n=20)、治疗组(n=20),对照组接受常规康复治疗,治疗组在对照组基础上,增加针对踝关节背伸与跖屈肌群的...目的探讨应用等速肌力训练加强踝关节屈伸肌群的肌力,对老年脑卒中患者平衡功能的影响。方法选取40例老年脑卒中患者随机分为对照组(n=20)、治疗组(n=20),对照组接受常规康复治疗,治疗组在对照组基础上,增加针对踝关节背伸与跖屈肌群的等速肌力训练。2组患者治疗前和治疗3周后均进行Berg平衡量表(Berg balance scale,BBS);"起立—走"计时测试(Timed up and go test,TUGT);以及Pro Kin平衡仪的评估,参数包括Y-COP标准差、运动轨迹长度、运动轨迹面积、踝关节背伸与跖屈肌群的等速峰力矩等平衡功能相关指标的测量。结果 2组患者经过平衡训练后,平衡功能的各项指标均较治疗前有改善(P<0.05);治疗组患者治疗后平衡功能与对照组比较,各项评估指标均优于对照组(P<0.05)。结论踝关节等速肌力训练,可以明显改善老年脑卒中患者踝关节背伸与跖屈肌群的肌力及平衡功能。展开更多
文摘Aims: The purpose of this study was to clarify the thought processes of nurses in performing nursing assessment. Methods: The participants comprised 20 nurses working in a surgery ward. Patient information on a case, including presenting illness, vital signs, and other findings from admission until 09:00 on the day after surgery, was shown to the participants. After reading the case report, the nurses presented their assessments. Based on these assessments, nursing problems, patient strengths, and patient information were identified. Nursing problems and patient strengths were described by various words and sentences, and were classified according to similar content. Results: The number of nursing problems ranged from 1 to 8 and patient strengths from 0 to 6 for each nurse. The mean number of nursing problems was 4.7 ± 1.8, and the mean number of patient strengths was 2.2 ± 1.4. The main nursing problems were respiratory complications, postoperative wound pain, and anxiety, and the main patient strength was family cooperation. Patient information as evidence of respiratory complications included history of smoking, chest radiography results, postoperative vital signs, sputum color and properties. Patient information as evidence of postoperative wound pain included complaints of pain, epidural anesthesia, use of patient-controlled anesthesia and its effect. Patient information indicating family cooperation included family structure, preoperative visits by family, and presence of family while providing informed consent. Significant differences were seen in the number of nursing problems and patient strengths according to cognitive style. Conclusions: Postoperative complications were the nursing problems most commonly extracted by nurses. To clarify nursing problems and patient strengths, the nurses made assessments on the basis of information such as patient complaints, vital signs, and test results. However, extracted nursing problems and patient strengths were diverse, suggesting that nursing problems and patient strengths as determined by nurses differed between individual nurses.
基金a grant from theMedical Scientific ResearchFoundation of GuangdongProvince, No. A2003526
文摘BACKGROUND ： Functional magnetic resonance imaging （fMRI） studies have disclosed the changes of the motor function in the motor cortex of ipsilateral and contralateral hemispheres of tumor, which have special significance for making the surgical planning and most greatly minimizing the postoperative functional damages. OBJECTIVE： To analyze the association between the manifestation characteristics of hand functional area and motor dysfunction using fMRI in patients with space-occupying lesions of tumor in motor cortex. DESIGN ： A case-controlled observation SETTING： Department of Radiology, Second Affiliated Hospital, Shantou University Medical College .PARTICIPANTS： Twenty-three patients （13 males and 10 females） with space-occupying lesions of central sulcus area, aged 21-53 years with a mean age of （47±1） years were selected from the Second Affiliated Hospital of Shantou University Medical College. All the patients were diagnosed by MR scanning as space-occupying lesions of motor area, and pathologically confirmed that the lesions involved central sulcus and central Iobule; Lesions occurred in left and right hemispheres in 13 and 10 cases respectively. The tumor types were astrocytoma （n =8）, metastatic tumours （n =7）, meningiomas （n =5） and oligodendroglioma （n =3）. The muscle strength was normal in 11 cases （grade 5） and obviously decreased in 12 cases （grade 2-3 in 3 cases and grade 4 in 9 cases）; muscle strengths of both upper and lower limbs were decreased in 7 cases, and only that of upper limbs was decreased in 5 cases. Informed consents were obtained from all the subjects. Meanwhile, 9 healthy physical examinees （5 males and 4 females） of 20-56 years old with an average of （34±1） years were taken as controls. All the patients and healthy subjects were right-handed. METHODS： All the enrolled subjects were examined with MR scanning and functional imaging. Twenty cases whose clinical symptoms were mild in the patient group and 9 healthy volunteers adopted simple active finger-tapping movements, and for the 3 cases whose clinical symptoms were severe in the patient group, the simple passive finger-tapping movements were used. The manifestations in the activated brain areas were analyzed in the patients with brain tumor of different muscle strength and the controls. The motor deficit and activation of contralateral primary motor cortex （M1） in simple finger-tapping movements were observed in the patient group. MAIN OUTCOME MEASURES： （1） Brain areas activated by finger-tapping movements in each group： （2） Activated volumes in hemisphere by finger-tapping movements between groups. RESULTS： The contralateral M1 area could not be activated in 1 case in the patient group,, all the other 22 patients and 9 healthy subjects were involved in the analysis of results. （1） In the control group, unilateral finger tapping movement activated the contralateral primary motor cortex （M1）, bilateral SMA and bilateral PMC. The activation volume was the largest in contralateral primary motor cortex （M1）, smaller in the SMA, and the smallest in PMC. The finger tapping movement in healthy subjects could activate contralateral primary motor cortex （M1）, bilateral SMA and bilateral PMC, which had no obvious differences from the manifestations of brain functional area activated by active finger tapping. There was no significant difference in the volume of activated functional areas between right and left hands. In the patient group, the central sulcos around the tumor in the activated M1 area displaced towards dorsal or ventral side, also extended. The distance of displacement in the functional area was determined as compared with the contralateral central sulcus, and the results suggested the M1 displacement, including that there were 10 cases with the M1 displacement larger than 10 mm in the patients with motor deficit, which were obviously more than in those without motor deficit （n =1, P 〈 0.01）, and the activated volume in contralateral M1 area was obvious smaller in the patients with motor deficit than in those without motor deficit （P 〈 0.01）. （2） The M1 activation and changes were observed in contralateral hemisphere in the patient group, and the activated volume was obviously larger than that in the control group （P 〈 0.01）. The activated volumes of M1 and PMC in ipsilateral hemisphere were obviously larger than those in the control group （P 〈 0.05）, but that of SMA had no obvious difference between the two groups （P 〉 0.05）. CONCLUSION： fMRI can be used to observe the activation of the brain motor functional areas of patient with space-occupying lesions in motor area, and evaluate the state of their motor function. The larger the distance of displacement of M1 compressed by tumor, the more obviously the muscle strength decreases in the patients.
文摘目的:探究等速肌力训练联合镜像疗法对脑卒中偏瘫病人平衡能力及自理能力的影响。方法:选取2020年1月—2022年12月在医院治疗的100例早期脑卒中偏瘫病人作为研究对象,按随机数字表法将其分为联合组与对照组,每组50例。对照组采用等速肌力训练,联合组在对照组的基础上联合镜像疗法,观察两组平衡功能[Berg平衡量表(Berg Balance Scale,BBS)]、躯干控制能力[躯干控制测试量表(Trunk Control Test,TCT)]、骨骼肌指数(SMI)、步行能力[Holden功能性步行量表(FAC)]、自理能力(Barthel量表)。结果:干预2、4周后,两组BBS得分均高于干预前(P<0.05),且联合组干预2、4周后BBS得分均高于对照组(P<0.05);干预2、4周后,两组TCT得分均高于干预前,且联合组干预2、4周后TCT得分均高于对照组(P<0.05);干预2、4周后,两组SMI均高于干预前(P<0.05),且联合组干预2、4周后SMI均高于对照组(P<0.05);干预2、4周后,两组FAC分级均高于干预前(P<0.05),且联合组干预2、4周后FAC分级均高于对照组(P<0.05);干预2、4周后,两组Barthel量表得分均高于干预前(P<0.05),且联合组干预2、4周后Barthel量表得分均高于对照组(P<0.05)。结论:等速肌力训练联合镜像疗法可改善脑卒中偏瘫病人的平衡功能、躯干控制能力、步行能力,提高其骨骼肌指数和自理能力。
文摘目的探讨应用等速肌力训练加强踝关节屈伸肌群的肌力,对老年脑卒中患者平衡功能的影响。方法选取40例老年脑卒中患者随机分为对照组(n=20)、治疗组(n=20),对照组接受常规康复治疗,治疗组在对照组基础上,增加针对踝关节背伸与跖屈肌群的等速肌力训练。2组患者治疗前和治疗3周后均进行Berg平衡量表(Berg balance scale,BBS);"起立—走"计时测试(Timed up and go test,TUGT);以及Pro Kin平衡仪的评估,参数包括Y-COP标准差、运动轨迹长度、运动轨迹面积、踝关节背伸与跖屈肌群的等速峰力矩等平衡功能相关指标的测量。结果 2组患者经过平衡训练后,平衡功能的各项指标均较治疗前有改善(P<0.05);治疗组患者治疗后平衡功能与对照组比较,各项评估指标均优于对照组(P<0.05)。结论踝关节等速肌力训练,可以明显改善老年脑卒中患者踝关节背伸与跖屈肌群的肌力及平衡功能。
