论著

青光眼日间手术患者自我管理行为现状及相关因素分析

Influence factor of self-management among glaucoma patients undergoing day surgery

:129-136
 
目的:探讨青光眼日间手术患者的自我管理行为现状及影响因素分析。方法:采用便利抽样法选取2021年9月—2022年5月于广州市某三级甲等眼科专科医院就诊的223例青光眼日间手术患者。采用一般资料调查表、青光眼自我管理行为量表、慢性疾病自我效能量表和青光眼知识学习问卷进行问卷调查。结果:青光眼日间手术患者的自我管理行为得分为(54.03±6.95)分,其中生活调整维度得分最低。慢性病自我效能与自我管理行为呈正相关(r=0.368, P<0.001)。疾病知识与自我管理行为无显著相关性(r=0.077, P=0.252)。多因素线性回归分析结果显示,患者的文化程度(P<0.001)和自我效能(P=0.028)是自我管理行为的影响因素,可解释自我管理行为总变异的12.4%。结论:青光眼日间手术患者具有良好的自我管理行为,较低的自我效能和文化程度是自我管理行为的危险因素,因此应优先提高患者的自我效能,并提供个性化教育。

Objective: To determine self-management and its association with self-efficacy and knowledge among glaucoma patients undergoing day surgery. Methods: A total of 223 glaucoma patients were recruited from September 2021 to May 2022and they were investigated with the Glaucoma Self Management Questionnaire (GSMQ), The Self- Efficacy in Chronic Disease Scale (SECD-6), and the glaucoma knowledge questionnaire. Results: Of the 223 study participants, the study population had a total GSMQ score of 54.03±6.95 with the lowest score found in the life adjustment dimension. The total SECD-6 score was showing a significantly positive correlation with the total GSMQ score(r =0.368, <0.001). The total score of disease knowledge was without significant correlation with the total GSMQ score (=0.077, =0.252). Multivariate linear regression analysis showed that self-efficacy (<0.001) and education level was independently associated with self-management(=0.028). Conclusions: Glaucoma patients undergoing daytime surgery demonstrated good overall self-management, yet further improvement was required in terms of life adjustment. Low self-efficacy and educational level were identified as risk factors for self-management. Therefore, self-management programs should prioritize enhancing patients' self-efficacy and delivering individualized education.

论著

眼科急诊预检分诊标准体系构建及初步验证

Construction and preliminary verification of the ophthalmic emergency pre-examination and triage standard system

:91-98
 
目的:基于我国国情构建科学、简便且高效的眼科急诊预检分诊标准,为眼科医护人员提供高效的眼科急诊预检分诊工具。方法:基于文献查询法、半结构访谈法、德尔菲法及层次分析法确定眼科急诊预检分诊标准内容。通过提取2023年8月1日-2023年8月10日急诊分诊系统及HIMSS电子病历系统数据,分析初次分诊的级别与接诊医生最终诊断的所属级别符合率,对眼科急诊预检分诊标准体系的应用效果进行初步验证。结果:对18名专家进行2轮专家咨询,有效问卷回收率均为100%,专家权威系数均为0.95,肯德尔和谐系数分别为0.5640.117(均P<0.05)。最终构建的眼科急诊预检分诊标准体系包括3个一级指标、11个二级指标。初步验证显示,该预检分诊标准体系具有92.7%的分诊准确率。结论:本研究构建的眼科急诊预检分诊标准体系结构合理、内容全面,具有科学性及实用性,可为眼科临床急诊预检分诊工作提供准确、有效的分诊工具,有助于提高临床工作效率及预检分诊质量。
Objective: To establish a scientific, simple, and efficient ophthalmic emergency pre-examination triage standard, and provide efficient ophthalmic emergency pre-examination triage tools for ophthalmic staffs, based on national conditions. Methods: With literature search, semi-structured interview, Delphi Method, and Analytic Hierarchy Process, the content of ophthalmic emergency pre-examination and triage standard are confirmed. By extracting data from the emergency triage system and HIMSS electronic medical record system from August 1st, 2023 to August 10th, 2023, the consistency rate between the initial triage level and the final diagnosis level of the attending doctor was analyzed, and the application effect of the ophthalmic emergency pre-examination and triage standard system was preliminarily verified. Results: Two rounds of expert consultation were conducted among 18 experts, all with a 100% effective questionnaire response rate. The expert authority coefficients were 0.95, and the Kendall harmony coefficients were 0.564 and 0.117, respectively (all P<0.05). The final constructed ophthalmic emergency pre-examination triage standard system includes 3 primary indicators and 11 secondary indicators. Through verification, the pre screening triage standard system has a good triage accuracy rate of up to 92.7%. Conclusions: The structure of the ophthalmic emergency pre-examination triage standard system constructed in this study is reasonable, comprehensive, scientific, and practical. It can provide accurate and effective triage tools for ophthalmic clinical emergency pre-examination triage work efficiency, and preexamination triage quality.
综述

眼科急诊预检分诊标准的研究进展

Research progress in ophthalmic emergency pre-examination and triage

:461-465
 
随着人口老龄化、生活方式的改变,眼科疾病患病人数的增加、国家眼病诊疗相关政策的持续推动、居民健康意识的逐渐提升,眼科门急诊患者数量持续增长,亟需构建科学的眼科急诊预检分诊标准,合理配置医疗资源,确保患者得到及时、恰当的治疗。国外已有医院依据患者症状或体征的严重程度对患者进行等级划分,建立起相对成熟的眼科急诊预检分诊模式,我国目前尚没有统一的、权威的眼科急诊预检分诊标准,国内外现行的眼科急诊预检分诊模式的分诊精准度及临床适用性有待进一步探索。该文通过综述国内外眼科急诊分诊标准及应用评价、眼科远程急诊预检分诊方式研究进展,以期为构建符合我国国情的、科学有效的眼科急诊预检分诊标准、提高眼科急诊分诊质量提供参考。
With the aging of population, the changing of lifestyle and the increasing number of ophthalmic emergency patients,Chinese national policies related to ophthalmic diagnosis and treatment are continually promoted, and residents' health awareness are gradually improved, the volume of ophthalmic outpatients and emergency patients continues to increase. It is urgent needed to establish scientific ophthalmic emergency pre-examination and triage criteria, to reasonably allocate medical resources, and to ensure that patients receive timely and appropriate treatment. The relatively mature ophthalmic emergency pre-examination and triage models with the severity of patients' symptoms or physical signs,have been established in foreign hospitals. Currently, there is no unified and authoritative ophthalmic emergency triage criteria in China. The accuracy and clinical applicability of the existing ophthalmic emergency triage models at home and abroad need to be further explored. This article reviewed the ophthalmic emergency triage criteria and application evaluation at home and abroad, and remote emergency triage in ophthalmology, in order to provide a reference for establishing a scientific and effective ophthalmic emergency triage criteria comformed Chinese national conditions, and improving the quality of ophthalmic emergency triage.
论著

眼科日间病房护理质量指标的构建

Establishing nursing quality indicators for ophthalmic intra-day ward

:558-563
 
目的:构建眼科日间病房护理质量指标,为眼科日间病房的护理质量管理提供理论依据。方法:以Donabedian三维质量结构模式为理论框架,通过查阅文献、小组讨论,初步拟定眼科专科护理质量评价指标。通过专家函询,对指标进行筛选和修订,确定了眼科日间病房护理质量指标。结果:经过2轮函询,专家意见趋向一致,2轮问卷回收率均为100%,协调系数分别为0.129、0.342(P<0.01)。构建的眼科专科护理质量指标包括3项一级指标,分别为结构指标(二级指标2项)、过程指标(二级指标8项)和结果指标(二级指标3项)。结论:该指标具有较高的科学性、可靠性、可行性以及专科特色,可为眼科日间病房护理质量的评价提供良好的方法。
Objective: To set up nursing quality indicators for ophthalmic intra-day ward, providing theoretical basis for nursing quality management in ophthalmic intra-day ward. Methods: Based on the "Donabedian three dimensional quality structure model" as the theoretical framework, the preliminary ophthalmic specialized nursing quality assessment indicators were designed by literature review and group discussion. The ophthalmic nursing quality indicators for intraday ward were finalized by expers consultated, indicators screened and revised. Results: After two rounds of inquration by letters, the opinions from the experts were consistent. Questionnaire response rates were both 100% in two rounds, with coordination coefficients of 0.129 and 0.342 respectively (P< 0.01). The nursing quality indicators for ophthalmic intra-day ward were established, including 3 primary indicators, which are structual indicators (2 secondary indicators), process indicators (8 secondary indicators) and outcome indicatiors(3 secondary indicators). Conclusion: The indicators are scientific, reliable, feasible with specialized characteristics, which can provide a good reference for evaluating the nursing quality in ophthalmic intra-day wards.
论著

开角型青光眼患者眼部用药规范化护理管理的最佳证据总结

Summary of the best evidence on standardized ocular medication management among open-angle glaucoma patients

:17-24
 
目的:检索并总结开角型青光眼患者眼部用药规范化护理管理的最佳证据,为临床实践提供参考。方法:通过护理循证方法提出实践问题,按照循证证据检索数据库的“6S”分类模型,检索有关开角型青光眼患者眼部用药管理的所有证据资源类型,包括临床指南、最佳实践信息册、证据总结、系统评价和专家共识等。由2名循证护理研究员对纳入文献的质量进行独立评价并进行证据的归纳总结。结果:最终纳入12篇文献,包括4篇指南、3篇证据总结和5篇系统评价;汇总了19条有关开角型青光眼眼部用药管理的最佳证据,包括滴眼技术指导、依从性管理和信息提供3个方面。结论:总结开角型青光眼眼部用药管理的最佳证据,可为临床医务人员管理患者提供参考和借鉴,以达到患者规范用药、控制眼压和延缓疾病进展的目的。
Objective: To retrieve and summarize the best evidence on standardized ocular medication management among open-angle glaucoma patients. Methods: With evidence-based nursing method, practical problemswere identified. According to the “6S” pyramid model of evidence resource, studies on standardized ocular medication management among open-angle glaucoma patients were retrieved, including clinical guidelines, best practice information booklet, systematic reviews, and expert consensus. Two evidence-based nursing researchers independently evaluated the quality of the included literature and summarized the evidence. Results: A total of 12 articles were ultimately enrolled, including 4 clinical guidelines, 3 evidence summaries and 5 systematic reviews. Finally, 3 aspects including 19 pieces of best evidence were summarized, which were Eye drop technical instruction, medication adherence management and related information provision. Conclusion: The best evidence for the medication management of open-angle glaucoma patients were summarized, which provide reference for clinical medical staffs to manage patients, so as to achieve the purpose of standardizing medication,controlling intraocular pressure and preventing disease progression.
Original Article

Stressful factors experienced by patients while waiting vitreo-retinal day surgery: a qualitative study

Stressful factors experienced by patients while waiting vitreo-retinal day surgery: a qualitative study

:1-8
 

Purpose: The day surgery mode has significantly reduced preoperative waiting time for patients. However, this mode also led to brief and sometimes abrupt interactions between patients with vision loss and nursing staff during the preoperative visits. Additionally, patients may experience negative emotions. The aim of this study was to describe the preoperative experiences and identify related stressful factors among patients waiting vitreo-retinal day surgery. Methods: This study was guided by an interpretive approach. Semi-structured, face-to-face, in-depth interviews were conducted with patients from August 2021 to October 2024. Inductive content analysis and research software were used to analyze the data. Results: Twenty-seven patients agreed to participate the interviews. Their ages ranged from 19 to 70 years old. The waiting time before hospitalization varied from 7 to 90 days. Three main categories emerged from patients’ complaints: day surgery procedures, concerns about eye conditions and supports. Conclusions: The findings underscore the importance of preoperative care services. It is suggested that providing accurate preoperative information and effective support can significantly enhance the quality of preoperative care service.


Purpose: The day surgery mode has significantly reduced preoperative waiting time for patients. However, this mode also led to brief and sometimes abrupt interactions between patients with vision loss and nursing staff during the preoperative visitsAdditionally, patients may experience negative emotions. The aim of this study was to describe the preoperative experiences and identify related stressful factors among patients waiting vitreo-retinal day surgery. Methods: This study was guided by an interpretive approach. Semi-structured, face-to-face, in-depth interviews were conducted with patients from August 2021 to October 2024. Inductive content analysis and research software were used to analyze the data. Results: Twenty-seven patients agreed to participate the interviews. Their ages ranged from 19 to 70 yearold. The waiting time before hospitalization varied from 7 to 90 days. Three main categories emerged from patients’ complaints: day surgery procedures, concerns about eye conditions and supports. Conclusions: The findings underscore the importance of preoperative care services. It is suggested that providing accurate preoperative information and effective support can significantly enhance the quality of preoperative care service.
眼健康专栏

小儿眼科检查前使用水合氯醛的护理

Nursing care of using chloral hydrate before pediatric ophthalmology examination

:66-68
 

10% 水合氯醛是最常用的小儿镇静药之一,广泛应用于眼科小儿检查和治疗前。对于年龄小、不配合的患儿,如何合理、安全使用水合氯醛,提高其镇静效果,减少其并发症发生,笔者总结护理心得如下:使用前对小儿进行全身的评估和家长的准备,使用时要掌握口服或灌肠的操作技巧,使用后要注意观察小儿的全身反应、用药效果和做好家长的宣教。

10% chloral hydrate is one of the most commonly used pediatric sedatives, which is widely used before ophthalmic pediatric examination and treatment. For young uncooperative children, how to use chloral hydrate reasonably and safely to improve their sedative effect and reduce the occurrence of complications, we summarized the nursing experiences, including evaluating childs whole body and the preparation of parents before its use; mastering operative techniques of oral or enema route of admission in its use; paying attention to observe the child's systemic response and efficacy of drug, and patient education

眼健康专栏

青光眼患者配戴太阳镜有讲究

Rational selection and wear of sunglasses for glaucoma patients

:3-5
 
佩戴太阳镜对眼疾患者的眼睛起保护作用。但并非所有青光眼患者适合佩戴太阳镜,闭角型青光眼患者佩戴需慎重。青光眼患者应根据病情合理地佩戴使用太阳镜。正确地选择和佩戴太阳镜才能对眼睛达到最好地保护作用。

The patients with eye diseases can wear sunglasses to protect their eyes. Not all patients with glaucoma are suitable for wearing sunglasses, especially for patients with untreated angle-closure glaucoma. Patients with glaucoma should select and wear the appropriate types of sunglasses according to individual conditions. Proper selection and wearing of sunglasses exert the optimal effect upon protecting the eyes.

医学教育

眼科专科护士培训体系的构建

Establishment of a training system for ophthalmic specialist nurses

:547-553
 
目的:构建具有较强科学性和实用性的眼科专科护士培训体系,为眼科专科护士的准入、培养、考核提供理论基础。方法:通过查阅文献、焦点小组和专家会议法,拟定眼科专科护士培训体系的课程、带教、评价体系。结果:构建的眼科专科护士培训体系内容包括课程体系、培训过程、临床实践指标、考核评价方法4个部分。其中,课程体系部分包含一级指标5项,二级指标11项,三级指标55项;培训过程包括一级指标4项、二级指标12项;临床实践指标包括一级指标6项、二级指标23项;考核评价方法包括一级指标5项、二级指标10项。结论:眼科专科护士培训体系构建过程科学,内容设置合理,对开展专科护士培训具有较好的指导意义。
Objective: To develop a scientific and practical training system for ophthalmic specialist nurses and provide theoratical basis for the the admission, training and assessment of ophthalmic specialist nurses. Methods: Through extensive review of domestic and foreign literatures, a focus group interview and an expert meeting, the curriculum, teaching and evaluation system of the ophthalmic specialist nurses training system was developed.Results: The training system for ophthalmic specialist nurses consists of four parts: training content, training process, clinical practice, assessment and evaluation. Among them, the training content includes 5 first-level indicators, 11 second-level indicators and 55 third-level indicators. The training process of ophthalmic specialist nurses includes 4 indicators of the first level and 12 indicators of the second level. The clinical practice indexes of ophthalmic specialist nurses include 6 indexes of the first grade and 23 indexes of the second grade. The methods of assessment and evaluation of ophthalmic specialist nurses include 5 indicators of the first level and 10 indicators of the second level. Conclusion: The scientific process and reasonable content of the training system for ophthalmic specialist nurses have a good guiding significance for the training of ophthalmic specialist nurses.
发明与创新

一种眼科多功能尺的研制

Clinical use of an ophthalmological multifunctional ruler

:1020-1022
 
为较好地满足眼科诊疗的使用要求,提升医护人员的工作效率以及患者的治疗效果,笔者设计了一种眼科多功能尺。该眼科多功能尺主要采用PVC材料,其结构主要包括圆盘、主尺、第一副尺、第二副尺以及第三副尺;功能主要包括测量长度、视力检查、照明、患者体位角度测量等。该眼科多功能尺设计巧妙,功能较齐全,能够较好地满足眼科医疗和诊断过程的使用要求。
To meet the demands of ophthalmic medical diagnosis, and to improve the efficiency of medical staff and patients’ treatment, the authors designed an ophthalmological multifunctional ruler. Its main material is PVC, and mainly includes a circular disk and 4 rules (the main ruler, the first ruler, the second ruler and the third ruler). Its functions mainly contain the measurement of length, visual test, illumination, the angle measurement for patients position and so on. The ruler is ingenious in design and has complete functions, which can meet the requirements of ophthalmic medical treatment and diagnosis.
其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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