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.
眼科护理

15例自膨胀水凝胶眶内植入术患儿的围手术期护理

Perioperative nursing of 15 children with self-expanding hydrogel orbital implantation

:177-180
 
本文总结了15例自膨胀水凝胶眶内植入术患儿围手术期的护理要点。术前主要评估患儿是否完善术前检查,给予患儿及其家属个性化的心理护理,进行术前准备以及禁食禁饮的管理。术后主要给予患儿安全管理,饮食、疼痛、眼部用药以及弹力绷带包扎护理,关注有无并发症的发生及给予相应的护理,并对患儿及其家属做好出院指导。15例患儿均顺利完成手术,术后均出现术眼疼痛,2例出现眶压增高,1例出现呕吐,均得到妥善处理。术后随访3~18个月,患儿均获得了较为满意的眼部外观,生活质量得到了提高。
This paper summarized the nursing experience of 15 children with self-expanding hydrogel orbital implantation during perioperative period. Before operation, children were fully evaluated, given with psychological care, preoperative preparation and management of fasting and drinking. After the surgery, the patients were mainly given with safety management, diet, pain, medicine and elastic bandage dressing care. Nurses should pay attention to the occurrence of complications and give corresponding nursing care and offer useful discharge guidance for the children and their parents. All 15 children completed the operation successfully, postoperative eye pain occurred in 15 cases after operation, and the orbital pressure increased in 2 cases, 1 case vomited, and all cases were properly treated. After postoperative follow-up for 3–18 months, 15 children were satisfied with the appearance of the eye,and the life quality was improved.
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.
论著

角膜移植日间手术患者的延续护理需求调查及其影响因素

Investigation and analysis of transitional care needs among patients with keratoplasty in day ward and its influencing factors

:393-400
 
目的:探究角膜移植日间手术患者的延续护理需求现状及其影响因素。方法:采用便利抽样法抽取行角膜移植日间手术的173例患者,采用课题组自行设计的一般资料调查表、角膜移植日间手术患者延续护理需求调查问卷进行调查。采用独立样本t检验、单因素方差分析、多元线性回归进行统计分析。结果:角膜移植日间术后患者延续护理需求得分为88.13±15.55,其中,对疾病相关知识的需求得分最高,为4.39±0.66,对心理护理的需求得分最低,为2.72±1.18;在延续护理实施方式方面,74.6%患者倾向于电话随访,只有5.8%倾向于上门服务;在影响因素方面,婚姻状况、视力、家庭月收入、文化程度是延续护理需求的影响因素。结论:角膜移植日间术后患者的延续护理需求较高,应根据患者延续护理需求及影响因素进行个性化指导,以提高角膜移植手术的成功率和减少并发症的发生。
Objective: To explore transition care needs among patients with keratoplasty in day ward and analyze the influencing factors. Methods: Using convenience sampling method, 173 patients undergoing keratoplasty in day ward were selected, and they were investigated by using a self-designed general information questionnaire and a questionnaire of transitional care needs of patients with keratoplasty in day ward. T-test, one-way analysis of variance (ANOVA), multiple linear regression were used to analyze the data. Results: The total score of transitional care needs among patients with keratoplasty in day ward was 88.13±15.55. The demand for disease related knowledge was the highest (4.39±0.66), the demand for mental nursing was the lowest (2.72±1.18). In terms of the way of implementation, 74.6% patients preferred telephone follow-up and only 5.8% preferred door-to-door service. Single-factor analysis showed that marital status, vision, monthly income, educational level were the factors influencing the demand for transitional care (P<0.05). Conclusion: Patients with keratoplasty in day ward have a high demand for transitional care. In order to improve the success rate of keratoplasty and reduce the incidence of complications, personalized guidance should be given according to patients’ transitional care needs and influencing factors.
论著

眼科互联网护理咨询门诊的探索与实践

:814-820
 
目的:通过中山大学中山眼科中心眼科互联网护理咨询门诊建设与运营经验,对互联网专科护理服务模式及效果进行分析,为眼科互联网+护理服务提供参考。方法:依托医院优质资源,成立眼科互联网护理咨询门诊;根据眼科患者的实际需求,制订互联网护理咨询门诊服务制度、工作流程,对出诊专家进行资质审核、培训与考核。收集、统计眼科互联网护理咨询门诊接诊量、患者满意度、首诊问题分类及护士职业获益感等数据。结果:2021年6月26日至12月31日累计接诊患者1266人次;接诊时间主要在08:00—22:00;咨询次数最多的问题种类是眼健康知识科普;患者对眼科互联网护理咨询门诊的总体满意度为99.52%;眼科互联网护理咨询门诊运营后,眼科护士职业获益感总分及各维度得分均有提高,差异均有统计学意义(均P<0.05)。结论:眼科互联网护理咨询门诊服务可有效满足各类人群的眼健康护理需求,患者满意度高,亦可提高眼科护理人员的职业获益感,值得进一步推广
Objective: Based on the construction and practice of Internet nurse-led clinic in our hospital, the model and effect of Internet specialized nursing service were analyzed to provide reference for Internet-based nursing service in ophthalmology. Methods: Relying on the hospital’s high-quality resources, the Internet nurse-led clinic in ophthalmology was established. According to the actual needs of ophthalmology patients, the Internet nursing consultation outpatient service system and workflow were formulated, experts’ qualification were reviewed, and training and assessment for the experts were conducted. The data on the number of outpatient visits, patients’ satisfaction, advisory questions and nurses’ perceived professional benefits were collected and analyzed. Results: From 26th June to 31st December 2021, the number of clinical reception was 1 266. The visit time is mainly between 08:00 to 22:00, the most frequently asked questions were eye health knowledge, the overall patients’ satisfaction was 99.52%, and the total score and the score of all dimensions of nurses’ perceived professional benefits were improved, with statistical significance (all P<0.05). Conclusion: Ophthalmic internet nurse-led consultation clinic can effectively meet the health care needs of all kinds of people, with high patient satisfaction, and can also improve nurses’ perceived professional benefits, which is worthy of further promotion.
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
    浏览
  • 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
    浏览
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