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

湿性老年性黄斑变性患者自我感受负担现状及影响因素研究

A study on status and influencing factors of self-perceived burden in patients with wet age-related macular degeneration

:441-448
 
目的:了解湿性老年性黄斑变性(age-related macular degeneration,AMD)患者自我感受负担(self-perceived burden,SPB)现状及其影响因素。方法:采用方便抽样法选取2021年1月至11月在中山大学中山眼科中心就诊的204例湿性AMD患者为研究对象,采用一般资料调查表、SPB量表、家庭支持自评量表、医学应对问卷对其进行测评。结果:患者SPB得分是(21.98±6.68)分,总体属于轻度SPB。湿性AMD患者的SPB水平与家庭支出(r=?0.326, P<0.001)和面对应对(r=?0.365, P<0.001)呈负相关,与回避(r=0.456, P<0.001)及屈服(r=0.310, P<0.001)应对方式呈正相关性。多重线性回归显示,独居、高龄、自费、双眼患病及采用回避应对的患者的SPB更高,而高文化水平、高家庭支持的患者SPB较轻。结论:湿性AMD患者有轻度SPB,但仍存在改善空间,医护工作者在工作中应重点关注高龄、文化程度低、家庭收入低、自费、独居、双眼患病及低视力的患者,及时进行心理疏导,减轻患者的SPB水平。
Objective: To understand the current status and influencing factors of self-preceived burden (SPB) in patients with wet age-related macular degeneration (AMD). Methods: 204 patiens with wet AMD who were treated in Zhongshan Ophthalmic Center, Sun Yat-sen University from January to November 2021 were enrolled as the study subjects with convenience sampling method. A general information questionnaire, SPB scale, family support self-assessment scale, and medical coping questionnaire were collected from the subjects for assessment. Results: The patient’s SPB score was 21.98±6.68, which is generally mild SPB. The SPB level of patients with wet AMD was negatively correlated with family support (r=-0.326, P<0.001) and coping (r=?0.365, P<0.001), and were positively correlated with avoidance (r= 0.456,P<0.001), and surrender (r=0.310, P<0.001) coping style. Multiple linear regression showed that the patients who lived alone, were elder and self-funded, had binoclur diseases and used avoidance coping, had higher SPB. While the patients with high education and family support had lower SPB. Conclusions: It is still needed to pay attention to the patients with AMD having mild SPB. Medical workers should focus on patients with elder age, low education level, low family income, self-funded, living alone, binocular disease and low vision in their work, and provide timely psychological counseling to reduce the SPB level of patients.
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.
论著

眼外伤门诊急诊与住院病房一体化管理的实践与探讨

Discussion of integrated management of emergency department and wards for patients of ocular trauma

:143-147
 
目的:探讨眼外伤门诊急诊与住院病房一体化管理模式。方法:中山大学中山眼科中心于2015年4月成立眼外伤急诊部,组建眼外伤急诊队伍,实现眼外伤门诊急诊与住院病房一体化管理,即眼外伤患者从门诊到病房的接诊、治疗、随访进行一体化管理,简化急诊诊疗流程,最大限度保证医疗护理质量。结果:眼外伤门诊急诊与住院病房一体化管理模式是一种以患者为中心的新型管理模式。该模式能保障急诊患者诊治的及时性、连贯性;缩短急诊患者就诊到等候手术的时间,提高患者就诊满意度;在保证医疗质量的同时,医护人力资源得到合理高效使用;并取得较好的社会效益与经济效益。结论:眼外伤门诊急诊与住院病房一体化管理模式具备长远发展及推广的价值。
Objective: To discuss the integrated management in emergency department and wards for patients of ocular trauma. Methods: The emergency department and the team were organized in April 2015 to simplify the process of treatment for patients of ocular trauma, and to improve the benefit and outcome for those patients. Results: The integrated management of emergency department and wards for patients of ocular trauma was a new management model focusing upon the benefit of patients. This model could guarantee the timeliness and continuity by reducing waiting time for diagnosis or operations. The integrated model had obvious economic and social benefits by improving quality of care and reasonably using human resource. Conclusion: TTe integrated management model in emergency department and wards for patients of ocular trauma is worthy of further application. 

标准操作程序在玻璃体腔内注药术护理中的应用

Application of standard operation procedure in the intravitreal injection

:181-184
 

目的:探讨标准操作程序在玻璃体腔内注药术护理中的应用效果。方法:选择 2018 年 至 12 月中山大学中山眼科中心眼底专科门诊 504 例玻璃体腔内注药术患者作为研究对象,对护理人力资源的整合、患者等待手术时间、患者和家属的满意度、医护人员满意度进行评价。结果:标准操作程序后明确护士岗位职责,护士操作水平和综合能力有效提升,患者手术等待时间由原来的预约 周缩短为 2 d。患者和家属的满意度分别由 92.0% 和 91.0% 提高到 98.5% 和 97.0%。医护人员满意度的评价由 95% 提到至 98.4%结论:玻璃体腔内注药术标准操作程序不仅提升了工作效率,更提升了患者和家属、医务人员的满意度,规范化的标准操作程序是玻璃体腔内注药的安全保障。

Objective: To investigate the effect of standard operation procedure in the intravitreal injection. Methods: A total of 504 patients visiting the fundus clinics of our hospital from September to December 2018 were selected in this study. The integration of nursing human resources, patient waiting time, patient and family satisfaction, and medical staff satisfaction were evaluated. Results: The nursesjob responsibilities were clarified, and the Nursesoperation level and comprehensive ability were improved. The patientswaiting time for surgery was shortened from 2 weeks to 2 days. Patient and family satisfaction increased from 92.0% and 91.0% to 98.5% and 97.0%, respectively. The evaluation of the satisfaction of medical staff was elevated from 95% to 98.4%. Conclusion: The standard operation procedure of intravitreal injection not only improves the work efficiency, but also significantly increases the satisfaction of patients and their families and medical staffs. Therefore, the standard operation procedure can guarantee the safety of intravitreal injection.

论著

表格式护理记录单在眼底病中心日间病房精细化管理的应用

Application of eye nursing record sheets in the fine management of ophthalmic fundus center

:156-160
 
目的:自行设计并应用眼科表格式护理记录单,探讨眼科日间病房精细化护理管理工作的方法。方法:于中山大学中山眼科中心眼底病中心,根据日间手术流程,设计和运用眼底病中心24 h出入院护理记录单、眼底病中心日间病房交班记录单和眼底病中心日间病房手术记录单,书写方法基本以打勾、数字或简单文字记录为主。结果:新的表格式护理记录单大大节省护理记录和交班时间,提高护理工作效率,得到临床护理人员的广泛认可,提高医护对护理工作的满意度。结论:突出专科特色的表格式护理记录单能统一规范临床护理工作,提高护理工作效率和护理质量,保障护患安全,落实精细化护理管理。
Objective: To explore ffne management method of day ward in ocular department, through applying self-designed table format of eye nursing records. Methods: According to the day surgery process, the tables of 24-h nursing records and shifting records and surgery records were designed and applied to day ward of the ophthalmic fundus center. The basic writing methods included ticking, number and filling in the blanks. Results: The new nursing records tables decreased the time consumed in recording and shifting, improving the work efficiency, accepted widely by clinical staffs. Conclusion: The new table format with highlight of special features of the nursing records can unify and standard the clinical nursing work, improve the nursing work efficiency and nursing quality, ensure patients’ safety, and implement fine management. 
论著

医护一体化管理模式在眼底病中心日间病房的应用

Application of the medical integration mode in the day ward of ophthalmic fundus center

:148-151
 
目的:探讨医护一体化管理模式在眼底病中心日间病房中的应用与成效。方法:2015年6月至2016年6月于眼底病中心实行医护一体化管理模式,通过问卷调查比较实施前后医生和患者对护理工作的满意度。结果:医护一体化管理模式实行后,医生满意度显著提高,差异有统计学意义(t=?4.412,P<0.01),患者满意度有所提高,差异有统计学意义(t=2.592,P=0.01)。结论:采用医护一体化管理模式对眼底病日间手术住院患者进行管理,加强医护沟通,可有效提高护理质量,保障患者医疗、护理的安全性。
Objective: To explore the effect of the medical integration mode applying in the day ward of ophthalmic clinical key specialty. Methods: The ophthalmic fundus center started to carry out the medical integration mode from June 2015 to June 2016. Doctors’ and patients’ satisfaction towards nurses were surveyed before and after the implementation. Results: The doctors’ satisfaction towards nurses was statistically higher than before (t=?4.412, P<0.01). TTe patients’ satisfaction also improved, and the difference was statistically signiffcant (t=2.592, P=0.01). Conclusion: The medical integration mode strengthens the communication with doctors and patients, improves the nursing quality, and ensures the medical safety.
眼科护理

标准操作程序在玻璃体腔内注药术护理中的应用

Application of standard operation procedure in the intravitreal injection

:181-184
 
目的:探讨标准操作程序在玻璃体腔内注药术护理中的应用效果。方法:选择2018年9至12月中山大学中山眼科中心眼底专科门诊504例玻璃体腔内注药术患者作为研究对象,对护理人力资源的整合、患者等待手术时间、患者和家属的满意度、医护人员满意度进行评价。结果:标准操作程序后明确护士岗位职责,护士操作水平和综合能力有效提升,患者手术等待时间由原来的预约2周缩短为2 d。患者和家属的满意度分别由92.0%和91.0%提高到98.5%和97.0%。医护人员满意度的评价由95%提到至98.4%。结论:玻璃体腔内注药术标准操作程序不仅提升了工作效率,更提升了患者和家属、医务人员的满意度,规范化的标准操作程序是玻璃体腔内注药的安全保障。
Objective: To investigate the effect of standard operation procedure in the intravitreal injection. Methods: A total of 504 patients visiting the fundus clinics of our hospital from September to December 2018 were selected in this study. The integration of nursing human resources, patient waiting time, patient and family satisfaction,and medical staff satisfaction were evaluated. Results: The nurses’ job responsibilities were clarified, and the nurses’ operation level and comprehensive ability were improved. The patients’ waiting time for surgery was shortened from 2 weeks to 2 days. Patient and family satisfaction increased from 92.0% and 91.0% to 98.5% and 97.0%, respectively. The evaluation of the satisfaction of medical staff was elevated from 95% to 98.4%.Conclusion: The standard operation procedure of intravitreal injection not only improves the work efficiency, but also significantly increases the satisfaction of patients and their families and medical staffs. Therefore, the standard operation procedure can guarantee the safety of intravitreal injection.
发明与创新

一种基于眼科日间病房的玻璃体手术体位护理座椅

A seat for position nursing after pars plana vitrectomy in an ophthalmic day ward

:840-842
 
为在眼科日间手术模式下既能满足玻璃体视网膜术后体位需求,又能合理利用有限空间,本研究团队在原有的眼科日间病房座椅的基础上,增加玻璃体手术后体位护理等功能,发明了一种护理座椅[专利号:国家实用新型专利(ZL 2017 2 0942404. 1)]。该座椅采用钢喷塑(或不锈钢)、木板、海绵和人造革皮等材料,其结构主要包括座椅的主体部分、俯卧台、杂物篮、收纳架、输液杆套筒等部分。其制作材料简单,操作方便,安全使用,既能保证临床体位护理需求,又能节省空间,便于病房环境管理。
To meet the needs of the postoperative position nursing after pars plana vitrectomy in the day surgery mode,this research team has designed a nursing chair [patent number: National Uutility Model Patent (ZL 201720942404. 1)] based on the original chair of ophthalmic day ward, adding the functions of postvitreous nursing and so on. The seat is made from steel spray plastic (or stainless steel), wood, sponge and artificial leather, and the structure mainly consists of the main body, the countertop for prone position, the junk basket, the storage rack, and the infusion rod sleeve. The seat can be made by simple materials. The seat is easy to operate and safe to use, which can not only meet the needs of clinical body position nursing care, but also save the ward’ space and facilitate the environmental management of the ward.
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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