目的 为老年股骨颈骨折的患者制定合理的循证护理方案。 方法 在充分了解老年股骨颈患者病情的基础上，根据PICO原则，提出临床问题并转化为易于检索的形式，于2012年5月检索了Cochrane系统评价数据库（CDSR）、Cochrane对照试验注册中心（CCTR）、效果评论摘要数据库（DARE）、Medline、国家指南网（NGC）、PubMed 网站、中国生物医学文献数据库（CBM）以及复旦大学JBI循证护理中心，获取并评价相关的系统评价、随机对照试验以及临床指南。 结果 共检索到3篇系统评价、2篇临床随机对照试验和1篇临床实践指南。根据检索的结果，与患者及家属沟通后，选用Braden量表对患者进行压疮评估；指导患者每2小时翻身；进行腰背肌的锻炼，2～4 h/次，第1天5遍/次，之后逐渐递增为10～20遍/次；指导摄入高能量、高蛋白食物。1周后，患者机体状况良好，顺利接受手术治疗。 结论 采取循证护理的方法可以为患者提供科学、个性化的护理。
Objective To explore the burden situation among caregivers of stroke survivors, and analyze the association between burden and the quality of life among caregivers. Method In this cross-sectional study, a total of 230 stroke survivor-caregivers were investigated with basic demographic information, Zarit Burden Interview (ZBI) and the World Health Organization Quality of Life Instrument-Short Form (WHOQOL-BREF) from May 2015 to November 2015. Results The mean age of the caregivers of stroke survivors was (66.7±11.7) years, and the caregiver burden was in the mild level with the mean ZBI score of 21.11±6.96. The multiple linear regression analysis showed that the influencing factors of caregiver burden were the complications, self-care ability, residence of stroke survivors, and the self-rating health status of caregivers (P<0.05). And the total ZBI score was negatively correlated with the total WHOQOL-BREF scores (P<0.01), physiological dimensional scores (P<0.01), social dimensional scores (P<0.01), and environmental dimensional scores of caregivers (P<0.01). Conclusions The caregivers of stroke survivors suffer from general caregiver burden, and the heavier caregiver burden is, the poorer the quality of life of the caregivers is. According to the different conditions between urban and rural areas of China, it is reasonable to formulate a targeted program with the consideration of requirements referring to stroke survivors and their caregivers. It should involve physiological, psychological, social, environmental factors and so on to improve the caregivers’ quality of life finally.
This article interprets the core updated content of WHS Guidelines for the Treatment of Pressure Ulcers-2023 update compared to Wound Healing Society 2015 update on Guidelines for Pressure Ulcers in multiple key areas, including posture and support surface, infection, wound bed preparation, surgical treatment, and adjuvant therapy. Additionally, the article deeply interprets the new content of the 2023 updated guidelines (palliative wound care for patients with severe pressure ulcers), in order to provide efficient and convenient reference tools for domestic medical personnel to quickly grasp the latest developments in pressure ulcer treatment, standardize treatment processes, and improve treatment effectiveness.