發(fā)布時(shí)間：2018-05-16 11:39

  本文選題：臨床護(hù)理路徑 + 糖尿病　； 參考：《廣西中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:對(duì)西醫(yī)臨床護(hù)理路徑、中西醫(yī)結(jié)合臨床護(hù)理路徑在我國(guó)糖尿病患者中的應(yīng)用效果進(jìn)行系統(tǒng)評(píng)價(jià),為今后糖尿病患者的臨床護(hù)理提供科學(xué)依據(jù)。方法:計(jì)算機(jī)檢索中國(guó)生物醫(yī)學(xué)數(shù)據(jù)庫、知網(wǎng)、維普、萬方、Cochrane圖書館、JBI循證衛(wèi)生保健數(shù)據(jù)庫、Medline、PubMed等中英文數(shù)據(jù)庫,納入符合標(biāo)準(zhǔn)的研究。兩個(gè)評(píng)價(jià)員首先獨(dú)立地閱讀文章題目,對(duì)相關(guān)文獻(xiàn)再閱讀摘要,關(guān)鍵詞,將符合納入標(biāo)準(zhǔn)的文獻(xiàn)進(jìn)行分類評(píng)價(jià)。不同意見討論解決由第三者判斷。對(duì)納入研究的方法學(xué)質(zhì)量從隨機(jī)順序的產(chǎn)生、分配隱藏、對(duì)研究對(duì)象及干預(yù)實(shí)施者采取盲法、對(duì)結(jié)果測(cè)評(píng)者采用盲法、結(jié)局指標(biāo)的完整性、選擇性報(bào)告研究結(jié)果的可能性、其他方面的偏倚7方面進(jìn)行評(píng)價(jià),用RevMan 5.3軟件進(jìn)行統(tǒng)計(jì)分析。對(duì)同質(zhì)性較好的多個(gè)研究結(jié)果,用固定效應(yīng)模型合并分析;對(duì)有統(tǒng)計(jì)學(xué)異質(zhì)性的研究,用隨機(jī)效應(yīng)模型合并分析;對(duì)有臨床或方法學(xué)異質(zhì)性的研究,用亞組分析、meta回歸和放棄meta分析來處理。連續(xù)性變量采用加權(quán)均數(shù)差(WMD)表示、二分類變量采用相對(duì)危險(xiǎn)度(RR),二者均計(jì)算95%的可信區(qū)間(CI)。結(jié)果:西醫(yī)臨床護(hù)理路徑納入81個(gè)研究,共9320例患者。Meta分析結(jié)果顯示:西醫(yī)臨床護(hù)理路徑在2型糖尿病患者中干預(yù)2周后患者健康知識(shí)達(dá)標(biāo)率、滿意率、依從性均高于常規(guī)護(hù)理組,空腹血糖值、餐后2小時(shí)血糖值均低于常規(guī)護(hù)理組;干預(yù)1周后患者依從性高于常規(guī)護(hù)理組,空腹血糖值、餐后2小時(shí)血糖值低于常規(guī)護(hù)理組,健康知識(shí)達(dá)標(biāo)率、滿意率與常規(guī)護(hù)理組沒有區(qū)別。中西醫(yī)結(jié)合臨床護(hù)理路徑納入6個(gè)研究,共752例患者。我們對(duì)患者健康知識(shí)達(dá)標(biāo)率、滿意率、住院時(shí)間這3個(gè)指標(biāo)采用meta分析,剩余3個(gè)指標(biāo)進(jìn)行了描述性分析。Meta分析結(jié)果顯示中西醫(yī)結(jié)合臨床護(hù)理路徑組患者健康知識(shí)達(dá)標(biāo)率、滿意率高于常規(guī)護(hù)理組,住院時(shí)間低于常規(guī)護(hù)理組。結(jié)論:在糖尿病患者中實(shí)施干預(yù)2周的臨床護(hù)理路徑模式,可有效提升糖尿病患者健康知識(shí)達(dá)標(biāo)率、滿意率、依從性,降低住院時(shí)間、住院費(fèi)用,改善患者血糖水平,值得臨床推廣應(yīng)用。由于納入文獻(xiàn)質(zhì)量較低,希望今后有更多更為嚴(yán)謹(jǐn)?shù)呐R床隨機(jī)對(duì)照試驗(yàn)來進(jìn)一步驗(yàn)證。
[Abstract]:Objective: to systematically evaluate the clinical nursing path of Western medicine and the clinical nursing path of integrated traditional Chinese and Western medicine in the patients with diabetes in China and provide scientific basis for the clinical nursing of diabetic patients in the future. Methods: the computer retrieval of Chinese biomedical database, the Chinese medicine network, VP, Wanfang, Cochrane library, JBI evidence-based health care. Database, Medline, PubMed and other Chinese and English databases, which are included in the standard study. Two evaluators first read the title of the article independently, read the related literature again and read the summary, and the key words will be classified and evaluated according to the standard. The different opinions are discussed and resolved by the third. The methodological quality of the included study is from random. In order to produce, distribute hidden, take blind law to the research object and the intervention implementer, evaluate the result evaluator with the blind method, the completeness of the outcome index, the possibility of the selective report on the result of the study, the 7 aspects of the other aspects, and use the RevMan 5.3 software to carry out the unified analysis. Combined analysis of effect models; combined analysis of random effect models for statistical heterogeneity; study of clinical or methodological heterogeneity, subgroup analysis, meta regression and abandonment of meta analysis. The continuity variables were weighted mean number difference (WMD), two classified variables used relative risk degree (RR), and the two all calculated 95% Results: CI. Results: the clinical nursing path of Western medicine was included in 81 studies. A total of 9320 patients were analyzed by.Meta analysis. The results showed that the health knowledge standard rate, satisfaction rate and compliance of the western medicine clinical nursing pathway were higher than those of the conventional nursing group after 2 weeks of intervention in type 2 diabetes patients, and the value of fasting blood glucose and 2 hours after meal were lower than those of conventional nursing. After 1 weeks of intervention, the compliance of the patients was higher than that of the conventional nursing group. The value of fasting blood glucose and the 2 hour postprandial blood glucose were lower than that of the conventional nursing group. The rate of health knowledge reached the standard and the satisfaction rate was not different from that of the conventional nursing group. The clinical nursing path of the combination of Chinese and Western medicine was included in 6 studies and 752 patients. The 3 indexes of time were analyzed by meta, and the remaining 3 indexes were analyzed by the descriptive analysis of.Meta. The results showed that the health knowledge of the patients was higher than that of the conventional nursing group and the time of hospitalization was lower than that of the conventional nursing group. Conclusion: the clinical nursing path mode of intervention for 2 weeks in the patients with diabetes was carried out. It can effectively improve the health knowledge standard rate, satisfaction rate, compliance, reduce the time of hospitalization, hospitalization expenses, and improve the blood glucose level of patients. It is worthy of clinical application. Because of the low quality of the literature, we hope to have more rigorous and more rigorous clinical randomized trial to verify it in the future.

【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R473.5

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