The purpose of this study is to clarify the characteristics of patients with decreased cognitive function undergoing treatment for acute exacerbation phase of chronic heart failure as a basic survey with a view to the...The purpose of this study is to clarify the characteristics of patients with decreased cognitive function undergoing treatment for acute exacerbation phase of chronic heart failure as a basic survey with a view to the standardization of nursing to prevent discontinuation of treatment of patients with declining cognitive function in the acute exacerbation phase of chronic heart failure. As the first stage of the research, using the interview guide created based on the background of discontinuation of treatment and symptomatic monitoring from 33 target literature sources, seven certified chronic heart failure nurses and 15 certified dementia nurses were given semi-structured interviews. Data obtained from the interviews was analyzed by qualitative induction. As a result, we obtained opinions/views on 8 situations namely, “cognitive function at hospitalization”, “characteristics at hospitalization, “characteristics when receiving examinations, procedures or treatment”, “characteristics of course of treatment”, “characteristics related to difficulties in grasping the symptoms of chronic heart failure and indices of deterioration”, “characteristics when using diuretics”, “characteristics concerning compliance with dietary restrictions” and “support required for discharge from hospital” concerning patients with declining cognitive function. In the future, it is necessary to prepare nursing protocols incorporating these contents for standardization of nursing.展开更多
目的·系统评价经颅磁刺激(transcranial magnetic stimulation,TMS)对阿尔茨海默病(Alzheimer′s disease,AD)患者认知功能及伴痴呆的行为精神症状(behavioral and psychological symptoms of dementia,BPSD)的疗效。方法·检...目的·系统评价经颅磁刺激(transcranial magnetic stimulation,TMS)对阿尔茨海默病(Alzheimer′s disease,AD)患者认知功能及伴痴呆的行为精神症状(behavioral and psychological symptoms of dementia,BPSD)的疗效。方法·检索2019年11月2日以前的中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase、The Cochrane Library及中国和美国临床试验注册中心等9个数据库的所有文献。英文以“Alzheimer′s disease”“transcranial magnetic stimulation”和“randomize controlled trial”为主题词进行检索,并检索自由词;中文以“阿尔茨海默病”“经颅磁刺激”“随机对照试验”为主题词进行检索。按照预先制定的纳入和排除标准,筛选文献。使用RevMan 5.3软件,以标准化均数差(standardized mean difference,SMD)为效应值,区间估计使用95%置信区间(confidence interval,CI)进行统计分析;应用GradeProfile 3.2.2软件进行证据质量等级评价。结果·共纳入23篇文献。在改善认知功能方面:阿尔茨海默病疾病评估量表−认知子量表评价结果提示,高频TMS组效应值SMD=−0.64(95%CI−0.89~−0.40,P=0.000),低频组效应值SMD=−0.58(95%CI−1.12~−0.05,P=0.030);Grade证据质量等级显示,高频组为极低质量,低频组为低质量。使用简易智力状态检查量表评价认知功能时,根据TMS频率的高低、数值及治疗的次数分为3个亚组进行,结果提示,高频TMS组效应量SMD=1.30(95%CI 0.76~1.85,P=0.000),低频组疗效无统计学意义,Grade证据质量等级显示高频组和低频组均为极低质量;5 Hz组效应量SMD=3.99(95%CI 0.81~7.16,P=0.010),Grade证据质量等级为极低质量;治疗次数>40次且≤60次组效应量SMD=3.28(95%CI 1.67~4.90,P=0.000),Grade证据质量等级为极低质量。在改善BPSD方面:使用神经精神量表评价,结果无统计学意义,Grade证据质量等级为极低质量。使用AD病理行为症状量表评价分析显示,高频组效应量SMD=−0.83展开更多
文摘The purpose of this study is to clarify the characteristics of patients with decreased cognitive function undergoing treatment for acute exacerbation phase of chronic heart failure as a basic survey with a view to the standardization of nursing to prevent discontinuation of treatment of patients with declining cognitive function in the acute exacerbation phase of chronic heart failure. As the first stage of the research, using the interview guide created based on the background of discontinuation of treatment and symptomatic monitoring from 33 target literature sources, seven certified chronic heart failure nurses and 15 certified dementia nurses were given semi-structured interviews. Data obtained from the interviews was analyzed by qualitative induction. As a result, we obtained opinions/views on 8 situations namely, “cognitive function at hospitalization”, “characteristics at hospitalization, “characteristics when receiving examinations, procedures or treatment”, “characteristics of course of treatment”, “characteristics related to difficulties in grasping the symptoms of chronic heart failure and indices of deterioration”, “characteristics when using diuretics”, “characteristics concerning compliance with dietary restrictions” and “support required for discharge from hospital” concerning patients with declining cognitive function. In the future, it is necessary to prepare nursing protocols incorporating these contents for standardization of nursing.
文摘目的·系统评价经颅磁刺激(transcranial magnetic stimulation,TMS)对阿尔茨海默病(Alzheimer′s disease,AD)患者认知功能及伴痴呆的行为精神症状(behavioral and psychological symptoms of dementia,BPSD)的疗效。方法·检索2019年11月2日以前的中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase、The Cochrane Library及中国和美国临床试验注册中心等9个数据库的所有文献。英文以“Alzheimer′s disease”“transcranial magnetic stimulation”和“randomize controlled trial”为主题词进行检索,并检索自由词;中文以“阿尔茨海默病”“经颅磁刺激”“随机对照试验”为主题词进行检索。按照预先制定的纳入和排除标准,筛选文献。使用RevMan 5.3软件,以标准化均数差(standardized mean difference,SMD)为效应值,区间估计使用95%置信区间(confidence interval,CI)进行统计分析;应用GradeProfile 3.2.2软件进行证据质量等级评价。结果·共纳入23篇文献。在改善认知功能方面:阿尔茨海默病疾病评估量表−认知子量表评价结果提示,高频TMS组效应值SMD=−0.64(95%CI−0.89~−0.40,P=0.000),低频组效应值SMD=−0.58(95%CI−1.12~−0.05,P=0.030);Grade证据质量等级显示,高频组为极低质量,低频组为低质量。使用简易智力状态检查量表评价认知功能时,根据TMS频率的高低、数值及治疗的次数分为3个亚组进行,结果提示,高频TMS组效应量SMD=1.30(95%CI 0.76~1.85,P=0.000),低频组疗效无统计学意义,Grade证据质量等级显示高频组和低频组均为极低质量;5 Hz组效应量SMD=3.99(95%CI 0.81~7.16,P=0.010),Grade证据质量等级为极低质量;治疗次数>40次且≤60次组效应量SMD=3.28(95%CI 1.67~4.90,P=0.000),Grade证据质量等级为极低质量。在改善BPSD方面:使用神经精神量表评价,结果无统计学意义,Grade证据质量等级为极低质量。使用AD病理行为症状量表评价分析显示,高频组效应量SMD=−0.83
