In the management of diabetic nephropathy patients with hemodialysis, diabetes link nurse (DLN) can realize the continuity of nursing management, simplify the communication between multiple disciplines, and play multiple roles such as relieving patients’ psychology, participating in scientific research and clinical management. In this paper, by introducing the origin and development status of DLN in foreign countries, and summarizing the function and clinical contribution of DLN in the management of diabetic nephropathy hemodialysis patients. This article combines the current development status of DLN in China, to arouse the attention of clinical nursing colleagues, and provide some reference for the management of diabetic nephropathy patients with hemodialysis and the training of DLN in China.
【摘要】 目的 了解腫瘤復發患者希望水平及其影響因素。 方法 2010年10-12月采用Herth希望量表和自制的一般情況調查表,對302例腫瘤復發患者進行問卷調查,并對相關影響因素進行分析。 結果 腫瘤復發患者希望總體均分為（31.14±5.56）分,7.95%（24例）的患者希望評分為低等水平,74.50%（225例）的患者希望評分為中等水平,17.55%（53例）的患者希望評分為高等水平。腫瘤復發患者希望水平得分的主要影響因素有:婚姻狀況、工作狀況、醫療費用支付情況、腫瘤類型以及無瘤生存時間。其中,與未婚患者相比,離異患者希望水平較低；與在職患者相比,退休患者希望水平較高；在醫療費用的支付方式上,自費所占的比例越大,患者希望水平越低；與其他腫瘤類型相比,以乳腺癌患者希望水平最低；此外,患者無瘤生存時間越長,其希望水平就越低。 結論 盡管腫瘤復發患者希望水平受多種因素的影響,但多數患者仍對現狀和未來充滿希望,其希望仍維持在較高水平。【Abstract】 Objective To explore the level of hope and the influential factors of hope in patient with tumor recurrence. Methods A total of 302 patients with tumor recurrence were enrolled. The patients were investigated by Herth Hope Scale and self-designed questionnaire. Results The average level of hope in patients with tumor recurrence was 31.14±5.56; of the total patients，7.95% (24 patients) had low level, 74.50% (225 patients) had media level and 17.55% (53 patients) had high level of hope. Parts of demographic characteristics had significant influences on level of hope and specifically: patient devoiced had lower level of hope than patients married (F=-1.868，Plt;0.05); patients retired had higher level of hope than patients on job (F=2.004，Plt;0.005); patients with greater own proportion of medical expense had lower level of hope than patients with smaller own proportion of medical expense (F=-0.937，Plt;0.05); patients with breast cancer had lower level of hope than patients with other type of cancer (F=-10.824，Plt;0.001); and finally, patients with longer free survival time had lower level of hope than patients with shorter free survival time (F=-1.930，Plt;0.001). Conclusion Parts of demographic characteristics have significant influences on level of hope in patients with tumor recurrence, but most patients still have high level of hope.
Objective Methods of evidence-based medicine were used to make an individulized treatment plan concerning newly diagnosed type 2 diabetes mellitus in elderly patients. Method After clinical problems were put forward, evidence was collected from third issue, 2003, Cochrane Library, Medline (PubMed 1990.1-2003.2) and http:// sumsearch.uthscsa.edu/ searchform4.htm according to the search strategy. Subject words were: diabetes mellitus non-insulin-dependent; self-monitor of blood glucose; micro-and macro-vascular complications; sulphonylureas; insulin ; aspirin; metformin; acarbose; self-monitor of blood glucose; older patient; hypertension management; Lipid management; RCT; human; meta-analysis；systmatic review. Results A total of 112 RCTs, and 24 systematic reviews were identified. A rational treatment plan was made upon a serious evaluation of the data. After one year follow-up, the plan was proved optimal. Conclusions The treatment efficacy in newly diagnosed type 2 diabetes mellitus in the elderly has been improved by determining an individulized treatment plan according to evidence-based methods.
