TfyP CHJ Y HOC VIET NAM TAP 459 - THANG 10 - SO 1 - 2017 5. Deng-Gao L., Wan-Lin Z., Zu-Yan Z., et al
(2008). Localization of impacted maxillary canines and observation of adjacent incisorresorption with cone-beam computed tomography. Oral Surg. Oral Med. Oral Path. Oral Radial. Endod. 105:91 - 98.
6. Ericson S., Bjerklin K., Falahat B. (2002). Does the canine dental follicle cause resorption of
permanent incisor roots-' A computed tomographic study of erupting maxillary canines. Angle Orthodontist. 72, pp. 95 - 104.
. Falahat B., Ericson S., Bjerklin K. (2008).
Incisor root resorption due to ectopic maxillary canines. A long-term radiographic follow-up. Angle Orthodontist .78, pp. 778 - 785.
DANH GIA MirC DO MET a NGirai BENH SUY TIM MAN TINH DIEU TRI TAI KHOA TIM MACH BENH VIEN DA KHOA TJNH NAM DINH
Nguyen Thi LTnh*, Vu Dire Dinh**, Tran Van Long*
T O M TAT
Md dau: Met la trieu triTng pho bien hay gap tren ngu'di benh suy bm. Nhan biet dUdc mu'e dp met va nhuYig yeu to lien quan den met de nang cao chat lu'cing cugc song ciia ngu'di benh suy tim. Muc tieu:
Danh gia mu'e do met d ngUdi benh suy tim man tinh dieu tri tai khoa tim mach Benh vien da khoa tinh Nam Dinh, Phu'dng phap: Nghien cuU mo ta cat ngang, dd lieu dUdc thu thap thong qua bo cau hoi phong van trdc tiep. Ket qua: Trong so 264 doi tu'dng tham gia nghien cifu cd 169 ngu'di chiem 64% met con lai 36%
khong met. Ket luan va khuyen nghjiCan quan tam hon nCia ve dang gia mCrc do met va cac yeu to lien quan den met ciia ngUdi benh suy tim man tinh, td do biet dUdc tinh trang ciia ngu'di benh de dieu chinh kjp thdi che dp cham soc va dieu tn cho ngudi benh nang cao chat lUdng cuoc song cho ngu'di benh.
Tu" kiioa: Suy tim man tinh, met moi.
SUMMARY
EVALUATING THE LEVEL OF FATIGUE I N PATIENT W I T H HEART FAILURE AT NAM
D I N H GENERAL HOSPITAL Introduction: Fatigue is a common symptom of patient with heart failure. Identifing level of fatigue to improve the quality of life of heart failure patients.
Objectives: To determine the level of fatigue of patients with chronic heart failure at cardiology department of IMam Dinh General Hospital.
Methodology: Descriptive research, data was collected by using questionnaire to direct interview.
Results: data from 264 subjects showed that 169 subjects equal 64% werefatigue and 36% were not fatigue. Conclusions and Recommendations:
More attention should be paid to level of fatigue and fatigue-related factors in patients with chronic heart failure, thus toassess the patient's status for adjusting timelyof caring and treatment to enhancing the quality of life of heart failure patients.
Hrddng Oai hoc Dieu Du&ng Nam Dinh
*'^Benh viin E Ha Ngi Chiu trach nhiem chfnh: Vij Qdc Djnh Email: [email protected] Ngay nhan bai: 27/7/2017 Ngay phan bien khoa hoc: 28/8/2017 Ngay duyet bai: 11/9/2017
Key ivonfe.-Chronic heart failure, fatigue.
I. OAT VAN BE
Hien nay, ty le mac va tir vong do benh tim mach (BTM) tren toan the gicfi kha cao 10,3% va 30,9%. To chtTc Y te The gidi (WHO) ddc tfnh rang eo den 17 trieu ngu'di chet hang nam do benh tim tren the gidi. Suy bm la dien bien cuoi ciing ciia benh bm mach, lam giam hoac mat han sire lao dong ciia benh nhan va la mot trong nhii'ng nguyen nhan chfnh dan den tir vong [3]
va CO so ngu'di mac tren the gidi ngay cang tang [7], Met la mot trong hai trieu chiTng pho bien nhat (ciing vdi khd thd) va xuat hien dau tien tren benh nhan suy tim, tac ddng tieu cUc den chat lu'dng cupe song va hieu xuat boat d6ng hang ngay ciia ngu'di benh [1],[4]. Xac dinh du'dc rniic do met d ngu'di benh suy tim man cd the giup cae nhan vien y te du'a ra eae bien phap can thiep de giam met cho ngu'di benh STM tir dd nang cao chat \ddng dieu trj va cham sdc CLJng nhd chat lu'dng cuoc song cho ngu'di benh STM [6]. Vi vay chiing tdi tien hanh nghien cifu de tai: "Danh gia muC do met d benh nhan suy tim man tfnh dieu tri tai Khoa Tim mach benh vien Da khoa tinh Nam D!nh"^d\ muc tieu:
Xac dinh mu'e do met & ngu'di benh suy tim man tfnh dieu tri tai khoa tim mach benh vien da khoa tinh Nam binh.
II. DOI TUONG VA PHUOlMG PHAP NGHIEN CU'U 2 . 1 . Doi tir'tfng nghien cu'u: Ngu'di benh suy dm man tinh dieu tri tai Khoa tim mach Benh vien da khoa tinh Nam Dinh tir dau thang 2 den het thang 4/2017.
2.2. Phu'cftig phap nghien CUIJ: MO ta cat ngang.
2.3. Phu'dng phap chon m l u ya cd mau:
2.3.1. Phu'dng phap chon miu: Chon mau thuan tien, ebon ngu'di benh cd chan doan bi suy tim man tinh dieu tri tai Khoa Tim Mach benh vien Da khoa tinh Nam Dinh, Lay doi tddng nghien cu'u theo tieu chuan \da chon.
VIETNAM MEDICAL JOURNAL N°1 - OCTOBER - 2017
2.3.2. Cong thu'c tinh cd mau: Phan meni tfnh c3 mau Sample Size 2.0. dddc sd dung de ho trd qua trinh tfnh toan c3 mau. Cong thu'c tinh cd mau u'dc lu'dng 1 ty le du'dc sir dung:
Z\\-al2).pi\- p) n= d'- ^ ^ Trong do: n: cd m l u toi thieu, Zi-a/j: he so tin cay, kiem djnh 2 phia (=1,96), a: miTc y nghTa (=0,05), p: u'dc lu'dng ty le benh nhan suy tim nhu'ng khong c6 bieu hien met la 20% (theo ket qua khac sat sd bo tai khoa tim mach, BVDK tinh Nam Dinh thang 1/2017), d: Sai so chap nhan du'dc ciia u'dc lu'dng (=0,05).
Thay cac gia trj vao c6ng thu'c, c3 mau toi thieu n=240. U'dc lifdng ty le doi tu'dng bo cuoc, tir choi tham gia nghien ciTu la khoang 10%.
Vay, cd mau can thu thap toi thieu la 264 benh nhan suy tim vao nghien eiru.
2.3.3. Phu'dng phap nghien cu'u: Tien ciTu cat ngang.
2.3.4. Cong cu thu thap so lieu: Sd dung bo cau hoi danh gia miTc do met,
Xu" ly so lieu; Sd dung phan mem SPSS 20.0 tIL KET QUA NGHIEN CLTU
3 . 1 . Dac diem nhom benh nhan vao nghien cu'u
Bang 3.1. Dae diem chung nhom benh nhan vao nghien cu'u
Dac diem Tuoi (trung binh + dp
lech chuan) DUdi 50
51-60 61-70 71-80 Tren 80
GiAi Nam NO' Trinh do hoc van
Khonq di hoc Cap 1 Cap 2 Cap 3 Tmnq cap
Cao dang Oai hoc Sau da! hoc Wtic dp suy t i m
So ngu'di benh
14 30 58 65 97 135 129 3 74 68 88 15 5 7 4
T y i e
5,3 11,4 22 24,6 36,7 51.1 48.9 1.1 28.0 25.8 33.3 5.7 1.9 2.7 1.5
Do I Boll Do III Do IV Benh i<em theo
Co Khonq
10 110 121 23 233 31
3,8 41,7 45,8 8,7 88.3 11.7 Nhan xet: D6 tuoi trung binh cua doi tu'dng tham gia nghien cu'u la 73,96 ± 12,812; trong tong so 264 doi tu'dng tham gia nghien eiru co 97 ngu'di (36,7%) chiem gan mot nii^ doi tu'dng tham gia nghien ciTu do tuoi tren 80 tuoi, thap nhat la d dp tuoi du'diSO cd 14 ngu'di chiem 5,3%, Do tuoi 71-80 chiem 24,6%; do tuoi 61-70 chiem 22% cuoi cung la do tuoi 51-60 chiem 11,4%, ty le nam va nff gan bang nhau vdi nam cd 135 ngu'di chiem 5 1 , 1 % , va niJ co 129 ngu'di chiem 48,9%. Cd den 88,2% ngu'di tham gia nghien cifu co trinh dp hoc van tir giao due pho thong trd xuong (trung hoc pho thong, trung hoc cd sd, tieu hoe, khong di hoc). So ngu'di cd trinh dp dai hpc va cao dang khong nhieu lan lu'dt la 2,7% va 1,9%. Con lai la trinh dp trung cap chiem 5,7% va sau dai hoe 1,5%. Nhu'ng ngu'di suy tim man tinh phan Idn deu eo benh kem theo cd 233 ngu'di chiem 88,3% va chi co 31 ngu'di khdng cd benh kem theo chiem ll,7%.Mu'c dp suy tim do I I I cd ty le eao nhat chiem 45,8%, tiep theo la suy Um miTc do I I la 41,7%, con lai la dp IV 8,7% va do I rat it 3,8%.
3.2. Miii'c do met
l l
BlS'u do 3.1. Ty le BN suy tim man tinh CO blSu hien met
Nhan xet Diem trung binh mut dp met !a 4,793±1,4575. Tong diem met cao nhat la 9 diem va thap nhat la 2,5 d i l m . Phan Idn ngi/Si benh deu cam thay met chiem 64%. Con iai 36%
ngu'di benh khong met.
TAP CHl Y HOC VIET NAM TAP 459 • THANG 10 - SO 1 - 2017
Khong Hoi
I I
m#t met
Khdng m§t I Hai met
• Met Rat met
Bieu do 3.2. Phan loai mSt
Nhan xet. Mdc do met eiia ngu'di benh du'dc chia lam 4 miTc dp: khong met, hdi met, met va rat met. Trong t»ng so 264 doi tu'dng tham gia nghien ciTu so ngu'di hdl met chiem ty le cao nhat 38,3%
tiep theo 36% ngu'di khong met va so ngu'di rat met co 2,6%.
IV. BAN LUAN
4 . 1 . fiac diem nhom benh nhan vao nghien cu'u: Nghien cu\j tien "hanh phong van ve met va nhihig yeu to lien quan tren 264 ngu'di benh suy tim man tinh tai khoa tim mach benh vien da khoa tinh Nam Djnh. Trong do nam gidi chiem 5 1 , 1 % tu'dng du'dng vdi nu" 48,9%. Ty le nay ciia chiing toi gan giong vdi ty le eiia Tang va cong su" nam 2009 [7] cd ty le nam 53,3% va nu' la 46,7%. Mot nghien cirtj khac cua tac gia Falk va cong sd nam 2008 [6] cho ket qua ty le nam 60% va nLf" 4 0 % ; eiia Ekman nam 2002 la nam 58%, nu' 42% eo khac biet n h o v d i ty le trong nghien cu'u cua chung toi do m i u nghien euXi ft hdn chung toi nen tinh dai dien chu^ cao.
Dieu nay cho thay ty le mac suy tim man tinh cua nam gidi va niJ gidi gan nhu" nhau.
Do tuoi trung binh eiia doi tu'dng tham gia nghien cuXi la 73,96 ± 12,812 thap nhat la 33 tuoi va eao nhat la 108 tuoi. Ket qua nay thap hdn so vdi dp tuoi trung binh doi tu'dng tham gia nghien ciTu ciia tac gia Sharon A. Stephen nam 2000 (77 tuoi) va cao hdn so vdi ket qua nghien eiru cua Nasiri nam 2016 (68,8 ± 11,7).
Trinh dp hpc vaneiia doi tu'dng tham gia nghien ciJu phan Idn la trung hoc pho thong chiem 33.3%, tiep do den trinh dp hoc van la tieu hpc chiem 28% va trung hoc cd sd^25.8%.
Trinh do hoc van tren trung hpc pho thdng chiem ty'le thap nhat lan lu'dt la 11.8%, eo 1.1%
doi tu'dng khong di hpc tuy nhien ho van dpc du'dc va nghe ndi tot. Trinh do hpc van ciia cac doi tu'dng da dap iTng du'dc tieu chiuan Ida chpn.
Mire dp suy tim: Phan Idn doi tu'dng tham gia nghien eiiu mac suy tim dp I I chiem 41,7% va suy tim do I I I 45,8%. So it mac suy tim dp IV 8.7% con iai cd 3,8% suy tim dp I. Dieu nay cho thay da so ngu'di benh va ngu'di nha ciia ho cung
da quan tam den van de sire khoe ciia ngu'di benh. 6 mire do I do bieu hien benh chu'a ro rang nen so it ngu'di benh dl kham va dieu tri.
Benh kem theo: Benh suy tim khong phai la mot benh ma la tap hdp rat nhieu trieu chiTng cua benh tang huyet ap, benh mach vanh, hep hd van tim [2], [5]... Vi vay phan Idn so ngu'di benh suy tim deu cd benh kem theo. Ket qua nghien eiiu cho thay co den 88,3% ngu'di benh ngoai suy tim ra eon cd benh khac kem theo, so con lai 11,7% la khong cd benh kem theo.
4.2. Mu'e do met cua ngu'di benh suy tim man tinh: Met la mot trong nhihig trieu chu'ng hay gap d suy tim, la cam giac yeu toan than khi heat dong binh thu'dng hoac khi tap the due do tim khong bdm du mau giau oxy den cac cd quan quan trpng nhu' nao va ed bap. Nhu'ng nguyen nhan d i n den met thu'dng da yeu to hdn niJa d nhuhg giai doan eiia suy tim dau hieu met khong ro rang do vay ngu'di benh ciing nhu" nhan vien y te quan tam den trieu chiTng nay, chi khi that SLT met mdi quan den [6].
Trong 264 doi tu'dng tham gia nghien ciTu ty le ngu'di met chiem 64% so edn lai 36% ngu'di benh khong met. Sd met ciia ngu'di benh suy tim man tinh anh hu'dng rat nhieu den cupe song va sinh boat hang ngay cua ho. Co the la nguyen nhan tang them ganh nang cho benh. Nhan biet du'dc met de dieu chinh qua trinh cham sdc ngu'di benh la rat quan trpng de mang den hieu qua cham sdc va dieu tri tot hdn. Trong mot so nghien ciTu, ty le BN met trong suy tim man tinh dao dong tiT 56%-87% [4], [6], [7].
Trong so nhu'ng BN cd bieu hien met (169/264, 64%), muTc dp "hdi met" ch\im ty le cao nhat. Khao sat mu'e dp met cua chiing toi diTa tren bang eau hdi va viee tra Idi phu thuoc nhieu vao earn quan eiia benh nhan cung nhd thdi diem ma benh tat ciia lip dien bien tot hay
VIETNAM MEDICAL JOURNAL N°1 • OCTOBER - 2017 xau. Tuy nhien, ket qua cung cho thay mot hdc
tranh tu'dng doi rxo rang ve phan loai mu'e dp met d BN suy bm man tinh va day ciing la dieu rat dang dUdc cac thay thuoc lam sang tham khao de ap dung vao cong tac cham soc, dieu tri BN. Theo m6t so tac gia nhu' Anna E, Inger E (2002), Kristin Falk et al (2008), Tang.W. R (2009), mu'e dp met d BN suy tim man tfnh cung gan tu'dng tu' nhu' ket qua nghien cu'u cua chung toi tuy mu'e dp "rat met" co eao hdn chut it, cd le do tuoi TB ciia nhdm BN nghien cull eiia cac tac gia nay cao hdn ciia chung tdi [4], [6], [7].
V. KET LUJBkN
- Trong 264 doi tu'dng tham gia nghien cull ty le ngu'di met chiem 64% so eon lai 36% ngu'di benh khdng met.
- Trong so benh nhan cd met, phan bo mu'e do met la: hdi met: 38,3%, met: 23,1 %, rat met: 2,6%.
KHUYEN NGHI
Tiep tuc nghien cu'u ve cac yeu to anh hu'dng den met d BN suy tim man tinh tai khoa noi tim mach, BVDK tinh Nam Djnh.
TAI UEU T H A M KHAO
1. Ngo Quy Chau va cong su* (2012), Suy tim, Benh hoc Ngi khoa, Nha xuat ban Y hoc Ha Noi 2. Nguyen Duy Toa, Nguyen Oanh Oanti va
Nguyen Lan Hieu (2015J, Nghien cdu t^ le, dac diem lam sang, can lam san^ benh nhan suy tim man tinh cd rung nhl, Tap chi Y-DUcJc hoc quan si/
so 4: 96-102.
3. Ann. £(2013), Fatigue as a Symptom of Coronary Heart Disease, the degree of Doctor of Philosophy in Nursing Sciences in the Graduate College of the University of Illinois at Chicago
*». Anna E, Inger E (2002), "Fatigue in chronic heart failure - does gender make a difference", European Journal of Cardiovascular Nursing 1(20021, tr. 77-82.
5. Bennett R.M, Russell 3, Cappelleri J.C, et ai f2010). Identification of svmotom and functional domains that fibromvalqia oatients would ltl<e to see improved: A cluster analysis. BMC Musculoskeletal Disorders. 2010;11:134.
6. Kristin Falk et al (2008), Fatigue in patients with chronic heart failure — A burden assooated with emotional and symptom distress, European Journal of ardiovascuiar Nursings (2008) 91-96.
7. Tang.W. R, Yu. C. Y and Yeh. S. J (2009),
"Fatigue and its related factors in patients with chronic heart failure ", Journal of Clinical Nursing, 19, tr 69-78.
TIM HIEU MOT S 6 YEU T 6 ANH HU'6'NG DEN CONG TAC TRUYEN THONG GlAo DUG SU'C K H 6 E CHO NGU-ai BENH
TAI BENH VllN E NAM 2 0 1 6 - 2 0 1 7
T O M TAT
Md tfau: Truyen thong GDSK dong vai tro rat quan trpng trong cac benh vien. Muc tieu nghien CIJ'U: Phan tich mot so yeu to anh hudng den cong tac taiyen thSng glad dye sire khoe cho ngUcJi benh tai cac Idioa l§m sang, Benh vien E nani 2016- 2017.
Phu'dng phap nghien cihi: Mo ta cat ngang. Ket qua nghien culi: Cac yeu to anh hu'dng den TTGDSK tai BVE bao gom: Nhan ILTC cho cong tac TTGDSK, Cd sd vat chat trang thiet bj cho cong tac TTGDSK, Ke hoach to chiTc, quan ly cac hoat dong TTGDSK, Dac di^m ciia benh nhan anh hUdng der cong tac TTGDSK, va mot so c^c yeu to khac. Ket luan: Can giai quyet tot cac van de anh hu'dng da neu tren de c6 the xay dung du'dc mot ke hoach hoat dong phii hdp cho TTGDSK tai BVE trong thdi gian tdi.
*Benh vien E
'''*Tntdng Dai hoc YteCong cong Ch|U trach nhiem chinh: Nguyen Phu'dng Thao Email: [email protected] Ngay nhan bai: \inm\l Ngay phan bien khoa hoc: 16/8/2017 Ngay duyet bai: 30/8/2017
N g u y e n Phtfomg T h a o * , D o M a i H o a * * Tit khoa: TTGDSK, BVE, cac yeu to anh hu8ng.
SUMMARY
SOME FACTORS AFFECTING THE COMMUNICATION OF HEALTH EDUCATION AMONG PATIENTS AT HOSPITAL E, 2016-2017
Introduction: Health education communication plays a very important rale in hospitals. Objectives:
Analyze a number of factors affecbng the communication of health education among patients in dinical departments. Hospital E 2016- 2017. Methods:
Cross-sectional descriptive study. Results: Factors influencing Health education and communication in Hospital E include: Human resources for health education and communication, facilities for communication and education Health, organizational planning, management of health communication and education, characteristics of patients affecting health communication and education, and a number of other factors. Conclusion: It is necessary to address the above mentioned issues in order to develop a suitable work plan for Health Education Communication in Hospital E in the near future.
Keywords: Health education communication, E Hospital, influencing factors
