Objective:To evaluate the rehabilitation efficacy of early mobilization based on collaboration care model for patients with laparoscopic colorectal surgery.Methods:Cluster sampling method was used in the department to recruit colorectal cancer patients with laparoscopic surgery. The control group (49 cases) received routine perioperative care and exercise, and the intervention group (47 cases) received the coordinated early mobilization combined with routine perioperative care and exercise, from January to March 2019. Primary outcome were health status and the proportion of patients returning to preoperative functional walking capacity (6-min walk test) at 4 weeks after surgery. The in-hospital mobilization (time out-of-bed), time to achieve discharge criteria, time to recover gastrointestinal function and complication rate were explored.Results:In intervention group,89.4%(42/47) of patients achieved mobilization target on 4 days after surgery compared with 42.6%(20/47) on the day of surgery. Time out of bed were greater in the intervention group compared with the control group, and there were differences between the two groups( Z values were -8.437--7.381, P<0.01). Time to recover gastrointestinal function and the recovery of energy on 3 days after surgery were (58.74±17.41) h, (59.02±9.46) points in the observation group, and (71.82±21.53) h, (62.61±7.68) points in the control group, and there were significant differences between the two groups ( t values were -3.263, -2.046, P<0.05). But other outcome measures were not different between the two groups ( P>0.05). Conclusions:For colorectal laparoscopic surgery patients, the coordinated early mobilization improved the adherence to ambulation, in-hospital mobilization, time to recover gastrointestinal function and recovery of energy to promote rehabilitation.
Objective To construct the index system of the core competence of nursing emergency personnel in the case of infectious disease outbreak, and to provide reference basis for the assessment and training of the core competence of nursing emergency personnel. Methods Based on the core competence indicators of nurses defined by the International Nurses' Association and the action framework of WHO's outbreak of infectious diseases as the theoretical framework, the item pool was summarized through semi- structured interviews and research group meetings, the Delphi expert letter consultation method was used to construct the indicator system, and the analytic hierarchy process and the average distribution method were used to determine the weight of indicators at all levels. Results Two rounds of Delphi expert letter consultation, 36 questionnaires were issued in each round, and the effective recovery rate was 86% (31) and 92% (33), respectively.Finally, it was determined that the core competence index system of nursing emergency personnel for infectious disease emergencies included 5 first-level indicators, 13 second- level indicators and 53 third- level indicators. The coefficient of variation ranged from 0 to 0.173, the weight ranged from 0.074 to 0.525, and the balanced combination weight ranged from 0.165 to 0.266. Conclusion The index system of the core competence of nursing emergency personnel in infectious disease emergencies is comprehensive and scientific, which can provide theoretical basis for evaluating and training the core competence of nursing emergency personnel in infectious disease emergencies. © 2021 Chinese Medical Journals Publishing House Co.Ltd. All rights reserved.
Objective To explore the protective cognition of the first batch of nurses against novel coronavirus pneumonia on apparatus-related stress injury, so as to provide reference for formulating and implementing relevant training and improving management measures. Methods Using the phenomenological method of qualitative research, from January 20, 2020 to February 17, 2020, a half structured in-depth interview was conducted among the echelon nurses who completed the first batch of nurses against novel coronavirus pneumonia on apparatus-related stress injury. A total of 13 nurses in isolation wards were interviewed for the study. Results Using the method of Colaizzi phenomenology to analyze the interview data, the related knowledge cognition was low, the identification of risk factors was limited, the risk assessment was not carried out, the treatment measures were not timely, the awareness of protection was lacking, the management training was not perfect, and the medical protection materials were not enough. Conclusion The first batch of nurses to fight against novel coronavirus pneumonia had a low awareness of the prevention of medical device- related stress injury. Hospital managers should strengthen the training of related knowledge, improve management strategies, enhance the awareness of protection, and identify risk factors early, take preventive measures to ensure the safety and health of front-line medical staff in a timely manner. © 2021 Chinese Medical Journals Publishing House Co.Ltd. All rights reserved.
Objective:To explore the effect of therapeutic communication on infusion safety, disease uncertainty, coping styles, anxiety and depression in patients with emergency infusion.Methods:A total of 126 patients treated with infusion patients in emergency department in Jiangsu Provincial People's Hospital, the First Affiliated Hospital of Nanjing Medical University from July 2019 to December 2019 were selected and divided into two groups by random digits table method with 63 cases in each group. Patients in the control group received routine nursing, and patients in the intervention group received therapeutic communication nursing intervention on this basis. The incidence of adverse events of infusion during the intervention of the two groups of patients was observed. The disease uncertainty, coping styles, anxiety and depression were evaluated by Mishel's Uncertainty in Illness Scale (MUIS), Medical Coping Mode Questionnaire (MCMQ), Self-rating Anxiety Scale (SAS) and Self-rating Depressive Scale (SDS) before and after intervention.Results:The final collection of 109 patients with complete questionnaire, the recovery rate was 86.51% (109/126), including 55 cases in the intervention group, 54 cases in the control group. The incidence of adverse events of infusion was 16.36%(9/55) in the intervention group and 29.63%(16/54) in the control group, and there was significant difference( χ2 value was 5.057, P<0.05). There was no significant difference in the score of MUIS, MCMQ, SAS, SDS before the intervention between the two groups ( P>0.05). After the intervention, the uncertainty, unpredictability, lack of information and complexity dimension of the intervention group patients' MUIS scores were respectively (17.76 ± 2.49), (12.03 ± 2.51), (11.82 ± 2.12), (11.74 ± 2.24), which were lower than those in the control group (24.72 ± 2.94), (16.31 ± 2.27), (16.13 ± 2.51), (15.39 ± 2.31), the differences were significant( t values were -13.346- -8.375, P<0.05). The confront score of the intervention group patients' MCMQ was (19.13 ± 2.62) higher than that in the control group(13.79 ± 1.96), the avoidance and yield scores were respectively (8.71 ± 1.34), (9.81 ± 1.17), which were lower than those in the control group (14.57 ± 1.93), (15.12 ± 1.86), the differences were significant( t values were 12.031, -18.441, -17.875, P<0.05). The scores of SAS and SDS in the intervention group were (29.43 ± 3.62), (27.67 ± 3.11) respectively, which were lower than those in the control group (37.44 ± 5.31), (40.12 ± 4.92), the differences were significant( t values were -9.216, -15.821, P<0.05). Conclusions:Therapeutic communication can reduce the risk of emergency infusion, reduce the uncertainty of patients to the disease, improve patients' countermeasures to the disease, relieve patients' anxiety and depression, and improve the nursing quality of emergency infusion patients.
Objective:To develop a quality assessment scale of ICU transitional care based on patient-reported outcomes and test its performance.Methods:According to the guidelines of patient-reported outcomes development process, the item pool was established combining with analysis of relevant literatures and patients′ experience and needs in ICU transitional period based on the grounded theory about ICU transitional care. Cognitive test of patients and Delphi expert correspondence were utilized to amend the initial scale before pretest. One hundred and seventy-seven patients who had been transferred from ICU to general ward from March to August 2019 in Tianjin Third Central Hospital were recruited by convenience sampling method for project analysis.Results:The active coefficient and authority degree of expert were above 0.90 and 0.785 respectively for the two rounds of expert enquiry. The final scale consisted of 28 items, from which 4 principal factors, which were preparation for self-care, communication and coordination, psychological support and health belief, respectively, were extracted by exploratory factor analysis, explaining 78.307% of total variance. The content validity index of each item was 0.769-1.000, and the scale-level content validity was 0.896. The Cronbach α coefficients of the 4 factors and the scale were 0.844, 0.793, 0.897, 0.681 and 0.807, respectively.Conclusions:The patient-reported outcomes scale measuring ICU transitional care quality has good reliability and validity and can be used as an auxiliary tool measuring ICU transitional care quality in clinic.
Objective:To investigate the current status of clinical teaching towards postgraduates of master of nursing specialist(MNS) in China.Methods:Objective sampling was used to invest 390 MNS clinical nursing teachers in 36 hospitals across the country. The survey included the admission and evaluation criteria of teachers, the MNS postgraduates′ clinical teaching plan and implementation, and the assessment of MNS postgraduate ′s clinical practice ability, etc. Results:Among the criteria for clinical teachers for MNS postgraduates, 79.49% of departments required bachelor ′s degree or above, and 67.18% of departments requested medium-grade professional title or above; 47.44% of the departments demanded that clinical teachers had the research experience, 58.21% departments asked for the experience of articles publication. The main method of selecting clinical teaching teachers was examination (50%), while 31.28% departments had no definite criteria. The evaluation indicators of clinical teachers mainly depended on the results of students ′ clinical practice capability assessment (81.79%) and students ′ satisfaction (80%). Only 49.23% of the study objects knew the training objectives of MNS. The pivotal abilities of MNS graduate students were the ability of clinical nursing practice (91.79%) and clinical research (82.82%). The MNS postgraduate teaching plan of each department was mainly derived from the requirements of tutors and colleges (87.69%). The mode of clinical teaching was that one student was guided by a fixed clinical teacher (87.18%). Clinical practice assessment methods of MNS mainly included theoretical knowledge assessment (88.46%) and the performance of section lectures (82.56%). The assessment personnel were mainly clinical teachers (95.40%) and head nurses (83.51%). The self-assessment of clinical teachers was rated at the medium level about their performance on the postgraduate MNS students ′ clinical teaching. Conclusions:The homogenization and standardization of the construction of MNS clinical teaching base needs to be improved in China. In the field of defining the criteria of clinical teaching teachers, strengthening the construction of clinical faculty, perfecting the clinical teaching plan and evaluation system according to the cultivation objectives and specialist characteristics, and elevating the comprehensive medical education combined with clinical education and college education, further exploration is indispensable.
Objective:To investigate the risk factors of elderly, sports cognitive risk syndrome falling, repeated falls and fractures after falls.Methods:A total of 3 552 people were enrolled in the Department of Neurology, the First Affiliated Hospital of China Medical University from April 2015 to April 2016. The demographics of each selected individual were recorded. The selected individuals were assessed by MMSE for the presence of Subjective Cognitive Complaint (SCC), and the pace was used to assess whether there was slow walking and whether there was MCR (SCC + slow walking). All individuals were divided into MCR group and non-MCR group according to the evaluation results. The non-MCR group was subdivided into SCC subgroup, slow speed walking subgroup and healthy subgroup. Baseline variables were compared between the two groups, and demographics between subgroups, subgroups, and MCR groups were compared. Follow-up was followed every 4 months for a total of 2 years. The number of people who fell during the follow-up period, repeated falls, and fractures were recorded. With all demographics and SCC, walking at a slower pace, MCR was an independent variable, with a fall during follow-up, repeated falls and post-fall fractures as dependent variables, and a COX proportional hazard regression model of independent and dependent variables.Results:The proportions of the MCR group in higher education, depression, the use of crutches were 10.2% (36/352), 22.4% (79/352), 44.9% (158/352), the BMI, number of medications in the MCR group were (27.0 ± 4.3) kg/m 2, (6.8±3.2), the proportions of non-MCR group in higher education, depression, using crutches ratio were 22.9% (732/3 200), 12.8% (409/3 200), 22.8% (729 /3 200), the BMI, number of medications of non-MCR group were (24.8 ± 3.8) kg/m 2, (5.2 ± 3.1), the two groups showed statistical significant difference( χ2 values were 29.93, 3.45, 24.98, t values were 12.34, 82.71, P<0.05). The proportions of higher education, depression and crutches were 18.9% (289/1531), 13.2% (202 /1531) and 22.5% (344/1531) in SCC subgroup. The difference between MCR group and SCC subgroup was statistically significant ( χ2 values were 14.99, 19.28, 73.56, P<0.05). The higher education level of the slow walking group was 16.6% (34/205), which was significantly different from that of the MCR group ( χ2 value was 4.77, P<0.05). The proportions of higher education level, arthritis, depression and crutches in the healthy subgroup were 27.9% (409/1 464), 12.9 (190/1 464), 11.2% (164/1 464) and 19.7% (288/1 464), while that in the SCC subgroup were 18.9% (289/1 531), 16.2 (248/1 531), 13.2% (202/1 531) and 22.5% (344/1 531), and that in the slow walking subgroup were 16.6% (34/205), 21.5% (44/205), 20.9 (43/205) and 47.3% (97/205). There were significant differences among the three subgroups ( χ2 values were 13.08-78.28, P<0.05). BMI and number of drugs in healthy subgroups were (23.4±4.4) kg/m 2 and (4.7±2.8) , SCC group was (25.2±4.3) kg/m 2 and (5.1±2.9) kinds, and slow walking subgroup were (25.1±3.8) kg/m 2 and (6.7±3.1) kinds. The differences among the three subgroups were statistically significant ( t values were 2.68,7.21, P<0.05). The risks of falling, repeated falling and fracture after falling in MCR patients were 1.22, 1.47 and 2.54 ( P<0.05). Conclusions:Age, MCR is a high risk factor for falls in the elderly, repeated falls and fractures after falls. In clinical care, MCR needs to be evaluated and attention should be payed to the elderly.
Objective:To observe clinical effect of thunder-fire moxibustion with meridian point, including lumbar spinal cordacupoints of bladder meridian and abdominal acupoints of Ren channel, which treating on deficiency of kidney and spleen and blood stasis in chronic kidney diseases (CKD) stage 3.Methods:Totally 60 patients were randomly divided into treatment and control group. 30 patients in control were treated with blood pressure and lipid adjustment, Chinese medicine and nutritional therapy. 30 patients in treatment group were treated with thunder-fire moxibustion with meridian point based on control. A moxibustion-treated course has 2 weeks, patients were treated every other day. Observe blood urea nitrogen (Bun) , creatinine (Scr) , glomerular filtration rate (eGFR) , Chinese medicine syndrome and quantitative score, as well as clinical efficacy.Results:After 4 weeks of intervention, the TCM syndrome score [8 (4,10)] in the treatment group was significantly lower than that in the control group [12 (10,14)], with a statistically significant difference ( Z=-3.706, P = 0.000); in the quantitative score of symptom classification, the patients in the treatment group were significantly lower than those in the control group [2 (0,2)], chills [2 (2,2)], fatigue [2 (2,4)], the difference was statistically significant ( Z=-2.625, -3.593, -4.609, P < 0.01). The frequency of nocturia in the treatment group was significantly higher than that in the control group ( Z=-1.989, P < 0.05), while that in the treatment group was not significantly better than that in the control group ( P > 0.05). In terms of clinical efficacy, the total effective rate of the treatment group was 93.3% (28/30), which was better than73.3% (22/30) of the control group ( χ2= 38.19, P = 0.000). Conclusion:Thunder-fire moxibustion with meridian point improve deficiency of kidney and spleen and blood stasis of patients in CKD stage3, such as weak waist, cold chills, poor appetite, weakness and nocturia, as well as ameliorate renal function.
Objective:To comb the development of transitional care, analyze and compare the research hotspots and frontiers at home and abroad.Methods:CNKI Database and Web of Science Core Collection were taken as data sources to retrieve the relevant literature published from 2000 to 2019; CiteSpace software was used to construct scientific knowledge maps for visualization analysis.Results:A total of 285 Chinese and 1 179 English documents were retrieved, and the annual publications showed an upward trend from 2012. The high-yield institutions and authors were relatively scattered. Chinese papers focused on subjective indicators such as quality of life, and most of which were literature review. While English papers tended to focus on objective indicators, such as readmission and mortality rate, and the research type was mainly intervention study. The Chinese keywords "WeChat" and English "palliative care" were with the strongest citation bursts in recent years.Conclusions:The domestic development of transitional care is relatively lagging; cooperation between institutions and authors should be strengthened. Future researches on palliative care or combined with WeChat platform may become hotspots in this field.
Objective:To introduce the method of making mesh elastic gloves, and to explore its application effect in the treatment of zinc oxide paste in patients with subacute eczema in the hands.Methods:This study was a kind of experimental study. A total of 96 patients with subacute eczema in the hands in the Dermatology Ward of the First Affiliated Hospital of Yangtze University were selected as the study subjects.They were divided into the control group (admitted from June to December in 2017) and the experimental group (admitted from June to December in 2018) according to the time of admission, 48 cases in each group. After the two procedures(apply medicine and cover with sterile gauze) of the conventional zinc oxide paste coating, the control group was fixed with "gauze bandage+ medical tape", and the experimental group was fixed with "mesh elastic gloves". The external fixed cost and time, the disassembly time, the dressing fixation, the comfort condition, the grip strength, the daily activity of the hand, and the healing effect of the skin lesions were evaluated.Results:The external fixed cost and time, the disassembly time, grip strength and hand daily activities ability of the patients in the experimental group were (0.37±0.05) yuan, (26.06±2.53) s, (13.70±1.28) s, (25.96±5.83) kg, and (65.04±7.10) points, significantly better than the control group (1.63±0.21) yuan, (160.98±22.82) s, (22.36±3.50) s, (20.01±3.56) kg, (61.83±6.31) points, the difference between the two groups was statistically significant ( t value was-40.931--2.340, P< 0.01 or 0.05). The total rate of comfort, the total rate of dressing loss and the total effective rate of skin lesion healing in the experimental group were respectively 100%(48/48), 0, 98% (47/48), significantly better than the control group 79% (38/48), 46% (22/48), 71% (34/48), the difference between the two groups were statistically significant ( χ 2 value was 11.163, 28.541, 13.353, all P<0.01). Conclusions:The application of mesh elastic gloves in the treatment of zinc oxide paste in patients with subacute eczema in the hands can not only save the cost of external fixation and the time of external fixation and disassembly, but also improve dressing fixation and comfort, and improve grip and hand daily activities. At the same time, the healing effect of hand skin lesions can also be improved. In short, it meets the needs of dermatology hand coating.
Objective:To explore mechanism of how nurse managers' transformational leadership affects patient satisfaction, and to examine the mediating role of nurses' psychological empowerment.Methods:A total of 140 nurses and 310 patients in Sun Yat-sen University Cancer Center were surveyed. The Leadership Practice Inventory-other, the Psychological Empowerment Scale and two items from the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (Chinese version) were used to measure nurse-perceived nurse managers' transformational leadership behaviors, nurses' psychological empowerment and patient satisfaction. The descriptive statistics and correlation analysis were performed using the SPSS 20.0. software package, and the structure equation modeling was performed using the MPlus 7.0.Results:Higher frequencies of nurse managers adopting transformational leadership were associated with higher level of nurses' psychological empowerment ( β=0.665, P < 0.05); higher level of nurses' psychological empowerment was associated with higher overall patient satisfaction ( β=0.243, P < 0.05); nurses' psychological empowerment mediated the relationship between nurse managers' transformational leadership and patients' overall satisfaction ( β=0.162, P=0.014); the effects of nurse managers' transformational leadership and nurses' psychological empowerment on patients' recommendation of hospital were not statistically significant ( P>0.05). Conclusions:Nurse managers are encouraged to adopt transformational leadership, i.e., improving clinical and leadership skills, trying to be nurses' role model, solving problems at work, empowering and motivating nurses, thus to increase nurses' senses of empowerment, and to improve patient satisfaction eventually.
Objective:To investigate the effect of the lower extremitas abduction brace pads which is designed by our team in helping patient turnover after orthopedic femoral neck fracture, intertrochanteric fracture, femoral head replacement.Methods:Using prospective cohort study to facilitate sampling From October 2016 to August 2017, in an upper third-class hospital of Jiangsu province, we selected 100 patients in Orthopedics dept. No.1 at random as the experimental group and 80 patients in dept. No.2 as the control group. Lower extremitas abduction brace pads were used in experimental group and pillows, backrests and clothes were used in control group. Comfort level, incidence of skin pressure injury, joint dislocation rate and the compliance of the two groups were compared.Results:The number of patients in experimental group who rated the comfort up to 3 (feel a little pain and uncomfortable) was much higher than that in control group ( OD value was 5.801, P<0.01), while which rated 1 (feel painful, unbearable and extremely uncomfortable) was lower than that of control group ( OD value was 0.168 ,P<0.01) . The ratio of stress injury and dislocation were lower in experimental group ( OD value was 0.126, P=0.046). There was no significant difference between two groups in the ratio of dislocation after femoral head replacement ( OD value was 0.000, P=0.444) and leg deep vein thrombosis ( OD value was 0.000, P=1.000). Conclusion:Lower extremitas abduction brace pads can effectively improve the comfort of the patients and reduce the ratio of stress injury.
Objective:To investigate fathers′ knowledge, attitude and practice of breastfeeding and to analyze the related factors.Methods:From August 2018 to April 2019, 200 fathers of newborns in a Shanghai tertiary obstetrics and gynaecology hospital were surveyed about their breastfeeding knowledge, attitude and practice by convenient sampling and self-designed questionnaires.Results:The average knowledge score was 9.80±2.61, the attitude score was 38.71±4.45, the behavioral score was 39.72±6.48. Multiple linear regression results showed that parents′ education level and the wives′ delivery times were the main factors affecting breastfeeding knowledge score ( t values were 2.016, 2.068, 2.988, P < 0.05). The fathers′ knowledge score and the wives′ delivery method were the main factors affecting attitude score ( t values were -3.029,5.225, P < 0.05). Attitude score and infants′ age stage were the main factors affecting behavior score ( t values were 1.985, 2.633, P<0.05). Conclusion:Fathers′ breastfeeding attitude was positive, but they still had wrong perceptions. There were many deficiencies in breastfeeding related behaviors of fathers. It is necessary for hospitals, communities or other relevant institutions to educate fathers with knowledge related to breastfeeding, to encourage fathers to pay more attention to breastfeeding and urge fathers′ behavior improvement, so as to increase the rate of breastfeeding and promote the health of mothers and infants.
Objective:To examine the relative importance of four emotion regulation strategies (i.e. cognitive reappraisal, expressive suppression, rumination and mindfulness) in explaining job burnout and depression of nurses.Methods:We conducted a cross-sectional study with questionnaires for 1 037 nurses from two general hospitals. Maslach Burnout Inventory-Human Service Survey (MBI-HSS), the Patient Health Questionnaire-9 (PHQ-9), Emotion Regulation Questionnaire (ERQ), Ruminative Responses Scale (RRS) and Short Inventory of Mindfulness Capability (SIM-C) were assessed.Results:Dominance analysis revealed that in terms of job burnout, rumination, cognitive reappraisal and mindfulness could explain 41.38% (0.132/0.319), 30.09% (0.096/0.319) and 28.53% (0.091/0.319). In terms of depression, rumination and mindfulness could explain 68.6% (0.362/0.528)and 24.43% (0.129/0.528).Conclusions:Rumination and mindfulness were important predictors of job burnout and depression of nurses. This study indicates that reducing ruminative responses and enhancement of mindfulness are the important approach to reduce nurses′ job burnout and depression.
Objective:To explore the effect of preoperative visit with Child Life mode in the management of preschool children′s anxiety.Methods:A total of 80 cases of children of pre-school age who were operated from September 2018 to February 2019 were selected by cluster sampling method. The children from September to November 2018 who were given the traditional mode of preoperative visit were set as the control group. Children from December 2018 to February 2019 who were given preoperative visit with Child Life mode were set as the experimental group. The Modified Yale Perioperative Anxiety Scale (m-YPAS) scores, Induction Compliance Checklist (ICC) scores and Pediatric Anesthesia Emergence Delirium (PAED) scores were compared between the two groups at 4 different perioperative time points (6 hours after admission, waiting for surgery, induction of anesthesia, and 6 hours after surgery).Results:Totally three patients were suspended from the study due to surgery. A total of 77 children were studied, 38 in the experimental group and 39 in the control group. The score of m-YPAS in the experimental group was significantly lower than that of the control group(17.57±16.64 vs. 42.04±27.46, t value was 3.85, P<0.01) while waiting for surgery. The score of m-YPAS in the experimental group was significantly lower than control group (31.64±27.95 vs. 62.22±25.13, t value was 4.26, P<0.01) at the anesthesia induction. Compare with the control group, the score of m-YPAS in the experimental group showed no significant difference at both time of 6 hours after admission (18.19±17.83 vs.19.85±17.92, t value was 0.87, P>0.05) and 6 hours after surgery(35.61±15.70 vs. 41.81±17.97, t value was 1.37, P>0.05). Compare with the control group the score of ICC in the experimental group was significantly decreased (1.40±1.39 vs. 3.78±2.60, t value was 4.88, P<0.01) at the anesthesia induction. The score of PEAD in the experimental group and control group, there was no significant difference between the two groups (7.18±2.45 vs. 7.85±3.05, t value was 0.91, P>0.05). Conclusions:Compared with the traditional preoperative visit mode, the preoperative visit mode of Child Life can effectively relieve the anxiety of preschool children undergoing general anesthesia surgery while they are waiting for surgery and during anesthesia induction, and can improve the degree of cooperation during anesthesia induction.
Objective:To study the application effect of family-centered care (FCC) model in children ′s health care. Methods:The data of 200 children who came to the hospital for outpatient care in our hospital were analyzed. They were divided into two groups according to the principle of random number. 100 cases in the control group were given traditional child health care, and 100 cases in the observation group were treated with FCC. Service care, comparing the implementation of child care services under different care modes.Results:After the FCC model was used in the observation group, parents ′ knowledge of children ′s health knowledge (79.0±6.6), child care compliance 98.0% (98/100), health service effect 95.0% (95/100), nursing satisfaction 96.0% (96/100), the control group was (65.0±5.8), 88.0% (88/100), 80.0% (80/100), and 80.0% (80/100), respectively. There was statistical significance ( t value was 15.934, χ2 value was 7.68, 16.50, 12.12, P<0.05). The neuropsychological development scores were evaluated in the two groups. The observation group had a large exercise score (90.9±6.2) and a fine action score (86.8±7.2), adaptability score (96.5±6.5), language score (89.2±2.5), and social development score (88.3±2.5). The control group was (88.2±6.0), (84.0±6.0), (94.0±4.8), (87.9±3.0), (87.0±2.5), and there were statistics between the two groups. Academic significance ( t value was 2.253-3.329, P<0.05). Conclusion:The implementation of the FCC model in children ′s health care can improve children ′s understanding of disease knowledge and child care compliance.
Nursing staff plays a crucial role in the end-stage of a patient′s life, and it is inevitable for nursing staff to face and handle problems about death. The ability to cope with death is of vital importance, which can reduce the risk of emotional distress in nurses, and assist nurses to better participate in patients' end-stage care, and improve the quality of care. This paper summarizes the definition, components, theoretical frameworks and models, assessment tools, status quo, influencing factors of the coping with death competence, and propose the corresponding intervention strategy according to the situation of our country, provide references for the future research.
Objective:To discuss the impact and practicability of pluralistic management when puerpera with hepatitis B virus (HBV) in hospital.Methods:By review researching and convenient sampling, two groups of puerpera with HBV were studied comparatively by the index of the time of breast milk, the breastfeeding rate and the satisfaction rate in hospital.The control group (411 cases, January to December, 2017) carried on the normal regulations nursing and the observation group (411 cases, January to October, 2018) carried on the pluralistic management in the Obstetrics and Gynecology Department of the Fifth Medical Center of PLA General Hospital.Results:The rate of the starting time of milk secretion (<24, 24-48, 49-72, >72 h) was 29.4%(121/411), 36.0%(148/411), 24.6%(101/411), 1.0%(41/411) in the observation group, and 13.6%(56/411), 21.7%(89/411), 33.3%(137/411), 31.4%(129/411) in the control group. The differences between the two groups were significant ( χ2 value was 7.66-57.43, all P<0.01). Postpartum hospital stay in 3 days and 6 days, the breastfeeding rate and average rate was 90.4%(198/219), 95.3%(183/192), 92.7%(381/411) in the observation group, and 79.0%(180/228), 84.2%(154/183), 81.3%(334/411) in the control group, the differences between the two groups were significant ( χ2 value was 11.13, 12.7, 23.61, all P<0.01). The total satisfaction rate in hospital was 99.5%(409/411) in the observation group, and 91.2%(375/411) in the control group, the difference between the two groups was significant ( χ2 value was 31.93, P<0.01). Conclusions:Pluralistic management can raise the rate of breastfeeding of puerpera with HBV and the satisfaction of puerpera with HBV and her family.
