社会疏离普遍存在于脑卒中患者的疾病过程中,且与脑卒中疾病互为影响.本文从脑卒中患者社会疏离的概述、国内外研究现状、测评工具及影响因素等方面进行综述,并提出减轻脑卒中患者社会疏离的建议,旨在为提高脑卒中患者社会参与度、促进社会融入提供理论依据.
Objective To deeply understand the self-management obstacles in patients with ankylosing spondylitis(AS)in emerging adulthood,so as to provide a reference for the development of future self-management intervention protocols for these patients.Methods From February to October 2021,a total of 14 patients were selected by convenience sampling who visited or were hospitalized in the Rheumatology and Immunology Department of a Grade III-A hospital in Nanjing for AS in emerging adulthood.They underwent face-to-face semi-structured in-depth interviews based on the interview outline designed from the Integrated Model of Change and the descriptive phenomenological approach.Then,the interview data were analyzed by Colaizzi's 7-step analysis method.Results A total of 3 themes and 7 sub-themes were extracted address the self-management obstacles in patients with AS in emerging adulthood as follows.Lack of self-management willingness in the awareness stage:weak self-management willingness,lack of self-management knowledge and skills,and insufficient perception of the benefits and consequences of self-management behaviors;lack of health management beliefs in the motivation stage:lack of health management beliefs,and insufficient information support for effective self-management;lack of social support and supervision in the action stage:poor compliance with self-management behaviors,low level of self-efficacy,and weak support and supervision of family members and healthcare providers.Conclusion Healthcare providers should strengthen the self-management awareness of patients with AS in emerging adulthood and improve their perception of disease risk.They should also expand access to professional information so as to help patients establish correct health management beliefs.Furthermore,they should fully mobilize the social support system and actively explore a disease management model for patients with AS in emerging adulthood that aligns with China's realities.
Objective To summarize the best evidence for postpartum glucose management in women with gestational diabetes mellitus(GDM)by retrieving and evaluating domestic and foreign literature.Methods Rel-evant articles were retrieved from the databases at home and abroad,and then target articles were evaluated and graded based on the literature evaluation and evidence grading criteria specified by Australia's JBI evi-dence-based healthcare center,in order to extract the best evidence for postpartum glucose management in women with GDM.Results A total of 24 articles were finally included,including 12 guidelines,1 expert con-sensus,3 clinical decisions and 8 systematic reviews.A total of 20 pieces of best evidence were summarized,involving the following 5 aspects:postpartum glucose screening,pharmaceutical administration,lifestyle inter-vention,breastfeeding guidance,and postpartum contraception and planned pregnancy management.Conclusion The best evidence for postpartum glucose management in women with GDM can offer standardized measures for glu-cose management in these patients and serve as a clinical practice reference for healthcare providers.
Objective To analyze the studies on scientific research performance management in Chinese hospitals,understand the research status and future trends in this field,and provide valuable insights for researchers in this field to select research topics.Methods Articles about scientific research performance management in Chinese hospitals were retrieved with subject terms in CNKI,Wanfang Data and VIP.Then,bibliometrics analysis was made on the number of publications,authors,research institutions and keywords by using the CiteSpace software.Results A total of 286 articles were included in this study.Since 1998,the number of publications has shown an overall upward trend.The top three magazines with the highest number of publications were the Chinese Journal of Medical Science Research Management,Chinese Hospital Management and Hospital Administration Journal of Chinese People's Liberation Army.The top three institutions with the highest number of publications were Shanghai Jiao Tong University,Beijing University of Chinese Medicine and Peking University People's Hospital,forming a cooperative network of research authors centered on Sun Ruihua.The top five keywords were scientific research performance,hospital,scientific research management,performance appraisal and performance evaluation.A total of 9 natural clusters were formed:scientific research performance,scientific research funds,scientific research,scientific research management,indicator system,performance appraisal,scientific research output,performance evaluation and sci-tech papers.In the past three years,the hotspots of domestic studies on hospital scientific research performance management have focused on the research content and research object.The research content encompassed scientific research performance,scientific research management,performance appraisal and performance evaluation;the research object involved public hospitals,hospital departments and clinicians.Conclusion In recent years,there has been a continuous increase in the number of publications on scientific research performance management in Chinese hospitals;however,challenges persist with regard to inadequate publication and limited research content.The strengthening of cooperation between regions and hospitals is recommended to further stimulate the research potential of hospital researchers,thereby facilitating in-depth studies on scientific research performance management in Chinese hospitals.
目的 了解COPD患者"互联网+护理服务"体验,探讨影响"互联网+护理服务"管理的因素.方法 2021年5月至2022年7月,采用目的抽样方法选取接受过江苏省某三级医院"互联网+护理服务"COPD线下家庭护理服务的16例患者作为研究对象,通过半结构访谈进行资料收集,运用主题分析法确定主题与亚主题.结果 针对COPD患者"互联网+护理服务"体验共提取3个主题:①COPD"互联网+护理服务"方案的优点(增加熟悉感、提供便利、提高自我掌控感);②COPD"互联网+护理服务"方案的缺点(信息针对性不强、反馈时效性低、增加焦虑);③COPD"互联网+护理服务"方案的普及任重道远(护理认可度低、患者隐私安全需加强、患者互联网技术素养不高、平台智能性不足、未纳入医保).结论 互联网+护理服务"的应用可以提升COPD患者安全感,减少医疗服务成本,在新型冠状病毒感染流行期间可以减少患者入院次数,提高生活质量,值得推广.同时,管理者应优化微信平台服务内容及形式,提高患者平台使用体验感;规范护理人员准入制度,提高患者对护理认可度;加强患者出院指导,提高其平台使用能力.
体外膜肺氧合(ECMO)治疗的迅速发展给重度呼吸衰竭患者带来了新的希望,提高了医疗救治水平.早期功能锻炼可以帮助ECMO患者改善神经肌肉无力、促进功能恢复并降低治疗成本.但在ECMO患者中开展功能锻炼也存在着挑战,以康复时机、康复团队建设等方面较为突出.本文就成人ECMO患者早期功能锻炼的意义、目前存在的问题与锻炼方法进行综述,以期为我国EC-MO患者早期功能锻炼方案的规范化建设提供参考.
目的 探讨融合心理情景剧翻转课堂的混合式教学方案在《精神科护理学》课程中的应用效果.方法 2021年5月,采用方便抽样方法选取上海中医药大学护理学院本科二年级学生作为研究对象,按照选课先后顺序将其分为观察组(n=40)和对照组(n=72).观察组采用融合心理情景剧翻转课堂的混合式教学方案进行《精神科护理学》课程教学,对照组采用传统教学模式进行教学.干预后(课程结束后),比较两组学生的客观成绩、任务负荷水平和课程满意度.结果 干预后,观察组客观成绩优于对照组(P<0.001),任务负荷水平低于对照组(P<0.001),课程满意度与对照组的差异不具有统计学意义(P=0.991).结论 在《精神科护理学》课程中,融合心理情景剧翻转课堂的混合式教学方案能帮助学生在减轻学习负荷的同时提高成绩,具有较高的课程满意度,值得推广.
回顾国内外相关文献,在实施传统延续性护理模式的基础上应用互联网技术可以突破时间和空间的限制,为糖尿病足患者提供全方位、高效率及多样化的护理服务.本文就"互联网+延续性护理"模式的概述、在糖尿病足患者中的应用方式、作用效果、现存问题及对策进行综述,旨在为促进"互联网+延续性护理"模式在糖尿病足患者中的广泛应用提供参考.
目的 调查急性ST段抬高型心肌梗死(STEMI)患者门-球(D2B)时间现状,并分析其影响因素.方法 2021年1月至2022年12月,采用方便抽样方法选取收治于江西省中西医结合医院的86例急性STEMI患者作为研究对象,依据D2B时间将患者分为延迟组(n=32)和未延迟组(n=54),采用自行设计的调查问卷对其进行调查,并采用logistic回归分析急性STEMI患者D2B时间延迟的影响因素.结果 被调查的86例患者中有32例患者出现D2B时间延迟,延迟率为37.21%.logistic回归分析显示,院前延迟时间、自行前往医院、有消化系统疾病史和对疾病不了解是急性STEMI患者D2B时间延迟的独立危险因素(P<0.05,OR>1),居住地为城镇、首诊心肌梗死、有PCI史、有心脏病史和文化程度高是急性STE-MI患者D2B时间延迟的独立保护因素(P<0.05,OR<1).结论 急性STEMI患者D2B时间延迟受多重因素影响,医护人员可实施针对性改进措施以提高患者诊疗效率和存活率.
Objective To analyze the related risk factors affecting the re-admission of adolescents with depression after discharge,then construct a risk prediction model and validate the model.Methods From June 2018 to May 2021,a total of 348 adolescents with depression who were hospitalized in the Third People's Hospital of Ganzhou were selected by convenience sampling.They were investigated by using the General Information Questionnaire,Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS)and Multidimensional Scale of Perceived Social Support(MSPSS).Patients were randomized(7∶3)to the modeling group(n=244)and the validation group(n=104).Univariate analysis and multivariate logistic regression were used to analyze the independent influencing factors of re-admission within one year after discharge in the modeling group.Then,a risk prediction model of re-admission within one year after discharge for adolescents with depression was established based on the independent influencing factors.The model was evaluated by the receiver operating characteristic(ROC)curve,the goodness of fit was predicted by the Hosmer-Lemeshow test,and the model was externally validated using the patient data in the validation group.Results In the modeling group,43 patients were re-admitted to the hospital due to recurrent depression within one year after discharge,with an incidence of 17.62%.The results of univariate and multivariate analysis showed that BMI≥24 kg/m2,family history of mental disorder,lack of sleep and anxiety were independent risk factors for adolescents with depression to be re-admitted to the hospital within one year after discharge,while the total score of MSPSS and the scores of family support,teacher support and friend support were independent protective factors(P<0.05).The ROC results of the risk prediction model constructed based on independent influencing factors showed that the area under the ROC curve of the risk early warning model was 0.878(95%CI:0.829-0.928),with a sensitivity of 79.1%and specificity of 87.1%.Hosmer-Lemeshow goodness of fit test showed χ2=11.589 and P=0.171.The model was validated to have a sensitivity of 83.33%,a specificity of 81.93%,and an overall accuracy of 82.19%.Conclusion There are many factors influencing the re-admission of adolescents with depression within one year after discharge.The risk prediction model constructed in this study has good prediction efficiency and certain clinical application value.
Objective To investigate the status quo of midwives'clinical application of moderate perineal protection technique during delivery in East China and analyze its influencing factors.Methods From April to May 2021,a total of 1884 midwives were selected by convenience sampling from hospitals at all levels in East China(Shanghai,Jiangsu,Zhejiang,Shandong and Fujian).They were investigated by using a self-made questionnaire.Results Among them,1338(71.02%)midwives applied the moderate perineal protection technique in clinical practice.The logistic regression analysis showed that the clinical application of moderate perineal protection technique was mainly influenced by hospital attributes,midwives'years of working and whether they have received operation training on the moderate perineal protection technique.Conclusion The proportion of midwives applying moderate perineal technology in clinical practice in East China needs to be further improved.Relevant clinical administrators should further improve the midwifery education system and midwifery training mechanism so as to address the needs of midwives applying moderate perineal technology in clinical practice.
目的 调查福建省儿科护士突发公共卫生事件应急能力培训现状,并分析其影响因素.方法 2023年7-8月,采用整体抽样方法选取福建省所有儿科护士3379名作为研究对象.采用自行设计的"福建省儿科护士突发公共卫生事件应急能力培训现状调查问卷"对其进行调查.结果 接受过突发公共卫生事件应急能力培训的儿科护士有2470名(73.10%).回归分析结果显示,职称、工作年限、岗位和医院所在地区是儿科护士接受突发公共卫生事件应急能力培训的主要影响因素(P<0.05).结论 儿科护士接受突发公共卫生事件应急能力培训现状有待进一步改善,相关医院管理者应采取针对性综合措施以提升儿科护理队伍突发公共卫生事件应急能力.
脑卒中后的运动预测模型与患者肢体功能康复具有密切关系.本文回顾了国内外运动功能恢复预测模型,分析各类预测模型优缺点,以期为促使临床更好使用运动功能恢复预测模型并更有效的改善患者功能预后提供参考.
[本刊讯] 为进一步规范居家和社区医养结合服务内容,提高服务质量,国家卫生健康委会同国家中医药局、国家疾控局研究制定并印发了《居家和社区医养结合服务指南(试行)》(以下简称《指南》).《指南》对居家和社区医养结合服务的总则、基本要求、服务内容与要求、服务流程与要求等四方面作出了明确规范.
Objective To investigate the status quo of supportive management perceived by caregivers in nursing homes and analyze its influencing factors.Methods From July to September 2022,a total of 646 caregivers were selected by convenience sampling from 12 nursing homes in Suzhou City.They were investigated by using the General Information Questionnaire,Maslach Burnout Inventory-General Survey(MBI-GS)and Chinese version of Supportive Supervisory Scale(SSS-C).Results For the 646 nurses,the SSS-C score was(42.28±6.51)points.The regression analysis showed that the SSS-C score perceived by caregivers was mainly influenced by the nature of nursing homes,average monthly income,professional attitude,working area,years of experience in elderly care,type of certificate held by caregivers,views on promotion channels,satisfaction with same-shift nurses(supervisors),satisfaction with current working conditions and MBI-GS score.Conclusion There is still room for improvement in the supportive management perceived by caregivers in nursing homes.Administrators should pay attention to improving the physical and humanistic environment of caregivers,and reduce their work stress and job burnout by increasing remuneration and strengthening staffing,so as to improve the supportive management perceived by caregivers.
Objective To explore the application effect of chronic illness trajectory model-based intervention on chronic obstructive pulmonary disease(COPD).Methods From January 2020 to July 2022,a total of 89 COPD patients who were admitted to Yangzhou Hongquan Hospital in Jiangsu Province were selected by convenience sampling.They were divided into the control group(n=44)and the observation group(n=45)by their odd/even outpatient registration numbers.Patients in the control group were given routine nursing intervention,while those in the observation group were given chronic illness trajectory model-based intervention.BODE index,dyspnea index(modified Medical Research Council),forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),maximal mid-expiratory flow(MMEF),partial pressure of oxygen in arterial blood(PaO2),partial pressure of carbon dioxide(PaCO2),blood pH,oxygen saturation(SaO2),self-management skills(the Rating Scale of Health Self-management Skill for Adults)and quality of life(St.George's Respiratory Questionnaire)were compared between the two groups at admission(before intervention)and before discharge(after intervention)respectively.Results After the intervention,the BODE index,FEV1,FVC,MMEF,PaO2,SaO2,blood pH and AHSMSRS scores in the observation group were all superior to those in the control group(P<0.05);the mMRC,PaCO2 and SGRQ scores were all lower than those in the control group(P<0.05).Conclusion Chronic illness trajectory model-based intervention can improve pulmonary function,blood gas indexes,self-management skills and quality of life in COPD patients.Therefore,it is worthy of clinical promotion.
目的 探讨一站式管理对孕妇MRI检查效能及图像质量的影响.方法 2018年1月至2022年11月,采用方便抽样方法选取在空军军医大学第二附属医院进行MRI检查的137名孕妇作为研究对象,根据预约检查时间将其分为对照组(n=67)和观察组(n=70).对照组接受常规检查管理办法进行MRI检查,观察组接受一站式管理办法进行MRI检查.比较两组孕妇的一次性检查成功率、检查耗时及MRI影像质量.结果 观察组一次检查成功率、检查平均耗时及影像质量均优于对照组(P<0.05).结论 一站式管理能帮助孕妇缩短MRI检查耗时、提高一次性检查成功率和影像质量,值得推广.
Objective To investigate the internal characteristics of preoperative symptoms in patients first diagnosed with breast cancer,and to analyze the distribution differences of demographic variables among different categories.Methods From June to December 2021,a total of 198 patients were selected by convenience sampling who were first diagnosed with breast cancer and admitted to a Grade III-A hospital in Shanghai.They were investigated using the General Information Questionnaire,Numerical Rating Scale,State-Trait Anxiety Inventory Form Y,Pittsburgh Sleep Quality Index,Functional Assessment of Chronic Illness Therapy-Fatigue Scale(FACIT-F)and Functional Assessment of Cancer Therapy-Breast(FACT-B)before surgery.Then,latent profile analysis was performed by Mplus 8.0 software on the results of their symptoms.Results Breast cancer patients can be divided into three categories according to their preoperative symptoms scores(pain-anxiety-fatigue-sleep disorder):severe symptom group(n=80,40.40%),medium symptom group(n= 91,45.96%)and mild symptom group(n=27,13.64%).Compared with the mild symptom group,the FACT-B score was lower in severe and medium symptom groups,without a statistical difference(P>0.05).The preoperative symptoms of breast cancer patients in different categories differed in age(F=3.310,P=0.039)and occupation(χ2=15.041,P=0.020)distribution(P<0.05).Conclusion The preoperative symptoms of patients first diagnosed with breast cancer are heterogeneous.Age and occupation are important factors that influence the latent categories of preoperative symptoms of these patients.Healthcare providers should pay attention to young patients first diagnosed with breast cancer during their employment,and improve their quality of life by providing personalized nursing.
目的 探讨情绪释放技术在老年白内障日间手术患者术前护理中的应用.方法 通过便利抽样法,选取2021年9-12月于烟台毓璜顶医院手术室接受白内障日间手术的老年患者216例为研究对象.将2021年9-10月符合纳入标准的108例患者设为对照组,2021年11-12月收治的108例患者设为观察组.对照组采取常规术前护理干预,观察组在对照组基础上联合情绪释放技术进行术前护理干预.比较两组患者的焦虑评分、血压值及患者满意度.结果 干预后观察组患者焦虑评分低于对照组,差异有统计学意义(P＜0.05).两组患者干预后血压值均较干预前降低,但干预后观察组血压值低于对照组,差异有统计学意义(P＜0.05).观察组患者满意度评分高于对照组,差异有统计学意义(P＜0.05).结论 情绪释放技术可以有效缓解老年白内障日间手术患者的焦虑情绪,降低术前血压,提高患者满意度,为护理服务质量的提升、手术的顺利进行提供保障.
目的 探讨随迁老人生活满意度、人际幸福感与生存质量的关系.方法 采用方便抽样法,于2021年9-12月选取北京市、天津市各一个区及河北省两市的500名随迁老人为研究对象.采用一般资料调查表、生活满意度调查表、人际幸福感量表和健康调查简表对其进行调查.结果 随迁老人生活满意度得分为(10.81±3.22)分,人际幸福感得分为(14.44±2.86)分,生存质量得分为(60.89±18.04)分;生活满意度对生存质量的影响具有直接效应(P＜0.001),人际幸福感对生存质量的影响具有直接效应(P＜0.001),人际幸福感在生活满意度与生存质量之间存在中介效应(P＜0.001),中介效应占总效应的74.3％.结论 随迁老人健康状况低于社区一般老年人,生活满意度与人际幸福感影响其生存质量,人际幸福感在生活满意度与生存质量间起中介效应.应鼓励随迁老人积极参与社会活动,提升人际幸福感,有助于其提高生存质量.
