INTRODUCTION:Frailty is thought to be associated with an increased risk of adverse health outcomes such as death and falls, but comparatively little is known about the impact of frailty transitions on the adverse health outcomes. Moreover, owing to insufficient sample size or a single-center study design, previous studies have not been sufficiently representative of elderly inpatients in China. This study aimed to provide estimates at the population level of the association between frailty transitions and adverse outcomes among elderly inpatients following discharge. METHODS:This was a large-scale multicenter cohort study conducted from October 2018 to February 2021. The FRAIL scale was used to estimate frailty status. Frailty transitions were derived by considering frailty status at baseline and the 3-month follow-up, which encompassed five patterns: persistent non-frailty, persistent pre-frailty, persistent frailty, improvement in frailty, and worsening of frailty. The outcome variables included mortality, falls, hospital readmissions, and Health-Related Quality of Life (HRQoL). Cox proportional hazard regression, generalized linear models and linear regression was used to examine the association between frailty transitions and adverse health outcomes. RESULTS:A total of 8,256 patients were included in the study, 40.70% of study participants were non-frail, 43.04% were pre-frail, and 16.27% were frail. Compared with patients who persistently non-frail patients, those who frailty improvement, persistent pre-frailty, worsening frailty, and persistent frailty showcased escalated risks of mortality within 2 years after enrollment [HR (95% CI): 1.32 (1.06-1.64)], 1.71 (1.37-2.13), 2.43 (1.95-3.02), and 2.44 (1.81-3.29), respectively. These groups also faced elevated hazards of 2-year falls [OR(95% CI): 1.586(1.13-2.23), 2.21(1.55-3.15), 1.94(1.33-2.82), 2.71(1.59-4.62)] and re-hospitalization risk within 2 years[OR(95% CI): 1.33(1.13-1.56), 1.56(1.32-1.86), 1.53(1.28-1.83), 2.29(1.74-3.01). The number of falls increased by 0.76 over 2 years in frailty-worsened patients and 0.81 in persistently pre-frail patients. The total days of rehospitalization increased by 0.35 over 2 years in frailty-improved patients, by 0.61 in frailty-worsened patients, by 0.66 in elderly in persistently pre-frail patients and by 0.80 in persistently frail patients. Moreover, patients exhibiting frailty-improved [-1.23 (95% CI: -2.12 to -0.35)], persistently pre-frail[-4.95 (95% CI: -5.96 to -3.94)], frailty-worsened [-3.67 (95% CI: -4.71 to -2.62)], and persistently frail [-9.76 (95% CI: -11.60 to -7.93)] displayed inverse correlations with the regression coefficients of HRQoL. DISCUSSION:Frailty-improved, worsened, persistently pre-frail, and frail inpatients face higher risks of mortality, falls, rehospitalization, reduced HRQoL than consistently non-frail inpatients. Screening for frailty among elderly inpatients can identify individuals at increased risk of adverse health outcomes.

BACKGROUND:Due to high-pressure environments, heavy workloads, and working in "three-shift" schedules, Intensive Care Unit (ICU) nurses experience high-level presenteeism. This may compromise nursing quality and patient safety and damage nurses' physical and mental health. Therefore, there's an urgent need for effective interventions to promote the healthy development of nursing human resources and maintain nursing team stability. AIM:To evaluate the effect of an 8-week Mindfulness-Based Stress Reduction (MBSR) training on presenteeism among ICU nurses. METHODS:ICU nurses with high levels of presenteeism were invited to participate in the study. The ICU wards were randomly assigned to either the intervention group or the control group. The intervention group (40 nurses) received an 8-week MBSR program delivered by a certified mindfulness therapist. In comparison, the control group (40 nurses) received standard psychological counseling, including emotional control, psychological regulation, and sleep management. Both groups were assessed using the Stanford Presenteeism Scale-6 (SPS-6) and the Five Facet Mindfulness Questionnaire (FFMQ) before and after the intervention, and 12 weeks after the intervention. METHODS:This study employed a cluster randomized controlled trial with a two-arm design. ICU nurses with high presenteeism were invited and randomly assigned to groups by floor. The intervention group (40 nurses) underwent an 8-week MBSR program delivered by a certified mindfulness therapist, while the control group (40 nurses) received standard psychological counseling, including emotion regulation, psychological adjustment, and sleep management. Both groups were assessed using the Stanford Presenteeism Scale-6 (SPS-6) and the Five Facet Mindfulness Questionnaire (FFMQ) at baseline, post-intervention, and 12 weeks post-intervention. RESULTS:Linear mixed model analysis showed significant group, time, and group-time interaction effects on SPS-6 scores (P < 0.05). The experimental group had significantly lower SPS-6 scores at 8 and 12 weeks post-intervention than the control group and their pre-intervention scores (P < 0.05). For FFMQ scores, significant group and time effects (P < 0.05) but no significant group-time interaction (P > 0.05) were found. The experimental group's FFMQ scores were significantly higher at 8 and 12 weeks post - intervention than the control group and their pre-intervention scores (P < 0.05). CONCLUSION:The Mindfulness-Based Stress Reduction intervention was associated with increased mindfulness levels over time, and it significantly reduced presenteeism, with sustained effects observed over time. CLINICAL IMPLICATIONS FOR NURSING MANAGEMENT:MBSR, as a psychological intervention method, has the advantages of improving nurses' mental health and work efficiency, reducing presenteeism, and ensuring patient safety. Nursing managers can integrate MBSR into hospital policies by organizing regular MBSR sessions on mental health days or during team-building activities. This not only enhances nurses' psychological resilience but also promotes a positive work environment, contributing to a safer and more efficient healthcare setting. PATIENT OR PUBLIC CONTRIBUTION:Participants were involved solely in the data collection process. No participant contributions were required for the study's design, outcome measurement or implementation.

Background: The internet + nursing service is an important initiative for implementing the strategy of healthy China and actively responding to the aging of the population. However, the current literature on residents’ awareness and willingness to participate is insufficient and presents large variations and limitations. Therefore, this study aims to systematically evaluate the awareness and willingness of Chinese residents to participate in internet + nursing service to comprehensively understand the level of awareness and acceptance of this emerging service model among Chinese residents and to provide strong support for relevant policy formulation and service optimization. Methods: The PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang Data, SinoMed, and VIP databases were electronically searched to collect cross-sectional studies related to the awareness and willingness of Chinese residents to participate in internet + nursing service from inception to January 2024. Two reviewers independently screened the literature, extracted the data, and assessed the risk of bias of the included studies. Results: A total of 27 cross-sectional studies involving 11,761 subjects were included. The results of the meta-analysis showed that the percentage of Chinese residents willing to participate in internet + nursing service was 76.3% (95% CI [71.2%, 81.3%]). The results of the subgroup analysis showed that residents who lived in Western regions (82.1%), had employee medical insurance (85.9%), were suffering from other diseases (89.2%), were under the age of 60 (87.8%), were not married (78.9%), and had an undergraduate degree or above (85.5%) had a relatively high willingness to participate in internet + nursing service. The rate of awareness of internet + nursing service among Chinese residents was 48.6% (95% CI [24.1%, 73.2%]), which shows a downwards trend over time (67.4% in 2019, 56.1% in 2020, and 45.1% in 2021). Conclusion: The willingness to participate in internet + nursing service among Chinese residents is high, but the awareness rate is low. It is necessary to improve the awareness and willingness of Chinese residents to use internet + nursing service through various channels and aspects of publicity and promotion to achieve the goal of innovating the health service model, accurately connecting with the diverse health needs of people, and actively responding to the aging population.

As a significant global health issue, frailty has important implications for clinical practice and public health. Systemic inflammation has been identified as an important mechanism influencing the development of frailty. However, the potential impact of the inflammatory marker alpha-1-acid glycoprotein (AGP) on frailty is unclear. The aim of this study was to investigate the relationship between AGP levels and frailty. The present study employed a cross-sectional design and included a sample of 3802 females aged 20-49 years, drawn from the 2015-2023 National Health and Nutrition Examination Survey (NHANES) database. A weighted multivariate logistic regression was employed to construct a series of adjustment models, comprising crude, partial and fully adjusted models, with the objective of testing the potential association between AGP and frailty. Smoothed curve fitting plots were used to test the nonlinear relationship between AGP and frailty. The diagnostic value of AGP and hsCRP for frailty was compared using receiver operating characteristic (ROC) curve analysis. Finally, subgroup analyses and interaction tests were conducted to explore the stability of the findings. After adjusting for all potential confounding variables, AGP was found to be significantly and positively associated with frailty, with a corresponding 2.42-fold increase in the incidence of frailty observed for each unit increase in AGP (OR = 3.42, 95%CI = 1.83-6.39, P < 0.001). When AGP was analyzed as a tertile variable, individuals in the highest tertile had a higher risk of frailty compared to those in the lowest tertile after adjusting for all covariates (OR = 1.78, 95%CI = 1.21-2.59, p = 0.003, P for trend = 0.002). The results of the multifactor-adjusted smoothed curve fitting plots and threshold effect analyses indicated a nonlinear relationship between AGP and frailty, with an inflection point of 1.05. In addition, ROC curve analysis showed that AGP (AUC = 0.664) had a greater diagnostic value for frailty than hsCRP (AUC = 0.656). Subgroup and interaction analyses demonstrated that none of the examined variables showed a statistically significant interaction with the association between AGP and frailty. The results of this cross-sectional study indicate a significant positive association between AGP and frailty in a population of females aged 20-49 years in the United States. However, these findings need to be further validated and extended in large-scale prospective studies.

Aim: To empirically investigate the impact of ethical leadership on nurses' moral courage in China and examine the mediating role of psychological empowerment in this relationship. Background: Moral courage is essential for alleviating nurses' moral distress, safeguarding patients' safety and rights, and providing high-quality care. Previous studies have emphasized the strong relationship between ethical leadership and moral courage; however, little is known about the actual impact of ethical leadership on nurses' moral courage. This study introduces psychological empowerment, sets out to test empirically its role in the relationship between ethical leadership and moral courage, and provides countermeasures and a theoretical basis for cultivating nurses' moral courage. Methods: Between February and May 2023, a questionnaire survey was conducted among 837 nurses from five hospitals in Sichuan Province, southwest China. The three validated self-report scales, the ethical leadership scale, psychological empowerment scale, and nurses' moral courage scale, were used to collect data. We used IBM SPSS 27.0 for descriptive statistics, univariate analyses, Cronbach's α, and correlations of each variable, modeling a hypothesized model of ethical leadership on moral courage in nurses and testing the internal mechanisms by AMOS 26.0. Results: Ethical leadership significantly positively correlated with psychological empowerment (r = 0.374, p <  0.01), as well as moral courage (r = 0.341, p <  0.01). In addition, psychological empowerment significantly positively correlated with moral courage (r = 0.518, p <  0.01). The structural equation modeling (SEM) shows a satisfactory model fit: χ 2 = 2156.36, df = 849, χ 2/df = 2.540, root mean square of approximation = 0.043, standard root mean square residual = 0.047, normed fit index = 0.911, Tucker-Lewis index = 0.941, and comparative fit index = 0.944. Ethical leadership directly influenced moral courage (β = 0.135, p=0.006) and indirectly affected moral courage via psychological empowerment (β = 0.247, p=0.001). Conclusion: Promoting ethical leadership and psychological empowerment is essential for nurses to promote moral courage. The results of this study illustrate the pivotal role of psychological empowerment in establishing the impact of ethical leadership on nurses' moral courage and the partially mediating part of psychological empowerment in this relationship. Implications for Nursing Management: Nursing managers should understand the importance of moral courage in protecting patients' rights and interests, as well as in maintaining a stable nursing workforce. They should reinforce the positive influence of ethical leadership and embrace an ethical leadership style. In addition, providing relevant training to enhance nurses' psychological empowerment will help cultivate moral courage among them.

Background: Breast cancer (BC) is the most common cancer and the leading cause of cancer death in women. Immune features play an important role in improving the prognosis prediction of BC. However, while previous immune signatures consisted mainly of immune genes, immune cell-based signatures have been rarely reported. Methods: In this study, we report that a novel immune cell signature is effective in improving prognostic prediction by combining M2 macrophages. We identified 17 differentially infiltrating immune cells between cancer and normal groups. Prognostic features of the four immune cells identified by LASSO COX analysis showed good performance for survival risk stratification in both the training and validation datasets. Independent prognostic analysis showed that M2 macrophages were significantly associated with survival in BC patients and both the cells and the risk score were the main prognostic factors independent of survival in BC patients. Results: Therefore, we combined M2 macrophages and risk scores to create a nomogram with good prognostic predictive power. Finally, we attempted to study the effect of M2 on M2 macrophage progression in BC in vitro. BC cells cultured with M2 macrophage-conditioned medium exhibited distinct malignant features, including migration and invasion. Conclusion: The findings suggest that M2 macrophages are associated with poor prognosis in breast cancer patients possibly by promoting tumor invasion and migration. This work may provide a new strategy for prognostic prediction and immunotherapy in BC.

Abstract Background Psychological empowerment notably impacts nurses’ work engagement and high-quality care. A spiritual climate is a work environment that respects individuals and encourages them to express personal views. Previous studies have shown that a spiritual climate enhances psychological empowerment, however, the relationship between them among the nursing population remains unclear. This study aimed to explore the effect of a spiritual climate on nurses’ psychological empowerment and provide a scientific basis for improving psychological empowerment among nurses. Methods A cross-sectional survey of 837 nurses from five hospitals in Sichuan Province, Southwest China, was conducted using a convenience sampling method; this survey included nurses’ demographic characteristics, the Psychological Empowerment Scale (PES), and the Chinese version of the Spiritual Climate Scale (C-SCS). The data were analysed using one-way analysis of variance (ANOVA), correlation analysis, and multiple linear regression. Results The sample of 837 nurses attained a psychological empowerment score of (45.49 ± 6.42) and a spiritual climate score of (75.25 ± 16.75). The one-way ANOVA revealed that psychological empowerment scores among nurses varied based on differences in age, department, years of work experience, professional title, level of work intensity, and children (yes/no). Pearson’s correlation analyses revealed a significant positive correlation between the spiritual climate and nurses’ psychological empowerment (r = 0.564, P < 0.001), and multiple linear regression analysis showed that working in the intensive care unit (ICU), work intensity, and the four items pertaining to spiritual climate influenced nurses’ psychological empowerment, explaining 32.6% of the total variance in psychological empowerment. Conclusion The findings suggested that the spiritual climate perceived by nurses and psychological empowerment are moderately high. Working in the ICU, work intensity, and the four items pertaining to spiritual climate influence nurses’ psychological empowerment. Nursing managers should pay attention to the daily work intensity of nurses, especially ICU nurses, organize work tasks reasonably, promote dynamic and balanced nurse human resource deployment based on patients’ conditions and nurses’ workloads, and implement scientific scheduling plans to establish a positive spiritual climate in the workplace. Additionally, group workshops and systematic training programs can effectively enhance psychological empowerment among nurses.

The escalating global prevalence of polypharmacy presents a growing challenge to public health. In light of this issue, the primary objective of our study was to investigate the status of polypharmacy and its association with clinical outcomes in a large sample of hospitalized older patients aged 65 years and over. A two-year prospective cohort study was carried out at six tertiary-level hospitals in China. Polypharmacy was defined as the prescription of 5 or more different medications daily, including over-the-counter and non-prescription medications. Baseline polypharmacy, multimorbidity, and other variables were collected when at admission, and 2-year outcomes were recorded by telephone follow-up. We used multivariate logistic regression analysis to examine the associations between polypharmacy and 2-year outcomes. The overall response rate was 87.2

Background Population aging might increase the prevalence of undernutrition in older people, which increases the risk of frailty. Numerous studies have indicated that myokines are released by skeletal myocytes in response to muscular contractions and might be associated with frailty. This study aimed to evaluate whether myokines are biomarkers of frailty in older inpatients with undernutrition. Methods The frailty biomarkers were extracted from the Gene Expression Omnibus and Genecards datasets. Relevant myokines and health-related variables were assessed in 55 inpatients aged ≥ 65 years from the Peking Union Medical College Hospital prospective longitudinal frailty study. Serum was prepared for enzyme-linked immunosorbent assay using the appropriate kits. Correlations between biomarkers and frailty status were calculated by Spearman’s correlation analysis. Multiple linear regression was performed to investigate the association between factors and frailty scores. Results The prevalence of frailty was 13.21%. The bioinformatics analysis indicated that leptin, adenosine 5′-monophosphate-activated protein kinase (AMPK), irisin, decorin, and myostatin were potential biomarkers of frailty. The frailty group had significantly higher concentrations of leptin, AMPK, and MSTN than the robust group (p < 0.05). AMPK was significantly positively correlated with frailty (p < 0.05). The pre-frailty and frailty groups had significantly lower concentrations of irisin than the robust group (p < 0.05), whereas the DCN concentration did not differ among the groups. Multiple linear regression suggested that the 15 factors influencing the coefficients of association, the top 50% were the ADL score, MNA-SF score, serum albumin concentration, urination function, hearing function, leptin concentration, GDS-15 score, and MSTN concentration. Conclusions Proinflammatory myokines, particularly leptin, myostatin, and AMPK, negatively affect muscle mass and strength in older adults. ADL and nutritional status play major roles in the development of frailty. Our results confirm that identification of frailty relies upon clinical variables, myokine concentrations, and functional parameters, which might enable the identification and monitoring of frailty.

结合既往资料,基于对国内外相关文献的梳理与分析,探讨道德型领导在护理领域中的研究进展情况.分析文献发现,道德型领导在护理领域中的内涵尚未完全统一,国外有关道德型领导在护理领域中的研究较国内更成熟,从定性研究、测评工具的编制、量性研究到干预策略的构建等一步步在完善中;而国内的研究起步较晚,形式比较单一,均为量性研究.本研究对国内外护理领域中的道德型领导概念、研究现状、测量工具、积极影响及培训策略进行阐述,以期为道德型领导在我国护理领域中的相关研究提供借鉴和参考.

ObjectiveTo develop and externally validate a frailty prediction model integrating physical factors, psychological variables and routine laboratory test parameters to predict the 30-day frailty risk in older adults with undernutrition.MethodsBased on an ongoing survey of geriatrics syndrome in elder adults across China (SGSE), this prognostic study identified the putative prognostic indicators for predicting the 30-day frailty risk of older adults with undernutrition. Using multivariable logistic regression analysis with backward elimination, the predictive model was subjected to internal (bootstrap) and external validation, and its calibration was evaluated by the calibration slope and its C statistic discriminative ability. The model derivation and model validation cohorts were collected between October 2018 and February 2019 from a prospective, large-scale cohort study of hospitalized older adults in tertiary hospitals in China. The modeling derivation cohort data (n = 2,194) were based on the SGSE data comprising southwest Sichuan Province, northern Beijing municipality, northwest Qinghai Province, northeast Heilongjiang Province, and eastern Zhejiang Province, with SGSE data from Hubei Province used to externally validate the model (validation cohort, n = 648).ResultsThe incidence of frailty in the older undernutrition derivation cohort was 13.54% and 13.43% in the validation cohort. The final model developed to estimate the individual predicted risk of 30-day frailty was presented as a regression formula: predicted risk of 30-day frailty = [1/(1+e−riskscore)], where riskscore = −0.106 + 0.034 × age + 0.796 × sex −0.361 × vision dysfunction + 0.373 × hearing dysfunction + 0.408 × urination dysfunction – 0.012 × ADL + 0.064 × depression – 0.139 × nutritional status – 0.007 × hemoglobin – 0.034 × serum albumin – 0.012 × (male: ADL). Area under the curve (AUC) of 0.71 in the derivation cohort, and discrimination of the model were similar in both cohorts, with a C statistic of nearly 0.7, with excellent calibration of observed and predicted risks.ConclusionA new prediction model that quantifies the absolute risk of frailty of older patients suffering from undernutrition was developed and externally validated. Based on physical, psychological, and biological variables, the model provides an important assessment tool to provide different healthcare needs at different times for undernutrition frailty patients.Clinical trial registrationChinese Clinical Trial Registry [ChiCTR1800017682].

This article reviews the concept, measuring tools, the current situation of tacit knowledge sharing among nurses, and the influencing factors. Relevant countermeasures are put forward to enhance nurses′ tacit knowledge sharing. The current problems lying in nurses′ tacit knowledge sharing and future research development directions are proposed, in a bid to provide references for cultivating nurses′ willingness to share tacit knowledge and promoting nurses′ tacit knowledge sharing behaviors.

目的 系统评价导师责任制在我国护士规范化培训中的应用效果.方法 计算机检索PubMed、EMBASE、The Cochrane Library、web of science、中国知网、万方、维普、中国生物医学文献数据库自建库以来的文献,由两名评价员按照纳入及排除标准独立筛选文献、提取数据和质量评价后,采用Review Manager 5.4 和Stata 16.0 软件进行Meta分析.结果 共纳入 18 项研究,2994 例研究对象,其中观察组 1500 例,对照组 1444 例.Meta分析结果显示:与对照组相比,导师责任制在提高理论考试成绩(SMD=0.99,95％CI:0.82～1.15)、操作技能考试成绩(WMD=4.16,95％CI:2.56～5.76)与综合实践能力(WMD=10.51,95％CI:2.10～18.93)的同时,还能够提高规范化培训护士的科研能力(SMD=1.17,95％CI:0.84～1.49)、评判性思维能力(WMD=0.61,95％CI:0.43～0.80)、沟通交流能力(WMD= 0.80,95％CI:0.33～1.26)、一般自我效能(WMD=0.28,95％CI:0.12～0.44)与职业自我效能(WMD=2.73,95％CI:1.85～3.61),最终提升学员满意度(SMD=1.02,95％CI:0.05～1.99)和患者满意度(SMD= 2.14,95％CI:0.10～4.17),与传统教学模式相比,差异均有统计学意义(P<0.01).结论 导师责任制能提高护士规范化培训的效果.

经外周静脉置入中心静脉导管(PICC)在肿瘤化疗患者中应用广泛,因带管时间较长,容易引起导管相关并发症.导管相关并发症的发生与健康教育和患者自我管理不到位等密切相关.本文就目前国内外肿瘤PICC患者健康教育模式的研究现状进行综述,旨在为肿瘤PICC患者建立多元化、系统化的健康教育模式提供参考.

随着医疗技术的发展,癌症儿童五年生存率不断提高,但癌症及相关治疗给患儿带来了诸多不良影响.其中,癌因性疲乏是最常见的副作用之一,严重影响了癌症患儿的生活质量及后期康复.本文就癌症患儿癌因性疲乏的影响因素和非药物干预方法进行综述,以期为癌症患儿癌因性疲乏的临床护理实践及相关研究提供参考.

随着医疗信息化建设的不断完善,医疗数据资源的不断积累,基于真实世界数据的研究受到广泛关注.作为数据处理的高效工具,机器学习被应用于病理诊断、临床决策及风险预警等多个方面,其在护理领域中的应用也越来越广泛.本文从机器学习在护理不良事件和并发症、康复护理、慢病管理、护理管理、心理护理及中医护理等方面进行系统综述,为开展基于机器学习的护理实践提供参考,以促进学科间的交叉融合发展.

青少年抑郁障碍是严重公共卫生问题.研究发现,青少年抑郁障碍的产生和发展受环境和遗传的双重影响.本文对家庭环境和遗传与青少年抑郁障碍的相关性进行综述,为解决青少年心理健康问题提供思路和依据.

BACKGROUND:Urinary tract infection (UTI) is one of major nosocomial infections significantly affecting the outcomes of immobile stroke patients. Previous studies have identified several risk factors, but it is still challenging to accurately estimate personal UTI risk.AIM:To develop predictive models for UTI risk identification for immobile stroke patients.METHODS:Research data were collected from our previous multicentre study. Derivation cohort included 3982 immobile stroke patients collected from November 1st, 2015 to June 30th, 2016; external validation cohort included 3837 patients collected from November 1st, 2016 to July 30th, 2017. Six machine learning models and an ensemble learning model were derived, based on 80% of derivation cohort, and effectiveness was evaluated with the remaining 20%. Shapley additive explanation values were used to determine feature importance and examine the clinical significance of prediction models.FINDINGS:In all, 2.59% (103/3982) patients were diagnosed with UTI in derivation cohort, 1.38% (53/3837) in external cohort. The ensemble learning model performed the best in area under the receiver operating characteristic (ROC) curve in internal validation (82.2%); second best in external validation (80.8%). In addition, the ensemble learning model performed the best sensitivity in both internal and external validation sets (80.9% and 81.1%, respectively). Seven UTI risk factors (pneumonia, glucocorticoid use, female sex, mixed cerebrovascular disease, increased age, prolonged length of stay, and duration of catheterization) were also identified.CONCLUSION:This ensemble learning model demonstrated promising performance. Future work should continue to develop a more concise scoring tool based on machine learning models and prospectively examining the model in practical use, thus improving clinical outcomes.

目的 调查我国三级医院ICU护士隐性缺勤现状,并分析相关影响因素.方法 采用便利抽样法,采用一般资料问卷、隐性缺勤问卷、社会支持量表、变革领导风格量表、职业应对自我效能量表、工作家庭冲突量表对我国24个省、市、自治区794名ICU护士进行调查.结果 ICU护士隐性缺勤平均得分为(15.83±4.44)分.ICU护士领悟社会支持得分为(63.46±12.48)分;职业应对自我效能得分为(22.33±6.94)分;工作家庭冲突得分为(27.05±8.08)分.ICU护士隐性缺勤与家庭支持、朋友支持、其他支持及领悟社会支持总分呈负相关(r=-0.328～-0.390,均P<0.05);隐性缺勤与职业负担、关系相处困难、职业应对自我效能总分呈正相关(r=0.441～0.478,均P<0.05);隐性缺勤与工作-家庭冲突、家庭-工作冲突、工作家庭冲突总分呈正相关(r=0.339～0.442,均P<0.05).多因素分析结果显示,身体健康状况、感知工作压力、是否遭受工作场所暴力、领悟社会支持、职业应对自我效能和工作家庭冲突为ICU护士隐性缺勤的影响因素,合计可以解释总变异的34.4％.结论 ICU护士隐性缺勤处于中等水平,有待进一步改善.临床护理管理者应关注ICU护士的特殊心理需求,给予正确引导,降低隐性缺勤的发生率,提高护士工作幸福感.

随着糖尿病患病人口的增加,糖尿病足的患病率也呈上升态势,对足部溃疡进行预防极为重要.本文通过对现有的糖尿病足部溃疡风险分级系统以及影响糖尿病患者的足部自我护理行为的因素进行分析和归纳,为后续糖尿病足风险筛查以及改善患者不良的足部自我护理行为提供参考.