Objective To synthesize the effects of educational intervention on the screening rate of first-degree relatives of cancer patients. Methods A total of eight Chinese and English databases were searched (PubMed, Embase, Cochrane Library, CINAHL, Web of Science, Scopus, Medline and China Biology Medicine disc) from the time of library establishment to June 2023, for randomized controlled trials investigating the effects of educational intervention on screening rate of first-degree relatives of cancer patients. Two researchers independently screened and evaluated the quality of studies. RevMan 5.3 software was used to calculate the pooled effect size. Results Thirteen studies involving 5628 participants were chosen to include in the meta-analysis. The results revealed that health education can increase screening rate of first-degree relatives of cancer patients (RR = 1.39, 95% CI = 1.16–1.65, P = 0.0002). The effect shown after short-term follow-up (≤6 months) was insignificant in terms of improving screening rate (RR = 1.46, 95% CI = 0.94–2.26, P = 0.09), but after long-term follow-up (＞6 months) the improvement was greater (RR = 1.37, 95% CI = 1.13–1.65, P = 0.002). Conclusion Health education is effective in increasing the screening rate of first-degree relatives of cancer patients. The effect is more evident after long-term than short-term follow-up.

目的:探讨课程思政视域下基于小规模私有在线课程(SPOC)的《健康评估》线上线下混合式教学效果.方法:2020 年 1 月—2021 年 12 月选取 2019 级护理学专业本科生作为混合式教学组,以接受传统教学模式的 2018 级为对照组,授课结束评估两组学生成绩、满意度、健康评估观念及意见和感受.结果:混合式教学组学生总成绩为(79.76±7.82)分,高于对照组的(74.80±9.97)分,差异有统计学意义(t=4.450,P<0.01);混合式教学组学生对健康评估在护理实践中重要性的认识和内涵的理解优于对照组.结论:课程思政视域下开展健康评估混合式教学实践有效但仍需进一步改进,一方面结合学生学习需求和压力开展教学改革,另一方面需要引导教师感知教学改革获益感,实现思政育人和师生双向成长.

Self-harm, which affects the whole family system, is an international public health concern. Empirical evidence supports the efficacy of interventions incorporating a family/parent training component for self-injurious thoughts and behaviours, and a quantitative synthesis of these empirical studies has been undertaken and updated. A qualitative synthesis of the experiences of parents whose child self-harms remains limited. This report aimed to systematically review qualitative research about the experiences, preferences, and expectations of parents whose children self-harmed. A comprehensive search was conducted across ten databases and four grey literature sources, along with the manual search of reference lists and relevant websites. Study screening, data extraction, and quality appraisal were all performed by two independent researchers. Twenty-four articles, two of which were mixed-methods studies, were included and analysed using a meta-aggregation approach. Five synthesized findings were identified: initial negative reactions to the discovery of their child's self-harm, the ongoing impact of self-harm on parents and the wider family, parents' various coping strategies, parents' negative experiences with mental health professionals expectations, and the lack of and need for psychoeducational resources. Our review finds that parents express keen interest in engaging with the treatment process, and our results support family-based therapy. However, with the overwhelming emotions most parents experience, clinicians should approach them with sensitivity, empathy and finesse. Psychoeducational self-help resources should also be made readily available to parents who are reluctant to seek help.

该折叠式临时病床,以三个框架连接为床体框架,以六个移动支架为支撑框架,以三个固定床垫和两个连接床垫为床板.第一床垫和第三床垫的长度方向的外端均设置有竖向贯通的固定孔,可以有效地固定病人的输液架.临时病床在第一框架、第二框架和第三框架展平时作为临时病床使用,在第二框架和第三框架折叠时作为休息椅子使用.同时设置有万向轮、固定锁、多方位护栏,实现了安全实用、方便、可靠,多功能化,有效的利用了医院的资源,还可以使病房的住院环境得以改善,对医务人员的医疗工作干扰降至最低,能够改善临床现有的病床资源利用问题.

目的:分析三级综合医院住院患者的就医体验、满意度状况及其影响因素,为改进医疗服务质量提供参考.方法:采用住院患者体验量表对郑州市5家三级综合医院的500名住院患者进行调查.结果:共回收438份有效问卷,住院患者就医体验均分为(3.79±0.47),其中服务态度体验(4.16±0.61)和技术质量体验(4.15±0.53)得分较高,情感支持体验(3.43±0.67)和疾病交流体验(3.58±0.66)得分较低;总体满意度得分为(8.50±1.58).回归分析显示,感知价值、情感支持、环境后勤、疾病交流是住院患者满意度的影响因素,可以解释36.7％的变异量.结论:住院患者就医体验和满意度总体状况较好,情感支持和疾病交流是亟待改善的关键环节.医院在提升医疗服务质量的同时,要重视人文关怀、沟通交流和环境后勤等非技术性因素的完善,促进患者的价值认同,提升住院患者的满意度.

目的:饮食控制是2型糖尿病治疗的基础,是糖尿病患者病情改善中的重要的措施.为更好的开展糖尿病患者的延续性护理,本文设计一款糖尿病患者饮食监控微信小程序,实现对糖尿病患者的饮食监管.方法:该小程序包括记录、测评、发现、我的4个模块;患者、医护人员2种模式.平台通过分析各类食物中糖分、碳水、脂肪、热量等比例,给予患者日常饮食推荐;结果:患者可以通过平台记录日常饮食内容与总量;医护人员可以接收相关联患者的饮食情况.结论:糖尿病患者饮食监管小程序的设计可以实现对医护人员对糖尿病患者的饮食监管,同时有利于糖尿病患者养成良好饮食习惯,提高患者对自身血糖水平的控制能力.

目的 探讨中年癌症患者配偶积极感受现状及其与自我效能的关系.方法 采用一般情况量表、照顾者积极感受量表及一般自我效能表对便利抽取的95例中年癌症患者配偶进行调查,获悉其积极感受及自我效能现状,分析积极感受与自我效能之间的关系.结果 中年癌症患者配偶积极感受得分为(31.04±6.07)分、自我肯定维度得分(19.87±4.02)分及生活展望维度得分(10.18±3.17)分,与同类研究对比处于低水平,性别、年龄、宗教信仰、孩子是否上学、患病时长等因素是影响积极感受的主要因素;自我效能得分为(22.32±5.99)分,与同类研究对比处于低水平,性别、年龄、身体状况、家庭收入、患者患病时长等因素是影响自我效能的主要因素;配偶积极感受总分、自我肯定维度、生活展望维度得分与自我效能呈正相关关系(r值分别为0.532、0.546、0.424).结论 中年癌症患者配偶存在积极感受,并且自我效能对配偶的积极感受有正性影响.医护人员应积极采取措施提高中年癌症患者配偶的自我效能,以提高配偶的积极感受,从而提高照顾质量及患者和配偶的生活质量.

CONTEXT:Quality of palliative care and death in mainland China is at a low level of the rest of the world, the public is lacked of proper understanding of the relevant information is one of the important reasons. There has been a shift in policy of palliative care in municipalities recently in mainland China.OBJECTIVES:To measure the advance care planning-related knowledge and attitudes of Chinese community-dwelling older adults, in the hope of presenting a specific implementation of the strategy.METHODS:We conducted a mixed-method sequential explanatory study, composed of a quantitative survey followed by qualitative interviews. The first quantitative phase included 523 community elderly individuals, who completed a validated questionnaire. After statistical analysis, a semistructured qualitative interview has been developed and conducted with 16 of them in order to help explain findings obtained in the first phase.RESULTS:The study was conducted with 523 community-dwelling older adults. The cognition level of advance care planning (ACP) was low, and attitude toward ACP was active. Living alone or living with a spouse (and children), have a religion, poor health condition, and life-sustaining treatment-related experience can affect how they behave with ACP. However, lack of trust in ACP, lack of life education and relevant legislation or policies, and Chinese traditional culture and emotion may impede their take-up.CONCLUSIONS:This study indicated that the awareness and participation of ACP of community-dwelling older adults in mainland China are not enough. The influence of national conditions and culture should be fully considered during the process of ACP development.

[目的]了解当前河南省某市农村地区分散供养型五保老人的生活质量、护理需求及其应对方式现状,为农村分散供养型五保老人护理服务体系的完善及生活质量的提高提供参考依据.[方法]采用世界卫生组织生活质量简表中文版、农村老人护理需求问卷及简易应对方式量表作为调查工具,方便抽取106例河南省南阳市部分农村地区分散供养型五保老人进行问卷调查.[结果]农村分散供养五保老人在生理、心理领域得分均低于全国常模水平.年龄、性别、月均医疗支出、患慢性疾病种数、自理能力和对目前照顾的满意度是影响其生活质量的主要因素.该人群总的护理需求得分为(3.36±0.76)分,疾病预防维度得分为(3.37±0.80)分,健康促进维度得分为(3.35±0.77)分.分散供养五保老人在消极应对和积极应对方面得分分别为(1.67±0.53)分、(1.42±0.60)分,低于全国常模水平(P<0.05).[结论]分散供养五保老人生活质量整体较差,长期的护理需求水平较高.应在尽可能满足分散供养五保老人护理需求的同时,评估该人群的应对方式,指导其采取积极的应对方式,从而提高分散供养五保老人的整体生活质量.

目的:了解医患双方对医护人员的角色认知和情感体验,分析其相关影响因素,为促进良性医患关系发展提供参考.方法:采取方便抽样的方法对郑州市8家三级医院384名医护人员及761名患者进行问卷调查.结果:技术性方面,医患双方对医生的角色期待是治疗者,分别占98.95％和99.74％;对护士的角色期待主要是治疗者和护理者,医方分别占99.73％和99.21％,患方分别占99.74％和99.21％.非技术因素中,医患双方对医生的期待角色是沟通者、支持者和合作者,医方分别占98.70％、97.92％和97.13％,患方分别占99.34％、98.42％和95.92％;对护士的期待角色是沟通者和照顾者,医方分别占98.70％和97.92％,患方分别占99.34％和98.42％.结论:患者对就诊医院满意度较高,对医护人员最根本的角色期待是治疗者,期待的非技术角色是沟通者、支持者、照顾者和合作者.

[目的]验证综合干预对改善大学生拒绝敏感性和社交焦虑的效果.[方法]对50名本科在校生进行拒绝敏感性和社交焦虑的现况调查,根据调查结果制定综合性干预方案并实施干预,分析干预前后学生拒绝敏感性和社交焦虑的水平变化.[结果]是否担任班委、性格、是否参加社团、情商、语言表达能力是影响大学生拒绝敏感性的主要因素(P＜0.05),经济水平、同胞人数、性格、母亲文化程度和学习成绩是影响大学生社交焦虑的主要因素(P＜0.05),综合干预后大学生的拒绝敏感性和社交焦虑水平显著降低.[结论]大学生拒绝敏感性和社交焦虑问题较严重,综合干预可以改善大学生的拒绝敏感性和社交焦虑水平.

对美国家庭开业护士分析,归纳其准入标准、课程设置、实践环节和注册等方面情况,分析其主要经验和特点,为国内社区、家庭方向护理硕士专业学位研究生以及高级执业护师培养提供参考.

《中国老龄产业发展报告( 2014 )》〔1〕指出,到2050年我国老年人口将达到4. 8亿,约占全球老年人口的四分之一,是世界上老年人口最多,增长速度最快的国家. 我国于2011 年出台了《社会养老服务体系建设规划( 2011-2015 )》,提出了构建"以居家养老为基础、社区养老为依托、机构养老为支撑"的社会化养老服务体系目标. 该体系中"社区"将发挥联系家庭与机构的纽带作用,弥补家庭照料功能弱化和社会机构养老资源的不足,同时接受社会化、专业化、市场化服务,既符合中国国情和传统文化,也是未来养老方式的发展趋向. 但同时也指出,目前社区养老存在管理责任不明确、政府资金投入不足、基础设施不完善、专业人才短缺、服务项目供给不足、老年社会参与组织及机制不健全等问题,造成社区养老并未发挥其应有的社会作用〔2〕. 与我国相似,澳大利亚也是世界上老龄人口增长最快的国家之一〔3〕,但其在养老护理服务产业方面起步早、经验丰富,已建立起较为完善的养老护理服务体系,其养老方式也主要有居家养老、社区养老及机构养老3 种类型,其中居家式的社区养老最受老年人欢迎且发展最为成熟〔4~6〕,本文拟对澳大利亚社区居家养老服务的申请、评估、服务内容及付费等方面予以详细介绍,并借鉴其先进经验.

介绍护士主导的全科团队家访模式在老年人、妇女儿童及慢性病人等社区重点人群保健中的作用,以有利于社区护理资源的充分利用,丰富这部分人群的健康知识,在身心方面给予其帮助,提高其健康素养和生活质量.

综述家属负性情绪对肿瘤病人影响及干预的研究进展,介绍常见陪护家属负性情绪的类型、测评方法及负性情绪对不同病人的影响,对可能影响情绪的因素和研究中的不足进行分析,对比分析多种干预方法及效果评价.指出目前的文献中对肿瘤病人家属的针对性干预措施及效果评价还较少,今后还有待进一步研究.

Objective To explore the effect of action research based on group learning in hospice care module for nursing students. Methods 82 students were divided into cooperative learning group (40) and conventional teaching group (42). The cognition and attitude of good death questionnaire was used to evaluate teaching effect before and after teaching of hospice care. After teaching, self-feedback and self-feedback questionnaire were made to evaluate the effect of cooperative learning group. SPSS 17 was used to make comparison of data between groups and within groups, and t test, chi square test or Fisher exact probability 2 were also used . Results There were no difference between two groups of nurses before teaching. The students' cognitive level and attitude in cooperative learning group increased significantly, especially their cognitive level of physiological needs (t=5.398, P=0.001), cognition and attitude of death education in intervention group was higher than control group (t=2.992, P=0.004; t=3.661, P=0.001). Although 95% of the nursing students of the cooperative learning group thought group cooperative studying could improve their interests and cultivated their comprehensive abilities, only 50% could accept this kind of studying methods . Conclusions Action research based on group cooperative studying can improve students' cognitive level and attitude of good death, and it is also good for cultivating their ability of au-tonomous learning, innovation, cooperation, and meanwhile, educational action research is a good way to improve both teaching effect and research ability of teacher staffs, but in practice, students' acceptance of group learning needs to be improved.

近年来，乳腺癌发病率在全球呈上升趋势，是威胁女性的恶性肿瘤之一。中国癌症基金会发起的首个大规模乳腺癌流行病学调研项目显示我国女性乳腺癌发病年龄趋于年轻化［1］，与欧美国家相比，我国乳腺癌年轻化趋势更明显［2］，如今20岁左右的女性也多发生［3］。女大学生普遍处于这一阶段，在生理、心理上逐渐走向成熟，却对乳腺癌年轻化发病情况和预防保健认知不容乐观。据报道，高校女生对乳腺癌知晓率及预防行为率均处于低下水平［4］。本文从饮食、文胸的穿戴方式、精神压力等与乳腺癌发生的影响因素做一综述，旨在提高女大学生对乳腺癌年轻化认知及预防水平，以期提高对乳腺癌的重视。

静脉采血是临床常见的护理操作，贯穿于临床护理与治疗的整个过程[1]。随着医疗科技水平的不断发展，各式各样的静脉采血针已广泛应用于临床[2]。传统的采血针由于采血管的负压吸引不能及时控制血量造成血量偏差，影响血标本化验值，甚至有需重新穿刺或更换新的真空采血管，浪费了资源又增加了患者痛苦，另在采血管数目较多时，不但费时费力增加了护理人员工作量，还给护理人员、家属及患者带来心理负担。针对传统采血针的缺点为此我们设计了可调控式静脉采血针装置。现报道如下。