目的 探讨神经外科患儿照护者心理弹性水平的影响因素.方法 采用便利抽样随机抽取2019-08—2020-01入住首都医科大学宣武医院神经外科儿童病区的患儿照护者共99例,采用一般资料调查表、心理弹性量表(CD-RISC)、疾病不确定感量表(PPUS)和焦虑量表(SAS)进行评估,并分析心理弹性的影响因素.结果 神经外科患儿照护者的心理弹性得分为(62.36±13.47)分,焦虑得分为(36.69±6.27)分,疾病不确定感得分为(85.50±13.35)分.心理弹性评分与焦虑和疾病不确定感中的不确定性、复杂性、信息缺乏性和不可预测性均呈负相关(P<0.01).不同受教育程度、家庭人均月收入、居住地、宗教信仰、支付方式的神经外科患儿照护者心理弹性得分比较均存在统计学差异(P<0.05).多元逐步线性回归分析显示家庭人均月收入、宗教信仰、疾病不确定感和焦虑是影响神经外科患儿照护者心理弹性的相关因素(P<0.05).结论 神经外科患儿照护者心理弹性较差,焦虑水平较高,疾病不确定感处于中等水平,医护人员要多关注低收入家庭,并对患儿照护者进行健康宣教,对提高患儿照护者的心理弹性具有重要意义.

目的:了解神经科护士对神经重症康复护理知信行现状并探索其影响因素,为神经重症康复护理专科人才的培养提供依据.方法:采用自制调查问卷,通过便利抽样的方法对368名神经科护士进行调查.结果:回收有效问卷345份,调查对象神经重症康复护理知信行量表总得分(120.45±12.53)分,其中知识维度(44.53±8.74)分,得分率53.01％;态度维度(38.63±3.14)分,得分率96.58％;行为维度(36.23±7.79)分,得分率80.51％.在神经科接受过和未接受过相关培训的护士对神经重症康复护理知识、态度和行为得分不同(P＜0.05);此外,不同学历和职称的护士对神经重症康复护理知识得分不同(P＜0.05);不同科室的护士对神经重症康复护理行为得分不同(P＜0.05).结论:职称、所在科室及是否参加专业培训是影响神经科护士对神经重症康复护理知信行水平的主要因素;针对神经科护士对神经重症康复护理的知识储备薄弱,护理管理者应建立和完善神经重症康复护理培训体系,强化神经科护士的知识和行为,从而提高神经重症患者的护理质量.

新冠肺炎大多数患者预后良好,少数伴有基础性疾病或者老年人患者病情会较快发展至危重,表现出持续性的呼吸困难,严重时出现急性呼吸窘迫综合征,部分患者还可出现谵妄.谵妄患者机械通气及住院时间更长、病死率更高、长期认知损害风险更大.依据系统化整体护理模式内涵及理论基础,根据危重型新冠肺炎合并谵妄护理特点,结合患者病情变化突然,护理人员心理应激反应强烈,以及对危重型新冠肺炎合并谵妄的护理知识和技能不足等短板,采取护理程序再造、加强护理人员管理、强化质量控制等系统化整体护理模式,为危重型新冠肺炎合并谵妄患者的临床护理提供理论借鉴.

Objective:To understand the current status of health-promoting lifestyle of neurosurgery nurses and to explore the effect of sleep quality on their health-promoting lifestyle.Methods:Using the convenient sampling method, a total of 150 nurses from Department of Neurosurgery of Xuanwu Hospital of Capital Medical University were selected as the research objects from March to April 2020. The general information questionnaire, Pittsburgh Sleep Quality Index (PQSI) and Health Promoting Lifestyle Profile-Ⅱ (HPLP-Ⅱ) were used to investigate. A total of 150 questionnaires were sent out in this study and 149 were effectively received, with the effective recovery of 99.3%.Results:The total score of HPLP-Ⅱ of neurosurgical nurses was (128.07±20.63) , and the health promotion lifestyle was at the general level. The total score of PSQI was 8.0 (4.5, 12.0) , and 55.7% (83/149) nurses had poor sleep quality. There was a negative correlation between HPLP-Ⅱ total score of neurosurgical nurses and PSQI total score ( r=-0.393, P<0.01) . The results of multiple linear regression analysis showed that PSQI total score and working years were the influencing factors of health promotion lifestyle ( P<0.05) . Conclusions:The health-promoting lifestyle of neurosurgery nurses is at an average level and there are widespread sleep quality problems. The health-promoting lifestyle is positively correlated with sleep quality. The better the health-promoting lifestyle, the better the sleep quality. Corresponding interventions are recommended to improve the sleep quality of neurosurgery nurses, thereby promoting their maintenance of a healthy lifestyle.

Objective:To understand the status quo of job burnout and sleep quality among neurosurgery nurses in a ClassⅢ Grade A hospital in Beijing and analyze their correlations to provide basis for formulating relevant intervention measures.Methods:Using the convenient sampling method, a total of 150 nurses from Department of Neurosurgery of Xuanwu Hospital of Capital Medical University from March to April 2020 were selected as the research objects. The survey was carried out using the general information questionnaire, the Chinese version of Maslach Burnout Inventory (MBI) and Pittsburgh Sleep Quality Index (PQSI) scale. Pearson correlation analysis method was used to analyze the effect of job burnout of nurses in department of neurosurgery on sleep quality. A total of 150 questionnaires were distributed in this study and 149 valid questionnaires were recovered, with an effective recovery rate of 99.3%.Results:The emotional exhaustion dimension score of the job burnout scale for neurosurgical nurses was (22.79±7.08) , indicating moderate burnout. The score of depersonalization dimension was (8.17±3.63) , indicating moderate burnout. The score of low personal achievement was (19.09±6.04) , indicating high burnout. The total PSQI score of neurosurgical nurses was 8.0 (4.5, 12.0) and 83 nurses (55.7%, 83/149) had poor sleep quality. Emotional exhaustion in job burnout of neurosurgery nurses was positively correlated with PSQI total score ( r=0.356, P<0.01) , and depersonalization dimension was positively correlated with PSQI total score ( r=0.180, P<0.05) , while low personal achievement dimension was negatively correlated with PSQI total score ( r=-0.120, P<0.05) . The results of multiple linear regression analysis showed that PSQI total score and working years were the influencing factors of emotional exhaustion dimension ( P<0.05) , while PSQI total score and weekly overtime time were the influencing factors of depersonalization dimension ( P<0.05) . Conclusions:The degree of job burnout of neurosurgical nurses is in the middle and high level and different degrees of sleep problems are common. The higher the degree of burnout, the worse the quality of sleep.

目的 了解神经外科护士对患者身体约束的知信行现状.方法 采用身体约束知信行问卷对180名神经外科护士进行调查,分析护士对患者身体约束的知识、态度、行为得分情况.结果 180名护士的患者身体约束知识问卷得分为(12.40±1.90)分,身体约束态度问卷得分为(34.53±3.22)分,身体约束行为问卷得分为(52.98±5.77)分,均处于中等水平.不同年龄、不同临床工作年限护士的患者身体约束态度问卷得分及不同学历护士的患者身体约束知识问卷得分比较,差异均有统计学意义(均P<0.05).结论 神经外科护士对患者身体约束的知信行水平亟待提高,应加强对护士的患者身体约束的知识、行为培训,重视人文关怀理念的培养,以降低身体约束对患者造成身心伤害.

目的 探讨规范化培训护士压力源以及职业倦怠的现状并分析其相关性.方法 2018年9月,采用方便抽样法,选取北京市某三级甲等医院279名正在规范化培训的护士为调查对象,采用中国护士工作压力源量表和职业倦怠量表(MBI-GS)进行问卷调查.结果 279名规范化培训护士工作压力总均分为2.95±0.75,得分最高的2个维度分别为“工作量及时间分配”(3.19±0.94)和“护理专业及工作”(3.16±0.84).职业倦怠总均分为1.83±0.76;93.5％为轻度倦怠,6.5％为中度倦怠,无重度倦怠.相关分析显示,工作压力各方面与职业倦怠各维度均呈显著正相关(均P＜0.05).工作压力中的工作量及时间分配、管理及人际关系是职业倦怠的主要预测因素(β=5.415、14.174,均P＜0.05).结论 规范化培训护士工作压力较高,职业倦怠处于轻度倦怠状态,管理者应采取多种措施缓解护士工作压力,尤其关注工作量及时间分配和管理及人际关系方面,避免进一步加重护士职业倦怠.

目的 探讨规范化护士与家属沟通模式对神经外科重症监护室患者家属焦虑程度与满意度的影响,为建立监护室护士与患者家属沟通方式提供依据.方法 选取2015年1月—2015年6月入住神经外科重症监护室的42例患者家属作为对照组,2015年7月—2015年12月入住神经外科重症监护室的46例患者家属作为观察组.观察组由经过培训的专门责任组成员应用健康教育记录单与患者家属进行系统的、标准化的、连续的沟通,内容包括入院介绍、出院介绍、健康宣教、患者一般情况、目前的主要问题及护理措施、护理效果等,每天定时定点进行并记录.对照组应用传统的沟通方式,由每班的责任护士常规开展相关内容介绍.通过问卷调查比较两组患者家属对住院期间护理工作满意度的情况以及患者家属焦虑程度.结果 观察组患者家属满意度评分(99.18±1.32)分明显高于对照组的(94.99±2.91)分,两组比较差异有统计学意义(P＜0.05).观察组患者家属焦虑程度评分(57.96±9.71)分明显低于对照组的(62.15±9.15)分,两组比较差异有统计学意义(t=2.03,P=0.045).结论 神经外科重症监护室实施规范化护士与家属沟通模式,可以有效降低患者家属焦虑程度,提高患者家属满意度.

This paper reviews the contents, mechanism of action, operating principles and application effects of sensory stimulation program in the rehabilitation of critically ill neurologic patients with disorders of consciousness. It points out that the operating standards of sensory stimulation program need to be unified. In the future, more large-sample, multi-center randomized controlled studies of sensory stimulation program in the rehabilitation of critically ill neurologic patients with disorders of consciousness need to be carried out to provide a reference for clinical implementation of sensory stimulation program.

目的 调查规范化培训护士遭遇横向暴力的现状.方法 采用便利抽样法,于2018年9月选取北京某三级甲等医院正在规范化培训的279名护士作为研究对象.采用规范化培训护士横向暴力调查问卷对其进行调查.结果 279名规范化培训护士,60名(21.5％)的护士报告说在过去12个月里遇受过横向暴力;横向暴力主要来自高年资护士,最常见的显性横向暴力为"言语上的讽刺",最常见的隐性横向暴力为"打击你的积极性";遭受横向暴力会对护士的身体、心理以及护理专业产生影响.不同工作年限的规范化培训护士,其遭受横向暴力情况比较,差异有统计学意义(P<0.05).结论 规范化培训护士横向暴力发生率为21.5％,工作>1～2年的规范化培训护士更容易遭受横向暴力,暴力形式以隐性暴力为主,遭受横向暴力会对其心理、身体及护理专业产生不良影响,护士的横向暴力相关知识培训尚需加强.护理管理者在加强规范化培训护士理论知识与护理技能的同时,应高度关注其横向暴力的问题,积极寻找有效措施预防和减少横向暴力的发生,以促进护理事业健康持续发展.

In the era of big data, nursing staff have begun to use data mining technology to extract valuable information from massive nursing data to guide the development of clinical nursing, nursing management, nursing education and nursing research. This paper reviews the common methods of data mining, combs the application and research progress of data mining technology in nursing field, and puts forward the future development trend of data mining in nursing field, which can provide reference for nursing academia.

目的 探讨构建神经外科护士专科理论培训模式,提高护士专科理论水平.方法 通过德尔菲法,邀请具有教学经验与神经外科临床经验的专家设计神经外科护士专科理论培训内容与课程设置,细化课程实施方案,建立神经外科护士专科理论培训模式,通过培训前后理论考核进行效果评价.结果 在专科理论培训内容设置中,两轮专家权威系数为0.861、0.883,专家意见变异系数<25％.护理人员培训后理论成绩明显高于培训前(P<0.01).结论 本研究参与专家权威性高,设计的神经外科护士专科理论培训内容可靠;课程实施方案具有针对性、可行性,提高了护理人员理论考试成绩,对不同阶段和不同层次护士进行系统化培训,都能取得很好的培训效果.

Objective To investigate the effect of early cognitive rehabilitation training on cognitive function of patients after carotid endarterectomy. Methods The clinical data of 32 patients with carotid stenosis undergoing carotid endarterectomy ( CEA) admitted to the neurosurgery department of Chongqing emergency medical center from January 2016 to June 2018 were retrospectively analyzed.Sixteen pa-tients with conventional CEA admitted from January 2016 to June 2017 were treated as the control group.Sixteen patients with early cognitive rehabilitation training admitted from July 2017 to June 2018 were treated as cognitive on the basis of routine treatment after CEA.In the train-ing group,the Montréal Cognitive Assessment Scale (MoCA) scores at 1 week and 3 months after surgery were analyzed. Results There was no significant difference in MoCA score between the two groups (P>0.05) at 1 week after surgery compared with those before surgery. The MoCA scores of the two groups were significantly higher than those before the operation 3 months after surgery(P<0.05).The change of the cognitive training group was more significant than that of the control group(P<0.05). Conclusion After carotid endarterectomy,early cognitive rehabilitation training can help reduce the incidence of postoperative cognitive dysfunction and improve cognitive function.

目的 探讨缺血性脑卒中术后血管性认知障碍患者行综合认知干预训练的方法和效果评价,为血管性认知障碍患者的照护方法提供依据.方法 以某三级甲等医院缺血性脑卒中术后血管性认知障碍患者53例为研究对象,予以人工认知干预训练,计算机干预训练和人工电话随访,采用简易智能精神状态检查表、蒙特利尔认知评估量表、日常生活能力量表,分别于干预前、干预3个月末、干预6个月末进行评估,采用方差分析进行数据分析.结果 不同时间点的简易智能精神评分、蒙特利尔认知评分差异具有统计学意义(FMMSE=24.59、FMoCA=50.71、P<0.05),但日常生活能力评分在3个时间点的得分差异无统计学意义(F=1.37,P>0.05).结论 综合认知干预训练的实施,能够改善缺血性脑卒中术后血管性认知障碍患者的认知功能,但对日常生活能力得分的改善不明显,有待进一步观察.

[目的]探讨缺血性脑卒中非急性期血管性认知障碍现状,并分析其影响因素。[方法]采用自行设计的一般资料问卷、简易智能精神状态检查表（MMSE）和蒙特利尔认知评估量表（MoCA）,对285例缺血性脑卒中非急性期病人进行测评。[结果]缺血性脑卒中非急性期病人血管性认知障碍的患病率为53.0%。多因素Logistic回归分析显示,年龄、医疗付费、饮食、家务、狭窄程度是影响血管性认知功能障碍发生的主要影响因素（P＜0.05）,可解释认知功能水平29.3%的变异量。[结论]缺血性脑卒中非急性期病人具有较高血管性认知障碍发生率,医务人员应加强对高危人群的认知功能的关注,积极开展筛查,并针对可改变的因素尽早采取干预措施,延缓认知障碍进展,提高病人的生存质量。

Intracranial aneurysm is a common disease in neurosurgery whose greatest risk is causing death and cripple due to aneurysm breakage and hemorrhage. The complications caused by surgery similarly lead to assignable consequence. Therefore, the treatments for unruptured intracranial aneurysm are still being debated. Being with unruptured intracranial aneurysm makes patients feel anxiety and depression so as to affect their psychological state. This paper reviewed the current situation, influencing factors and common evaluation tools of anxiety and depression in patients with unruptured intracranial aneurysm to provide a basis for identifying unruptured intracranial aneurysm high-risk groups with anxiety and depression and making appropriate mental nursing intervention so as to improve patients' life quality.

Objective To explore the effect of early lactation initiation combined with individualized guidance on breastfeeding behavior and quality of primiparae.Methods A total of 300 primiparae in our hospital were randomly divided into observation group and control group,given routine nursing care,and early lactation initiation intervention combined with individual guidance,respectively.Maternal breastfeeding behavior and quality of two groups were compared.Results The initiation time of lactation in the observation group was less than that in the control group (P ＜ 0.05).The observation group had higher postpartum lactation initiation volume within 1 week,and better mastery of breast feeding knowledge and skills than that in the control group(P ＜0.05).The rate of breastfeeding in the observation group was higher than that in the control group at all stages of follow-up (6 weeks after discharge,3 weeks,and 6 months after delivery) (P ＜ 0.05).Conclusion Early lactation initiation intervention and individualized guidance can effectively improve breastfeeding knowledge,improve lactation and promote breastfeeding,so it is worthy of clinical application.

目的 调查未破裂颅内动脉瘤患者的认知和焦虑、抑郁状态,为临床干预提供依据.方法 采用方便抽样的方法,回顾性连续纳入2017年9月至2018年2月首都医科大学宣武医院神经外科收治的106例未破裂颅内动脉瘤住院患者作为研究对象.使用蒙特利尔认知评估量表(MoCA),对其认知状态进行评估,并将所有患者分为认知正常组(26例)与认知障碍组(80例).使用汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评估所有患者焦虑、抑郁水平.应用SPSS 24.0软件进行两组间各指标差异的统计学分析.结果 (1)MoCA评分:106例患者MoCA评分7～30[26(22,28)]分,26例(24.5％)患者总体认知水平出现异常,认知正常组与认知障碍组患者MoCA评分差异有统计学意义[27(25,29)分比20(15,22)分,Z=-6.438,P<0.01].(2)HAMA评分:总体HAMA评分10.0(5.8,16.0)分,其中可能焦虑33例(31.1％),肯定焦虑28例(26.4％),明显焦虑10例(9.4％),严重焦虑1例(0.9％);认知正常组与认知障碍组患者HAMA评分[8.5(5.0,15.0)分比12.5(6.0,22.0)分]差异无统计学意义(P>0.05),两组焦虑程度差异有统计学意义(P<0.05).(3)HAMD评分:总体HAMD评分7.0(3.0,11.0)分,其中轻度抑郁46例(43.4％),中度抑郁5例(4.7％),重度抑郁2例(1.9％),认知正常组与认知障碍组患者HAMD评分[6.0(3.0,9.8)分比8.5(4.5,16.2)分]及抑郁程度差异均有统计学意义(均P<0.05).(4)MoCA评分与HAMA、HAMD评分相关性:MoCA评分与HAMA、HAMD评分均呈负相关(相关系数r值分别为-0.231、-0.318,P值分别为0.017、0.001).结论 未破裂颅内动脉瘤患者的认知水平与焦虑、抑郁情绪关系紧密相关.焦虑、抑郁情绪普遍存在于未破裂颅内动脉瘤患者中,有必要对其进行针对性的心理干预.

Objective To analyze WeChat push on maternal psychological state and mastery of maternal and infant health care knowledge in puerperae.Methods A total of 200 pregnant women in our hospital were divided into observation group (n =100) with WeChat push in health education and control group (n =100) with WeChat push according to isometric random sampling method,mastery of health knowledge and psychological status in the two groups were compared.Results Before nursing,maternal anxiety score,depression score showed no significant difference between the two groups (P ＞ 0.05),but there were significant between-group differences in anxiety score,depression score,and mastery rate of health knowledge (P ＜ 0.05).Conclusion WeChat push in health education can effectively improve maternal mental state and mastery rate health knowledge,so it is of great value in promotion.

Objective To describe the demographic and clinical characteristics of the population with visual impairment attending Ningxia disabled rehabilitation center.Design Cross-sectional study.Participants 322 cases with visual impairment attending Ningxia disabled rehabilitation center were selected.Methods The clinical records of the patients attending Ningxia disabled rehabilitation center between January,2015 and December,2015 were retrospectively reviewed.The main data were age,gender,education,visual acuity,diagnosis and prescription of low vision aids.Main Outcome Measures Age,gender,category of visual impairment,cause of visual impairment and prescription of low vision aids.Results Of the 322 patients,56.2％ were male.The mean age was 50.9±16.2 years.The majority (65.2％) of the patients were aged 40～69 years.There were 39.1％ with moderate visual impairment,15.5％ with severe visual impairment and 45.3％ with blindness.The leading causes of visual impairment were degenerative myopia(16.5％).The most frequently prescribed low vision aids was non-optical aids(54.2％).Near aids (45.1％) were dispensed more than distant aid tools (0.7％).The commonest near aids were handheld magnifier (35.9％) and spectacle-type magnifiers (32.3％).Conclusions The majority of patients with visual impairment were elderly,the main cause of visual impairment was degenerative myopia.Non-optical aids had great help to patients' daily life.Near aids were dispensed more than distant aid tools.