目的 探讨基于循证医学的PDCA循环管理干预对发热门诊患者心理应激及治疗依从性的影响.方法 选取河南省人民医院 2021 年 7 月至 2022 年 6 月收治的 95 例发热门诊患者,采用随机信封法分为对照组(47 例)、观察组(48 例),对照组予以常规护理干预,观察组在此基础上予以基于循证医学的PDCA循环管理干预.比较两组干预前后心理应激[汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)]、治疗依从性、应对方式[特质应对方式调查量表(TCSQ)]及护理满意度.结果 解除留观前 1 h观察组HAMA、HAMD评分均低于对照组;观察组治疗依从率(91.67%)高于对照组(76.60%);观察组解除留观前 1 h积极应对、消极应对评分改善程度高于对照组;观察组护理满意率(100.00%)高于对照组(87.23%),差异有统计学意义(P＜0.05).结论 基于循证医学的PDCA循环管理干预能降低发热门诊患者心理应激反应,改善其应对方式,提高患者治疗依从性及护理满意度.

本文对国内外人工智能在2型糖尿病(T2DM)患者自我管理中的应用情况进行综述,包括人工智能的概念、优势、应用方式及效果等内容,并对人工智能应用于T2DM患者自我管理中存在的问题和面临的挑战进行探讨及展望,为T2DM患者的自我管理和医护人员的临床决策提供理论依据.

[目的]调查护理研究生人文关怀品质与专业承诺的现状及二者之间的相关性.[方法]采用护士人文关怀品质评价量表和护理专业承诺量表通过问卷星平台对 187 名护理研究生进行调查.[结果]护理研究生的人文关怀品质总分为(116.96±15.00)分,专业承诺总分为(89.28±18.59)分,二者呈正相关(r=0.408,P<0.01).[结论]护理研究生人文关怀品质整体水平较好,专业承诺整体较高.护理教育者应更注重人文关怀理念及能力的培养,提高护理研究生的专业价值认同.

Purpose The objectives are to explore the prevalence of DNR orders, the factors influencing them, and the association between DNR signing and health care utilization among advanced cancer patients. Methods This was a retrospective cohort study. Data from cancer decedents in three hospitals in China from January 2016 to December 2017 during their last hospitalization before death were obtained from the electronic medical records system. Results In total, 427 cancer patients were included; 59.0% had a DNR order. Patients who had solid tumors, lived in urban areas, had more than one comorbidity, and had more than five symptoms were more likely to have DNR orders. The cut-off of the timing of obtaining a DNR order was 3 days, as determined by the median number of days from the signing of a DNR order to patient death. Patients with early DNR orders (more than 3 days before death) were less likely to be transferred to the intensive care unit and undergo cardiopulmonary resuscitation, tracheal intubation, and ventilation, while they were more likely to be given morphine and psychological support compared with those with late (within 3 days before death) and no orders. Conclusions Advanced cancer patients with solid tumors living in urban areas with more symptoms and comorbidities are relatively more likely to have DNR orders. Early DNR orders are associated with less aggressive procedures and more comfort measures. However, these orders are always signed late. Future studies are needed to better understand the timing of DNR orders.

为方便护生利用碎片化时间学习护理学专有名词,设计了一款基于微信小程序的护理学专有名词学习平台,包括学习课程、组队学习、老师、交流学习、个人设置5个模块.该小程序设计简约美观,操作方便,为护生学习查找、复习巩固护理学专有名词提供了轻松互动的平台,能满足护生对护理学专有名词学习的需求.

对于早产儿和病弱婴儿等新生儿来讲,母乳所给予的不仅仅是营养,也是增强病弱婴儿免疫能力的物质,可以提高其存活的概率.伴随早产而来的多种因素可导致母乳量不足,无法及时给早产儿及病弱婴儿提供所需要的母乳,所以母乳库的建立在早产儿和患儿的救治方面就显得尤为重要.本文通过对国内外母乳库的运行管理现状以及母乳捐赠情况及意向的综述,了解国内外母乳库建设与运营的情况,分析国内外的差异以及国内母乳库发展所存在的问题,并展望未来中国母乳库的发展.

本文从教学内容及时间安排、师资、教育对象、教育方案、评价方法和工具、实施效果等方面综述了国内外医护合作仿真模拟教学在护理教学领域的研究现状,旨在为我国未来医护合作仿真模拟教学的发展提供建议和参考.

[目的]评价微信健康教育在大学生艾滋病预防中的应用效果.[方法]便利抽取郑州市某高校100名全日制在校大学生作为研究对象,利用微信平台对其进行健康教育,比较健康教育前后大学生艾滋病相关知识知晓率 、对艾滋病的态度及性相关问题态度.[结果]利用微信平台实施健康教育后,大学生对共用不经消毒的注射器,共用牙刷 、剃须刀,蚊虫叮咬等艾滋病传播途径的知晓率较健康教育前增加(P<0.05),对自身感染艾滋病的可能性态度发生变化(P<0.05).[结论]利用微信平台对大学生进行艾滋病相关知识健康教育可有效提高大学生艾滋病知识知晓率,对大学生疾病相关态度产生一定影响.

[目的]探讨微信健康教育对产妇育儿自我效能和睡眠质量的影响.[方法]将门诊行围生期保健的孕妇随机分为试验组、对照组各60例,试验组采用微信方式进行健康教育,对照组采用常规方式进行健康教育,于病人出院回门诊复查时进行调查,比较两组产妇育儿自我效能及睡眠状况.[结果]干预后,试验组产妇育儿自我效能得分高于对照组(P<0.05),存在睡眠质量问题的例数少于对照组(P<0.05).[结论]采用微信方式进行健康教育可提高产妇育儿自我效能,改善其睡眠质量.

大学生艾滋病疫情呈不断加重趋势,尤其是男男同性性行为已成为大学校园艾滋病蔓延的主要途径.同伴教育作为艾滋病干预的高效举措,对于提高艾滋病预防知识,进而预防艾滋病传播有着显著效果.然而目前国内高校对同伴教育的目的、实施方法及效果评价方法缺乏系统认识,已经开展同伴教育干预的高校,在实施过程中也存在一些共性的问题.该综述就同伴教育的概念及起源,在高校中的应用领域以及开展同伴教育存在的问题逐一阐述,为以后我国高校普遍开展大学生艾滋病同伴教育干预活动提供参考.

AIMS AND OBJECTIVESTo examine the prevalence of post-traumatic stress disorder symptoms and to explore the predictive factors of post-traumatic stress disorder symptoms among bereaved adolescents four years after the Yushu earthquake.BACKGROUNDOn 14 April 2010, the 7·1-magnitude Yushu earthquake occurred in the high-altitude, hypoxia-prone regions primarily inhabited by ethnic minorities. Many adolescents lost their parents during the earthquake. This study examined post-traumatic stress disorder and its predictors among bereaved Tibetan adolescents four years after the trauma in China.DESIGNThis was a cross-sectional descriptive study.METHODSThis study used a cross-sectional design with 830 bereaved adolescents. Participant demographic data included gender, age and grade, and the earthquake exposure variables included the deceased relatives, whether they were buried, injured or amputated (non-life-threatening) and whether they witnessed a burial, injury or death. The post-traumatic stress disorder Checklist-Civilian version was used to assess the symptoms and prevalence of post-traumatic stress disorder, and the Coping Style Scale assessed coping styles.RESULTSThe results indicated that the prevalence of post-traumatic stress disorder was 19·3%. Individuals who were buried, injured or amputated (non-life-threatening), who witnessed a burial, injury or death, who suffered severe property loss during the earthquake and who had negative coping skills were the most likely individuals to have post-traumatic stress disorder symptoms.CONCLUSIONSThe presence of post-traumatic stress disorder was very prevalent among adolescents four years after the Yushu earthquake. Effective mental health services should be developed to facilitate postdisaster recovery for bereaved adolescents at high risk for post-traumatic stress disorder.RELEVANCE TO CLINICAL PRACTICEThe findings in this study improve our understanding of post-traumatic stress disorder and related risk factors in bereaved adolescents in non-Western communities, providing useful information for rebuilding and relief work.

Objective:To systematically review the of nursing intervention in improvement of feeding intolerance in preterm infants in line with Chinese cultural background.Methods:Systematic literature search was performed according to the Cochrane Neonatal Collaborative Review Group search strategy.Randomized controlled trials on nursing intervention in preterm infants in China to promote gastrointestinal motility were identified from the WanFang Data,VIP,CNKI.Meta analysis was carried out for RCTs which met inclusion criteria.Results: 5 RCTs were included.The Meta result showed that,for premature infants with feeding intolerance,the time to establish enteral nutrition in premature infants with feeding intolerance[WMD=-1.08,90％CI(-2.62,-0.98),P<0.000 1],the gastric tube remain time [WMD=-4.60,95％CI(-6.15,-3.06),P<0.000 01],the length of hospital stay was shortened by nursing intervention.Additionally,the weight of the premature infants was improved.Conclusions: The early and correct nursing intervention was helpful for establishing a complete mode of enteral nutrition in premature infants with feeding intolerance.

Objective:To know about the infant feeding attitude and influencing factors among nursing students in Wuhan city.Methods:A total of 363 nurse students were recruited by convenient cluster method in Wuhan,they were investigated by Iowa Infant Feeding Attitude Scale(ⅡFAS) and a self-designed nurse student breastfeeding knowledge questionnaire.Results:The score of ⅡFAS was 59.02±5.83.The nurse students breastfeed knowledge score was 5.99±5.83.Pearson correlation analysis showed that breastfeeding knowledge was positively related with IIFAS(r=0.416,P=0.000).Multiple regression analysis showed that three factors entered the regression equation,they were breastfeeding knowledge,grade,and thinking whether medical staff support breastfeeding(β=0.286,0.286,0.152,P< 0.05).Conclusion:More plentiful breastfeeding knowledge more inclined to breastfeeding infant feeding attitude.Breastfeeding knowledge,grade,nursing students think whether medical staff support breastfeeding was the main factor affecting the infant feeding attitude of nursing students in Wuhan.

阐述育儿自我效能的概念、评价工具及应用,从影响因素、护理干预方面综述产妇育儿效能的研究进展.我国对产妇育儿自我效能的评价工具相对较少,且多由国外的量表翻译和修订而成,具有一定的文化差异性,我国研究者自行研制问卷较少.同时应将提高自我效能的干预措施拓宽到社区水平,不断探讨多样化的护理干预.

Objective To investigate the nursing aides' working experience of private pension institutions,and provide advances of decision-making on targeted pension institution development strategy.Methods 12 nursing aides for the aged were surveyed by using deep half-structural interviews and were recorded,noted during the whole interviews.Data were analyzed by coding step by step.Results The primary feelings of the participants including vocational responsibility was gradually enhanced in the interaction with the elderly,multiple service consciousness was built up during the process of meeting diverse demands of the elderly,standardized training demands formed from servicing in pension institutions.Conclusion Understanding and care are the key factors for the pension caregivers whose multiple service ability should be ascended,and their training should be further standardized.

目的：探讨皮下注射流程改良对低分子肝素钙患者抗血栓效果及并发症的影响。方法：将130例低分子肝素钙抗血栓治疗的患者分为2组，观察组患者接受改良的低分子肝素钙皮下注射，对照组患者常规方法注射。治疗7d后，比较患者血常规、凝血功能及血小板聚集功能、并发症发生率。结果：两组患者注射前后PT、APTT及ADP差异无统计学意义(P>0.05)，患者皮下出血发生率、出血程度和硬结发生率比较，差异有统计学意义(P<0.05)。结论：改良皮下注射流程可降低患者并发症发生率，保障低分子肝素钙抗血栓效果。

Objective To describe the status of publication papers on nursing of 47 grade three and first-class hospitals in Henan province from the year of 1991 to 2014 and provide valuable reference basis for the relevant departments to make policy. Methods The methods of literature metrology was used to analyze the amount, journals, key words distribution and other information of the 12 422 articles with the keyword 'nursing', which were included by China National Knowledge Infrastructure (CNKI) and Wanfang data, VIP database. Results The number of published articles of the investigated units was in the upward trend on the whole. But the number of annual published articles on the core periodicals was significantly lower than the total. The articles were mainly distributed on 3 nursing core journals, 5 non-nursing journals of Henan province, which were mostly for regional academic exchanges. 11 key words of nursing articles of Henan were the same as the nation but different for the sequence. Conclusions The grade three and first-class hospitals in Henan are in urgent need of the construction of systematic and standardized scientific research training system. The channel for the exchange of nursing academic needs to be widen. Clinical nursing research should be paid more attention to the characteristic field.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的:了解河南省在校大学生的健康素养现状,分析影响健康素养的因素,为制定提高河南省大学生健康素养水平的干预措施提供依据。方法:采用一般资料调查表和《2008中国公民健康素养调查问卷》对便利抽取的645名大学生进行问卷调查,应用SPSS17.0进行统计分析。结果:大学生的总体健康素养、健康理念与基本知识、健康生活方式与行为和健康技能的具备率分别为22.3%、33.8%、24.5%和65.1%。以百分制计分后,总体健康素养、健康理念与基本知识、健康生活方式与行为和健康技能的得分分别为68.33±13.14、33.33±7.93、28.54±6.30和6.46±1.62。影响大学生健康素养的因素有性别、学历、专业和生源地,其中学历和专业进入多因素回归方程。结论:河南省在校大学生的健康素养水平较低,学校有关管理部门应根据不同层级学生的特点采取措施有针对性地提高其健康素养。</span>

[目的]探讨护士长的角色冲突与角色模糊现状,分析社会支持对护士长的角色冲突与角色模糊的影响。[方法]采用角色冲突与角色模糊量表及社会支持量表对武汉市4所三级甲等医院136名护士长进行问卷调查。[结果]护士长的角色冲突、角色模糊评分为(35.84±8.54)分、(35.10±3.42)分;角色冲突、角色模糊与社会支持呈负相关,与主观支持呈正相关。[结论]护士长的角色压力较大,护理管理者应加强护士长管理知识的培训,提高护士长角色认知能力,更好地发挥其管理职能;家庭、朋友和工作单位等应对护士长提供帮助,降低其角色压力。