目的:以"结构-过程-结果"三维质量结构模型为基础构建多发性骨髓瘤临床护理质量评价指标,为评价多发性骨髓瘤患者护理质量提供依据.方法:基于"结构-过程-结果"三维质量结构模型,研究小组通过文献检索、半结构访谈及专家函询法,确定多发性骨髓瘤临床护理质量评价指标及各指标的权重.结果:2轮函询问卷的有效回收率均为100％,专家的权威系数为0.870,一、二、三级指标的协调系数为0.21～0.32.最终形成一级指标3项、二级指标11项、三级指标25项的多发性骨髓瘤临床护理质量评价指标,并确定了各指标权重.结论:构建的多发性骨髓瘤临床护理质量评价指标科学、可靠、实用,可用于评价多发性骨髓瘤患者的临床护理质量.

目的 探讨智慧型闭环移动护理管理系统在临床用血质量管理中的应用效果.方法 将青岛大学附属医院信息管理系统(7.0.2)与输血科(血库)信息管理系统(6.4.0.56)整合,优化输血护理流程,实现输血智慧化闭环护理管理.设对照组:通过HIS选取2017年1月～12月(闭环管理实施前)入住本院血液内科行输血治疗的患者789人;观察组:2018年1月～12月(闭环管理实施后)入住本院血液内科行输血治疗的患者836人.采用自行设计的输血规范管理查检表,规范执行条目数为分子、查检总条目数为分母得出规范执行率.对闭环管理实施前后血标本采集规范查对率、取血后＜30 min输注率、床旁输血双人核查执行率、输血巡视规范率、＜4 h红细胞输注完毕率及输血护理记录规范率做比较,采用x2检验或Fisher精确概率法做统计分析,评价用血质量管理改进效率.采用目的抽样法,抽取涉及输血的临床科室(血液内科、心外科、手术室、综合ICU)护士长共8名做半结构式访谈,访谈围绕智慧型闭环移动护理信息系统在临床用血质量管理中的效果展开,对访谈结果做分析.结果 观察组与对照组床旁输血双人核查执行率为100％ (836/836) vs 97.72％ (771/789),血标本采集规范查对率99.04％ (828/836) vs97.34％(768/789)、取血后＜30 min输注率97.97％(819/836) vs 95.06％ (750/789)、输血巡视规范率99.28％(830/836) vs 94.93％(712/789)、＜4 h红细胞输注完毕率99.16％(829/836) vs 97.47％(769/789)及输血护理记录规范率100％ (836/836) vs 89.73％ (708/789)(P＜0.05);输血质量控制记录、质控结果汇总、质控结果反馈耗时明显缩短.结论 智慧型闭环移动护理管理系统应用于临床用血质量管理,有效提升了输血(时间)效率和护理质量,有助于确保临床用血安全.

目的:对个人—工作匹配量表(Areas of Worklife Scale,AWS)进行汉化并验证其信度、效度.方法:获得原作者授权同意后,以Brislin翻译模型为基础,采用两人翻译-回译法,通过专家小组评议和跨文化调试,形成中文版AWS.采用便利抽样法选取青岛市3所三级甲等综合医院500名护士进行问卷调查并进行条目分析和信度、效度检验.结果:所有条目的决断值CR在11.958～42.776之间,条目与所对应维度得分的相关系数为0.561～0.819.量表Cronbach'sα系数为0.894,各维度的Cronbach'sα系数为0.715 ～ 0.922,整个量表的分半信度为0.738,各维度的分半信度为0.702 ～ 0.948,整个量表重测信度为0.850,各个维度重测信度为0.710 ～ 0.900;AWS量表水平的内容效度指数为0.933;中文版AWS量表共提取6个公因子,解释方差贡献率为65.979％,验证性因子分析结果显示适配度良好.结论:汉化后的AWS量表具有良好的信度、效度,可有效反映被测护士个人—工作匹配现状.

Objective:To explore the effects of experiential teaching based Carolina care model on humanistic care ability, emotional intelligence and communication skills among undergraduate practice nursing students.Methods:In August 2018, this study selected 80 undergraduate practice nursing students with clinical practice in the Affiliated Hospital of Qingdao University as subjects by conveniences sampling. The experiential teaching based Carolina care model for nursing students was implemented during clinical practice for 6 months. The intervention effects were assessed with the Caring Ability Inventory (CAI) , Emotional Intelligence Scale (EIS) and the Supportive Communicative Scale (SCS) . SPSS 22.0 was used to data analysis. The paired t test was used to compare the scores of CAI, EIS and SCS in undergraduate nursing students before and after intervention. Results:After intervention, the scores of CAI, EIS and SCS of undergraduate practice nursing students were (224.31±15.98) , (135.43±11.50) and (78.80±7.90) respectively higher than those [ (194.23±19.73) , (133.75±12.17) and (74.58±8.23) ]before intervention with statistical differences ( t=24.11, 2.20, 3.00; P<0.05) . Conclusions:Carolina care model based experiential teaching can improve humanistic care ability, emotional intelligence and communication skills of undergraduate practice nursing students.

[目的]回顾性总结分析肝移植病人术后发生肺部感染的危险因素,并探讨针对性的护理对策.[方法]收集在青岛大学附属医院105例行肝移植病人的围术期临床资料,并根据是否发生肺部感染分为感染组27例和非感染组78例,对两组病人的临床资料进行单因素t检验和Logistic多元回归分析,筛选出肝移植病人术后肺部感染的危险因素.[结果]术中输血量、手术时间、留置胃管时间、术后呼吸机使用时间及术后凝血酶原时间为肝移植病人术后肺部感染的危险因素(P＜0.05).[结论]明确肝移植病人术后肺部感染的危险因素,并针对性地进行护理干预有利于降低肝移植病人术后肺部感染的发生率.

目的:对英文版夜尿症相关生活质量量表(N-QOL)进行汉化,并检测中文版N-QOL信效度.方法:征得源量表作者同意后对英文版N-QOL量表进行汉化,通过咨询相关专家及预试验对量表条目进行调适,并检测其信效度.结果:中文版N-QOL具有良好的信效度,各条目专家内容效度指数(I-CVI)范围为0.8～1.0,量表内容效度指数(S-CVI)为0.923;睡眠/精力维度、困扰/关注维度及总量表的Cronbach′sα系数分别为0.763、0.734、0.782;探索性因子分析中,共提取4个因子,4个因子的累积贡献率为70.38％;量表对平均每晚排尿2次与≥3次两组患者的生活质量具有较好的区分效度.结论:中文版N-QOL量表具有良好的信效度,可用于我国夜尿症患者生活质量的测评及对夜尿症相关治疗效果的评价.

目的:探讨延续性护理在恶性肿瘤预期性恶心呕吐(ANV)患者中的应用效果.方法:采用便利抽样法收集我院肿瘤科ANV患者66例,随机分为实验组和对照组各33例.对照组给予常规出院指导和健康教育,实验组在此基础上实施延续性护理.采用一般资料问卷、焦虑自评量表(SAS)、抑郁自评量表(SDS)和简易应对方式问卷,分析干预前后两组ANV分级、焦虑状态、抑郁状态和自我应对能力的状况.结果:实验组ANV分级与干预前、对照组干预后比较差异有统计学意义(P<0.01);干预后实验组SAS评分、SDS评分、积极应对能力评分、消极应对评分与对照组比较差异有统计学意义(P<0.01).结论:延续性护理可预防ANV,减轻ANV患者焦虑和抑郁,提高自我应对能力.

Objective To explore the influence of cognitive function on self-care in patients with chronic heart failure, to screen out patients with cognitive impairment and to provide priority for them in continuous care service. Methods With a cross-sectional study, patients with heart failure (n=152) were recruited from Heart Failure Care Unit and Intensive Care Unit of a hospital specialized in cardiovascular disease in Beijing. The cognitive function and the level of self-care were measured through the Montreal Cognitive Assessment and Self-Care in Heart Failure Index. Results The Montreal Cognitive Assessment score showed that 21.3%of the patients (scored <24) suffered from cognitive impairment and their delayed memory, langue, visual spatial and executive capability were impaired most seriously. Multiple regression analysis indicated that age, New York Heart Association Class, depression a nd cognitive function accounted for 30.1% of the total variance in self-care maintenance; the Montreal Cognitive Assessment score explained 21.5%, 29.2% and 36.5% of the variance in self-care maintenance, management and confidence respectively. Conclusion Cognitive impairment, a hidden co-morbidity, may impede patients ’ ability of self-care. The patients with cognitive impairment should be screened out and provided with priority in continuous care service.

对慢性心力衰竭（Chronic Heart Failure，CHF）患者心功能的评估，除要考虑心功能分级、左室射血分数的变化外，一般还应有运动耐量的指标。作为评估运动耐量的金标准，心肺运动测试（Cardiopulmonary Exercise Testing，CPET）因设备复杂、需要专业人员参与及要求患者达到最大运动量，其在临床上的应用受到了限制。而6分钟步行试验简便易行、运动强度接近人体日常活动，临床上易被患者接受，对评估患者运动耐量具有一定的作用。近年来，6分钟步行试验在国内外已得到广泛应用，不仅用于CHF患者心功能的评定，其应用领域已逐渐扩展到预测患者预后及评价心衰治疗效果。最近，国外有研究试图将6MWT作为一种运动干预手段应用于CHF患者尤其是老年心衰患者中，并取得了较好效果，这一点值得国内借鉴。现将6MWT在临床中的应用现状及进展综述如下。

Objective To explore the fluid control in patients with congestive heart failure,and discuss its effect on patients' thirsty,quality of life and prognosis.Methods Self-designed thirsty scale,Minnesota quality of life survey and telephone visit were used to collect 273 heart failure patients' data regarding fluid control,thirsty and quality of life before admission,during hospitalization and 3 months after discharge,and analyze the effect of fluid control on patients' quality of life and prognosis.Results Patients' rate of fluid control was 28.6％,97.4％ and 82.8％ before admission,during hospitalization and 3 months after discharge,and the difference was statistically significant (x2 =350.581,P ＜ 0.01).The thirsty score before admission,during hospitalization and 3 months after discharge was (2.45 ± 1.53),(3.30 ± 1.59),(1.98 ± 1.32) in patients with fluid control and (1.39 ± 0.88),(1.43 ± 1.13),(1.33 ± 0.83) in patients without fluid control,and the differences were statistically significant (t =5.734,4.268,3.762,respectively; P ＜ 0.05).Quality of life before hospitalization was (65.61 ± 19.40) in patients with fluid control,higher than that in patients without fluid control,and the difference was statistically significant (t =3.307,P ＜0.01).Quality of life after hospitalization was (30.55 ± 29.40) in patients with fluid control,and had no statistically significant difference from that in patients without fluid control (t =0.259,P ＞ 0.05).There was no statistically significant difference in cases of re -hospitalization and death due to heart failure between two groups (P ＞ 0.05).Conclusions Patients with heart failure have higher rate of fluid control during hospitalization and 3 months after discharge.Adherence to fluid control can increase patients' thirsty,but has no significant influence on their quality of life and prognosis.

目的：调查贫血在心力衰竭患者中的发生率及其对预后的影响。<br>　　方法：收集心力衰竭患者入院后首次血常规等资料，并电话追踪患者出院后因心力衰竭再住院或死亡等相关资料；分别以Hb，60~90 g/L，30~60 g/L，女90~110 g/L、男90~120 g/L，男≥120 g/L、女≥110 g/L划分为极重度、重度、中度、轻度贫血和正常，采用K-W统计方法分析贫血对心力衰竭预后的影响。

目的描述居家与养老院65～80岁老人夜尿相关生活质量(Nocturia Quality Of Life,N-QOL)状况并对二者进行比较;分析平均每晚排尿次数对N-QOL的影响。方法 2012年6月至9月便利抽取山东地区居家及养老院65～80岁老人各85例,调查基线资料、平均每晚排尿次数及N-QOL;两独立样本t检验比较居家与养老院老人N-QOL并探讨平均每晚排尿次数对N-QOL的影响。结果居家与养老院老人N-QOL平均得分分别为49.28±3.93和46.31±2.75,差异具有统计学意义(P<0.05);平均每晚排尿次数对N-QOL具有显著影响(P<0.05)。结论居家与养老院老人N-QOL存在差异;平均每晚排尿次数对老年人N-QOL具有显著影响。