Digital health technologies were emerging to help understand the health behaviors of stroke patients and improved patient adherence to stroke management strategies. This paper overviewed the application status of digital health technology in stroke life cycle management at home and abroad, and the next development direction. This article aimed to provide new ideas for the whole life cycle health management of stroke disease.

High flow nasal cannula oxygen therapy has been widely used in China due to its ability to maintain the normal function of airway mucous,reduce physiological dead space,provide high-flow warm and humidified gas and provide certain ventilation support. At present,there is no clear guidance document for nursing staff in China.Beijing Hospital and other 11 hospitals have formulated the “Nursing Standard for High Flow Nasal Cannula Oxygen in Adults（T/CRHA 015-2023）”,a group standard of the Chinese Research Hospital Association,which provides the basic requirements,assessment,operation and infection control methods for caring adult patients with nasal high flow oxygen therapy. The present article is interpreting some items concerning the each part of standard to help the users understand the standard and promote the normative practice of high flow nasal cannula oxygen therapy.

目的 规范成人活动期炎症性肠病患者的护理.方法 查阅国内外炎症性肠病相关指南、专家共识及重要期刊文献,结合临床护理专家的工作经验,形成《成人活动期炎症性肠病护理专家共识》(《共识》),通过2轮专家咨询、6轮线上会议讨论进行整理和修改,形成终版《共识》.结果 《共识》包括护理评估、症状护理、药物护理、营养护理、心理护理和延续护理6个方面.结论 《共识》具有一定的科学性和实用性,可为成人活动期炎症性肠病患者的整体护理提供指导.

目的 了解临床护士对氧疗安全的认知情况,为制订相关培训方案提供参考.方法 采用便利抽样法,于2019年5月4日—6月30日采用自行编制的问卷对来自30个省市200所医院的2789名护士进行调查,调查内容包括氧疗医嘱内容及实施人员、氧疗目的和适应证、氧疗评估、氧疗实施等.结果 共收回问卷2789份,其中有效问卷2719份,有效问卷回收率为97.49％.87.75％的护士认识到应根据医嘱实施氧疗,但只有18.50％的护士认为氧疗医嘱应包括目标血氧饱和度;82.42％的护士误认为氧疗可以治疗患者的原发病;95.29％的护士误认为氧疗可以缓解患者呼吸困难的症状;仅3.49％的护士知晓当患者血氧饱和度下降3％时需要连续监测血氧饱和度;除COPD患者外,护士对其他具有高碳酸血症风险的患者知晓率均小于70.00％;仅22.25％的护士能正确指出高碳酸血症风险患者氧疗时的目标血氧饱和度;仅16.77％的护士能正确回答氧疗停止1 h后监测患者血氧饱和度的时间.结论 临床护士在氧疗安全方面的认知有待提高.应开展系统培训,纠正护士在氧疗认知上的误区,以进一步规范氧疗实践,为患者提供更为安全、精准的氧疗.

目的:调查消化内镜护士专科培训及职业发展需求,为明确消化内镜专科护士规范化培训方案、推进护士职业持续发展提供参考依据.方法:采用自行设计的消化内镜护理工作问卷对全国28个省、自治区、直辖市的消化内镜护士进行调查.结果:调查对象4509人,33.40％的调查对象认为学校所学知识和技能不能满足目前岗位需要;团队协作能力(76.98％)、临床动手能力(76.56％)、沟通交际能力(74.01％)等相关素质及能力非常重要;80.53％的调查对象认为建立消化内镜专科护士培训基地是目前最亟待解决的问题.结论:应尽快完善消化内镜专科护士的标准化培训体系,实施消化内镜专科护士全国性的资格认证,多途径满足各级护理人员对消化内镜护理专业知识的学习和考核.

Sleep health becomes an important component of global public health. The incidence of sleep disorders is increasing rapidly worldwide, which seriously affects people's quality of life. In China, the lack of professional sleep physicians and technicians, the distribution of sleep centers and the unbalanced development of medical resources have seriously restricted the development of sleep medicine and the improvement of sleep health guarantee level. In Europe and America and other developed countries, sleep medicine has become a new interdisciplinary discipline. The development of nurses as sleep coordinator has become an irresistible trend. Nurses have been trained to become the main force of sleep technicians. These successful attempts in the field of sleep medicine provide reference for promoting the development of nursing care in China from the aspects of medical care, teaching and research.

目的:调查我国护士的急性缺血性脑卒中静脉溶栓治疗的护理实践现状以及依照指南的实施情况.方法:采取两阶段抽样的方法,通过自行设计的"急性缺血性脑卒中静脉溶栓护理知识与实践现状调查问卷"调查我国23个省、自治区、直辖市69家医院的1518名从事静脉溶栓护理实践的护士.结果:1518名护士年龄为26～56(30.73±6.42)岁,调查结果显示,急性缺血性脑卒中筛查工具-FAST评估量表的掌握率为54.3％(825例),溶栓前血糖、血压的控制范围的知晓率分别为50.7％(769例)和28.3％(430例),溶栓期间患者吸氧标准的知晓率为22.4％(340例),溶栓过程中及溶栓后的护理、并发症的观察等实践内容的知晓率为27.8％～53.8％.结论:护士对静脉溶栓护理相关知识掌握不足.已有静脉溶栓指南在护理实践中不能被准确地转化与实施,护理人员在急性缺血性脑卒中静脉溶栓实践过程中依然存在疑惑,迫切需要相关部门尽快制定相关标准,促进静脉溶栓护理实践的标准化发展.

谵妄常见人群有重症患者、老年患者、术后患者、成人癌症患者,发病率高,增加患者病死率.本文基于当前谵妄管理指南证据,对成人住院患者谵妄评估、非药物干预策略等进行介绍,以期为临床护理人员提出指导建议,降低谵妄风险.

氧气疗法(oxygen therapy,简称氧疗)是各种原因引起的低氧血症患者常规和必不可少的治疗方法,具有纠正缺氧、缓解呼吸困难、保护重要脏器功能、促进疾病痊愈的重要作用.氧疗作为一种诊疗方法,既可给患者带来有益的治疗作用,也可能会对患者造成不良影响.2018年4月,发表在Lancet的一篇系统评价[1]指出,对于血氧饱和度正常的患者给予氧气吸入会增加患者的病死率.

目的 翻译国际居民评估工具家庭护理评估量表(International Resident Assessment Instrument Home Care,InterRAI Home Care),简称InterRAI家庭护理评估量表,并对中文版InterRAI家庭护理评估量表的信效度进行检验.方法 采用Beaton简洁六步法对Inter-RAI家庭护理评估量表进行翻译和跨文化调试,形成中文版InterRAI家庭护理评估量表.采用便利取样法.选取在北京市东城区6所社区卫生服务中心门诊就诊、符合纳入标准的老年患者215例,使用中文版InterRAI家庭护理评估量表和改良巴氏指数量表、改良工具性日常生活能力量表、简易精神状态检查量表对社区居家老年人进行评估.结果 中文版InterRAI家庭护理评估量表总的Cronbach's α系数为0.871,量表平均内容效度为1.00,评定者间信度为0.916～0.942.中文版InterRAI家庭护理评估量表的ADL维度与改良巴氏指数量表每个条目的Pearson相关系数为-0.999～-0.810;工具性日常生活能力维度与改良工具性日常生活能力量表的每个条目的Pearson相关系数为-0.996～-0.962;触发认知能力问题与MMSE量表评分判断认知障碍的一致性系数为100％;使用中文版Inter-RAI家庭护理评估系统所触发的问题与医生诊断间的一致性是100％.结论 中文版InterRAI家庭护理评估量表在社区居家老年人群体中具有良好的信效度,量表的稳定性好、可靠性高,可以在我国社区居家老年人群体中使用.

该文从培训内容、培训模式、师资情况等方面对呼吸慢性病管理专职护士的培训进行实践,并分析目前呼吸慢性病专职护士培训方面需要改进的问题,提出相应的策略,以期为后期呼吸慢性病管理专职护士培训内容、培训方法的制订提供参考价值,提升呼吸慢性病管理专职护士的培训质量.

目的 了解并分析ICU护士对老年患者践行有创机械通气吸痰护理实践指南的现况.方法 采用自设的ICU护士为老年患者实施人工气道内吸痰护理的观察表,对77名ICU护士的231次操作进行评价;针对吸痰操作行为与指南推荐实践不符的情况,对实施操作的护士进行提问,从个人内在因素和外在因素两方面对访谈资料进行主题提炼.结果 ICU护士吸痰操作行为得分为(61.98±6.23)分,吸痰管型号的选择、负压的选择未见与指南推荐一致的操作,吸痰前后给予高浓度氧的操作仅占3.5％.提炼出5个二级主题,分别为知识、信念态度、人员、设备、制度.结论 ICU护士的实际操作行为与临床实践指南整体较符合,但部分吸痰行为还有待改善;护士经验固化是阻碍实践指南临床应用的主要原因.

Objective: The research aims to understand the meaning of self-management in elderly patients with chronic diseases from the perspectives of under new rural cooperative medical insurance. Methods: Totally 204 elderly patients with chronic disease were recruited from outpatient and ward of a second level hospital in Fangshan district by convenience sampling. Self-management behaviors of patients with chronic disease were estimated by Self-management Behavior Scale. Results: Elderly patients were lack of physical exercises; duration of exercise was well enough. The scores of cognitive symptom management and communication with physicians were poor. Age, gender, education, disease type, disease education were related to patients' self-management behaviors (P<0.05). Conclusion: Self-management behaviors of rural elderly patients with chronic diseases were poor. Education in strategies to implement self-management is needed for rural elderly patients.

[目的]探讨延续护理对老年晚期胃癌病人化疗不良反应和生活质量的影响.[方法]将102例老年晚期胃癌病人按随机数字表法分为观察组和对照组,每组51例,对照组采用常规护理,观察组在对照组基础上采用延续性护理,比较两组病人应用奥沙利铂+替吉奥方案2周期后化疗不良反应程度、生活质量和护理满意度.[结果]观察组病人生活质量评分均高于对照组、化疗不良反应程度低于对照组、护理满意度高于对照组,经比较差异均有统计学意义(P<0.05).[结论]采取延续性护理措施可降低和减轻老年晚期胃癌病人化疗不良反应,提高病人生活质量和护理满意度.

Along with the rapidly aging population, the prevalence of chronic diseases also increased greatly in the elderly. Chronic diseases are complex and lifelong conditions, and transitional care plays an important role in the chronic disease management. In this review, the authors summarized the concept of transitional care, care model, problems and suggestions for implementing transitional care in patients with chronic diseases.

Objective: To analyze health issues and caring needs among Chinese community-dwelling elders in Beijing and to test the applicability of interRAI HC in home care of China. Methods: A convenient sampling was utilized to collect 120 community-dwelling elders in Beijing Xicheng district. InterRAI HC was used to collect data and the clinical assessment protocols were applied to analyze the health issues of elders. Health issues were then compared with the services they were provided. Results: The elders had health issues at physical, psychological, and social aspects. The average number of issues was 2 with the range of 1-5. As the elders aged (rs=0.45,P=0.03) and number of chronic illness increased (rs=0.34, P=0.04), the number of health issues were increased. The elders received higher rate (>70%) of services at the aspects of cardiorespiratory problems, pain, ADL, informal social support, and pressure ulcer.But they received lower rate (<40%) of services at the aspects of cardiorespiratory conditions, pain, ADL, informal aspect of prevention, home environment optimization, IADL, urinary incontinence, under-nutrition, and physical activity promotion. Conclusion: InterRAI HC can systemically assess the health issues among elderly and provide directions for further home care. InterRAI HC can also be utilized in the future to monitor the quality of home care for elders.

在为人工气道患者进行吸痰时,吸痰管的插入深度会影响吸痰的效果.目前人工气道内吸痰操作规范中关于吸痰管的插入深度并无明确规定,本文就吸痰管插入不同深度进行吸痰的有效性、安全性及插入深度的测量等方面展开综述,为临床护理工作提供相关证据.

Nowadays asthma cannot be cured completely, many asthma patients misunderstand asthma and their awareness of asthma is not deep in our country, which has many non-standard aspects in the treatment. This leads to asthma control is not ideal. The scientific nursing and health care contribute to asthma control. During the social transitional stage of returning home from hospital, we uses the trinity medical service mode, continues nursing and health education in asthma prevention, by the selection of reasonable education methods, timing, individualized health education for patients and their families to participate in self-care, to improve the prevention and treatment of patients with compliance, to reduce asthma,to maintain long-term stability, to enhance the quality of life.

慢性阻塞性肺疾病是一种高发病率、高致残率、高死亡率的疾病.目前对于稳定期慢性阻塞性肺疾病患者的主要非药物管理办法是推行肺康复治疗、氧疗、无创正压通气以及延续护理等方面,可在不同程度上改善患者运动耐力、呼吸功能和生活质量.

目的:调查社区慢性阻塞性肺疾病(COPD)患者自我管理水平,为社区开展COPD患者自我管理干预提供依据.方法:采用COPD自我管理问卷,对260名社区COPD病患者进行自我管理水平调查.结果:社区COPD患者自我管理总分为(156.92±36.47)分.患者文化程度、过去一年内因COPD急性加重住院次数、吸烟状况是患者自我管理水平的影响因素.结论:社区COPD患者自我管理水平不高,影响社区COPD患者自我管理水平的因素有文化程度、吸烟状况、住院次数.