目的 探讨上肢运动方案在肿瘤患者PICC置管护理中的应用效果.方法 将367例肿瘤PICC置管患者按照住院时间分为对照组184例和观察组183例.对照组给予常规护理,观察组在此基础上实施上肢运动.结果 腋静脉最大血流速度和平均血流速度的组间效应、时间效应及交互效应具有显著性,置管后28 d内观察组静脉血栓发生率及导管异位发生率显著低于对照组(P＜0.05,P＜0.01).结论 上肢运动有利于提高肿瘤PICC置管患者腋静脉血流速度和平均血流速度,降低静脉血栓和导管异位发生率.

>乳腺癌是全球最常见的恶性肿瘤,在140个国家中居女性癌症发病首位,乳腺癌术后早期渗出较多,影响皮瓣血运,容易诱发切口感染,影响伤口愈合,推迟后续治疗,延长住院时间,增加患者的医疗费用及精神压力 [ 1]。因此,有效的引流是护理中的重点。乳腺癌术中常规在胸骨旁及腋下分别放置引流管接一次性负压引流球,保证皮下持续负压吸引状态,促进引流液及时排出,定期更换引流球是引流管护理的重要内容,在引流管的护理严格无菌操作预防感染的发生

目的 探讨护士长诚信领导行为与团队关系冲突对护士留职意愿的影响.方法 采用方便抽样法抽取哈尔滨市3所三级甲等综合性医院629名护士,应用诚信领导量表、团队关系冲突量表和护士留职意愿量表进行调查.结果 护士感知护士长诚信领导行为得分40.64±9.85,团队关系冲突得分19.08±4.83,留职意愿得分19.32土4.25;团队关系冲突及护士长诚信领导行为的关系透明、内化道德观为护士留职意愿的主要影响因素(均P＜0.01).结论 护士留职意愿有待提高,可通过提高护士长的诚信领导行为,营造和谐的护理团队氛围,以提高护士的留职意愿.

Objective To explore the correlation between the incidence of violence and the satisfaction of nurses on the tumor hospital,and analyze the fac-tors of the satisfaction of nurses. Methods Totally,306 nurses in tumor hospital were investigated with the nurses'general data questionnaire,the patient's violent incident questionnaire and the nurse's satisfaction scale. Results Patient's violence score was (10. 07 ± 3. 62),tumor hospital nurse job satisfaction score was (114. 26 ± 31. 59),there was a negative correlation between them(P < 0. 01). Professional title and patients violence were the main influence factors of job sati-faction (P < 0. 01). Conclusion The incidence rate of violence in tumor hospital is higher,the hospital manager should take targeted measures to reduce the incidence of violence in the tumor hospital,improved nurses' job satisfaction and quality of nursing.

目的 探讨应用5A护理模式提高肺癌术后化疗患者自我效能的作用.方法 选取肺癌术后进行化疗的112例患者为研究对象,随机分为对照组和干预组各56例,对照组采用常规治疗和护理方法,干预组在常规治疗和护理的基础上,应用5A护理模式对患者进行干预,运用一般自我效能感量表比较两组患者自我效能的情况.结果 采用5A护理模式干预3个月和6个月的肺癌术后化疗患者自我效能得分显著高于采用常规护理方法的患者(均P＜0.05).结论 基于5A护理模式的护理干预方法能提高肺癌术后化疗患者的自我效能.

目的 探讨聚焦解决模式在改善肺癌患者癌因性疲乏和生存质量中的作用.方法 选取手术后进行化疗的肺癌患者220例为研究对象,按入院顺序分为对照组和干预组,各110例.对照组采用常规护理,干预组在此基础上,应用聚焦解决模式干预(描述问题、构建具体可行的目标、探查例外、给予反馈、评价进步).结果 患者的癌因性疲乏评分降低(P＜0.01或P＜0.05),生存质量各领域除恶心呕吐和腹泻外,评分均提高(P＜0.01或P＜0.05).结论 聚焦解决模式可以改善肺癌患者癌因性疲乏和生存质量,值得临床推广使用.

目的 探讨知信行教育模式对肿瘤内科护士癌痛控制护理知识、态度和行为的影响.方法 应用类实验研究设计,对照组护士采取科室常规培训,干预组在对照组的基础上采取知信行教育模式,比较6个月后两组护士癌痛控制护理知识、态度和行为.结果 实施知信行教育模式后,干预组护士癌痛知识与态度答对率高于对照组,差异具有统计学意义(P＜0.01);干预组护士癌痛控制护理活动各维度得分均高于对照组,差异具有统计学意义(P＜0.01或P＜0.05).结论 对肿瘤内科护士实施知信行教育模式,提高护士癌痛控制知识、态度和行为效果显著.

Objective To investigate anxiety levels and illness uncertainty caused by esophageal cancer during perioperative period, and to analyze the correlation between them. Methods A total of 90 patients with esophageal carcinectomy were selected in our hospital from March 2012 to September 2013 as sample, and were investigated with Mishel′s uncertainty in illness scale ( MUIS ) and Zung′s self-rating anxiety scale ( SAS ) . Results The MUIS level of esophageal carcinoma patients was medium. Total score of MUIS in preoperative, operative and 3 days of postoperative were (108. 43 ± 13. 51), (106. 89 ± 11. 97) and (98. 57 ± 12. 48); patient′s age, gender and educational level had significant differences impacting on illness uncertainty (P<0. 05). The total score of anxiety was (70. 48 ± 16. 92). The score of SAS was positively correlated with the total score of unclarity in illness (r=0. 352,P<0. 05), with uncertain of illness (r=0. 401,P<0. 05), with complexity (r=0. 217,P<0. 05), with incoherence (r=0. 634,P<0. 05), and with unpredictability (r=0. 142,P>0. 05). Conclusions Esophageal cancer patients in perioperative period shows a high level uncertainty of illness and anxiety, and there is a positive correlation between the two. Nurses should take effective measures to improve the uncertainty of illness and anxiety states for patients, and to improve the quality of care.

目的 了解护士工作嵌入、离职意愿现状,探讨两者之间的关系.方法 抽取哈尔滨市5所医院的307名护士,采用工作嵌入量表、离职意愿量表进行调查.结果 护士工作嵌入平均得分3.15±0.47,以社区匹配维度得分最高,组织联结维度得分最低;离职意愿平均得分2.71±0.61,3个维度中离职意愿Ⅲ(获得外部工作的可能性)得分最高;工作嵌入各维度与离职意愿存在显著负相关(P＜0.05,P＜0.01).组织牺牲、组织匹配、社区联结可以作为预测护士离职意愿的主要因素.结论 护士离职意愿处于较高水平,护理管理者应重视护士需求,适当授权以提高护士工作嵌入度,降低其离职意愿.

Objective: To investigate the effect of transcutaneous electrical acupoint stimulation(TEAS) on T lymphocyte subgroup, natural killer cell(NK cells) and its related cytokines secretion in perioperative lung cancer patients undergoing lobectomy.Method: Forty patients with pulmonary carcinoma were randomly divided into surgical group and TEAS surgical group. The patients in TEAS surgical group received TEAS stimulation for 30 min from 30 min before operation to 1, 2 and 3 days after operation. The levels of blood CD3+, CD4+, CD8+and CD4+/CD8+ratio as well as NK cells, and the concentrations of sIL-2R, IL-2, IFN-γ and IL-10 were determined at 30 min before operation, at the end of operation and at 1, 3 and 5 d after operation.Result: The levels of CD3+, CD4+, CD4+/CD8+ratio and NK cells in TEAS surgical group increased significantly at postoperative 1, 3 and 5 days compared with in surgical group. The expressions of CD8+, sIL-2R and IL-10 decreased significantly at postoperative 3 and 5 days, while the expressions of IL-2 and IFN-γ increased significantly(P0.05).Conclusion: TEAS may enhance the immune function of perioperative patients with lung cancer, strengthen the postoperative analgesia effect and reduce the analgesic consumption of postoperation.

临床研究护士(clinical research nurse,CRN)作为临床科研的组成部分,其工作行径对临床科研进程的顺利与否至关重要.国外早在许多年前就已经开始对临床研究护士进行了关注,并制定了相应的工作流程及标准.而我国对临床研究护士并未形成明确的岗位说明,对工作职责的内容也未形成标准的界定,尚属于探索与起步阶段.因此,本文通过回顾与分析关于临床研究护士国内外研究现状,总结与归纳临床研究护士的工作职责,使研究护士工作流程趋向规范化,为规范临床试验人员职责及人员的准入提供理论规范与指导.

In high quality nursing service in wards with standard treatment,responsibility system overall nursing model is further perfected.Through strengthening basic nursing,speccfic nursing service conotation is deepened,long-term quality control mechanism is constructed,and nursing quality is continuously improved.

目的探讨肺癌晚期患者的临终护理。方法 2009年6月～2011年6月对笔者所在医院收治的56例肺癌患者进行临终护理。结果通过对肺癌晚期患者进行护理措施,消除恐惧、焦虑等不良心理,症状得到控制,生命质量得到提高。结论对肺癌晚期患者提供细心的关怀护理,可有效提高患者生活质量,延长生命期。

目的探讨临床护理工作对肺癌全肺切除术后并发症的效果。方法选择本院肿瘤科2008年6月~2010年4月收治的行全肺切除术的肺癌患者92例为研究对象,随机分为对照组与护理组各46例,行区别性护理方式,并对分组的护理效果进行比较。结果护理组并发症发生8例(17.4%),显著低于对照组的15例(32.6%)。护理组患者术后死亡率为1例(2.2%),也显著低于对照组的3例(6.5%)。结论对肺癌全肺切除术患者在围术期从健康宣讲、呼吸系统并发症的护理、心血管系统并发症的护理、肺癌合并糖尿病并发症的护理、饮食护理等方面实施相应措施,可有效保证手术效果,促进患者恢复、控制术后心血管及呼吸系统等并发症的发生。

介绍介入性放射疗法治疗35例晚期肺癌患者的护理要点,包括术前心理护理,介绍手术方法,消除患者顾虑;术后观察生命体征、穿刺点有无渗血及血肿,预防感染,指导患者正确饮食,预防处理药物的不良反应,观察有无脊髓损伤、褥疮的发生。本组患者手术进行顺利,术后出现股动脉穿刺点渗血4例,脊髓损伤1例,胃肠道反应较重者10例,15例有不同程度的发热。

<正>1"破窗理论"的概念及意义"破窗理论"亦称"破窗效应",是指一种心理暗示造成的某种效应。其显示,人的行为和环境均具有强烈的暗示性和诱导性,对于不良行为和环境,我们必须抱有及时修好"第一扇被打碎玻璃窗"的积极警觉态度和雷厉风行的作风[1]。

Objective To understand the need and current status of management training among head nurses,then to provide bases for the further training.Methods A self-designed questionnaire was used to survey 475 nurses from 18 public hospitals in Heilongjiang province.Results 89.26% of the involved head nurses had received management training.For training contents,they hoped to attend some curriculum to improve their management capacities.For training modes,31.58% cases recognized short-term training courses,and 36.63% cases agreed lectures.Conclusion Management training is much in demand among head nurses.So hospitals should strengthen their training.And the training contents shoud be comprehensive,systematic,and trargeted.The training modes should be various and combined with the work nature.

目的探讨综合心理干预对住院肺癌患者生命质量的影响。方法将147例住院治疗的肺癌Ⅱ期患者随机分为干预组(77例)和对照组(70例),两组均按照常规治疗和护理,干预组在此基础上进行综合心理干预,包括团体心理干预、想象疗法以及意向疗法中的投射测验法,并采用QLQ-C30评价两组患者干预前后的生命质量。结果干预后两组患者的生命质量评分比较,差异有统计学意义(P<0.01)。结论综合性心理干预能改善肺癌患者的心理状况,进而提高其生命质量。

Objective To explore training objectives and management methods of nursing staff in various stages and provide references for clinical nursing managers.Methods The nurses from three wards were selected as trainees.With the guidance of the career planning theory,the training was implemented,combining the requires of clinical nursing work and the psychological needs of nurses in different stages,and the planning management policy was carried out.Results The job satisfaction of nurses and the patient satisfaction were both improved(P0.05).Conclusions Enhancing the training and management of clinical nurses in various stages and properly guiding their career development can improve the comprehensive ability and job satisfaction of nurses,effectively increase the quality of nursing,and create a win-win situation of nursing personnel and nursing work.

[目的]探讨心理干预对结直肠癌术后造瘘病人抑郁状态的改善作用。[方法]选择结直肠癌术后造瘘病人CES-D抑郁量表自评总分为≥16分的40例病人作为研究对象,随机分为干预组和对照组,每组20例,设计访谈式问卷调查相关因素,按5点评分法进行打分,干预组严格实施个性化心理干预,对照组接受外科常规护理,护理后两组再次按CES-D抑郁量表及自制问卷进行评估,确定干预前后两组病人抑郁状态改善情况。[结果]干预组病人护理后抑郁病人明显减少,抑郁量表评分明显减低。对5个因素需求程度明显降低,而对照组变化不明显。[结论]给予结直肠癌术后造瘘者抑郁状态的心理护理可减轻心理压力,改善抑郁状态,其护理效果优于传统护理方法。