该文介绍了苏州大学护理学院高级护理实践课程的多元化评价方案的设计过程和应用效果.根据护理硕士专业学位研究生的培养定位﹑高级护理实践课程目标和教学内容的特点,通过文献研究﹑专家小组会议构建了包括实践考核﹑人文素质活动﹑课堂综合表现及反思日记4个项目的多元化评价方案,对护理硕士专业学位研究生的知识﹑技能﹑态度﹑情感等方面进行全面评估.2019级48名学生的实践考核﹑人文素质活动﹑课堂综合表现及反思日记成绩分别为(87.68±3.45)分﹑(9.52±0.65)分﹑(8.90±0.97)分和(90.17±2.05)分,对多元化评价方案的反馈良好.该多元化评价方案能够激发学生学习的自主性和有效反思,提升学生的课堂参与度,培养其人文素养,可为其他院校相关课程的评价方案的设计与完善提供参考.

目的 建立高级护理实践工作坊,并探讨其在教学中的实践效果.方法 对某高校2016级-2018级88名护理硕士专业学位研究生采用工作坊教学法开展高级护理实践课程,并采用高级护理实践课程成绩、学生反思日记及对18名护理硕士的质性访谈进行效果评价.结果 工作坊教学后,护理硕士专业学位研究生综合能力考核的总分为(87.19±4.61)分.对学生反思日记和访谈结果进行分析,提取出工作坊培养了学生的综合素质、工作坊促进了学生的自我反思、工作坊的教学模式还需要进一步探索三大主题.结论 工作坊不仅提高了护理专业硕士的综合能力,而且有利于学生的职业成长,学生普遍反馈较好.

护理专业课程思政是指将思想政治教育融入护理学专业课程教学的各个环节,培养医德高尚、德才兼备,为人民服务的护理专业人才.高级护理实践是护理硕士专业学位研究生的专业核心课程,兼具人文性与专业性,该课程的学习能够为学生今后适应和胜任复杂的临床、教学和研究工作打下坚实的基础.为建立起更加通畅的思政获得渠道,内化学生思政水准,结合课程特色和学生特点,本文分析了高级护理实践课程思政建设的必要性和障碍,阐述了我院高级护理实践课程思政建设的实践路径.

Objective? To explore the cognition on humanistic care of nursing undergraduates in the process of early clinical experience. Methods? We selected 26 nursing undergraduates with Grade 2016 in school of nursing of Soochow University as subjects by convenience sampling. Then, we analyzed their clinical experience diary and results of symposium. Results? Students had a preliminary understanding and self-examination on humanistic care by clinical experience. A total of three themes were refined including perceived care, regurgitation-feeding other and reflection care. Conclusions? Early clinical experience could improve humanistic care of students, which is worth to be promoted and referred.

Objective To explore the effect of application of social learning theory in early clinical experience through the analysis of the early clinical experience of nursing undergraduates.Methods A total of 27 undergraduates of Grade 2013 from School of Nursing of a university were recruited.Early clinical experience curriculum was set up and after participation,the students were required to write and submit their diaries. Phenomenological analysis method of qualitative research was adopted to analyze and summary the diaries. Results Through observation of the mentor role model study,the students had a more profound understandin g of nursing major,and promoted professional emotion.Conclusions Social learning theory in clinical nursing undergraduates early experience course has achieved good results,which promote the common progress of students and teachers,and should be actively advocating and promotion.

Objective To explore the work experiences of intensive care unit ( ICU) charge nurses in a tertiary hospital of Soochow.Methods Phenomenology method was used to survey 10 ICU nurses of a tertiary hospital by non-structured interview. The data was analyzed by phenomenological analysis. Results Five main themes were found by category analysis, which included: enduring stress, suffering losses, bear negative feedback, upgrade oneself constantly, and achieve self ICU; charge nurse; work experience; qualitative researchvalue in professional nursing care. Conclusions The work experiences of ICU nurses contains the positive aspect and the negative aspect. The research results reveals the development of ICU nurses′ work experience and they expect an improvement of the whole social environment.

目的 构建预防髋、膝关节置换术后下肢深静脉血栓(deep vein thrombosis,DVT)的综合干预方案,实施并评价该方案在预防中老年髋、膝关节置换术后DVT的干预效果.方法 将90例患者随机分为对照组(45例)和干预组(45例).对照组接受预防DVT的常规护理;干预组患者给予基于DVT预防指南的综合干预策略,主要包括以健康信念模式为指导的健康教育、早期功能锻炼、梯度压力弹力袜或间歇充气加压装置、药物预防4项.结果 术后5～7d,干预组DVT疾病相关知识及健康信念水平的评分均优于对照组,差异均有统计学意义(P＜0.05).干预组血浆D-二聚体水平明显低于对照组(P＜0.05).干预组出现1例血流淤滞,对照组出现2例DVT、6例血流淤滞,干预组效果优于对照组,差异具有统计学意义(P＜0.05).结论 基于DVT预防指南的综合干预策略能够减轻关节置换患者术后DVT的相关症状,对降低DVT发生风险有效.

目的：探讨CBL引导的急诊急救医护合作实践培训教学模式及意义。方法对我校护理本科专业学生实习前开展了CBL引导下的，由来自临床的医生、护士、临床医学生及护生组成合作团队，通过急诊急救案例引导进行贴近临床的仿真实训，搭建“医生为主导、护士为主体”的仿真平台。结果 CBL引导的急诊急救医护合作模式开展后，从“护生”到“医学生”再到“医护专家”，形成了教学链，得到了“护生融入平时团队学习”、“医学生案例精细，分工明确”、“医护专家正反引导，组内互补”的反思结果。结论该培训模式帮助护生在实习前感受真实的临床情境，在急诊急救的医护合作中培养了他们发现问题、解决问题的能力、评判与创新思维能力、主动学习能力、沟通合作能力及临床决策能力，促进实习护生尽快与临床无缝对接。

Objective To build the Health Quotient Assessment Scale for puerperal women ,to provide compre‐hensive ,effective and uniform assessment tool for postpartum women's health management .Method Delphi (Delphi method) was used for 20 rounds of expert advice ,positive coefficient by analysts ,the extent and degree of coordina‐tion authority to test the reliability of the method .Result two round consultants positive coefficients were 90 .91%and 100% ;expert authority coefficient was 0 .86 ;expert coordination coefficients were 0 .348 and 0 .501 ,There was significant difference (P<0 .01) .Comprehensive analysis of the results of expert advice and established the three basic dimensions of health consultation tables and 42 entries pool .Conclusion Puerperal women and health providers to assess the scale has high reliability ,covering women's awareness of postpartum maternal and child health ,health knowledge and health capabilities ,puerperal women’s health as a basis for management's assessment .

Objective To develop the Postpartum Women Health Quotient Scale(PWHQS)and test its re-liability and validity. Methods Depth interview,literature review and Delphi consultation were per-formed to identify items of the scale.By convenience sampling method,totally 3 9 5 puerperae were investiga-ted by this scale.The scale was evaluated by content analysis,exploratory analysis and reliability and validity test.Results A 4 2-item scale was originally developed and eight of them were deleted after exploratory fac-tor analysis.Five factors were extracted with cumulative contribution rate of 6 3 .7 9 4%.The Cronbachαco-efficient was 0 .9 2 and the Spearman-Brown split-half coefficient was 0 .8 6 .The content validity of scale was 0 .9 2 2 .Regarding to the construct validity,the gather coefficient was 0 .5 4 7~0 .7 7 4;differentiate coefficient was 0 .1 4 8~0 .5 7 2;the relative coefficient between each factors was 0 .2 9 7~0 .5 6 5;and relative coefficient of factors and total score of scale was 0 .2 9 7~0 .8 4 9 .All the difference of correlation coefficients were statis-tically significant (all P<0.01).Conclusion The PWHQS is proved to be reliable and valid.It can be used to assess the health quotient level of puerperae.

目的：优化护理会诊单，减少护士书写的时间，完善电子病历中护理措施的落实及动态监控。方法对比采用电子护理会诊单前后会诊单书写时间、护理书写质量评分。结果与使用电子护理会诊单前相比，护士书写耗时明显减少，护理书写质量评分明显提高，差异均有显著意义（P＜0．05）。结论电子护理会诊单书写时间明显减少，护理书写质量不断提高，护理病历资料更趋完善。

Objective To evaluate the effect of health belief model combined with PDCA circulation in preventing DVT of patients undergoing total hip replacement and total knee replacement.Methods Patients who met our inclusion criteria were randomly divided into the intervention group and the control group with 45 cases in each group.The patients in the control group received routine health education.In addition,the intervention group received health education based on health belief model combined with PDCA circulation besides the routine.The intervention results were compared between the two groups.Results The patients' mastery of DVT disease related knowledge,health belief and the implementation of preventive measures in the intervention group were significantly better than those of the control group one week after surgery.The score of the health belief,perceived susceptibility,perceived severity,perceived benefits of action and serf-efficacy in the intervention group were significantly superior to those of the control group.1 patient appeared blood stasis in the intervention group.However,in the control group,there were 2 patients with DVT and 6 patients with blood stasis.The effect of preventive measures in the intervention group was better than the control group.Conclusions Health education based on health belief model combined with PDCA circulation could effectively enhanced the patients' DVT disease related knowledge,health belief and the implementation of preventive measures,thereby reduce the risk of DVT and improve the patients' quality of life.

目的：探讨微课模式的CBL教学法应用于《临床护理决策》教学的效果。方法将微课模式的CBL教学法应用于护理本科生《临床护理决策》教学过程中，并采用座谈会以及护理专业本科生临床决策能力测量问卷评估教学效果。结果36名本科生临床决策能力总分（105．61±2．46）分，其中发现问题能力维度平均得分率最低，为72．97％，确定目标能力维度平均得分率最高，为90．31％。学生与教师对微课模式的CBL教学法自评较满意。结论微课模式的CBL教学法应用于《临床护理决策》课程教学可提高学生的临床决策能力。

A network of approximately 35 volunteers from relevant departments and high-risk divisions was set up with the head nurse of the Orthopedics Department in charge. Trainings on the causes and mechanism of Deep Vein Thrombosis (DVT) as well as ways and strategies of intervention were held in a relaxing and pleasant atmosphere. Experts were asked to give lectures so that a lively culture of organizational learning was formed. Regular problem-oriented analyses of typical cases were conducted to share experience and prevent DVT at the very beginning. Regional radiation: The salon was open to colleagues in nursing from ifrst-class and second-class hospitals in the surrounding areas so that they could participate in the training, discussion and sharing sessions. In the meantime, the concept of "DVT prevention" was advocated in all levels of training programs to achieve regional radiation and wide coverage. The incidence of DVT decreased signiifcantly from the academic salon in our hospital. It's an effective model of organized nursing interventions will achieve the "glass ceiling effect" of "prevention ifrst".

Objective To explore the intervention mode of physician-nurse collaborative team in prevention and cure of chronic disease in community.Methods Prevalence and risk factors of chronic disease among patients in the community of twin towers of Suzhou were investigated,and intervention measures were formulated.Physician-nurse collaborative team provided group education and individual consulting for 120 patients with hypertension and (or) diabetes.Patients' knowledge about chronic disease,satisfaction with service after intervention,as well as exercise,compliance and dietary salt before and after intervention were evaluated and compared.Results After intervention,90％ patients learned the knowledge about chronic disease with 82％ accuracy.Ninety-two percent patients were satisfied with group education,and 98％ were satisfied with individual consulting.Patients' physical exercise improved from 61.67％ to 82.50％,medical compliance improved from 49.17％ to 75.83％ after intervention,and the differences were statistically significant (x2 =12.941,18.204,respectively; P＜0.05).Dietary salt was also reduced from(6.5125 ±0.865)g/d to(5.000 ±0.501)g/d six months after intervention,and the difference was statistically significant (t =33.352,P ＜ 0.05).Conclusions Physician-nurse collaborative team can improve patients' health knowledge,attitude,belief,and practice level,which can provide empirical basis for community intervention in the future.

[目的]探讨穴位按摩联合艾灸在预防脊柱术后腹胀的效果,为有效预防脊柱术后腹胀提供临床依据。[方法]将56例脊柱术后病人按照入院顺序分为观察组和对照组各28例。两组均给予术后常规护理,观察组在此基础上予以穴位按摩联合艾灸治疗,每天按摩足三里穴及上巨虚穴2次,并艾灸神阙、关元穴1次。观察两组术后肛门首次排气时间、腹胀发生率及严重程度。[结果]观察组肛门首次排气时间早于对照组,腹胀程度低于对照组。[结论]穴位按摩联合艾灸治疗能有效促进脊柱术后病人肠蠕动的恢复,从而预防腹胀的发生。

目的：探讨集束化干预策略在预防关节置换术后下肢深静脉血栓形成的效果。方法通过对30例髋、膝关节置换术后的患者采取集束化干预策略，包括早期功能锻炼、饮食饮水指导、梯度压力弹力袜或间歇充气加压装置、药物预防四项，分别在术前及术后7 d内观察记录患者下肢深静脉血栓（DV T ）的相关症状，检测术前及术后第5～7天血浆D-二聚体水平、彩色多普勒超声检查。结果仅1例患者股静脉血流滞缓，无一例发生下肢深静脉血栓。结论集束化干预策略能够减轻关节置换患者术后DVT的相关症状，对降低DVT发生风险有效。

Objective To develop a deep vein thrombosis health belief questionnaire(DVTHBQ)for patients undergoing major orthopedic operation,and investigate the reliability and validity of the DVTHBQ.Methods The establishment of DVTHBQ was based on the framework of Health Belief Model (HBM) combining theories and experience,and step-by-step through the preliminary experiment,data collection,evaluation of its validity and reliability,etc.Results The items of this questionnaire had a good discriminability.The total internal consistency reliability of the questionnaire was 0.88.The content validity of the questionnaire was 0.95.Factor analysis,which could explain more than 50％ variance,showed that the questionnaire had good construct validity.Conclusions The questionnaire was tested to be of good reliability and validity.The DVTHBQ could be an effective instrument to explain and predict the possibility of taking DVT preventive measures for patients undergoing major orthopedic operation.

下肢深静脉血栓(Deep Vein Thrombosis,DVT)是指血液在深静脉内不正常地凝结,使静脉腔完全或不完全阻塞的一种静脉回流障碍性疾病,好发部位为下肢深静脉,尤以左侧常见,是术后常见的并发症[1].亚洲骨科大手术患者的DVT发生率与西方国家相近,发生率为43.2％( 120/278)[2].目前国内尚缺乏关于DVT准确的流行病学资料.DVT可导致截肢等严重后果,甚至发生肺栓塞( Pulmonary Embolism,PE)而引起患者死亡.因此护理人员应加强对DVT的认识与掌握,采取积极预防措施,减少DVT的发生.