This systematic review was carried out to describe QoL and resilience in infertile patients, as well as the relationship between them, and to give a theoretical foundation for clinical practice. The databases of CNKI, Wanfang data, VIP database, PubMed, Web of Science, and Embase were searched without a time limit. A narrative synthesis of relevant articles was undertaken. This systematic review was registered on PROSPERO in advance. Of 21 studies eligible for inclusion in this review, 13 focused on the relationship between QoL and resilience, 5 on QoL influencing factors (resilience included), and 3 on mediation effect analysis on mental health (resilience as a mediator). Resilience can significantly predict the QoL of infertile patients. It seems plausible that more resilient couples will be less vulnerable to the stress of infertility. A global consortium of infertile population research could make cross-cultural comparisons of QoL and resilience possible. Future research should focus on resilience therapies.Systematic review registrationThis systematic review was registered on PROSPERO in advance (CRD42023414706).

目的:分析体外受精胚胎移植术(IVF-ET)患者取卵前焦虑抑郁发生情况及影响因素.方法:回顾性分析 2021 年 1 月至 2022 年 10 月在该院接受IVF-ET治疗的 120 例不孕症患者的临床资料,统计IVF-ET患者取卵前焦虑抑郁[焦虑自评量表(SAS)>50分且抑郁自评量表(SDS)>53 分]发生情况.采用单因素和多因素Logistic回归分析IVF-ET 患者取卵前发生焦虑抑郁的影响因素.结果:接受IVF-ET治疗的120例不孕症患者中,84例(70.00%)发生焦虑、抑郁;单因素和多因素Logistic回归分析结果显示,年龄较大、居住地为农村、家庭年收入低、辅助生殖次数多、丈夫或公婆对辅助生殖态度冷漠均是IVF-ET患者取卵前发生焦虑抑郁的独立危险因素(OR>1,P<0.05).结论:年龄较大、居住地为农村、家庭年收入低、辅助生殖次数多、丈夫或公婆对辅助生殖态度冷漠均是IVF-ET患者取卵前发生焦虑抑郁的独立危险因素,临床可针对这些因素予以预防性心理辅导,以减轻患者负性情绪,提高IVF-ET成功率.

Objective:To summarize the experience of the whole process management of fertility preservation in patients with malignant tumor.Methods:The clinical data and the whole-process management of 24 fertility preservation procedures in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from December 2019 to September 2022 were retrospectively analyzed. The key points of fertility preservation patient management included decision support for initial diagnosis, specially-assigned reception, privacy protection, whole-process inspection escort, humanized management at the stage of drainage promotion, infection prevention, psychological assessment and counseling, and professional health education.Results:After the whole process of careful treatment and nursing, all the 24 patients successfully completed fertility preservation, and no complications such as infection, bleeding after egg extraction occurred.Conclusion:When caring for patients with fertility preservation, the physical and psychological conditions of patients should be considered comprehensively, so as to provide more targeted nursing services to meet the needs of patients and achieve the best clinical results.

目的 了解我国辅助生殖技术(assisted reproductive technology,ART)患者二元应对水平,并分析其影响因素,为今后制定(assisted reproductive technology,ART)夫妇二元应对干预措施提供理论依据.方法 采用便利抽样法,选取2021年5月至2021年6月郑州大学第三附属医院生殖医学科接受ART助孕治疗的患者作为研究对象,给患者发放一般资料调查表、二元应对量表(Dyadic Coping Inventory,DCI)及Locke-Wallance婚姻调适测定量表(Marriage Ajustment Test,MAT),取得患者同意后,由患者本人独立填写,了解ART患者二元应对水平,并分析其影响因素.结果 患者二元应对总分为(121.43±12.40)分,处于中等水平;单因素分析中年龄、婚姻状况、婚龄、不孕因素、不孕类型、家庭类型、有无ART助孕史7项得分差异无统计学意义(均P＞0.05);文化程度、居住地、职业、月收入、有无子女、不孕年限6项得分差异有统计学意义(均P＜0.05);119例ART助孕女性Locke-Wallance婚姻调适测定总分为(114.24±13.68)分.婚姻调适测定总分与二元应对总分行皮尔逊相关分析,r=0.617,P=0.000,相关性显著;以二元应对得分为因变量,单因素分析中差异有统计学意义的变量及婚姻调适测定得分为自变量进行多元逐步回归分析,结果进入方程的因素有文化程度(初中及以下=1;高中或中专=2,大学及以上=3),职业(工人农民个体=1;机关、企事业单位人员=2;无业=3;其他=4)和婚姻调适测定.结论 接受辅助生殖技术助孕的患者二元应对处于中等水平,主要影响因素包括文化程度、职业类型及婚姻质量,临床工作中制定促进二元应对的干预措施时可以此为切入点.

目的:分析比较供精助孕治疗和夫精助孕治疗夫妇婚姻关系.方法:选择2019年7月—2019年11月就诊于河南省某三级甲等医院生殖中心接受供精助孕夫妇95对(供精组)和夫精助孕夫妇100对(夫精组)作为研究对象,采用一般资料问卷、Locke-Wollance婚姻调适测定量表、婚姻适应量表对其进行问卷调查以分析比较两组夫妇的婚姻关系.结果:供精助孕夫妇的婚姻调适和婚姻适应得分均高于夫精助孕夫妇(P<0.05).结论:供精助孕夫妇婚姻关系相对较好,但仍需进一步验证,应该对接受助孕治疗的夫妇进行及时的评估和针对性心理干预.

目的 调查护理实习生情绪管理能力现状及影响因素,为实习医院开展情绪管理教育提供参考.方法 采用调查问卷对河南省某三甲医院的525名护理实习生进行调查,应用逐步回归和分位回归方法 分析其情绪管理能力的影响因素.结果 护理实习生情绪管理能力问卷总均分为(4.19±0.62)分.适中情绪管理能力者受学校层次、曾获奖学金、月生活费、父母教养方式和能否留院规培的影响,父母教养方式对较低情绪管理能力者影响更甚,能否留院规培对较高情绪管理能力者影响较大.结论 护理实习生情绪管理能力较好,带教教师可针对具体影响因素,采取积极有效的措施提高护理实习生情绪管理能力.

目的 探讨线上与线下相结合的多途径宣教模式对辅助生殖技术(ART)助孕初诊患者的应用效果.方法 选取2019年1—6月在河南省某三甲医院生殖中心初次就诊的不孕症患者260例为研究组,选取2018年1-6月就诊的初诊不孕症患者260例为对照组.研究组采用线上与线下相结合的健康宣教方式,对照组采用常规的线下健康教育宣教模式.比较两组患者对就诊和检查流程的知晓程度、一次建档成功率、满意度等.结果 研究组患者就诊和检查流程的知晓程度、一次建档成功率、满意度及宣教内容的实用性、宣教方式的便捷性评价均高于对照组,差异均有统计学意义(P<0.05).结论 线上与线下相结合的多途径宣教模式可满足不同层次ART患者的需求,提高宣教质量和患者对宣教内容的知晓率和满意度.

[目的]探讨基于微信平台的人文关怀在宫腔镜检查病人疼痛管理中的应用效果.[方法]采用便利抽样,在郑州某医院门诊室选取病人1033例,按病人接受检查时间阶段分为观察组505例和对照组528例,两组均给予常规护理,在此基础上观察组采用基于微信平台的人文关怀,比较两组病人宫腔镜检查过程中的疼痛程度、宫腔镜检查时间、检查前疼痛信息告知满意度、宫腔镜检查可接受度.[结果]观察组病人疼痛程度、检查时间均低于对照组,疼痛信息告知满意度以及宫腔镜检查可接受度高于对照组,差异均具有统计学意义.[结论]基于微信平台的人文关怀可减轻宫腔镜检查病人的疼痛,提高病人疼痛信息告知满意度,提高病人对宫腔镜检查的接受度.

Objective:To explore the preventive effects of group personalized nursing intervention based on IMB model in high-risk population of gestational diabetes mellitus (GDM) .Methods:Totally 130 high-risk patients with GDM who created medical files and planned to labor in the Third Affiliated Hospital of Zhengzhou University from November 2018 to January 2019 were selected by convenient sampling. Excluding 2 patients with threatened abortion, 9 who did not labor in our hospital, and 3 with invalid questionnaires, finally 116 pregnant women were included, who were divided into the observation group ( n=57) and the control group ( n=59) according to the random number table. Pregnant women in the control group received routine care based on IMB model, while pregnant women in the observation group were divided into several subgroups, including overweight/obesity, advance age, GDM history, and family history groups, with 6-10 cases in each subgroup. Personalized nursing intervention for high-risk factors and lifestyles were provided for different subgroups. The self-made GDM Knowledge Questionnaire, incidence of GDM, oral glucose tolerance test (OGTT) results, weight gain during pregnancy, and pregnancy outcome were used to compare the effects of intervention between the two groups. Results:There was no significant difference in GDM knowledge scores between the two groups before intervention ( P>0.05) , while there was statistically significant difference in GDM knowledge scores between the two groups after intervention ( P<0.01) . The weight gain of the observation group was (13.03±5.58) kg, which was lower than (16.02±4.92) kg of the control group, and the difference was statistically significant ( t=3.068, P=0.003) . The incidence of GDM in the observation group was 12.28%, lower than 28.81% in the control group, and the difference was statistically significant ( P<0.05) . After the OGTT, there was no statistically significant difference in fasting blood glucose between the two groups ( P>0.05) ; there was statistically significant difference between the blood glucose values of the two groups 1 and 2 hours after taking sugar ( P<0.05) . There was no statistically significant difference in the incidence of cesarean section, premature delivery, gestational hypertension, premature rupture of fetal membranes, giant infants, and neonatal hypoglycemia between the two groups ( P>0.05) . Conclusions:Group personalized nursing intervention based on the IMB model is helpful to improve the knowledge level of high-risk population of GDM, and reduce the incidence of GDM and weight gain during pregnancy, and its effects on pregnancy outcome need to be further explored.

目的 综述妊娠期糖尿病的高危因素和预防措施,为妊娠期糖尿病的预防奠定理论基础.方法 以“妊娠期糖尿病高危因素”、“预防措施”作为关键词在CNKI数据库中检索,以“High risk factors of gestational diabetes”、“Prevention measure”作为检索词在Pubmed数据库中检索相关文献.结果 孕前BMI、高龄、糖尿病家族史等是GDM的高危因素;现有的预防措施:风险评估、饮食干预、运动干预、基于网络平台生活方式的干预、药物干预.结论 应尽早的识别高危人群并采取干预措施,对预防GDM的发生具有重要意义.

目的 构建疫情防控常态下适合妇幼保健机构护士长的培训大纲.方法 通过文献回顾,结合临床现状与德尔菲专家咨询法,构建基于岗位胜任力的护士长培训大纲.结果 专家权威系数0.886,培训大纲各维度和条目重要性赋值的变异系数范围分别为0.03 ～0.05,0.05 ～0.18,最终形成理论知识、临床技能、管理能力和个人特质4个维度,涵盖30个条目的妇幼保健机构护士长岗位胜任力培训大纲.结论 疫情防控常态下妇幼保健机构护士长岗位胜任力培训大纲构建方法合理,专家权威程度较高,意见较为统一,且大纲内容涵盖较为全面.

目的:比较过氧化氢低温等离子与戊二醛在宫腔镜灭菌中的应用效果.方法:选取2017年度的218例宫腔镜患者作为A组,采用戊二醛灭菌,选取2018年度632例宫腔镜患者作为B组,采用过氧化氢低温等离子灭菌,比较两组宫腔镜清洗时间、合格率、对洗镜人员的危害.结果:A组灭菌时间比B组长,A组对洗镜人员的危害比B组严重,两组比较差异明显(P<0.05);两组合格率无显著差异(P>0.05).结论:过氧化氢低温等离子在宫腔镜灭菌中效果显著,清洗时间短,合格率高,还不会对洗镜人员产生危害.

目的 编制适用于我国孕妇的自由体位分娩知识问卷并检验其信效度.方法 根据文献回顾和临床经验,制定初始问卷.通过预调查和专家咨询评定形成测试问卷,使用该问卷对169名孕妇进行调查,测定问卷信效度.结果 孕妇自由体位分娩知信行简易问卷包括17个条目,各条目内容效度指数(I-CVI)为0.80～1.00,问卷水平的内容效度指数S-CVI/Ave为0.98,S-CVI/UA为0.88;探索性因子分析提取3个因子,累积方差贡献率为50.300％;问卷总体Cronbach'sα系数为0.791.结论 该问卷具有良好的信效度,可以作为评估孕妇对自由体位知识知晓程度的研究工具.

目的:探讨人性化护理在产科护理中的应用价值.方法:采用便利抽样法选取2015年12月～2017年12月收治的83例产妇为研究对象,按照摸球法分为研究组42例和对照组41例.研究组实施人性化护理,对照组实施常规护理.比较两组护理效果.结果:研究组剖宫产率低于对照组,阴道分娩率高于对照组(P＜0.05);干预后,研究组焦虑及抑郁评分均低于对照组(P＜0.05);研究组护理满意度高于对照组(P＜0.05).结论:产科护理中应用人性化护理,可改善分娩方式,帮助产妇调节心理状态,提升护理满意度.

目的 探讨一对一导师制在助产士临床实践培训中的应用效果.方法 采用目的抽样法选取2016年9月-2017年9月在河南省某三级医院参加培训的54名助产士为研究对象,采用一对一导师制进行临床实践培训,经3个月培训后,比较助产士核心胜任力和一般自我效能感.结果 培训后,助产士核心胜任力的总均分为(4.14±0.33)分,助产士一般自我效能感总分为(29.19±5.74)分,均高于培训前(P＜0.01).结论 对助产士采用一对一导师制临床实践培训,能有效提高其核心胜任力和自我效能感.

目前各种医用内镜在临床诊疗上的应用越来越广泛,在很大程度上提高了诊疗技术. 然而内镜作为侵入性医疗器械,操作过程中难免会被患者体液血液污染. 由于内镜结构复杂,虽经反复清洗消毒,管腔表面的不规则连接、裂缝或磨损等处仍可能存在细菌积累〔1].

目的 探讨宫腔镜检查患者并发心脑综合征的影响因素.方法 选取河南省某妇幼专科医院门诊行宫腔镜检查的患者1 009例,调查心脑综合征发生情况,并分析一般资料和临床资料与心脑综合征发生的关系.结果 心脑综合征的发生率为19.2％,Logistic回归分析显示术中不使用微型钳剪是宫腔镜检查患者并发心脑综合征的保护性因素,而操作时间延长、疼痛、焦虑抑郁得分是宫腔镜检查患者并发心脑综合征的危险因素.结论 宫腔镜检查患者并发心脑综合征受到多个因素影响,临床医护人员可根据不同因素制定针对性干预措施,提高操作熟练度,减少心脑综合征的发生,减轻患者痛苦.

Objective To investigate the present situation of midwifery and the appropriate technical application of midwifery in Henan Province.Methods Using convenience sampling method,questionnaire survey was conducted among 32 tertiary hospitals,47 secondary hospitals and 11 primary hospitals via the platform of midwifery section of Henan Province nursing association.Results For hospitals of different levels in Henan Province,the training rate of midwives was (19.55±20.28)％,80.2％ of the hospitals mentioned there was a need to increase midwives,the rates of natural delivery and perineal side cutting were (50.84±12.16)％ and (40.14±21.15)％,and there were significant differences in the rates of natural delivery and perineal side cutting among hospitals of different levels(P＜0.05).The proportion of application of appropriate techniques of midwifery was as follows:Doula delivery was 49.4％,labor in liberal position was 35.8％,epidural anesthesia was 56.8％,water birth was 4.9％,Lamaze breathing was 60.5％,and music therapy was 24.7％;the main reason for no Doula delivery was the shortage of midwives (75.6％),and the reasons for no labor in liberal position were the midwife had not been trained(57.7％) and there was safety hazard (57.7％).Conclusion The rate of standardized training for midwives was low,and there was a need of increasing midwives in hospitals of all levels in Henan Province.The appropriate technologies of midwifery need to be popularized,and the hospital should strengthen the training of related knowledge and skills for midwives in order to improve work ability,pronote natural delivery,and enhance application of appropriate techniques of midwifery.

Objective To investigate thc current status of perceptions of instructor caring and professional identity of nursing students during the clinical practice in a hospital,and to explore the correlation between them.Methods 595 nursing and midwifery students were surveyed by using self-reporting questionnaires consisted of demographic information,the nursing students' perception of instructor caring (NSPIC) and the professional identity scale during June to July 2017.The relationship between the NSPIC and the professional identity were analyzed by Pearson correlation.Results The total score of 595 nursing students' perception of instructor caring and professional identity were (133.93±11.73) and (43.85±44.69).It was found that the two were positively correlated (r=0.440,P＜0.01).Conclusions The care of nursing students need to be strengthened,and the professional identification of nursing students needs to be improved.The NSPIC has positive influence on nursing professional identity.Instructors should strengthen caring of nursing students to improve their professional identity.

目的 探讨射频消融选择性减胎术围术期护理.方法 回顾性分析6例射频消融选择性减胎术患者临床资料,总结其围术期护理经验.结果 6例孕妇均一次性进针成功,经减胎术后被减胎儿的心脏停止跳动,保留胎儿胎心正常,且未受任何影响,手术成功率100％.术后给予保胎、抗感染治疗及护理,无手术和护理并发症发生,取得良好妊娠结局.结论 射频消融是选择性减胎术的有效选择之一,为复杂性单绒毛膜双胎减胎术提供了一种新的治疗途径.