AIMS AND OBJECTIVES:To investigate the use of physical restraints in aged care facilities(ACFs)and analyse its associated risk factors.BACKGROUND:Physical restraints have been widely used in ACFs worldwide, but they can cause physical and mental harm to older people. It is important to regulate the use of physical restraint.DESIGN:A cross-sectional observational and correlational multicentre study.METHODS:By convenience sampling method, we selected eight ACFs in four representative regions of Hunan province, China, for this study. The ACF-related information was obtained by interviewing the managers and reviewing records. We conducted investigation and observation on the elderly in the ACFs to understand the use of physical restraints at three different times: 9:30-11:30, 16:00-18:00 and 19:30-21:30 on a working day. The STROBE checklist was followed for this cross-sectional study.RESULTS:This study found that the utilisation rate of physical restraints was 23.2%. The critical risk factors affecting the use of physical restrains include the following: (1) the ratio of nursing staff to the elderly residents; (2)whether there is a dementia care unit at the facility; (3) the number of elderly residents in each room; (4) the elderly residents' age, degree of education, marital status, care dependence and cognitive impairment; (5) whether the elderly has suffered from a stroke or senile dementia; (6) whether the elderly carries medical catheters.CONCLUSION:There is a lack of standardisation in the use of physical restraints in ACFs of central China. Chinese ACFs should develop guidelines and reduction measures to standardise the use of physical restraints, basing on the key factors affecting the use of physical restraints.RELEVANCE TO CLINICAL PRACTICE:The use of physical restraints in ACFs is threatening the safety of the elderly residents. Understanding the implementation of physical restraint in ACFs can provide reference for reducing the use of physical restraint.

Objective:To systematically evaluate the attitudes and experiences of nursing assistants in nursing homes on physical restraint, so as provide a reference for regulating and reducing the physical restraint.Methods:Cochrane Library, PubMed, Embase, EBSCO, Web of Science, China Biology Medicine (CBM) , China National Knowledge Infrastructure, WanFang Data, VIP and other domestic and foreign databases were searched by computer. The retrieval time limit was from the establishment of the database to June 2021. The quality of the article was evaluated using the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center in Australia, and the Meta synthesis was used to summarize and interpret the results.Results:A total of 7 articles were included, and 58 results, 11 categories and four synthesis results were extracted. That was, the factors that affected the implementation of physical restraint (the elderly's own factors, the factors of nursing assistants, the influence of other personnel, the factors of elderly care institutions) , the attitude towards physical restraint (support attitude, opposition attitude and neutral attitude) , emotional experience and release methods (emotional experience and ways of release) , existing deficiencies and suggestions for restraint use (existing deficiencies, related suggestions) .Conclusions:The use of physical restraint in elderly care institutions is the result of many factors. Nursing assistants have positive, negative and neutral attitudes and emotional experiences in the implementation of physical restraint, and based on their rich clinical experience, they can find existing problems in restraint use and make relevant suggestions. Relevant departments need to fully consider the interests of all parties when formulating physical restraint norms and restraint reduction strategies, and effectively solve the problem of physical restraint abuse from the root cause.

综述养老机构老年人身体约束和跌倒的研究进展,从高跌倒风险会增加老年人身体约束的使用、使用身体约束会增加跌倒的发生风险、减少或解除身体约束以及实施身体约束替代措施会减少跌倒的发生3个方面进行阐述,为养老机构最大限度减少身体约束提供参考.

目的 探讨新护士入科指引单在护理管理中的应用效果.方法 将全院36个病区的新护士随机分为对照组(n=40)和观察组(n=35).对照组新护士入科采用护士长经验口头指示的方法完成相关报到入职事项,观察组新护士入科按照入科指引单上所规定事项在限定时间内完成报到入职事项.比较两组新护士指引单内规定事项的完成情况.结果 入职1周和入职1个月后,观察组新护士的指引单完成率均明显高于对照组(P<0.05).结论 入科指引单的应用使新护士入科管理规范化,能够提高护理团队的执行力,提高护士和管理者对护理管理工作的满意度,值得借鉴和推广.

目的 了解医院护理人员离职意愿现状及相关影响因素,为护理管理者制定减少护理人员离职意愿的政策提供参考依据.方法 2017年1月,通过填写一般情况调查问卷、离职意愿量表和抑郁焦虑压力量表中文精简版,对长沙市某三级甲等综合医院自愿参加的369名护理人员进行调查.结果 参与调查的护理人员离职意愿总分为(15.77±3.25),指标值为65.7%;离职意愿总均分为(2.63±0.54),离职意愿处于较高或很高程度的达84.6%;单因素分析结果显示,不同性别、年龄、健康状况、有无健康问题、有无行政职务、工作年限、专业技术职称、晚夜班频率、所在科室系统、抑郁程度、焦虑程度、压力程度的护理人员的离职意愿得分差异有统计学意义(P<0.05);多元线性回归分析结果显示,年龄较轻的护士离职意愿高于年龄较大的;随着抑郁、焦虑程度的加重离职意愿增高;精神科护士离职意愿最高、辅助科室护士离职意愿最低(P<0.05).结论 长沙市某三甲医院护理人员离职意愿处于较高水平,年龄、抑郁、焦虑等级和所在科室系统是其离职意愿的主要影响因素.

目的 了解临床护理人员社会支持和负性情绪的现状,探讨两者之间的相关性.方法 采用社会支持评定量表(SSRS)和抑郁焦虑压力量表中文精简版(DASS-C21),对长沙市某三级甲等专科医院369名临床护理人员进行问卷调查.结果 该院护理人员社会支持总分为(36.93±8.248)分,焦虑是该院临床护理人员中最常见的负性情绪(55.3%),其次为抑郁(49.3%),压力相对较低(34.7%);社会支持程度与负性情绪抑郁、焦虑、压力均呈负相关(P<0.01).结论 本次研究的临床护理人员社会支持总分处于中等水平,焦虑、抑郁、压力等负性情绪较重,社会支持各维度与负性情绪焦虑、抑郁、压力均呈负相关,可以考虑从增加社会支持力度着手,改善或缓解护理人员的负性情绪.

总结了98例帕金森患者行脑深部电刺激术的护理措施。主要包括术前处理、术后护理、出院指导等。认为经过良好的全程的专科护理，提高了患者对手术治疗的耐受力，减少了手术并发症，促进了手术后的康复。

目的：对50例康复期精神分裂症患者进行统合型房树人绘画治疗，探讨绘画治疗对精神分裂症患者病情康复影响的研究。方法对50例康复期精神分裂症患者进行每周2次的统合型房树人绘画治疗，连续1个月，接受测验前和测验结束后，分别用护士用住院病人观察量表（ NOSIE）和简明精神病量表（ BPRS）进行评定并进行比较。结果经绘画治疗后精神分裂症患者的NOSIE各项因子得分与治疗前比较显著改善，差异有统计学意义（P＜0．05，P＜0．001）；经绘画治疗后精神分裂症患者的NOSIE病情总估计分和总积极因素分有明显增高、总消极因素分有明显下降，3个项目的总分在绘画治疗前后的变化经统计学处理差异有统计学意义（P＜0．001）；绘画治疗前后，50例精神分裂症患者的BPRS总分与NOSIE病情总估计分比较均呈负相关（r1＝－0．407，r2＝－0．05）。结论绘画治疗可以改善患者的负性情绪和消极行为，促进患者积极人格的发展；护士参与绘画治疗可以促进绘画治疗这一心理康复措施在临床顺利开展；同时护士用NOSIE配合BPRS评分有利于护士对患者的康复过程进行量化观察，及时调整护理对策，提高患者疗效，促进患者的康复。

目的 探讨冠心病患者冠状动脉介入术后并发症的发生状况和护理对策.方法 回顾性分析183例在我院介入治疗中心接受经桡动脉或股动脉行冠状动脉介入治疗术的患者的临床资料,总结术后并发症发生情况及采取的相对应处理措施.结果 183例患者冠状动脉介入术后发生并发症为55例,其中,血管并发症23例、尿潴留11例、迷走神经反射8例、造影剂相关肾病6例、造影剂副反应5例以及骨筋膜室综合征2例,经及时处理后,均予以纠正.结论 冠状动脉介入术后应注意观察有无血管并发症、尿潴留、迷走神经反射、造影剂相关肾病、造影剂副作用等并发症的发生,及时采取针对性的治疗和护理措施,将并发症的危害降至最低,更好地保障患者的安全.

目的评价护理干预对减轻居家阿尔茨海默病患者照顾者抑郁、焦虑情绪的效果,为居家阿尔茨海默病患者及其照顾者的社区护理干预提供依据。方法将152例临床诊断的阿尔茨海默病患者的照顾者随机分为对照组和干预组,分别于干预前和干预后3个月、6个月、9个月、12个月,使用一般情况问卷、抑郁自评量表(SDS)、焦虑自评量表(SAS)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评定并比较2组照顾者的抑郁、焦虑情绪。结果实施护理干预后,干预组照顾者SDS、SAS、HAMD及HAMA分值与对照组照顾者相比,差异有统计学意义(P<0.05)。结论针对居家阿尔茨海默病患者照顾者的护理干预有助于缓解照顾者的抑郁及焦虑情绪。

总结了137例DSA引导下行经皮腰椎间盘造影后行微创介入治疗腰椎间盘突出症患者的围手术期护理体会。主要护理措施包括加强治疗前后的基础护理和心理护理,对应的术中护理与相应配合,术后康复锻炼及日常保健的指导。认为通过有针对性地加强患者围术期的护理,可以取得患者更好地配合,保证手术的顺利进行,提高治愈率;更好地保障患者的安全,促进病情康复,减轻患者的痛苦,改善患者的生活质量。

总结128例原发性三叉神经痛患者在DSA引导下经皮卵圆孔穿刺行射频温控热凝术的并发症发生状况和护理措施.本组术中出现血压上升45例,一过性胸闷、心率加快3例,采取对症护理后好转,继续进行手术;恶心、呕吐1例,手术不能进行,送回病房对症处理;术后发生面部麻木67例,咀嚼肌无力20例,眼部干涩和角膜反射迟钝3例,实施心理护理安抚患者,症状可自行消失;面部穿刺点肿胀33例,给予冷敷和热敷干预;头痛、头晕、恶心、呕吐5例,给予对症护理和遵医嘱用药;结膜下充血1例,注意保护患者眼睛,佩戴防风镜.本组患者术后疼痛消失72例,疼痛明显缓解43例,疼痛有所缓解11例,疼痛无缓解2例,总有效率达98.4%.术后半年内复发者5例,0.5～3.5年内复发者7例,再次手术后疼痛消失.

总结了137例DSA引导下行经皮腰椎间盘造影后行微创介入治疗腰椎间盘突出症患者的围手术期护理体会.主要护理措施包括加强治疗前后的基础护理和心理护理,对应的术中护理与相应配合,术后康复锻炼及日常保健的指导.认为通过有针对性地加强患者围术期的护理,可以取得患者更好地配合,保证手术的顺利进行,提高治愈率;更好地保障患者的安全,促进病情康复,减轻患者的痛苦,改善患者的生活质量.

总结50例急诊介入止血患者手术的护理措施,包括介入术前心理护理,术前准备,术中配合和术后护理等,认为加强术前、术中、术后的观察与护理是保证急诊介入止血手术取得满意疗效的基础。

患者男,68岁.因高血压病10年,糖尿病5年,双下肢痛2年,于2006年11月28日17:30入院.查:BP180/110 mmHg,双肺清,心界向左下轻度扩大,心率84次/min,律齐,无杂音,双下肢无浮肿,无色素沉着、溃疡,双下肢膝关节以下压痛,尤以左下肢腓肠肌明显,深浅感觉正常.