The beneficial effects of family resilience and meaning in life on patients are established, but limited is known for the effect of perceived social support. We aim to investigate the impact of family resilience on the meaning of life among Chinese patients with breast cancer (BC) and to further detect whether perceived social support mediated this association. From February to June 2022, we conducted this cross-sectional study with 276 women who were diagnosed with BC in a tertial hospital in Guangdong province, China. The Chinese version of Meaning in Life Scale (C-MiLS) was used to measure the meaning in life. The Chinese version of the family resilience assessment scale (C-FRAS) and the perceived social support scale (PSSS) were adopted to obtain the family resilience and perceived social support, respectively. The mediating effect of perceived spousal support was estimated using the bootstrapped confidence interval (CI) via IBM SPSS AMOS 22.0. The mean scores were 60.79 ± 11.63 for meaning in life, 82.08 ± 11.48 for family resilience, and 62.72 ± 12.19 for perceived social support, respectively. Our results indicated the positive correlations of meaning in life with family resilience (β = 0.822, P < 0.05) and perceived social support (β = 0.886, P < 0.05). The perceived social support exerted the mediating effect in the relationship between family resilience and meaning in life (β = 0.368 [95

临床护理实践教学工作既是考验也是挑战,更是一种锻炼和提升,抓牢抓实临床线上教育教学,逐步建立与5G大数据时代相适应的在线教学工作机制,对于临床护理教学工作者来说,是一项重要的工作.目前,国内各种线上教学平台应运而生,广东省中医院研发"护惠教育云平台",开展基于护惠平台的微格闭环教学模式探索.护惠教育云平台是一个云学习系统,医院护理部牵头按照专科分类,进行全院学习视频的编制及系统课程上传.该平台根据护士不同层级,推送相应的学习资料,护生及临床护理人员可通过电子设备随时随地进行针对性的专科学习.护生在护惠教育平台上打卡、学习、参加课程考核、评价课程质量,教师在平台上反馈考核结果予学生,回答学生提出的问题,体现了微格闭环教学的特点.

目的 探讨新入职护士的自主学习能力在组织支持与职业韧性的中介效应,为护理管理及职业韧性研究提供参考依据.方法 于 2022 年 2-3 月,采用一般资料调查表、简化版组织支持感量表、自主学习能力量表以及职业韧性量表,对便利抽样的广东省某三级甲等医院的新护士进行调查.结果 171名新护士的自主学习能力总分为(129.03±17.38)分,组织支持感总分为(46.84±7.32)分,职业韧性总分为(98.20±13.05)分;中介效应分析结果显示,自主学习能力(β=0.641,P＜0.001)和组织支持感(β=0.290,P＜0.001)正向预测职业韧性.自主学习能力在组织支持感与职业韧性之间起部分中介作用,中介效应占比为 57.5％.结论 新护士的自主学习能力在组织支持与职业韧性起部分中介作用.

目的 构建一个科学、实用、全面的中医护理服务标准体系,系统指导中医护理服务标准的修制定工作,使中医护理行业获得良好的服务秩序,从而提高中医护理综合服务能力,推动中医护理服务规范化、标准化、同质化的发展.方法 以《服务业组织标准化工作指南》(GB/T 24421-2009)为准则,参考国内外医疗服务管理标准体系的构建,运用文献研究法、借鉴法、专家会议法等研究方法,收集和整理现行、在制、预制的中医护理服务标准,构建中医护理先进服务标准体系的框架、明细表、编制说明.结果 中医护理服务标准体系包括通用基础标准、服务保障标准及服务提供标准3个基本体系框架,进行二级、三级目录设置,最终共构建了一级主体系3个、二级子体系6个、三级小体系23个,指导修制定了708项中医护理服务相关的标准.结论 构建系统、全面的中医护理服务标准体系,具有较高的科学性和可操作性,体现了中医护理工作的内涵,能有效提升中医护理服务质量和水平.

Background. Fatigue is a common symptom in adults that may cause physical and psychological problems and reduce quality of life. Aromatherapy could possibly provide relief for those suffering from fatigue. Here, we evaluated the effect of aromatherapy on fatigue in adults. Methods. We searched the PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature, SinoMed, Wanfang, and Chinese Scientific Journal Database databases for randomized controlled trials of aromatherapy treatment for fatigue in adults from their inception to June 2021. Two reviewers searched independently, extracted the characteristics of the studies, and assessed the risk of bias using the Cochrane risk-of-bias tool and Stata v. 14.0. Results. Nineteen studies were included in this systematic review. Aromatherapy had a significant effect on fatigue (standardized mean difference −0.64, 95% confidence interval−1.14, −0.15, I2 94.4%, P<0.001). Subgroup analysis according to aromatic type, substance, frequency, treatment duration, intervention, outcomes measurement, and population type showed that aromatherapy had a significantly greater effect in the intervention group, compared to the control group. Funnel plots and Egger’s test indicated no significant publication bias. Conclusion. Our results suggest that aromatherapy ameliorates fatigue in adults who suffer from chronic diseases. A rigorous intervention program and larger randomized controlled trials are needed.

目的 构建基于核心能力的中医专科护士资质认证方案,为我国中医专科护士的资质认证做出探索和提供参考.方法 在前期构建中医专科护士核心能力评价指标体系的基础上,结合文献研究,采用 Delphi法构建基于核心能力的中医专科护士资质认证方案.结果 2轮专家函询结束后,形成包含 3项认证准入指标、12项高级护理实践项目和 12项核心能力认证考核方式的中医专科护士资质认证方案.2轮专家函询问卷有效回收率为 100%,专家权威系数(Cr)分别为 0.947、0.950,肯德尔协调系数分别为 0.257、0.308(P<0.001).结论 本研究构建的中医专科护士资质认证方案具有科学性和临床适用性,可为中医专科护士的培训与认证工作提供参考与指引,有助于提高中医专科护士培养质量,充分发挥中医专科护士优势.

目的 构建中医专科护士核心能力评价指标体系,为中医专科护士的培养与管理提供参考依据.方法 通过文献研究法、理论分析法初步构建中医专科护士核心能力评价指标,采用Delphi法对17名专家进行2轮咨询.结果 整合专家反馈意见后,最终形成包括7项一级指标,22项二级指标,67项三级指标的中医专科护士核心能力评价指标体系;3轮专家咨询的有效应答率均为100％,专家权威系数分别为0.947、0.950、0.962,肯德尔协调系数分别为0.237、0.192、0.173(P<0.05).结论 中医专科护士核心能力评价指标体系科学合理、内容全面,可为我国中医护理人才核心能力的培养、资质认证、岗位任用与管理提供参考依据.

目的 了解近10年患者授权教育研究的热点和发展趋势,以期为我国护理人员推进该健康教育模式的应用提供参考依据.方法 选用Pub Med数据库,检索2010年-2020年患者授权教育相关文献,将文献的主要主题词导入书目共现分析系统(bibliographic items co-occurrence matrix builder,BICOMB)软件进行文献计量学分析,得到高频主题词,形成主题词词篇矩阵、共现矩阵,采用g CLUTO软件进行双聚类分析和可视化分析.结果 最终纳入954篇文献,提取28个高频主要主题词-副主题词;文献计量显示,患者授权教育研究文献量逐年增长.双聚类分析、可视化矩阵显示,近10年该领域研究热点共7个,分别为远程医疗、互联网+健康教育、医患关系、依从性与生活质量、慢性病患者参与决策、电子医疗档案和自我照护.结论 患者授权教育研究处于良好发展态势.研究热点主要集中远程医疗、互联网+健康教育,涉及医患关系、依从性与生活质量、患者参与决策、自我照护,今后可以为研究的切入点,完善、优化患者授权教育研究的内容与质量,以提升患者授权教育的质量.

目的 探讨棍针拨筋疗法治疗原发性痛经的疗效.方法 将2019年6月—2020年9月广东省中医院妇科门诊诊治的102例原发性痛经患者随机分成对照组和观察组,对照组51例给予艾灸神阙、关元及三阴交治疗,观察组51例给予棍针拨筋疗法治疗,2组均治疗3个月经周期.观察2组治疗前后中医症状积分(经期或经前下腹胀痛、得温痛减、肢冷畏寒、经有血块、经色紫黯)、痛经程度评分(VAS评分)、COX痛经症状量表(CMSS)评分变化,比较2组总有效率及治疗安全性.结果 治疗后2组经期或经前下腹胀痛、得温痛减、肢冷畏寒、经有血块、经色紫黯积分,VAS评分、CMSS评分中症状严重程度评分和疼痛持续时间评分均明显降低(P均<0.05),且观察组治疗后以上评分均明显低于对照组(P均<0.05);观察组总有效率为100％(51/51),明显高于对照组90.2％(46/51),差异有统计学意义(P<0.05);2组治疗期间均未出现与艾灸及棍针拨筋疗法相关不良事件.结论 棍针拨筋疗法能够显著缓解痛经疼痛程度,缩短痛经持续时间,且安全,较艾灸疗法效果更好,是临床治疗原发性痛经的有效手段.

目的 调查新型冠状病毒肺炎疫情下医护人员的职业倦怠情况,以了解其工作状态,为减轻其身心压力,提升其工作效能提供依据.方法 2020年1-2月,采用便利抽样方法,选取广东省29家三级甲等综合医院370名临床医护人员作为调查对象.应用MBI-GS职业倦怠调查问卷对调查对象进行问卷调查,并对调查数据进行统计分析.结果 调查对象个人情绪维度得分为2.0(1.0,2.6)分,去人格化维度得分为1.0(0.3,1.8)分,个人成就感维度得分为1.2(0.7,2.8)分.不同科室、职业类别、年龄及职称的调查对象其MBI-GS职业倦怠调查问卷总分的差异均有统计学意义(P＜0.05).急诊科调查对象个人情绪维度得分为2.0(1.4,2.7)分;去人格化维度得分为1.0(0.5,2.0)分;个人成就感维度得分为1.4(0.8,2.8)分.不同年龄、职称的急诊科调查对象其MBI-GS职业倦怠调查问卷总分的差异均有统计学意义(P＜0.05).此外,94.05％的调查对象愿意诊疗/护理新冠肺炎患者,96.49％的调查对象愿意向患者及家属积极宣教新冠肺炎相关防护知识.结论 部分一线医护人员存在职业倦怠,个人成就感需要提升,医院应当关注医护人员的健康需求,合理调配人力资源,降低特殊科室工作负荷,更好地提升医护人员抵抗新冠肺炎的信心和能力.

Objective:To establish the evaluation system of core competence of nurses in the independent traditional Chinese medicine (TCM) nursing clinic, and to provide references for the cultivation and development of nurses in the TCM nursing clinic.Methods:Based on Delphi's expert inquiry, and on the basis of the management norms of TCM nursing clinic in our hospital, and referring to domestic and foreign literatures, an expert inquiry questionnaire on core competence of TCM nursing clinic nurses was compiled. In the form of email questionnaires, 26 experts in the TCM nursing clinic who met the selection criteria were consulted for two rounds.Results:The response rates of the experts in the two rounds were 100.0% and 88.5%, respectively, with the average response rate more than 90.0%. The authority of consultation was 0.906.Conclusion:Experts invited by experts are highly authoritative as a whole and highly responsive to this study. It basically establishes the evaluation system of core competence of nurses in the TCM nursing clinic, and to a certain extent promotes the continuous improvement and development of TCM nursing clinic.

目的:评价广东省10家三级甲等医院心内科护理人力资源效率.方法:采用便利抽样法选取广东省10家三级甲等医院,收集各医院心内科2018年1—12月期间3项护理投入指标(在编护士数、患者人均每日护理工时、床位数)和2项护理产出指标(危重病例数、收治患者总数)数据,运用数据包络分析法进行分析研究.结果:2018年1—12月期间,10家医院心内科平均护理整体效率为0.917,整体效率为1的单元有4个,占40％;平均纯技术效率为0.977,纯技术效率为1的单元有7个,占70％;平均规模效率为0.939,规模效率为1的单元有4个,占40％.结论:各三级甲等医院心内科护理人力资源效率总体不高,存在投入冗余及产出不足等问题.管理者可通过加强岗位科学管理,建立科学的绩效考核制度及培训体系等方式,优化护理人力资源配置,提高护理效率.

目的 探究中医护理门诊护士独立出诊的体验,为进一步完善中医护理门诊管理模式提供参考.方法 对15名护士进行半结构化访谈,采用内容分析法对原始资料进行分析.结果 中医护理门诊护士对独立出诊的体验和感受可归纳为3个主题:中医护理门诊的开展具有积极意义(提升职业认同感;促进职业发展;创造社会及经济效益)、中医护理门诊对执业者及管理者提出新挑战(专业精进,能力提升;优化管理,整合资源)、中医护理门诊存在一定职业风险(职业健康安全;医疗风险).结论 中医护理门诊能够提升护理职业认同感,促进护理职业发展,同时也对护士能力提出了更高要求.在其发展过程中,还需要整合现有资源,重视人才培养及职业安全,促进其不断发展壮大.

Background. Coronavirus disease 2019 (COVID-19) causes psychological distress and can have a negative impact on the general mental health and rehabilitation in affected patients under currently implemented isolation guidelines. Auricular point pressure (APP) as well-established technique in traditional Chinese medicine may help to relieve sleep disturbance and anxiety in COVID-19 patients. Methods. During the early phase of the epidemic/pandemic, patients were enrolled in this study (02/2020 until 03/2020 n = 84). They were strictly isolated on specific wards at the Hubei Provincial Hospital of Integrated Chinese and Western Medicine in Hubei. The retrospective cohort study design included two groups. Group A patients were treated with an auricular point pressure (APP) in addition to standard intensive care medicine while Group B participants (No-APP) received routine nursing measures alone. Treatment outcome was measured using the St. Mary’s Hospital Sleep Questionnaire (SMH) Score and the 7-Item Generalized Anxiety Disorder Scale (GAD-7). Both scores were measured in each patient at baseline and on the discharge day. Results. The SMH score and sleep status changed in APP patients at the end of the treatment period when compared with No-APP patients ( P < 0.01 ). APP-treated patients demonstrated lower GAD-7 scores than No-APP controls ( P < 0.01 ). Further, no significant differences in safety or adverse events between the APP and No-APP groups were observed. Conclusion. The results from our snapshot study during the early phase of the SARS-CoV-2 epidemic/pandemic suggest that auricular point pressure could be a simple and effective tool to relieve insomnia and situational anxiety in hospitalized patients suffering from COVID-19 and kept under disconcerting conditions of isolation.

目的 探讨中医护理门诊护士应具备的资质及执业范围,旨在为中医护理门诊护士的培养与发展提供借鉴.方法 通过文献回顾、理论分析、临床调研等方法初步构建中医护理门诊出诊护士需具备的资质及执业范围;采用德尔菲法,对符合遴选标准的26名中医护理门诊的专家,进行两轮专家咨询.结果 两轮专家的应答率分别为100％和88.46％,平均应答率在90％以上;专家咨询的权威程度为0.906.结论 中医护理门诊护士资质及执业范围的确定科学合理、内容全面、专业特色突出,能为中医护理门诊护士的培养提供可靠的参考依据.

Objective:To investigate the current status and influencing factors of stroke patients.Methods:Using stratified sampling method, 458 stroke patients was investigated for the health behavior from October to December, 2015. Based on PROCEDE-PROCEED model, logistic regression analysis was conducted with the health behavior level of the subjects as the dependent variable, and the characteristic factors in the chi-square test as the independent variables to analyze the factors which influence the health behavior level of stroke patients from predisposing factors, enabling factors and reinforcing factors.Results:The health behavior score of stroke patients was (14.5±3.9), which was at medium level. The score of each dimension was nutrition (0.80±0.25), disease management (0.60±0.26), interpersonal relationship (0.57±0.33), and medication compliance (0.49±0.41). The multiple logistic regression analysis showed that the predisposition factors including age ( OR=2.03, 95% CI=1.08-3.80) and history of hypertension( OR=2.35, 95%=1.16-4.76), the enabling factors including the allocation of social resources ( OR=1.73, 95% CI=0.89-3.36), and the reinforcing factors including family support ( OR=2.03, 95% CI=0.99-4.17) were important factors which affect the health behavior of stroke patients. Conclusion:The health behavior level of stroke patients need to be improved. The relevant community resource allocation system continuously, and focus on the impact of family environment and particularly the elderly and patients with a history of hypertension should be attentioned when improving the health behavior of patients.

目的 基于数据包络分析分析模型,对广东省某三级甲等医院2014—2019年护理人力资源效率及其变化情况进行动态及静态分析,为提高医院各护理单元人力资源配置效率提供依据和建议.方法 采用便利抽样法对广东省某三级甲等医院22个护理单元2014-2019年的人力资源效率数据进行收集,运用数据包络分析传统模型对2014年和2019年的护理人力资源效率情况进行静态分析,并结合Malmquist指数法对2014-2019年人力资源效率的变化情况进行动态分析.结果 研究医院2014年DEA有效的护理单元为6个,占24.3％,平均综合技术效率为0.950;2019年研究医院DEA有效的护理单元为8个,占36.4％,平均综合技术效率为0.896.该研究医院在6年内护理人力资源效率平均增长2.5％,技术效率下降了1.3％,技术进步效率增加了3.8％.结论 研究医院2014-2019年护理人力资源处于稳步上升阶段,技术进步是护理人力资源效率提升的推动因素,综合技术效率是引起该医院护理单元人力资源降低的主要原因.建议管理部门应注重护理人才队伍的建设,培养创新型护理人才,同时根据各科室的专科特色情况优化内部人力资源配置,进一步提高医院护理人力资源利用效率.

本文总结了新型冠状病毒肺炎患者隔离期间常见的心理特点,包括恐惧感、焦虑感、孤独感、悲观感,并初步探讨了相应的中西医结合护理对策.

ETHNOPHARMACOLOGICAL RELEVANCE:Constipation is a functional gastrointestinal disorder and one of the most prevalent conditions encountered in primary care settings. Rhubarb navel dressings have been used for more than 2,000 years in Chinese medicine to treat constipation. However, the effect of topical rhubarb administration has still not been well recognized and this strategy is not yet established as an evidence-based approach. AIM OF THE STUDY:In this study, we performed a prospective multicentric randomized controlled trial to evaluate the efficacy and safety of rhubarb navel plasters for patients with chronic constipation. MATERIALS AND METHODS:A total of 374 patients from six teaching hospitals were prospectively included between 09/2016 and 10/2017 in the study based on Rome III criteria. All participants were randomly assigned (1:1) into verum/placebo group and given either Rheum officinale rhubarb powder or a placebo flour stick on the navel for 6 h/day/8 days. Primary outcome measures were the Cleveland Constipation Score (CCS) for the feces condition and Bristol Stool Scale (BSS) for stool consistency and 24 h defecation frequency. RESULTS:The groups demonstrated no statistical differences in demographic data, clinical diagnoses and concomitant medication at baseline. In patients treated with the verum CCS was 5.61 (day 8, 95% CI 5.15-6.07) compared to 8.62 (95% CI 8.07-9.18) in placebo-treated controls (P < 0.001). The mean change of CCS at the end of treatment (day 8 versus [vs] day 0) was 6.04 in verum-treated vs 2.73 in placebo-treated controls (P < 0.001). Also 24 h defecation frequency (BSS) showed superior results (day 5: 0.84 vs 0.62, 95% CI 0.67-0.80, P < 0.001; day 6: 0.82 vs 0.60, 95% CI 0.64-0.78, P < 0.01 and day 8: 0.82 vs 0.60, 95% CI 0.64-0.78, P < 0.01) and better BSS type classification during treatment than controls (P < 0.05). No significant differences in adverse events between both groups became obvious. CONCLUSION:Rhubarb navel plaster administration over an 8-day-treatment period resulted in significantly improved bowel function as demonstrated by the CCS, 24 h defecating frequency and BSS. Our results suggest that rhubarb navel plasters represent a feasible, safe and efficient application route for the treatment of patients suffering from chronic constipation.