Objective:To explore the application effect of BOPPPS teaching(bridge-in, objective, pre-assessment, participatory learning, post-assessment, summary) model based on comprehensive surgical nursing cases in higher vocational nursing students.Methods:The nursing students of three-year higher vocational nursing in a vocational college in Jiangsu province were involved in the study. Two classes were randomly selected and divided into observation group (54 students) and control group (53 students). Students in the observation group were taught with BOPPPS teaching model that required comprehensive case resources of surgical nursing, while students in the control group were taught with traditional case-based learning. At the end of the course, the differences of students' comprehensive assessment scores, learning feelings and teachers' teaching skills evaluation were compared between the two groups. SPSS 20.0 was used for t test. Results:The comprehensive curriculum assessment results of nursing students in the observation group were higher than those of the control group [(65.20±10.08) scores vs. (60.97±10.41) scores], with statistical significance in the differences ( t=2.141, P=0.035). The total learning feeling scores of the observation group was higher than those of the control group [(77.50±4.93) scores vs. (72.21±7.15)], with statistical significance in the differences ( t=4.45, P<0.001). The scores of teachers' introduction, demonstration, questioning, change, organization, strengthening and ending skills in the observation group were higher than those in the control group, with significant differences ( P<0.05). Conclusion:BOPPPS teaching model based on comprehensive surgical nursing cases can optimize teaching design, improve teaching effect, and promote learning and teaching interactively.

目的 探讨双能CT碘浓度在定量预测甲状腺乳头状癌颈部淋巴结转移的临床价值.方法 回顾性分析97例甲状腺癌患者术前双能CT图像,依据病理结果分为非颈部淋巴结转移组与颈部淋巴结转移组.术前均行双能CT平扫加增强扫描,并经Liver VNC软件测量病灶及正常甲状腺组织碘浓度(IC),测得正常甲状腺碘浓度(1C甲状腺)、病灶碘浓度(IC病灶)、病灶与IC甲状腺差值(ICD)及ICD与IC甲状腺比值(ICDNR病灶),两组间各参数采用两独立样本t检验,绘制受试者工作特征(ROC)曲线并比较其诊断效能.结果 分别比较非淋巴结转移组与淋巴结转移组平扫、动脉期及静脉期IC病灶、ICD病灶、ICDNR病灶的值,平扫及动脉期在两组变量的比较中无明显统计学意义(P＞0.05),静脉期IC病灶、ICD病灶、ICDNR病灶的值的差异均有统计学意义(P＜0.05);根据静脉期结果绘制ROC曲线,曲线下面积(AUC)分别为0.477、0.744、0.730,三者截断值分别为1.65、1.35、0.283,敏感度分别为0.90、0.725、0.825,特异度分别为0.175、0.667、0.579.结论 静脉期IC病灶、ICD病灶、ICDNR病灶的值能有效预测甲状腺乳头状癌颈部淋巴结转移,其中静脉期ICD病灶诊断效能最高.

目的 探讨最佳颈部单能量CT值鉴别诊断甲状腺腺瘤与乳头状癌的价值.方法 回顾性分析2018年1月至2019年7月淮安市第一人民医院收治入院且经术后病理确诊的171例甲状腺肿瘤患者颈部CT资料,依据术后病理将患者分为腺瘤组(81例)及乳头状癌组(90例).比较两组患者术前最佳颈部单能量CT检查的病灶CT值(CT病灶)、甲状腺CT病灶与同一层面甲状腺正常组织CT值(CT正常组织)的比值(NCT T)及甲状腺CT病灶与同一层面颈总动脉CT值(CT颈总动脉)的比值(NCT A).以肿瘤组织病理检查结果为金标准,绘制最佳颈部单能量CT值诊断腺瘤受试者工作特征(ROC)曲线,计算CT病灶、NCTT、NCTA诊断甲状腺腺瘤及乳头状癌的灵敏度、特异度,比较CT病灶、NCTA及NCTT诊断腺瘤的ROC曲线下面积(AUC).结果 乳头状癌组CT病灶、NCTA、NCTT较腺瘤组较低,差异有统计学意义(P<0.05);CT病灶、NCTA、NCTT诊断甲状腺腺瘤的曲线下面积分别为0.949、0.924、0.927,其截断值分别为134.8 HU、0.860、0.844,对应的灵敏度分别为0.864、0.877、0.790,特异度分别为0.922、0.844、0.956.结论 甲状腺腺瘤患者最佳颈部单能量CT值较乳头状癌患者显著升高.颈部单能量CT值对甲状腺腺瘤与乳头状癌鉴别诊断有一定的价值,其中CT病灶识别甲状腺腺瘤的效能最高.

目的 观察临床护理路径管理在CT引导下胸腔镜肺小结节切除术患者中的应用效果.方法 选取肺小结节患者120例作为研究对象,随机分为路径组与对照组,每组60例,均行CT引导下胸腔镜肺小结节切除术.对照组实施胸外科围术期常规护理措施,路径组在此基础上实施临床护理路径管理.比较2组患者术后首次下床时间、胸腔引流管留置时间和住院时间,比较2组患者干预前后自理能力评分(Barthel指数评定量表评分)、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分和术后不同时点数字疼痛量表(NRS)评分.结果 路径组术后首次下床时间、胸腔引流管留置时间、住院时间均短于对照组,差异有统计学意义(P＜0.05).干预前,2组患者自理能力评分、SAS评分、SDS评分比较,差异无统计学意义(P＞0.05);干预后,路径组自理能力评分高于对照组,SAS评分、SDS评分低于对照组,差异有统计学意义(P＜0.05).术后12、24、48 h时,路径组NRS评分均低于对照组,差异有统计学意义(P＜0.05).结论 将临床护理路径管理应用于CT引导下胸腔镜肺小结节切除术患者,能有效缩短胸腔引流管留置时间,减轻术后疼痛和减少不良情绪,并缩短住院时间.

Objective:To explore the correlation among resilience, self-management and fear of progression in patients with inflammatory bowel disease, so as to provide a reference for clinical treatment and nursing of patients.Methods:From January 2020 to December 2021, 141 patients with inflammatory bowel disease who were hospitalized in the Department of Gastroenterology, the Affiliated Huaian First People's Hospital of Nanjing Medical University, were selected by convenience sampling as the research object. Questionnaires were conducted on the patients using the General Information Questionnaire, the Self-Management Behavior Scale for Patients with Inflammatory Bowel Disease, Connor-Davidson resilience scale (CD-RISC) , and the Fear of Progression Questionnaire-Short Form (FoP-Q-SF) .Results:Among 141 patients with inflammatory bowel disease, the total scores of the Self-Management Behavior Scale for Patients with Inflammatory Bowel Disease, CD-RISC, and FoP-Q-SF were (126.69±26.67) , (67.65±12.52) , and (30.25±9.23) , respectively. Pearson correlation analysis showed that the total score of the CD-RISC in patients with inflammatory bowel disease was negatively correlated with the total score of the FoP-Q-SF ( r=-0.68, P<0.05) . The total score of the Self-Management Behavior Scale for Patients with Inflammatory Bowel Disease was negatively correlated with the total score of the FoP-Q-SF ( r=-0.52, P<0.05) , and the total score of the CD-RISC was positively correlated with the total score of the Self-Management Behavior Scale for Patients with Inflammatory Bowel Disease ( r=0.72, P<0.05) . Conclusions:Both resilience and self-management in patients with inflammatory bowel disease were negatively correlated with fear of progression. Medical and nursing staff can enhance the resilience of patients and improve their disease self-management by formulating relevant intervention strategies, thereby effectively reducing their fear of progression.

OBJECTIVES:Nursing factors have been found to be associated with a reduction in readmission rates. Nevertheless, few attentions have been given to the effect of nursing factors on nursing home (NH) residents. This study was to assess the impact of nursing factors on the hospital readmissions and length of stay (LOS) of the elderly residents from the NH.STUDY DESIGN:This was a cross-sectional study.METHODS:Data were extracted from the NH of the LTCFocus.org data set between 2011 and 2018. The study included residents aged ≥55 years who were admitted to NH in the United States, following a hospitalization event. The nursing factors included facility-level data elements and medical care personnel. An unsupervised machine learning algorithm (K-means) was used to cluster NH according to readmission rate and LOS. Multivariate logistic regression analysis was performed.RESULTS:This study consisted of 107,000 NH-year observations. The median readmission rate was 17%, with a median LOS was 28.00 days. Three clusters were identified: cluster 1 was a high readmission rate with high LOS, cluster 2 was a low readmission rate with low LOS, and cluster 3 was a high readmission rate with low LOS. Multifacility and admission/bed were associated with a reduction in readmission rate and LOS in both cluster 1 vs cluster 2 and cluster 3 vs cluster 2. The special care unit and registered nurses' ratio were associated with decreased readmission rate and LOS in cluster 1 vs cluster 2. Total beds and Alzheimer unit decreased the readmission rate and LOS, whereas certified nursing assistant increased the readmission rate and LOS in cluster 3 vs cluster 2. NH for profit was associated with elevated readmission rate and LOS in cluster 1 vs cluster 2 and decreased readmission rate and LOS in cluster 3 vs cluster 2. Based on the subgroup analysis, the certified nursing assistant decreased readmission rate and LOS in cluster 1 vs cluster 2 and increased readmission rate and LOS in cluster 3 vs cluster 2 (all P < 0.005).CONCLUSION:This study indicates the importance of the improvement of nurse number and level and the inputs of facility characteristics in NH.

目的:探讨高职实习护生的专业认同与一般学业情绪的相关性.方法:以方便抽样原则,借助问卷星平台,使用护生专业认同感问卷、大学生一般学业情绪问卷,对江苏省某高职院426名实习护生展开调查.结果:高职实习护生的专业认同感为(90.55±10.25)分,其专业认同总分、专业期望均高于本科护生,专业情感低于本科护生,具有显著差异(P>0.05);护生的消极唤醒情绪与专业认同呈负相关,专业技能分项目与积极高唤醒情绪维度之间呈显著正相关(P<0.05)、专业意志与积极低唤醒情绪维度之间呈显著负相关(P<0.05).结论:高职实习护生的专业认同现状不够理想,与学业情绪密切相关;可通过培养其良性学业情绪来提升护生专业认同感.

目的 构建基于需求分析理论的外科护理综合案例资源库,探讨其在教学中的应用效果.方法 将198名护理专科护生随机分为对照组(n=98)和观察组(n=100),对照组学生应用传统案例教学,观察组学生采用基于需求分析理论构建的外科护理综合案例资源库进行教学.课程结束后,观察两组学生理论知识、实践技能考核成绩、学生的自身学习感受及对教师教学技能的评价.结果 观察组学生的理论和实践技能成绩优于对照组,除人文关怀能力项目外,观察组护生对教学效果评价各项的评分均高于对照组,对教师的提问、讲解、语言、变化、强化、结束技能的评分均高于对照组(均P<0.05).结论 将基于需求分析理论的外科护理综合案例资源库应用于教学中,可提高学生自主学习意识及理论知识、实践技能考核成绩,培养其职业能力,提升教师教学能力,提高课堂教学效率.

目的 探讨基于网络平台的协同育人机制对高职实习护生学业情绪的影响.方法 采取方便抽样法,选择江苏省某高职院校2014级实习护生255名,按随机数字表法分为对照组(127名)和观察组(128名).对照组采用常规模式进行管理,观察组采用基于网络平台的协同育人机制进行管理.实习结束后,比较两组实习综合考核成绩、实习感受以及学业情绪的差异.结果 观察组实习综合考核成绩、实习感受均优于对照组,差异有统计学意义(P＜0.05).在学业情绪方面,观察组积极高唤醒维度总分及兴趣、愉快、希望项目得分,积极低唤醒维度的自豪项目得分,消极高唤醒维度的焦虑项目得分均显著高于对照组,差异有统计学意义(P＜0.05);观察组消极低唤醒维度总分及失望、厌烦项目得分,消极高唤醒维度的羞愧和气氛项目得分,积极低唤醒维度的放松项目得分均显著低于对照组,差异有统计学意义(P＜0.05).结论 基于网络平台的协同育人机制有助于提高实习效果,培养护生积极学业情绪.

目的 探讨网络学习平台下远程导师制对专科实习护生自主学习能力的影响.方法 以2016级专科实习护生为研究对象,分为观察组(104人)、对照组(103人).护生实习期间引入网络学习平台,对照组采用常规学习管理模式,观察组采用远程导师制进行管理.实习结束后,比较两组护生的理论及技能得分、学习满意度、自主学习能力的差异性.结果 观察组护生的理论及技能得分、学习满意度得分、自主学习能力得分均显著高于对照组,差异有统计学意义(P＜0.05或P＜0.01).结论 网络学习平台下远程导师制可提升实习护生的自主学习能力,增强实习效果,深化护教融合.

Objective To investigate the present condition and influencing factors of falling in the elderly apartment,so as to provide empirical basis for the prevention of falling management among the elderly in the elderly apartment.Methods General information questionnaire and the community elderly fall risk assessment questionnaire were used to investigate the falling situation in 677 elderly in the elderly apartment.Results Totally,180 cases of 677 elderly people had fell before,the falling rate was 26.59％,sex,disease species affecting balance,subnormal vision,abnormal physical sensory,functional behavior assessment,walking safely in their own home,risk factors in home environment in the elderly apartment.Conclusion The elderly falling rate is higher and especially related with gender and disease species affecting balance.Fall risk should be controlled,optimizing the environment of the elderly apartment,strengthening the balance and control of sports training,in order to reduce the incidence of the elderly fall in elderly apartment.

Objective To investigate the incidence of falls in elderly people in a community of Suzhou during the past year and to provide evidence of preventive interventions. Methods The study collected 1 342 elderly people aged 60 and above, from a community of Suzhou using the method of cluster sampling. The participants were face-to-face interviewed their falling experiences during last year. Results A total of 223 people of the participants had falling experiences and occurred 392 times of falling during last year, and the falling incidence was 16. 62%. Among these cases, 650 (22. 62%) were female;692 (10. 98%) were male;the incidence of female was higher than the male (χ2 =32. 734,P<0. 01). The falling incidence rates of age 60-69, 70-79, 80 -89 and over 90 were 11. 33%, 16. 40%, 18. 52%, 26. 67%; falling incidence was increased with the age (χ2 =11. 261,P<0. 01). In 223 falling cases, only 5. 38% had not injured;72. 65%had soft tissue injury;18. 39% were bruised; 3. 59% had fractures and 62. 50% of them were hip fracture. 75. 35% of the people who had falling experience were afraid of second-time falling, while 32. 74% had limited the activities because of falling. Conclusions The falling incidence is very high in this community and falling experiences have negative effects on both physical and psychological health in elderly people. For this reason, effective preventive interventions are urged for these groups.

Objective To evaluate the effectiveness of trans-theoretical model ( TTM ) based intervention for patients with hypertension to promote physical activity. Methods A total of 118 patients were selected and randomly divided into experimental group (n=56) and control group (n=62) by random number table. The patients of the experimental group received the TTM-based intervention while the patients of the control group received the conventional intervention. The results of two groups were compared. Results The score of behavior changing stage and motor behavior of different follow-up time in two groups had significant differences (F=46. 37,50. 44;P <0. 01). The systolic pressure was (124. 93 ± 10. 29) mmHg, diastolic pressure (78.32 ±8.42) mmHg in the experimental group that were lower than (133. 24 ± 11. 87), (83. 02 ± 7.97)mmHginthecontrolgroup(t= -4.05, -3.11; P<0.01).Conclusions TTMbasedinterventionis effective for patients with hypertension to promote physical activity.

目的：了解急性心肌梗死（AMI）患者家属在患者住院期间的照护需求，为制定针对性的护理干预措施提供理论依据。方法采用质性研究中的现象学研究法，以半结构访谈法访谈AMI患者的家属照顾者21名，并以Colaizzi 7步分析法分析资料。结果经归纳，分为7个主题，分别为疾病知识需求、手术信息需求、药物指导需求、照顾技能需求、康复指导需求、家庭支持需求及医患、护患沟通需求。结论 AMI患者家属在院期间存在的照护需求较多，及时了解并满足家属的不同需求可一定程度地减轻家属照顾压力、提高其照护能力，促进患者康复。

Objective To explore the reliability and validity of Chinese version Family Caregiver Task Inventory( FCTI ) in the relatives of acute myocardial infarction patients .Methods Totals of two class-A hospitals were selected in Suzhou by convenience sampling method , 195 cases of acute myocardial infarction patients′relatives were surveyed .Results The Cronbach′sαof FCTI was 0.867.The Cronbach′sαof the five branch scales was 0.617 -0.694.The split-half reliability was 0.900.The split-half reliability of the five branch scales was 0.605-0.750.The results of the factor analysis showed that there were seven main factors , which showed a cumulative variance rate of 57.384%.Each factors had a load capacity of 0.484 -0.796, which was all over 0.04.Conclusions The Chinese version FCTI has a great reliability and validity , so it fits to evaluate the care ability of acute myocardial infarction patients′relatives .

当前国内就医病人的输液量较大,2009年我国医疗输液达104亿瓶,相当于该群体人均输液8瓶[1]。而这一类人群中,儿童、老年人占较大比例,由于他们自身忍耐性较差,或监护人的疏忽,极易发生脱针、渗液等现象,给病人带来不必要的痛苦。目前临床解决办法主要为在病人输液部位下放置直板式输液固定板起固定作用,这类装置虽然在某些程度上可起预防脱针的作用,但由于缺乏个性化定制,影响病人舒适度,具有一定局限

Objective To investigate the level and influencing factors of self-efficacy among nurses with needlestick injuries and explore effective strategies to improve self-efficacy.Methods 713 clinical nurses with needlestick injuries had been enrolled by convenience and stratified sampling method to comphte the investigation using the self-designed demographic questionnaire and General Self-Efficacy Scale.Results The average score of the self-efficacy was (2.70 ±0.52) points.69.1％ of the needlestick injury nurses had the sclf-efficacy score at the middle level; only 19.1％ of them had a higher level score on self-efficacy.Gender,title,section,initiative report,work environment,and occupational safety training were identified as the influencing factors of the self-efficiency.Conclusions Even though more than half of the nurses with needlestick injuries had a middle level self-efficacy,they need further improvement.Other influencing factors should be explored in future in order to develop the corresponding management intervention which can strengthen the self-efficacy of nurses with needlestick injuries.