目的 编制重症监护室(ICU)护士早期活动感知阻碍量表并进行信效度检验.方法 以技术-组织-环境(TOE)模型为理论指导框架,通过系统文献回顾、专家头脑风暴、专家函询、预调查形成量表初稿.采用 目的抽样法选取北京市5家三甲医院的ICU护士进行调查,于2020年8-12月完成测试量表调查(纳入有效问卷284份),于2021年8-9月完成正式量表调查(纳入有效问卷186份),对量表进行条目筛选及信效度检验.结果 形成的量表包括4个维度33个条目.探索性因子方面共提取4个因子,累积解释总方差变异为64.484％.验证性因子分析显示,x2自由度为2.668,近似误差均方根为0.078,均方根残差为0.043,拟合优度指数为0.972,规范拟合指数为0.926,比较拟合指数为0.968,表明量表结构稳定.量表Cronbach's α系数为0.891,重测信度为0.887,内容效度为0.92,各维度与问卷相关系数为0.606～0.823.结论 ICU护士早期活动感知阻碍量表信效度良好,可用于评价ICU护士早期活动感知阻碍水平.

随着我国人口高龄慢病化、失能失智化趋势的到来,长期照料需求的持续增长不可避免.受当前尚不健全的社区医养体系及传统孝道观念的影响,患者的日常照料主要由其家属承担,由此家庭照顾者角色在长期照料体系中的重要性日益凸显.研究显示,家庭照顾者在照护过程中所显现的健康赋权能力与患者的日常生活自理能力密切相关﹝1,2﹞;有效的照顾者赋权行为对患者疾病自我意识、自我决策的增强有着深刻影响﹝3﹞;不仅能够激发患者的自主责任意识,还能够大大提升家庭功能,促进家庭福祉﹝4﹞.关注家庭照顾者的健康赋权能力,或可为优化慢病管理、解决长期照护困境提供新视角.本文拟对近年来家庭照顾者健康赋权的相关研究进行阐述.

目的 基于Meta分析结果和Logistic回归模型,构建急性缺血性脑卒中复发风险预测模型.方法 系统搜集建库至2019年5月探讨急性缺血性脑卒中复发危险因素的相关文献,进行质量评价和资料提取后,通过Meta分析计算各相关危险因素的综合危险度,并在此基础上构建Logistic回归风险预测模型.结果 共纳入34篇文献,累计总样本量为235628例,复发样本量达28189例.Meta分析结果显示,目前吸烟、心脏病发作史、合并高血压、合并糖尿病、高纤维蛋白原、低密度脂蛋白/高密度脂蛋白(LDL/HDL)、他汀类药物依从性等为急性缺血性脑卒中复发的独立危险因素,综合危险度分别为:1.883、1.938、2.163、1.605、1.722、2.226和3.190,相应的Logistic风险预测模型为:Logit(P)=α+0.633X1+0.662X2+0.771X3+0.473X4+0.543X5+0.8X6+1.16X7.结论 基于循证构建的急性缺血性脑卒中复发风险预测模型,对于预防、管理急性缺血性脑卒中群体的复发具有一定的现实借鉴价值.

目的 明确颅脑肿瘤术后患者发生静脉血栓栓塞症(VTE)的危险因素.方法 检索中国知网、万方、维普、中国生物医学文献、PubMed、The Cochrane Library、Web of Science、EMbase等数据库建库至2021年11月1日颅脑肿瘤术VTE危险因素的队列研究或病例对照研究.由两名研究人员独立进行文献筛选、资料提取以及文献质量评价.使用RevMan 5.4软件对纳入文献进行Meta分析.结果 共纳入14篇文献,合计样本量40552例,发生VTE 1801例.Meta分析结果 显示,年龄>45岁、术前D-二聚体升高、肥胖、女性、术前日常生活活动能力处于依赖状态、术前呼吸机依赖、术前曾患脓毒血症、高级神经胶质瘤、手术时间>3.05 h、术后D-二聚体升高、术后下肢运动功能障碍、术后卧床不起、术后并发尿路感染为颅脑肿瘤术后患者发生VTE的危险因素.结论 颅脑肿瘤术后VTE发生与多种因素有关.建议构建颅脑肿瘤术后VTE风险预测模型,关注高风险人群,落实规范化静脉血栓风险评估,注重血栓评估过程管控.

目的 分析老年痴呆患者家庭照顾者虐待行为现状及其影响因素.方法 检索中、外文数据库,包括PubMed、Web of Science、ScienceDirect、PHMC、CNKI(中国知网)、WanFang(万方数据库)、VIP(维普数据库).按文献纳入排除标准进行筛查,评估文献质量,提取数据资料,使用Stata15.0软件对痴呆老年患者身体虐待、言语虐待、心理虐待和忽视的发生率进行meta分析,对其影响因素进行描述性分析.结果 最终纳入文献16篇,均为横断面调查,其中12篇研究报告了虐待行为发生率,15篇研究具体分析了虐待行为影响因素.结果 显示口头虐待行为发生率最高44％(95％CI:0.28～0.60),而忽视的发生率最低,仅为9％(95％CI:0.01～0.17).影响因素相关研究显示主要包括三方面:患者方面(年龄、痴呆症状和激动行为)、照顾者方面(性别、受教育程度、照顾负担、心理健康和对疾病知识了解程度)和其他方面(居住环境、患病前患者与照顾者之间的关系).结论 影响老年痴呆患者家庭照顾者虐待行为的因素较多,应积极针对影响因素采取干预措施,预防虐待行为的发生.

Objective:To systematically review the barriers encountered by nursing staff in the implementation of early activities in adult ICU units.Methods:A systematic search was conducted on CNKI, Wanfang Database, VIP Database, China Biomedical Database, PumMed, Web of Science, Cochrane Library and EMBASE for the research on the obstacles of early activity nursing implementation in adult ICU from the establishment of the database to July 2020, and the final integrated analysis of the included literature was carried out.Results:A total of 26 articles were included, and 59 obstacles in 5 categories were integrated, including 6 kinds of technical level, 13 kinds of organizational culture level, 7 kinds of personnel level, 4 kinds of structural level, and 29 kinds of 6 sub categories of patients level. The most frequent obstacles were unstable condition of patients, sedation or continuous deep sedation, low staffing level, disturbance of consciousness of patients, insufficient equipment related to early activities, and low willingness or compliance of patients to participate.Conclusion:The nursing staff are facing with many obstacles in guiding and assisting ICU adult patients to carry out early activities. It is necessary to formulate modified policies aiming at changeable factors in order to promote the application of early activities in adult ICU units.

i v e : T h e objectives of this overview is to appraise and synthesize published systematic reviews and metaanalyses investigating the rehabilitation effects of aquatic exercise therapy compared with all other non-water-based interventions on health outcomes in patients with stroke.Condition being studied: Stroke is also known as apoplexy or cerebrovascular accident.The incidence of stroke is on the rise globally and tends to be younger.It is predicted that the number of stroke INPLASY 1 International Platform of Registered Systematic Review and Meta-analysis Protocols INPLASY PROTOCOL Rehabilitation effectiveness of aquatic exercise therapy for patients with stroke：A protocol for overview of systematic reviews

目的:了解国外近5年发表的母乳喂养文献研究焦点,为我国母乳喂养实践与研究提供启示与借鉴.方法:检索PubMed 2015年～2019年收录的母乳喂养相关文献,对高频主题词进行词频及共词聚类分析.结果:共纳入5047篇文献,聚类分析总结出4个研究热点.结论:利用质性研究挖掘母乳喂养知信行的深层内容用于母乳喂养支持,重视基于证据的健康教育,开展早产儿母乳喂养的管理模式,可供借鉴.

Objective:To systematically evaluate the real breastfeeding experience in professional women.Methods:Qualitative studies on breastfeeding experience and needs in professional women which were published up to August 20, 2020 were retrieved from English databases such as PubMed, Medline, The Cochrane Library, Embase, Web of Science, Ovid, CINAHL, Joanna Briggs Institute Library, Chinese databases such as CNKI, Wanfang, VIP, SinoMed, and grey literature databases like ProQuest. After literature screening and evaluation, a collection integration method was used to integrate the results.Results:A total of 12 studies were included, and 57 complete research results were extracted, which were summarized into 8 new categories integrated into 3 new results: working mothers benefited from breastfeeding but also had negative experience due to returning to work; their breastfeeding was affected by multiple promotion and obstacles after returning to work; and they dealt with breastfeeding challenges after returning to work through self-management.Conclusions:We should actively pay attention to the breastfeeding experience of professional women, improve the support for breastfeeding of working mothers, and help them improve their self-management ability, in order to promote their breastfeeding behavior after returning to work.

目的 系统评价中青年脑卒中患者的疾病体验和心理感受,为改善护理服务质量,提高该人群康复治疗效果和心理健康提供依据.方法 2020年7月,计算机检索PubMed、Embase、Web of Science、Cochrane Library、ProQuest、中国生物医学文献数据库、中国知网、万方、维普期刊数据库中关于中青年脑卒中患者真实经历、心理体验和感受的质性研究,检索时限为建库至2020年7月.文献质量评价采用澳大利亚乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)循证卫生保健中心质性研究质量评价标准(2016版),采用汇集性整合方法对研究结果进行归纳整合.结果 共纳入14篇文献,提炼90个主题,归纳9个类别,形成3个主题:打破生活常态;寻求关注与支持;获得积极体验.结论 护理人员应关注患者的消极心理,联合家庭与社会方面的支持,帮助患者树立信心,回归家庭与社会;护理人员需提高自身专业素养,为患者制订针对性康复计划,完善延续性护理服务,及时为患者提供专业支持;护理人员应重视患者积极心理体验,协助患者维持积极状态,实现良性循环.

From the aspects of the definition and origin,types,characteristics,theoretical foundations,basic steps and methods of action research,this paper reviewed the main content and application status of action research method.In addition,this paper discussed its implications for development of nursing, looking forward to providing reference for clinical nursing personnel and nursing researchers.

ObjectiveTo investigate the status quo on empowerment among family caregivers of patients with stroke，further to explore its influencing factors.MethodsA survey，involving 221 stroke patients and their main caregivers，was conducted by using the the Barth Index Scale（BI） and Main Caregivers' Empowerment Measurement（MCEM）.ResultsThe total score of MCEM of family caregivers of stroke patients was 160.91±14.69.And the score of caregivers' relationship with patients was 3.68±0.42.The score of care goodwill was 3.54±0.47.The score of expectation of care results was 3.50±0.65.The score of caregiver's subjectivity was 3.31±0.49.The score of care belief was 3.20±0.59.The score of nursing care awareness was 3.08±0.55.The score of personal resource was 2.70±0.62.The score of consideration of the surroundings was 2.94±0.76.And the score of care knowledge and skills was 2.82±0.81.Multiple regression analysis showed that the chronic disease conditions，educational level and current working status quo of caregivers were the influencing factors of empowerment among family caregivers of stroke patients.ConclusionThis study suggest that the intervention project on empowerment among family caregivers of stroke patients should be further constructed.The concept of health care among family caregivers of stroke patients should be renewed.And the care burden of family caregivers should be reduced.And helping stroke patients to establish self⁃care and self⁃reliance consciousness should be advocated.

The incidence of bronchial asthma in children increases year by year, which seriously affects children's physical and mental health. Intestinal microbial structure and function has been a research hotspot in recent years. Colonization and succession of intestinal microbiota in early life are affected by many factors, and studies have shown that it is closely related to the onset of asthma. Early intervention on intestinal microbiota imbalance can effectively reduce the risk of childhood asthma. This article summarizes the research progress of the above related content.

Probiotics are a kind of living microorganisms added into food or drug, which are beneficial to our health. Probiotics can regulate the balance of microecosystem in intestine. Recently, people have paid more attention to the effect on the intestinal microecology. This article mainly made a review on the mechanism and application of probiotics.

Objective: To comprehensively evaluate the risk of recurrence after initial ischemic stroke, and to provide a relatively comprehensive reference for the prevention and control of stroke recurrence. Methods: CNKI, VIP, Wanfang, PubMed, Web of Science, Embase and other databases were collected to investigate the status of recurrence after initial ischemic stroke, the search period of which was from the establishment of databases to March 2019. And then quality evaluation and data extraction were carried out. The overall cumulative risks of stroke recurrence at 3 months, 6 months, 1 year, 2 years and 5 years after initial ischemic stroke were calculated, and heterogeneity analysis was performed. Results: A total of 29 studies from 19 provinces (cities, autonomous regions) in China were included. The cumulative total sample size was 22 484 cases, the cumulative recurrent sample size was 3 309 cases. The pooled cumulative risk was 4.5% (95% CI: 3.1-5.8) at 3 months, 7.8% (95% CI: 5.6-10.0) at 6 months, 13.6% (95% CI: 11.0-16.2) at 1 year, 17.5% (95% CI: 12.4-22.6) at 2 years and 30.9% (95% CI: 20.2-41.7) at 5 years after initial ischemic stroke. Conclusions: The recurrence rate of acute ischemic stroke in China is high. It is recommended that all levels of medical and health departments strengthen the prevention and treatment of ischemic stroke recurrence to reduce the recurrence of ischemic stroke and improve the prognosis of patients.

Objective: To understand the evidence-based practice readiness of developing evidence application projects in a 3A-level general hospital in Beijing, to identify barriers to evidence-based practice and to promote the successful application of evidence.Methods: All the clinical nurses who were going to participate in the application units of the evidence-based practice project were selected as the survey objects, and the self-made "Basic Information Questionnaire" and "Clinical Readiness to Evidence-based Nursing Assessment (CREBNA)" were used to conduct the survey.The total amounts and subscales were calculated.The factors that influence the score of the total scale were scored and analyzed. Results:The CREBNA total score was (119.87±19.18), the evidence subscale score was (47.94±8.54), the organizational environmental subscale score was (36.09±6.11),and the facilitator subscale score was (35.83±7.56).Univariate analysis showed that the total score of the scale was related to years of work, scientific research experience, knowledge of evidence-based care, and participation in evidence-based practice. Conclusion:The current evidence-based practice preparation situation is good.It is feasible to carry out evidence-based practice activities in the hospital.The follow-up development plan should be made based on the corresponding obstacle factors.

目的 整体把握近5年国际失智护理研究态势,为国内失智护理研究提供思路.方法 检索2013—2018年收录于Web of Science核心合集数据库中的相关文献,借助Cite Space对国际失智护理领域内的研究机构、核心期刊、被引文献、高频词进行可视化分析.结果 当前国际失智护理研究领域主要以荷兰为首的西方国家占主导;核心期刊主要有 《Journal of the American Geriatrics Society》、《International Journal of Geriatric Psychiatry》等刊物;关键词共现聚类分析共得出失智患者安全管理、晚期失智的姑息治疗、家庭照顾者负担、神经精神症状管理等4个国际研究热点.结论 国际失智护理研究热点对国内相关领域的研究具有一定的启示作用,建议循着本研究得出的热点,深入探寻失智护理研究的立足点,以推进我国失智护理事业的发展.