目的 编制适用于我国老年慢性病患者的健康赋能需求评估量表,并检验其信效度.方法 在文献分析及参照国内外相关工具的基础上编制量表条目池;通过2轮德尔菲专家函询,形成测试版老年慢性病患者健康赋能需求评估量表.便利选取2021年3—12月在广州市某三级甲等综合医院住院的236例老年慢性病患者进行问卷调查,检验量表信效度.结果 最终形成的老年慢性病患者健康赋能需求评估量表包含5个维度、30个条目,经因子分析提取5个公因子,累计方差贡献率为64.24％;各条目内容效度指数为0.72～1.00,总量表内容效度指数为0.94;量表各维度Cronbach'sα系数为0.78～0.90,折半系数为0.68～0.83;总量表Cronbach'sα系数为0.92,折半系数为0.76.结论 本研究所研制的老年慢性病患者健康赋能需求评估量表可作为老年慢性病患者赋能需求评估的工具,为科学地制订和实施符合患者需求的个性化慢性病管理措施提供依据.

Introduction and aim: Diabetic foot ulcer (DFU) is one of the most serious complications in patients with diabetes. Early identification of risk factors can prevent its occurrence and delay its progression. The aim of this project is to conduct an audit of DFU risk assessment protocols at a large tertiary hospital and evaluate the impact of any changes in compliance with the developed evidence-based best practice criteria. Methods: Preimplementation and postimplementation audits based on JBI's Practical Application of Clinical Evidence System were conducted at the Department of Endocrinology and Metabolism of a tertiary hospital in China. The Getting Research into Practice audit tool was used to analyze the barriers and inadequacies encountered in practice. A total of 12 nurses and 30 patients with diabetes were included in the baseline and follow-up audits. Results: There were 15 baseline audits that indicated deficits in DFU risk assessment by nurses, with 0% compliance for three criteria and 50% compliance or less for seven others. Strategies developed by the project team to address the identified barriers to compliance were adopted, leading to significant improvement in compliance with most criteria at the follow-up audit compared with baseline with 11 criteria achieving at least 90% compliance. Conclusion: The project showed that regular audits of foot ulcer risk assessment can help to identify barriers to their implementation. Advising patients of their risk status can support appropriate self-care practices. Further audits are needed to implement evidence-based practices in all aspects of diabetes patient care.

INTRODUCTION AND AIMS:As a critical form of stroke damage, aphasia negatively impacts stroke patients' return to society. Speech and language intervention has been found to assist in optimizing poststroke aphasia patient outcomes; consequently, early identification and diagnosis are vital for poststroke aphasia to ensure that patients receive the rehabilitation they require. This project aimed to promote evidence-based practice (EBP) in the assessment and screening of stroke patients with aphasia and to improve the clinical outcomes of patients who suffer from poststroke aphasia in a large tertiary hospital. METHODS:The current evidence implementation project was conducted in the neurology and rehabilitation departments of a tertiary hospital in China. Six audit criteria were developed for the baseline and follow-up audits. The project used the JBI PACES software, as well as JBI's Getting Research into Practice audit and feedback tool, to foster evidence-based healthcare in practice. RESULTS:Although the performance of all evidence-based criteria during the baseline audit was poor, barriers were identified through baseline, and the project team carried out and implemented developed strategies following Getting Research into Practice resources. All the criteria improved from baseline after the follow-up cycle, with four out of six criteria achieving a compliance rate of 100%, and two evidence-based criteria recorded at 73 and 80% compliance, respectively. CONCLUSION:The current project successfully increased EBP for the assessment and screening of stroke patients with aphasia. Further studies are needed to ensure the project's long-term sustainability.

目的 对脑卒中后失能综合评估量表进行汉化及信效度检验,探索该量表在国内的临床适用性.方法 采用Brislin双人直译-回译法、专家评议、预调查对量表进行文化调适,便利抽取203名脑卒中患者进行调查,对中文版量表进行项目分析,并验证其重测信度、评定者间信度、内容效度、效标关联效度.结果 脑卒中后失能综合评估量表重测信度相关性分析结果显示相关系数为0.988;评定者间信度Kappa系数为0.846(95％置信区间为0.793～0.899),P<0.001;各条目内容效度指数均在0.833～1.000之间,量表内容效度指数为0.935;以改良Rankin量表为标准,效标关联效度系数为0.896.结论 中文版脑卒中后失能综合评估量表具有良好的信效度,可作为我国临床脑卒中失能评估工具.

目的 基于二元应对理论探讨失能老年人及其配偶健康素养、 赋能水平与生活质量的关系.方法 2020年12月—2021年6月,采用一般资料调查问卷、日常生活功能指数量表、慢性病病人健康素养量表、中文版简化老年人健康赋能量表及中文版生活质量量表对广东省广州市、珠海市、深圳市520对失能老年人及其配偶进行问卷调查,采用Spearman相关分析、结构方程模型对有效数据(498对失能老年人及其配偶)进行分析.结果 回收有效问卷498对.失能老年人的健康素养、赋能水平与生活质量得分中位数分别为86.00、30.00、391.39分,配偶的健康素养、赋能水平与生活质量得分中位数分别为93.00、32.00、617.28分;相关分析结果显示,除配偶赋能水平与失能老年人生活质量相关性不显著(r=0.075,P=0.094>0.05),其余变量(失能老年人与配偶的健康素养、赋能、生活质量)之间两两呈正相关(r=0.156～0.657,均P<0.05).结构方程模型显示,失能老年人健康素养可直接或通过赋能水平间接作用于生活质量(路径系数分别为0.30、0.23,P<0.001),模型拟合良好(拟合优度指数=0.811,调整的拟合优度指数=0.788,近似误差均方根=0.057).失能老年人与配偶的健康素养互相促进(路径系数为0.47,P<0.001),失能老年人生活质量对配偶生活质量有积极影响(路径系数为0.18,P=0.004).结论 失能老年人与配偶的健康素养、生活质量相互影响,提示在面对失能这一压力事件时,不能将失能老年人与配偶割裂为单独的个体,应基于二元应对理论将失能老年人及其配偶照护者视为一个整体,共同提高健康素养和赋能水平,以提高失能老年人及其配偶的生活质量.

AIMS:To explore the role of self-efficacy (SE) in the effect of patient empowerment on self-management behaviours among patients with chronic illness and to investigate the moderating effect of three types of health locus of control (HLC) in this moderated mediation model.DESIGN:Cross-sectional design.METHODS:Data were collected in a general tertiary hospital, and a sample of 254 patients was recruited between August and October 2020. The effect of moderation and mediation was tested by the PROCESS macro (Model 4 and Model 8) for SPSS 25.0 by Hayes using 5000 bootstrap samples.RESULTS:Self-efficacy significantly mediated the relationship between patient empowerment and self-management behaviour with a 95% confidence interval excluding zero. The chance HLC demonstrated a moderating effect, and the interaction effect on SE and self-management behaviour was significant.CONCLUSION:Patient empowerment may improve confidence and adherence to self-management among people with chronic illness, and such benefits were conditional on the HLC of patients.IMPACT:This study addresses the relationship between patient empowerment and self-management behaviour in patients with different personality characteristics. This result indicated that classifying the type of HLC may enable the identification of subgroups of patients who may subsequently benefit from patient empowerment. In a patient-centred programme, nurses and other healthcare professionals correctly identifying patients' HLC type and understanding the implications and then providing appropriate health care plans for patients with different health beliefs may be useful to tailor the decision-making process.

目的 总结卒中后失语患者言语康复的相关证据,为临床医务人员开展言语康复管理提供依据.方法 系统检索国内外数据库与专业机构网站中有关卒中后失语患者言语康复的临床指南、证据总结、系统评价以及专家共识,并进行质量评价与证据提取.结果 共纳入14篇文献,包括1篇临床决策,1篇证据总结,8篇指南以及4篇系统评价.从言语康复的筛查与评估、组织培训、康复环境、康复时机、康复方式、随访以及健康教育7个方面总结了24条证据.结论 积极开展失语筛查、组织培训康复团队成员、营造良好的康复环境、把握最佳的康复时机、选择个性化的康复方式以及制定全面的健康教育与随访计划可提高言语康复的有效性.

目的 通过回顾国内外老年人健康需求评估工具,总结各类评估工具的内容特点及应用局限,为整合、开发适用于我国老年人的整体化健康需求评估工具提供参考.方法 回顾国内外相关研究,从老年人健康需求概况、老年人健康需求评估工具概况、各类工具的内部结构和应用情况及特点进行综述.结果 目前国际上针对老年人健康需求评估的工具包括:老年综合评估、国际居民评估工具、老年人健康照护需求自评问卷、健康需求工具、护理依赖量表等.当前,在评估方式、内容及结果判定方面尚未形成统一标准.国内老年健康服务体系尚未完善,老年健康需求评估尚处于探索阶段,相关工具有待进一步开发、应用.结论 丰富老年人健康需求评估的理论内涵和实践途径,开发、整合以老年人为中心的评估工具,有助于健康服务提供者采取有效措施充分发挥老年人在健康决策中的主观能动性,不断挖掘其自我健康管理的内在潜能,赋能老年人健康自我管理,最终改善老年人健康状况及生活质量,实现"健康老龄化".

PURPOSE The confidence in a study will be reduced due to the incorrect representation of statistical results. However, it is unknown to what extent p values are incorrectly represented in published nursing journals. The study aims to evaluate the articles in 30 nursing journals in terms of the error in reporting of p values (p = .000). DESIGN AND METHODS This was a bibliometric analysis. All papers published in 10 leading nursing journals (between 2015 and 2019), the 10 bottom nursing journals (2019), and 10 selected key nursing journals (2019) indexed in the Science Citation Index Journal Citation Reports were reviewed to detect errors in reporting of p values (p = .000). RESULTS A total of 3,788 papers were reviewed. Notably, it was found that 93.3% (28/30) of the nursing journals contained incorrect representation of p values (p = .000). The reporting rate of these journals ranges from 0% to 57.1%, with an overall rate of 12.8% (486/3,788). In addition, the rate of incorrect representation of p values (p = .000) showed no statistically significant difference between different publication years (Χ2 = 4.976, p = .290). However, the rate of reporting was different between study types, journals, and regions (p = .007, p = .020, and p < .001, respectively). CONCLUSIONS The incorrect representation of p values is common in nursing journals. CLINICAL RELEVANCE We recommend that both publishers and researchers be responsible for preventing statistical errors in manuscripts. Furthermore, various kinds of statistical training methods should be adopted to ensure that nurses and journal reviewers have enough statistical literacy.

Background Child health research comprises complex ethical considerations. Understanding the extent to which the ethical process is reported in child health research is needed to improve reporting. Aims To identify reportage of ethical considerations in child health research in leading nursing and paediatric journals. Methods All child health research published between 2015 and 2019 in 10 leading nursing journals and two paediatric journals were retrieved and critically appraised for the reportage of informed consent and ethical approval. Results Eight hundred and fifty-one child health research papers were included. Although 544 (79.9%) of the prospective studies mentioned informed consent, only 300 (55.2%) reported that written informed consent was obtained from the participants. Overall, 748 (87.9%) of child health research papers noted obtaining research ethics committee approval. Articles that mentioned financial support were significantly more likely to report informed consent and ethical approval than unfunded studies (allP< 0.001). Prospective studies showed higher rates of reportage of ethical approval compared to retrospective studies (P= 0.027). Rates of child consent (assent) obtained in different age groups of children ranged from 29.6% to 66.3%. Conclusion Despite improvements in the reportage of ethical review and approval processes in child health research, consistent and transparent reports are still lacking.