Objective:To investigate risk factors for cognitive decline in elderly hospitalised hypertensive patients, develop a risk prediction model and validate it.Methods:By the convenient sampling method, a total of 379 elderly hypertensive patients admitted to Department of Cardiology, Department of Geriatrics (General) and Department of Endocrinology in Xuanwu Hospital of Capital Medical University from April to October 2022 were selected as the study objects. Binomial Logistic regression analysis was used to explore the risk factors of cognitive frailty in elderly hospitalized hypertensive patients and establish a prediction model. Receiver operating characteristic curve (ROC) and Hosmer-Lemeshow goodness of fit test were used to evaluate the prediction effect and calibration degree of the model, and Bootstrap method was used for internal verification.Results:Among 379 elderly hospitalized hypertensive patients, 145 (38.3%) had cognitive frailty. Binomial Logistic regression analysis showed that age, education level, drinking history, daily exercise, use of angiotensin receptor antagonists, Barthel index and nutritional status were the influential factors for cognitive frailty in elderly hospitalized hypertensive patients ( P< 0.05). The area under ROC curve of the prediction model was 0.770 (95% CI: 0.721-0.819, P< 0.001), the sensitivity was 0.607, the specificity was 0.838, and the maximum approximate entry index was 0.445. Hosmer Lemeshow goodness of fit test χ 2=3.581, P=0.893. Internal validation was conducted using the Bootstrap method to resample 1 000 times, and the results showed that the average area under the ROC curve of the prediction model was 0.737 (0.687-0.788) . Conclusions:The risk prediction model for cognitive decline in elderly hospitalized hypertensive patients can predict the risk of cognitive frailty in elderly hospitalized hypertensive patients, which can provide references for medical staff to develop corresponding intervention measures.

目的:深入了解糖尿病足病人在疾病进程中对各个不同相关方面所认知的需求及其相互之间的关联影响,为医护人员制定高效的联合干预措施提供依据.方法:采用现象学方法对11例糖尿病足病人进行半结构访谈,运用Colaizzi七步法分析程序进行资料分析.结果:共形成3个类别及6个主题,分别为足部护理知识的需求、疾病自我管理的需求、家庭支持与照顾的需求、专业诊疗护理技术的需求、便利性诊疗护理服务的需求、疾病相关健康教育的需求.结论:糖尿病足病人需求是来自多方面且互相关联的,医护人员应从不同角度出发理解病人需求并重视病人在疾病发展全过程中存在的需求,通过多样化健康教育、开展居家护理服务、构建医院-社区-家庭3方联动的糖尿病足防控模式等措施满足病人需求,进而提高病人体验及生活质量.

目的:通过 Meta 分析评价疾病特异性移动健康软件对 2 型糖尿病病人健康管理效果的影响.方法:计算机检索 PubMed、EMbase、the Cochrane Library、CINAHL、万方数据库和中国知网数据库中有关疾病特异性移动健康软件对 2 型糖尿病病人健康管理效果的随机对照试验,检索时限为建库至 2021 年 12 月.经质量评价后,采用 RevMan 5.4 软件进行 Meta分析.结果:共纳入 12篇文献.Meta分析结果显示,基于疾病特异性移动健康应用软件可显著降低 2 型糖尿病病人的糖化血红蛋白[MD=-0.39,95%CI(-0.51,-0.28),Z=6.70,P＜0.00001],提高病人服药依从性.但在改善病人体质指数[MD=-0.08,95%CI(-0.37,0.21),Z=0.52,P=0.60]、总胆固醇水平[SMD=-0.07,95%CI(-0.22,0.08),Z=0.94,P=0.35]、收缩压[MD=2.32,95%CI(-0.22,4.86),P=0.07]及舒张压[MD=0.88,95%CI(-0.71,2.47),P=0.28]方面差异无统计学意义.结论:现有证据表明,疾病特异性移动健康软件可降低病人糖化血红蛋白水平、提升其服药依从性,但在改善病人血压、体质指数及总胆固醇水平上效果不显著,后期需开展更多临床高质量研究进一步验证其临床效果.

ObjectiveTo construct the workload relative value table of surgical system based on the relative value of resources，in order to provide a theoretical basis for scientifically measuring nursing workload and fairly reflecting the value of nursing work.MethodsBased on the relative value of resources，a multi⁃dimensional relative value table of surgical nursing workload was constructed using literature review，group meeting，Delphi methods.ResultsTaking venous transfusion indwelling needle puncture as baseline，the constructed relative value table of surgical nursing workload included 91 items of surgical system nursing operation，including eight items of nursing assessment，13 items of basic nursing，50 items of therapeutic nursing，eight items of health education，and 11 items of specialty nursing.ConclusionThe constructed relative value table of surgical system nursing workload can be used to objectively calculate the clinical nursing workload and provide a theoretical basis for nursing performance evaluation and human resource allocation.

目的:结合患者及医护人员的不同视角,深入探讨阻碍糖尿病足患者自我管理行为的可能原因,为糖尿病足患者防控措施的构建提供依据和建议.方法:采用现象学研究方法,对11名医护人员及11名患者进行半结构访谈,运用Colaizzi?7步分析法进行内容分析.结果:根据计划行为理论对主题进行归纳,共提炼出3种类别7个主题.①行为态度:疾病治疗无望感导致的消极自我管理,认知偏差导致的自我管理重要性认识缺乏;②主观规范:社会环境对疾病包容性不足,家庭环境对疾病控制支持有限;③知觉行为控制:自我管理知识获得局限,自我管理操作能力欠缺,自我管理客观条件束缚.结论:糖尿病足患者自我管理行为的维持受多重因素影响,护理人员应通过改变患者主观行为认知、降低外界给予的压力以及提供必要客观条件支持这3个方面促进患者行为意图的改善,以提高患者的自我管理能力.

This article briefly introduces the roles and characteristics of nurse practitioners abroad and reviews their role and influence in primary health care and puts forward some thoughts on the training of nurse practitioners in China, in order to provide a reference for the training of nurse practitioners in China.

目的:了解养老机构衰弱老年人运动锻炼行为的促进与阻碍因素.方法:2021年4月—5月,采用现象学方法深入访谈北京市某养老机构12名衰弱老年人,并基于能力-机会-动机-行为模型(COM-B模型),运用Colaizzi 7步分析法整理分析资料.结果:养老机构衰弱老年人运动锻炼行为促进因素包括感知运动锻炼的益处、主要社会关系的情绪支持、运动锻炼知识获取途径的多样化、促进人际互动的运动组织形式;阻碍因素包括对运动锻炼认识不足、身体活动受限、疾病状态不佳、对生命状态的负性心理、养老机构环境的约束.结论:养老机构衰弱老年人运动锻炼行为受多种因素的影响,医护人员应采取针对性措施提高老年人运动锻炼参与度,以改善其衰弱状态,促进健康老龄化.

目的:在三级预防模式下构建糖尿病足防控护理技能体系.方法:通过文献回顾法和德尔菲法确定糖尿病足防控护理技能体系内容.结果:两轮德尔菲专家咨询问卷的有效回收率为93.8％、100.0％;权威系数为0.877、0.927;肯德尔和谐系数为0.208、0.136(P<0.05).最终形成了包含3个一级条目和13个二级条目57个三级条目的糖尿病足防控护理技能体系.结论:构建的糖尿病足防控护理技能体系科学、合理、实用且内容具有针对性,可为糖尿病足防控护理人员培训和教学项目的确定与完善以及评估不同机构的糖尿病足防控范畴提供参考.

This article analyzes the overview of ward classification management, and its research status, impact on nursing management, the existing problems and related solutions. The goal of this article is to provide a sound scientific basis for nursing management in the future, and lay the foundation for the hospital to implement post classification management, optimize the allocation of human resources, establish performance appraisal mechanism and improve the quality of nursing.

目的 探索护士知觉压力水平对其健康行为能力的影响.方法 于2020年10-11月选取北京市某三级甲等医院的784名护士为研究对象,采用一般资料调查表、知觉压力量表和健康行为能力自评量表进行调查.结果 护士知觉压力评分为25.02±6.23,处于健康危险性压力状态的护士为519名(占66.2％),健康行为能力评分为81.53±20.61.护士知觉压力与健康行为能力呈负相关(r=-0.399,P＜0.01).多元线性分层回归显示,护士知觉压力水平是其健康行为能力的影响因素,紧张感及失控感两个维度均会影响护士的健康行为能力(均P＜0.01).结论 护士感知到的知觉压力水平越高其健康行为能力越差,护理管理者应通过多种策略给予护士心理社会支持,改善其压力水平,从而提升其健康行为能力,实现身心健康.

目的 从专科护士视角深入了解糖尿病足患者在疾病管理中存在的问题,并提出针对性的干预对策.方法 采用现象学中内容分析法对10名伤口专科护士进行半结构访谈,运用Colaizzi分析法进行资料分析.结果 共形成3个主题:患者疾病管理配合度不佳、疾病专业诊疗待完善及家庭社会支持欠缺等.结论 医护人员应重视糖尿病足患者存在的问题,通过针对性的健康教育策略、完善的糖尿病足多学科诊疗团队、充足的家庭社会支持等对策,加强疾病管理,控制糖尿病足患者的疾病进展,改善其生活质量.