目的 调查郑州市外科护士人文关怀能力与工作家庭支持的相关性.方法 采用便利抽样于2021-03—2021-05选取郑州市10所医院51个外科病房共845名外科护士.通过一般资料调查表、工作-家庭支持量表、人文关怀能力评价量表进行横断面调查.结果 外科护士工作-家庭支持总分及各位维度得分处于中等偏下水平,外科护士工作-家庭支持量表总分(109.19±26.678)分(范围:30～150分),人文关怀量表总分(193.59±28.423)分(范围:37～259分).不同年龄外科护士,结婚与否,养育子女个数,家庭主要收入来源不同,在工作-家庭支持总分、组织支持维度得分、情感支持维度得分、工具性支持维度得分上的差异均有统计学意义(P<0.05);在领导支持维度得分上的差异无统计学意义(P>0.05).外科护士人文关怀能力总分及各维度得分与工作-家庭支持总分及各维度得分呈正相关.结论 外科护士人文关怀能力尚有一定的提升空间,工作-家庭支持和外科护士人文关怀能力之间有密切关系.

目的:了解郑州市护理人员人文关怀能力现状及影响因素,为后期采取相应干预措施提供理论依据.方法:使用问卷星制成电子问卷(一般资料调查表、护士关怀能力问卷及工作—家庭支持量表),于2021年4月15日-4月25日应用便利抽样法选取郑州市10所医院的1234名护理人员进行问卷调查.结果:1234名护理人员人文关怀能力总分为(191.48±26.76)分,工作—家庭支持总分为(109.49±24.69)分;pearson相关分析显示护理人员人文关怀能力与工作—家庭支持得分及各维度得分均呈正相关(r=0.343～0.404,P＜0.01);多元线性回归分析显示工作—家庭支持得分、子女状况、同事关心程度是护理人员人文关怀能力的主要影响因素(P＜0.05).结论:郑州市护理人员人文关怀能力较低,工作—家庭支持得分高、有子女、同事关心程度高的护理人员人文关怀能力较高.

目的 分析新型冠状病毒肺炎疫情背景下河南省625名实习后期护生职业认同现状及其影响因素.方法 采用一般情况调查表、护生职业认同量表及焦虑自评量表,于2020年2—3月借助问卷星平台对河南省6所院校的实习后期护生进行调查.结果 625名实习后期护生职业认同总分为66.34±12.88分;多元线性回归分析显示,年龄>20岁、护理专业是第一志愿、愿意参与一线支援及"新冠肺炎"发生后家庭成员支持程度、护生专业喜欢程度、愿意从事临床工作是护生职业认同的影响因素.结论 新冠肺炎疫情背景下河南省实习后期护生职业认同得分处于中高水平,且受家庭支持及专业喜欢程度的影响.提示学校教师应结合疫情中护士的作用充分给予护生正性引导,提升其对护理专业的认同,为我国护理事业的发展储备人才.

目的 了解护士人文关怀能力与工作—家庭支持的状况,并探讨其相关性.方法 采用工作—家庭支持量表和护士人文关怀能力量表,对1 476名护士进行问卷调查.结果 护士工作—家庭支持总分为(107.54±25.59)分,人文关怀能力评分为(192.26 ±27.76)分.护士工作—家庭支持情况与人文关怀能力呈正相关(P＜0.05).回归分析结果显示,护士工作—家庭支持、工龄对护士的人文关怀能力的影响效应为20.50％.结论 护士人文关怀能力与工作—家庭支持密切相关.应给予护士更多的工作与家庭支持,以促进其人文关怀能力的提升.

目的:探讨基于三维质量评价模型的阶梯式气道管理方案在人工气道病人中的应用效果.方法:选取某三级甲等医院重症医学科2018年1月—2018年6月的人工气道病人为对照组,2019年1月—2019年6月的人工气道病人为干预组进行研究.对照组采用人工气道常规护理,干预组采取基于结构-过程-结果三维质量评价模型的阶梯式气道管理方案.根据病人情况将病人分为红灯、黄灯、绿灯3类后采取不同的护理措施.比较两组病人人工气道堵管的发生率、呼吸机相关性肺炎发生率、病人重症监护室(ICU)住院日及干预组干预前、干预后第2天及干预后第5天阶梯式组别人数的分布差异.结果:干预组干预前与干预后第2天阶梯式人数分布比较差异无统计学意义(P=0.749),干预前与干预后第5天、干预后第2天与干预后第5天阶梯式人数分布比较差异具有统计学意义(P均为0.000);干预组病人人工气道堵管率低于对照组,病人ICU住院日低于对照组,二者比较差异均具有统计学意义(P<0.05);两组病人呼吸机相关性肺炎发生率差异无统计学意义(P>0.05).结论:采取基于三维质量评价模型的阶梯式气道管理方案能够降低人工气道病人人工气道堵塞发生率及病人ICU住院日,改善人工气道病人的气道状态,提高病人的住院满意度,对病人的康复具有重要作用.

We aim to investigate the status and influence factors of health risk behaviors among middle school students and explore the relationship between social support, family care, and the health risk behaviors. The study was conducted in 3 middle schools in the Fan county located in the Puyang city. Independent measures were applied to assess adolescent health risk behaviors, perceive social support, and family care. Multiple regression analysis was used to analyze the main factors that affect adolescent health risk behaviors. The total scores of health risk behaviors were 53.87 ± 9.97, and all kinds of health risk behaviors were very common. The highest score was health-compromising (2.45 ± 0.43), and the lowest score was unprotected sex behaviors (1.07 ± 0.28). Multiple regression analysis showed that sex (P < .001), grade (P < .001), parent relationships (P < .001), father’s occupation (P = .035), mother’s education level (P = .011), social support (P < .001), affection (P < .001), and growth (P = .003) were the main factors of health risk behaviors, accounting for 25.3%. The health risk behaviors among middle school students in Fan county should attract the attention of education administration, schools, and parent due to the varied influencing factors. Related interventions should be conducted to reduce the severity and frequency of adolescent health risk behaviors and protect the health and growth of adolescents. In order to better analyze the health risk behaviors of middle school students, we will incorporate more influencing factors and carry out further causal analysis in the future.

目的 探讨重症监护室(intensive care unit,ICU)患者家属习得性无助感水平及其影响因素.方法 2019年12月至2020年3月,便利抽样法选取在郑州市某三级甲等医院IC U住院例患者217名家属为研究对象,采用一般情况调查表、疾病不确定感家属量表及习得性无助感量表对其进行调查.结果 IC U患者家属习得性无助感总分为(52.28±17.51),家属疾病不确定感得分为81.00(69.25,84.00);多元线性回归分析结果显示:患者年龄、家属性别、家属职业、是否允许探视、家属疾病不确定感得分是IC U患者家属习得性无助感的影响因素(均P<0.05).结论 IC U患者家属习得性无助感受多种因素的影响,IC U护士在关注患者心理健康的同时,也应积极关注家属的心理健康,及时采取针对性措施以降低患者家属习得性无助感,促进其心理健康.

该文报道1例多发伤肋骨骨折导致呼吸衰竭应用体外膜肺氧合治疗患者的护理.护理要点包括:体外膜肺氧合护理、安全转运、肺康复及功能锻炼、营养支持的护理、呼吸机相关性肺炎的预防.最终患者经9d治疗后病情明显好转,转入胸外科继续治疗.

习得性无助感(learned helplessness,LH)是指个体从负性经历(挫折、创伤或逆境等)中产生的无能为力或自暴自弃的心理状态或行为 [1],这一概念源于Seligman习得性无助理论.1967年Seligman 和 Maier在动物行为研究的基础上首次提出"习得性无助感"这一概念,并进一步形成习得性无助理论,之后这一理论被广泛应用于国内外教育学领域 [2].1990年Smith等 [3]将其应用至类风湿性关节炎患者中,发现习得性无助感与患者抑郁水平明显相关.

选取河南省两家三甲医院296名外科ICU护士作为研究对象,进行问卷调查其同情心疲乏、社会阻抑和工作投入的现状及相关性.结果显示,外科ICU护士有一定程度的同情心疲乏感,同情心疲乏与社会阻抑和工作投入密切相关.

目的 分析107例方舱医院内新型冠状病毒肺炎患者创伤后成长现状,分析其影响因素.方法 采用方便抽样法,选取2020年2月15—20日收治于武汉市青山方舱医院(A舱)的新型冠状病毒肺炎患者作为研究对象.采用一般情况调查表、Herth希望量表及创伤后成长量表对其进行调查,采用多元线性回归分析新型冠状病毒肺炎患者创伤后成长的影响因素.结果 107例新型冠状病毒肺炎患者创伤后成长总分为(65.75±19.19)分;多元线性回归分析显示,新型冠状病毒肺炎患者文化程度及希望水平进入回归方程(P<0.05),可解释总变异的35.8％.结论 本组方舱医院内新型冠状病毒肺炎患者创伤后成长得分处于较高水平,且受文化程度及希望水平的影响.护理人员应重点关注文化程度较低和希望水平不高的患者,给予其正性引导和人文关怀,有针对性地提高其希望水平,进而提高其创伤后成长水平.

多感官刺激疗法是以灯光效果、真实的触感、冥想音乐和令人放松的香气为媒介,为患者提供以视觉、听觉、触觉、味觉和嗅觉为主的感官刺激的治疗方法[1].多感官刺激疗法起源于20世纪70年代的荷兰,最初命名为Snoezelen,传至英国后,英国人根据其含义将其命名为"多感官环境"(multi-sensory environment).临床研究将其称为"Snoezelen"或"多感官刺激疗法(multi-sensory stimulation, MSS)"或"多感官环境刺激疗法(multi-sensory stimulation environments,MSSE)".多感官刺激疗法作为一种刺激或放松的方式,为患者提供了一种无压力、娱乐的环境.因其具有智力要求低、适用范围广、时间安排灵活等特点,被国外学者广泛应用于老年痴呆、神经发育障碍、慢性疼痛及教育学等领域.但在国内,多感官刺激疗法尚仅应用于教学领域,且缺乏较为严谨的随机对照类的干预性研究.大量文献及研究[2-4]表明,多感官刺激疗法在改善不适性行为、促进患者身心健康方面有着重要作用.本文就其在相关领域的研究进展作一综述,以期为我国学者进行相关研究提供借鉴和参考,现介绍如下.

Objective To understand residents' awareness and satisfaction of family doctor service and two-way referral through investigating their situation of visiting family doctors and demand for family doctor services in two pilot towns in Shaanxi Province.Methods Using the convenience sampling,local residents from Shengshui Town and Huangguan Town in Hanzhong City of Shaanxi Province were recruited according to the locations of investigators.Residents were interviewed face to face with a self-designed questionnaire from July to August of the year 2016.The main contents of the questionnaire were the baseline characteristics of residents,residents' awareness of family doctor service and two-way referral,residents' demand for family doctor services,ways they get information about family doctor services,residents' situation of visiting family doctors and asking for the two-way referral,residents' satisfaction of family doctor services,and residents' evaluation of the two-way referral.A total of 300 questionnaires were distributed and 225 effective questionnaires were collected.The effective recovery rate was 75.0％.Results There were 91.1％ (205/225) of the residents who knew the family doctor services and two-way referral.Top three service projects with the highest awareness rate were annual free medical examination [83.6％ (188/225)],the establishment and management of health records [56.0％ (126/225)] and reimbursement ratio of two-way referral [53.8％ (121/225)].There were significant differences among residents with different age,occupation and self-health status in residents' awareness rate of the family doctor services and two-way referral (P ＜ 0.05).And 72.9％ (164/225) of residents believed that the current service projects of family doctors could meet their basic needs.The service project with the highest demand rate [81.3％ (183/225)] was regular medical examination,and the main way the residents got information about family doctor services [36.0％ (81/225)] was the introduction of medical staff.In addition,89.3％ (201/225) of the residents were in favor of initial diagnosis in primary health care institutions,and 86.2％ (194/225) of the residents preferred to visit doctors in primary health care institutions.The most satisfying service project was service attitude.Moreover,18.2％ (41 /225) of the residents were satisfied with the service attitude very much,and 66.2％ (149/225) of the residents were satisfied with the service attitude.The residents who thought the referral to superior hospitals from the primary health care institutions was carried out in a more timely manner accounted for 21.3％ (48/225),and 70.7％ (159/225) of the residents thought the referral to superior hospitals was carried out in time.The residents who thought the superior hospitals took more timely action on the referral accounted for 22.7％ (51/225),and 62.6％ (141/225) of the residents thought the superior hospitals took action on the referral timely.Conclusion The residents' awareness and satisfaction of the family doctor services and two-way referral are both in a high level.Family doctor services and two-way referral plays an important role in increasing the initial diagnosis rate in primary health care institutions and relieving the treatment pressure of large hospitals,which makes it deserve to be promoted in the future.

目前,全球约有2430万老年痴呆患者,且每年新发病例达460万以上〔1〕. 我国大约有(600~700)万老年痴呆患者,占世界老年痴呆患者数量的25%, 65 岁以上人口痴呆发病率为5% ~7% 〔2〕. 老年痴呆主要临床表现是认知功能受损和行为精神症状,研究发现,在老年痴呆疾病两大主要临床表现中,与照顾者负担密切相关的是行为精神症状〔3〕. 受传统"孝"文化、社会保障体系以及养老体系不健全等多方面因素的影响,我国老年痴呆患者主要照顾者是家庭成员. 老年痴呆不仅严重影响患者的生活质量,同时也给照顾者带来了繁重的负担.本文将从生理、心理、社会经济三方面对因老年痴呆患者行为精神症状而带来的主要的家庭照顾者负担及引起相应照顾者某一具体负担的精神行为症状进行阐述.

据统计全球每年新增460万例老年痴呆患者,患病人数增长最多的地区是中国及其周围南亚国家[1].老年痴呆是导致老年人发生残疾并依赖他人的主要原因,其社会成本几乎等同于癌症、心脏病和中风三种疾病的社会成本之和[2].目前临床主要应用药物和非药物管理两种方法治疗老年痴呆.2012年美国食品和药物管理局及欧洲药品管理局对痴呆患者药物的使用发出警告,强调传统抗精神病药物和非典型抗精神病药物均可增加患者发生缺血性脑血管病及全因死亡的风险[3],故提倡将非药物治疗作为老年痴呆患者的首选治疗方法.

Objective To investigate the status and influencing factors of self-efficacy of caregivers of cer-vical cancer patients.Methods By convenience sampling,348 caregivers of cervical cancer patients were se-lected and investigated by using general information questionnaire and general self-efficacy scale.Results The average total score of caregivers'self-efficacy was (2.77±0.61),which was below the norm.The pa-tient's occupation,education level,current life status and caregiver's gender,occupation,education level, family residence,number of alternative caregivers were the main influencing factors of caregivers'self-effi-cacy (all P<0.05),which could explain 20.3% of the total variance.Conclusion The level of self-efficacy of caregivers in patients with cervical cancer is low,and there are many factors affect the self-efficacy of care-givers.The medical staff should take targeted interventions based on the demographic characteristics of car-egivers,to improve the level of caregivers'self-efficacy and help caregivers deal with problems related to diseases effectively which can also improve the life quality of patients and caregivers.

全球老龄化影响着世界上每一个国家〔1〕,2008 年世界人口前景估计指出全球老龄化将持续到2050年. 全球老龄化的日益加剧将会导致养老服务需求增加. 目前我国家庭结构核心化、小型化,老人空巢化、高龄化,传统的家庭养老观念日渐减弱,养老机构床位总体不足〔2〕等多方面问题的出现,以前的养老模式已经不适合现在的生活模式〔3〕,集传统家庭养老、机构养老二者优势的社区居家养老由此产生. 我国社区居家养老服务刚刚开展,与发达国家存在差距.

阿尔茨海默病（ AD）行为精神症状（ BPSD）是AD的常见临床表现之一，可出现在患病后的任意时期。国际老年精神病学会将其定义为“痴呆患者经常出现的知觉、思维内容、心境或行为等症状的紊乱”〔1〕。但是目前关于BPSD相关因素的综述并不多，本文就AD患者行为精神症状相关因素的研究进展作一综述。

目的 探讨长春市某3所三甲医院老年良性前列腺增生(BPH)患者睡眠障碍的影响因素.方法 根据匹兹堡睡眠质量指数量表(PSQI)得分,对PSQI>7分的老年BPH患者应用自行设计的一般资料调查表、国际前列腺症状评分表(IPSS)和焦虑自评量表(SAS)进行问卷调查.结果 存在睡眠障碍的老年良性前列腺增生患者PSQI总分为(12.00±2.58)分,IPSS得分为(20.63±4.86)分,SAS标准分为(53.45±10.40)分,PSQI总分与IPSS得分、SAS标准分均呈正相关(P<0.01);下尿路症状分级、商业、锻炼时间、正常饮食、离婚、教师、其他职业、医务人员、自己独居、性生活次数、吸烟、完全公费、疾病了解程度进入多元逐步回归方程.结论 长春市某3所三甲医院老年BPH患者睡眠障碍发生率较高,应采取针对性的措施改善其睡眠质量,消除焦虑情绪,减少睡眠障碍的发生,促进老年患者身心健康,提高生活质量.