Objective:To explore the perception and demand of children's parents on Internet children's hospital, and provide reference for improving the service model of Internet children's hospitals.Methods:This is a qualitative study. Totally 11 parents of children who visited the outpatient services of Guangzhou Women and Children's Medical Center from November to December 2021 were selected by convenience sampling, and a semi-structured interview was conducted with them based on a self-made outline. The Colaizzi phenomenological 7-step analysis method was used to analyze the data and refine the themes.Results:A total of four themes were extracted, namely, the high degree of parental recognition of the Internet children's hospital service model, the need for convenient, timely and safe information acquisition, the need for professional, reliable and friendly diagnosis and treatment services, and the need for reasonable and transparent fees.Conclusions:The online diagnosis and treatment services of Internet children's hospitals meet the needs of parents for medical treatment and have good prospects. At the same time, the service model of Internet children's hospitals should pay more attention to the convenience, professionalism, safety and economy of users, so as to promote its healthy development.

Objective To construct an internet hospital critical children identification system based on Pediatric Assessment Triangle（PAT）, and to evaluate its assessment accuracy. Methods According to the system development program, an internet hospital critical children identification system based on PAT was constructed. Forty standardized cases were collected, the condition of the children was judged using the system by 4 pediatric medical staff of internet hospital, and the reliability of the system was evaluated by simulation evaluation method. Then the condition of 644 children were assessed by 2 pediatric triage nurses using the PAT offline and 15 pediatric medical staff in internet hospitals using the system, and the diagnostic test evaluation system was used to evaluate the assessment accuracy of the system. Results The ICC of the 4 raters was 0.665, and the retest reliability was 0.527-0.899（all P＜0.05）. The sensitivity of the system for appearance, respiration, circulation and identification of critical children in the PAT was 70.0%, 86.7%, 50.0%, 80.0%, and the specificity was 79.3%, 93.6%, 99.7%, 73.5%, respectively. The Youden index was 0.493, 0.803, 0.497, 0.535（all P＜0.05）. Conclusion The consistency, stability and accuracy of the internet hospital critical children identification system based on PAT are satisfactory, which has certain clinical value.

目的 针对阴道分娩产妇潜伏期宫缩痛,实施非药物镇痛措施进行管理的循证实践.方法 以基于证据的持续质量改进模式为理论框架,应用循证护理的方法获取最佳证据,于2020年3-9月将证据应用于潜伏期阴道分娩产妇,比较循证实践前后产妇采用非药物镇痛措施的依从性和分娩疼痛等指标的变化.结果 循证实践应用了7条证据.循证实践后,潜伏期产妇采用非药物镇痛措施的依从性提高,疼痛水平显著下降,产妇对分娩指导及分娩经历的满意度明显提高(均P<0.05).结论 通过循证护理对阴道分娩产妇进行潜伏期分娩疼痛的管理,能有效促进产妇采纳非药物减痛措施,有效降低其潜伏期分娩疼痛程度,提高分娩满意度,可为潜伏期阴道分娩产妇非药物镇痛的规范化管理提供参考.

目的 探讨规范化培训住院医师抑郁、焦虑状况,为妇幼医院规培医师心理干预策略提供参考.方法 采用横断面研究方法,通过网络调查问卷,于2021年3月1日-4 月1日在广州某三甲妇幼医院调查了 252名规培医生,通过焦虑自评量表(generalized anxiety disorder,GAD-7),抑郁自评量表(patient health questionnaire-9,PHQ-9)对规培医生的抑郁、焦虑状况进行调查.采用独立样本t检验/方差分析进行单因素分析,采用非条件有序logistic回归对规培医生焦虑、抑郁状态的影响因素进行分析.结果9％(22/252)的规培医生出现重度焦虑倾向,16％(40/252)的规培医生出现中度焦虑倾向;4％(10/252)的规培医生出现重度抑郁倾向,9％(23/252)的规培医生出现中重度抑郁倾向,16％(40/252)的规培医生出现中度抑郁倾向.对生活压力的自评为"一般"和"非常大"的规培医生焦虑水平较高(均P＜0.05);对工作强度的评价为"比较大"和"非常大"、对生活压力的评价为"非常大"、对薪酬满意度为"非常不满意"的规培医生抑郁水平较高(均P＜0.05).结论 妇幼医院规培医生的抑郁、焦虑状况的影响值得重视,应尽早提供合适的心理干预.

目的 探讨妇产及儿科规范化培训住院医师职业倦怠状况,为规培医师心理干预策略提供参考.方法 采用横断面研究方法,于2021年3月1日-4月1日在广州某三甲妇幼医院调查了 252名规培医生,通过自制的一般情况调查表和马氏职业倦怠量表(maslach burnout inventory-human services survey,MBI-22)对规培医生的职业倦怠和一般情况进行调查.方法采用独立样本t检验/方差分析进行单因素分析,采用非条件有序Logistic回归、二分类Logistic回归对规培医生职业倦怠的影响因素进行分析.结果 48％(120/252)的规培医生出现高度的职业倦怠,影响因素为自身健康状况的认知(Wald x2=5.521,P=0.019)、对生活压力的认知(Wald x2=7.391,P=0.007)、性别(Wald x2=4.563,P=0.033)和年资(Wald x2=8.023,P=0.005)、对工作压力的认知(Wald x2=3.928,P=0.047).Logistic回归结果显示:规培二年级、对工作强度的评价较高、对工作压力的评价较高的规培医生职业倦怠较高(均P＜0.05).结论 妇产和儿科专业规培医生的职业倦怠状况严重,应尽早提供合适的心理干预.

Objective:To understand the real experience of hope in patients with cervical cancer during the postoperative recovery period, explore how to reconstruct hope from the perspective of positive psychology, and provide a scientific basis for the formulation of nursing and psychological intervention programs for patients with cervical cancer.Methods:Totally 7 patients with cervical cancer during the postoperative recovery period who were discharged after treatment in a Class Ⅲ Grade A specialized hospital in Guangzhou between August and December 2018 were selected by purposive sampling. They received in-depth individual interview using phenomenological methods. The interview content was organized according to Colaizzi's seven stage method.Results:Three themes were obtained through analysis, namely, understanding of hope, factors hindering hope, and reasons for hope to be reshaped and maintained.Conclusions:A good social support system should be established to provide patients with active and effective psychological intervention, and increase their positive psychological capital by improving the level of hope of patients, thereby improving the quality of life of patients and promoting their recovery.

目的:了解169例出院后妇科癌症患者的心理一致感现状,分析影响因素.方法:运用便利抽样,采用心理一致感量表(SOC)和研究者自行设计的一般信息调查表对广州市某三甲专科医院妇科病房住院治疗后出院的妇科癌症患者进行调查,并运用独立样本t检验和单因素方差分析进行统计学处理.结果:169例妇科癌症患者心理一致感总分为(70.78±12.87)分;45例(26.6％)处于低水平,74例(43.8％)处于中水平,50例(29.6％)处于高水平;在测评与心理一致感相关的17个因素中,婚姻、文化程度、家庭人均月收入、医疗费用支付能力、疾病诊断、癌痛、治疗状态、睡眠状况和性生活情况共9个因素的妇科癌症患者心理一致感水平差异有统计学意义(P<0.05).结论:妇科癌症患者心理一致感整体情况良好,水平受到多层面因素影响.未来的临床工作中可以关注心理一致感水平较低的患者,提供充分有效的知识教育指导,给予物质和精神的支持,树立起信心,帮助妇科癌症患者提高心理一致感,维护良好的身心健康.