目的:了解护理本科生循证实践能力现状与实践障碍因素,为护理教育及教学管理提供参考.方法:采用一般资料调查表、中文版护生循证实践能力评估量表、循证护理实践障碍量表对100名护理本科生进行横断面调查.结果:护理本科生循证实践能力评估量表的总均分为(2.68±0.35)分,各维度得分态度为(3.18±0.43)分、知识为(3.01±0.59)分、技能为(2.27±0.40)分;护理本科生循证实践障碍总得分为(80.44±17.13)分,百分制转换后得分为(53.63±11.42)分;多元线性回归分析显示,是否接受过循证实践教育、是否发表过论文或参加过科研项目、开展循证护理的资源条件、循证护理实践者特点4个因素进入回归方程,影响护理本科生循证实践能力的解释量为49.5％.结论:护理本科生循证实践处于中度障碍水平,循证实践能力整体水平有待提高;护理教育者应重视护理本科生循证实践的培养和发展,结合相关影响因素与障碍因素采取有效措施,为护理专业培养更多优秀人才.

Objective To summarize the best evidence of medication management in elderly patients with polypharmacy and provide reference for management of multi-drug administration for elderly patients. Methods Relevant evidence on medication management in elderly patients with polypharmacy was retrieved,including BMJ Best Practice,Up To Date,National Guideline Clearinghouse,National Institute for Health and Care Excellence,Registered Nurses Association of Ontario,Medive,Joanna Briggs Institute Library,Cochrane Library,Pub Med,CNKI,Wanfang,etc.. The time limit was set from the establishment of the database to February,2022. The quality assessment and classification were conducted by researchers using the quality evaluation standard and evidence grading system of JBI evidence-based health care center. Results A total of eight references were enrolled,including two guidelines,four expert consensus reports,two systematic reviews. Nineteen pieces of evidence were obtained,including safety assessment,management support,education and self-management. Conclusion The process of evidence production is specific,comprehensive and scientific. Clinical healthcare professionals should select the best evidence for clinical application in combination with actual situation of the hospital,clinical context and individual condition of patients to standardize the practice of patients’ medication management and ensure medication safety.

目的:探讨下肢被动运动在急性心肌梗死病人经皮冠状动脉介入治疗(PCI)术后早期康复中的应用效果.方法:选取2021年1月—2021年9月我院心内科收治的急性心肌梗死PCI术后病人100例作为研究对象,采用随机数字表法将病人分为试验组和对照组,每组50例.对照组病人PCI术后给予合理膳食干预、常规药物治疗和常规康复,试验组病人PCI术后给予合理膳食干预、常规药物治疗和下肢被动运动训练.于干预前(术后6 h)和干预后(出院前12 h)收集病人左室射血分数(LVEF)、左室舒张末期内径(LVEDD)数据,评价病人日常生活自理能力、焦虑和抑郁情况.于干预后(出院前12 h)收集病人峰值摄氧量(Peak VO2)数据.结果:干预后,试验组LVEF为(65.07±3.09)％,Peak VO2为(21.45±1.25)mL/(min·kg),Barthel指数为(96.10±2.91)分,高于对照组[LVEF为(59.85±3.05)％,Peak VO2为(19.70±1.22)mL/(min·kg),Barthel指数为(88.40±2.56)分],差异均有统计学意义(P<0.05);试验组LVEDD为(62.99±3.38)mm,SAS评分为(53.41±2.23)分,SDS评分为(42.81±4.54)分,低于对照组[LVEDD为(69.46±4.90)mm,SAS评分为(54.87±2.45)分,SDS评分为(44.59±4.31)分],差异有统计学意义(P<0.05).结论:下肢被动运动能提高急性心肌梗死PCI术后病人LVEF和Peak VO2,减少LVEDD,减轻焦虑和抑郁情绪,提高病人生活自理能力.

介绍了症状管理理论(SMT)的基本概念,重点围绕心力衰竭症状管理主要测评工具、心力衰竭病人症状管理的影响因素和应用现状进行阐述,旨在为构建适合心力衰竭病人的症状管理策略提供理论依据,推动SMT在临床护理中的应用.

目的 探讨经皮冠状动脉介入治疗(PCI)术后患者早期再入院的危险因素.方法 计算机检索PubMed、the Cochrane Library、Embase、Web of science、中国知网、中国生物医学文献数据库、万方、维普数据中关于PCI术后早期再入院危险因素的队列研究或病例对照研究.检索时限为建库至2021年7月13日.利用RenMan 5.3软件进行分析.结果 共纳入12篇文献,包括23项危险因素,结果显示有统计学意义的危险因素为年龄>65岁(OR=1.39,95％CI:1.21～1.59)、女性(OR=1.29,95％CI:1.24～1.33)、左室射血分数(OR=1.27,95％CI:1.17～1.37)、多支血管病变(OR=2.97,95％CI:2.00～4.41)、外周血管疾病(OR=1.44,95％CI:1.30～1.59)、慢性肺部疾病(OR=1.31,95％CI:1.22～1.40)、糖尿病(OR=1.23,95％CI:1.18～1.28)、肾功能不全(OR=1.37,95％CI:1.27～1.48)、卒中/短暂性脑缺血发作(OR=1.32,95％CI:1.07～1.62)、住院时间(OR=1.41,95％CI:1.00～1.98)、高血压(OR=1.12,95％CI:1.09～1.15)、心力衰竭(OR=1.40,95％CI:1.30～1.51)、贫血(OR=1.25,95％CI:1.13～1.37)和医疗保险(OR=1.19,95％CI:1.03～1.37).结论 现有证据表明,年龄>65岁、女性、左室射血分数、多支血管病变、外周血管疾病、慢性肺部疾病、糖尿病、肾功能不全、卒中/短暂性脑缺血发作、住院时间、高血压、心力衰竭、贫血和医疗保险是PCI术后早期再入院的危险因素.

目的:探讨重症监护病房医生对身体约束决策的认知情况,为促进高质量身体约束决策提供参考.方法:以质性研究的现象学方法为指导,对3所南昌市三级甲等医院的17名重症监护病房医生采用半结构式访谈法进行深度访谈,对访谈资料进行转录、编码、类属分析、描述和组织.结果:共提炼出4个主题:对决策主题及步骤的认知;决策过程的原因要素;决策过程中的障碍因素;对身体约束决策的建议.结论:重症监护病房医生对身体约束决策认知存在差异,医院管理层需积极引导,并优化决策支持系统,促进高质量身体约束决策.

Objective To analyze the undergraduate nursing students' needs of the course installation of Nursing English,to provide reform basis for course offering,to promote teaching effect and lay the foundation for culturing high-quality nursing staff.Methods A self-designed questionnaire was used to investigate the needs of the course installation of Nursing English in 800 undergraduate nursing students.Survey contents included English level,self-assessment of english capability, total attitude,studying motivation,course installation needs,and so on.The data was analyzed by SPSS 15.0.Results The needs of class time,learning strategy and teachers were alike (P ＞ 0.05 ),but the needs of course installation,class extent,proportion of english teaching,teaching contents and teaching material were different in students from different source( Z =- 3.617,- 4.039,- 2.682,- 2.565,- 2.876,- 3.174 ;P ＜ 0.05 ).The current english level of independent college students (29.4％ CET4,5.7％ CET6) was lower than those of undergraduate nursing students admitted from entrance examination (51.6％ CET4,13.0％ CET6),and Chi-square values were 12.953 and 12.281 (P ＜0.01 ) ; the learning motivation and objective was also lower ( Z =- 5.832,- 1.976; P ＜ 0.05 ) ; the need for original teaching material was significantly lower (42.9％ vs 60.2％ ; Z =- 2.723,P ＜ 0.01 ).Conclusions Learning interesting and confidence of english course of undergraduate students is insufficient and need to be raised.Course installation,teaching methods and learning material need to be reformed and the specialized english level of teachers needs to be increased.Learning motivation and objective of independent college should be improved.