AIMS:To explore risk factors for Coronary Heart Disease (CHD) in secondary prevention for patients with the disease in China. DESIGN:Cross-sectional study. METHODS:A two-stage sampling method was used (stratified sampling and systematic sampling). Patients who met WHO diagnostic criteria for CHD, had the capacity to give informed consent and volunteered to participate were recruited from five districts in Hengyang city, Hunan province, China. Six instruments were used: A general socio-demographic questionnaire, Coronary Heart Disease Self-Management Scale, International Physical Activity Questionnaires, Chinese Eight-Item Morisky Medication Adherence Scale, Zung's Self-Rating Anxiety Scale and Sexual Health Questionnaires. Participants completed the questionnaires in person or via telephone. Single-factor correlation analysis, Pearson correlation analysis and multiple linear regression analysis were carried out. RESULTS:A total of 373 patients were recruited with a mean age of 66.25 years (standard deviation = 9.98). The mean score was 57.00 (14.23) for self-management, 5.41 (1.82) for medication adherence, 53.61 (9.26) for anxiety, 8.66 (3.18) for sexual knowledge and 22.20 (9.68) for the need for sexual health education. The median was 1563.90 MET-min/day for total energy consumption of physical activity. Self-management, physical activity, medication adherence, anxiety and sexual health were significantly correlated with a range of demographic variables (age, gender, marital status, occupation, education levels, types of medical insurance, personal monthly income, living arrangements) and illness-related variables (illness duration, number of hospital admissions, type of therapy, number of other chronic diseases, cardiac function grading and BMI). CONCLUSION:This research has showed the risk factors related to self-management skills, medication adherence, anxiety, physical activity, sexual knowledge and the need for sexual health education in secondary prevention for patients with CHD. Health professionals play an important role in helping patients reduce risk factors for CHD to minimise its reoccurrence and mortality. RELEVANCE TO CLINICAL PRACTICE:Both hospital-based and community-based health professionals, especially nurses, have an important role to play in developing and implementing health promotion interventions to help patients with CHD reduce risk factors for the disease and thus reduce mortality. PATIENT OR PUBLIC CONTRIBUTION:No patient contribution. Community nursing staff contributed to the design of the general socio-demographic questionnaire for this study. REPORTING METHOD:The STROBE checklist was used to ensure comprehensive reporting (Appendix S1).

Purpose The purpose of this study was to identify and evaluate the use of the Patient-Reported Outcomes Measurement Information System in patients with gastrointestinal cancer, as well as provide references for analyzing treatment outcomes, gauging prognostic risk, and assessing clinical symptoms and function in gastrointestinal cancer patients. Methods PubMed, Web of Science, ProQuest, Embase, and CINAHL were systematically searched using keywords and controlled vocabulary through January 2023. Results The scoping review collected 30 studies published from 2012 to 2022, including observational studies ( n = 21), interventional studies ( n = 4), and mixed studies ( n = 5). Outcome indicators included mood, pain, fatigue, sleep, the ability to perform activities of daily living, social functioning, and other health problems. Conclusion Being a self-report questionnaire, the Patient-Reported Outcomes Measurement Information System offers a full assessment of patient’s symptoms and quality of life, and accurately captures their actual thoughts, feelings, and experiences. Individuals with gastrointestinal cancer made frequent use of the Patient-Reported Outcomes Measurement Information System to provide an accurate measure of their health status.

目的 探讨基于信息化管道管理体系的构建与应用.方法 选取该院2020年6-12月住院的置管患者200例为管道管理改善前组,2021年1-6月住院的置管患者200例为管道管理改善后组.成立管道信息化管理的专业小组,共同构建信息化管道管理体系,包括信息化管道标识、信息化管道评估记录、信息化管道不良事件管理和信息化置管资质管理,结合大数据信息化背景下管道数据统计及分析等.结果 改善后管道固定符合率、管道评估记录规范率明显高于改善前,非计划拔管、导管相关性血流感染发生率明显低于改善前,差异有统计学意义(P＜0.01).结论 信息化管道管理体系提升了医院管道的同质化管理水平,提高了管道护理质量与安全性,降低了全院非计划拔管和导管相关性血流感染发生率.

心血管疾病是全球范围内的常见病与多发病,发病年龄已呈现出年轻化趋势 [1].医学诊疗技术的不断突破与升级,使得心血管疾病危重患者的生存率持续攀升.经皮冠脉介入术(PCI)、冠状动脉旁路移植术、溶栓取栓等治疗方式的推广与应用,使更多危重急性心肌梗死(AMI)患者被成功救治 [2].心脏康复作为PCI术后患者的一项重要辅助治疗手段,其效果在临床已得到充分验证.AMI患者越早进行心脏康复治疗,预后越好 [3].本文通过对PCI术后患者心脏康复护理干预研究所采用的理论内涵、理论框架、干预效果进行综述,为PCI术后患者制定心脏康复方案提供参考与依据.

慢性心力衰竭(chronic heart failure,CHF)是心血管疾病的终末阶段,其住院率高、预后差[1].在药物治疗的基础上,实施规律、全程心脏运动康复是改善CHF患者心力储备及运动功能的重要手段[2].心脏康复已被用于改善稳定期心力衰竭患者的心功能作为I级推荐[3].但国内心力衰竭康复研究较少[4],患者难以长期坚持[5-6],真正参与运动康复的比 率很低7-8].

目的 探讨预防冠心病经皮冠脉介入术(PCI)后患者造影剂肾病(CIN)的充分、安全的口服水化剂量.方法 2020年5—9月该院收治的冠心病行PCI患者155例,按所属病区分为A组53例、B组52例、C组50例,分别予1.5 mL/(kg?h)、2 mL/(kg?h)、2.5 mL/(kg?h)的口服水化剂量.护士于三组术后3、24小时记录水化量和尿量,当班护士观察三组水化过程中有无急性左心衰竭、消化道症状及CIN发生.结果 三组饮水量和尿量随术后时间延长逐渐递增,A组<B组<C组.三组饮水量和尿量随术后时间延长逐渐增大,A组<B组<C组.A组术后3小时、24小时的饮水量与尿量均小于B、C两组,除与B组在术后3小时的尿量比较差异无统计学意义(P>0.05)外,余各项组间差异均有统计学意义(P<0.05).B组在术后3小时、24小时的饮水量与尿量均小于C组,但除术后3小时饮水量组间差异有统计学意义(P<0.05)外,余各项差异均无统计学意义(P>0.05).胃肠道症状发生率A组为0、B组为3.8％、C组为18.0％,CIN发生率A组为15.1％、B组为5.8％、C组为2.0％;组间差异均有统计学意义(P<0.05).三组均未发生急性左心衰竭.结论 冠心病PCI术后患者2.5 mL/(kg?h)的水化量是充分、安全的水化剂量.

AIMS:Secondary prevention of coronary heart disease is of utmost importance to facilitate people to achieve health outcomes and behaviours. This study was to investigate the effect of a nursing intervention based on Cox's interaction model of client health behaviour to improve health outcomes and behaviours of secondary prevention of coronary heart disease.DESIGN:This study is a cluster randomised controlled trial.METHODS:Participants were recruited between August and November 2019 in two community settings in Hengyang city, Hunan province, China. Participants in the intervention group received a nursing intervention based on Cox's interaction model of client health behaviour and routine health education, while those in the control group received routine health education only. The outcome variables included self-management, physical activity, medication compliance, anxiety, sexual knowledge, the ability to identify sexual health education needs, blood pressure, body mass index (BMI), and low-density lipoprotein cholesterol (LDL-C). The influential statistical tests applied to analyse the data included χ2 tests and t tests.RESULTS:Seventy-seven participants completed this study. Compared with the control group (n = 40), the intervention group (n = 37) showed statistically significant better health outcomes and behaviours regarding self-management, physical activity (except for high energy consumption), medication compliance, anxiety, sexual knowledge, the ability to identify sexual health education needs, systolic blood pressure, BMI, and LDL-C. However, there was no statistically significant difference in diastolic blood pressure and high energy consumption for physical activity.CONCLUSION:A well-developed nursing intervention based on Cox's interaction model of client health behaviour could successfully improve health outcomes and behaviours of secondary prevention of coronary heart disease. Such an intervention may be incorporated into community healthcare practice by nurses to improve patient care.IMPACT:This study provides a valuable insight to facilitate further development of effective nursing interventions to improve secondary prevention of coronary heart disease in community settings.

目的 探讨社区冠心病患者焦虑程度、性知识认知水平和性教育需求程度的影响因素及三者间的相关性.方法 选择2018年12月至2019年4月衡阳市某5个社区卫生服务中心抽取的200例冠心病患者进行问卷调查,获得186份冠心病患者的有效问卷.对其一般资料调查问卷、焦虑自评量表、冠心病患者性知识水平和性教育需求程度问卷进行横断面分析.结果 焦虑主要影响因素有文化程度、合并其他慢性病种数、心功能分级(P<0.05);性知识认知水平主要影响因素有年龄、文化程度、患病年限(P<0.05);性教育需求程度主要影响因素有性别、合并其他慢性病种数、心功能分级、居住方式(P<0.05);性知识认知水平与性教育需求程度呈正相关(r=0.346,P=0.000)、焦虑与性教育需求程度呈负相关(r=-0.305,P=0.000).结论 社区冠心病患者性知识认知水平越低,则性教育需求程度越低,而焦虑程度则越高,社区医护人员应对社区冠心病患者进行必要的性生活健康教育及心理疏导,缓解冠心病患者的焦虑情绪.

This cluster randomized controlled trial aimed to investigate the effects of an intervention to teach resourcefulness on depression and coping style of patients with coronary heart disease (CHD). A convenience sample of 72 patients in community settings took part. Participants in the intervention group (n = 36) received an 8-week intervention based on the concept of resourcefulness, plus routine health education. Participants in the control group (n = 36) received routine health education only. After the intervention, participants in the intervention group had significantly higher scores on resourcefulness and coping styles, and lower scores on depression than those in the control group (both ps < .001). The findings suggest that a well-developed intervention to teach resourcefulness could help patients with CHD to be more resourceful, improve their level of depression, and choose more effective strategies to cope with stress.

[目的]探讨脑瘫患儿父母在照顾患儿过程中的创伤后成长体验与应对方式现况.[方法]运用质性研究中的现象学方法,选取衡阳市某三级甲等医院儿童康复科符合纳入标准的11名脑瘫患儿父母作为访谈对象,对其进行半结构式访谈,访谈内容采用colaizzi现象学分析法进行分析.[结果]脑瘫患儿父母积极心理体验主要包括以下几个主题:积极应对;家庭和谐度提高;自身健康行为的改变;感悟人生哲学;对政府与社会的期望.[结论]脑瘫患儿父母在照顾脑瘫患儿时存在着创伤后成长体验,临床工作者应充分了解患儿父母的身心需求,挖掘其优势与潜能,制订有针对性的心理干预措施,帮助父母提高战胜疾病的信心及处理问题的能力,最终提高父母对患儿的照顾质量与生活质量.

在医教协同的背景下构建一个完善、优质的成人护理教育"互联网+"翻转课堂教学模式,培养学生自主学习和终生学习的能力,提高护理人才培养质量至关重要.文章重点探讨了如何在互联网背景下下构建适合成人学习者特点的线上线下翻转课堂教学模式.

[目的]探讨正常分娩适度保护会阴联合使用盐酸达克罗宁胶浆对分娩结局的影响.[方法]将愿意自然分娩的200例产妇采用随机数字表法分为观察组、对照组,每组100例.两组产妇正常分娩均给予适度保护会阴法助产.在此基础上观察组产妇阴道、小阴唇等黏膜表面予以盐酸达克罗宁胶浆局部麻醉及润滑,记录并比较两组产妇会阴完整率、会阴侧切率、会阴裂伤程度、产时会阴疼痛程度、产后2 h会阴疼痛程度、产后会阴伤口感染率、产后2 h阴道出血量、新生儿1 min阿氏(Apgar)评分、新生儿早吸吮成功率及产妇满意度.[结果]最终189例产妇完成本研究,其中观察组96例,对照组93例.观察组与对照组比较,产妇会阴侧切率及会阴裂伤程度降低,会阴完整例数增加,产时、产后2 h会阴疼痛程度减轻,产妇满意度上升,差异有统计学意义(P<0.05).[结论]在自然分娩过程中适度保护会阴联合使用盐酸达克罗宁胶浆能够有效降低产妇产时、产后2h会阴疼痛程度,产妇依从性增加,提高了会阴完整率,降低了产妇会阴侧切率、会阴裂伤程度及会阴伤口感染率,是一种方法简单、作用安全的分娩镇痛方法.

新型冠状病毒肺炎对人类造成了极大的威胁和影响.护士在这场抗"疫"战争中体现了护理的重要性和专业性.对新冠肺炎患者提供科学有效的护理,对病情的恢复至关重要.本文旨在对新冠肺炎应急护理管理、患者护理和护理研究最新进展作一综述,以期为后续护理及研究提供参考.

BACKGROUND Coronary heart disease (CHD) is one of the leading causes of mortality worldwide. Previous research has demonstrated that resourcefulness interventions can help individuals identify effective coping strategies to manage their conditions, reduce the incidence of depression, and improve their quality of life. However, little is known about such interventions for people with CHD in China. OBJECTIVE This study aimed to investigate the effects of a resourcefulness training intervention on depression and coping style of patients with CHD in China. METHODS A cluster randomized controlled trial design was used. A convenience sample of 72 patients in community settings took part in the study. Participants in the intervention group (n = 36) received an 8-week intervention based on the concept of resourcefulness, plus routine health education. Participants in the control group (n = 36) received routine health education only. Three outcomes (resourcefulness, depression, and coping styles) were measured using the Resourcefulness Scale, Center for Epidemiological Studies Depression Scale, and Medical Coping Mode Questionnaire. Data were collected at baseline and post intervention, and analyzed using frequencies, percentages, means, standard deviations, independent sample t tests, and χ tests. RESULTS After the intervention, participants in the intervention group had significantly higher scores on resourcefulness and coping styles, and lower scores on depression than those in the control group (both Ps < .001). CONCLUSIONS It is suggested that a well-developed resourcefulness intervention could help patients with CHD in China and beyond to be more resourceful, improve their level of depression, and choose more effective strategies to cope with stress.

本研究按照品管圈活动步骤,采用自行设计的问卷对急诊儿科晚夜间静脉输液患儿家属进行调查,找出不满意的要因并制定改进方案,实施改进措施及对整改前后进行统计分析,探讨"品管圈"活动对急诊儿科晚夜间静脉输液护理质量的改善效果.结果显示:患儿家属对穿刺技术、等待时间和输液环境的满意度由整改前的75.0％、83.0％和87.0％,提高至整改后89.2％、92.0％和95.2％,总体满意度由实施前的84.2％提高到实施后的94.2％,实施前后比较差异有统计学意义(P<0.05).品管圈活动可以提高患儿及家属对护理工作的满意度,促进护理质量的持续改进,在临床上值得推广与应用.

[目的]了解脑卒中偏瘫病人功能锻炼健康行为形成过程中的促进因素,为针对病人的需求制定有效的护理干预方法提供直接依据.[方法]采用目的抽样,对11例符合条件的脑卒中病人进行半结构式访谈,运用现象学资料分析方法对访谈内容进行分析.[结果]通过对访谈资料的归类与剖析,提炼出以下5个主题:充足的疾病相关知识;正确的风险意识;合适的社会支持;积极的结果预期;适当的自我调整,积极地应对困难.[结论]护理人员可根据研究所得出的促进因素,针对病人的现状提供相应的干预措施,促进其功能锻炼健康行为的形成与维持,从而促进肢体功能的康复,最终达到提高生活质量的目的.

Hippo通路由一系列激酶构成,在细胞增殖和凋亡过程中起重要作用.上皮细胞顶端-基底极性、平面细胞极性、机械张力和G蛋白偶联受体均可以调控该通路活性.越来越多的研究发现Hippo通路参与了动脉粥样硬化相关病理的发生发展,在这个过程中,内皮细胞、巨噬细胞和平滑肌细胞中的Hippo通路发挥着重要作用.本文主要针对Hippo通路的调控及其在As中的潜在作用作一综述,以期为As提供新的治疗靶点和途径.

Patient empowerment has been shown to have some positive impacts on self-efficacy, self-esteem, and recovery. However, information about the empowerment needs of patients after a percutaneous coronary intervention is scarce. The aim of this study was to develop a Chinese-language instrument to measure empowerment needs of such patients. The initial instrument was generated based on a literature review and interviews with patients after a percutaneous coronary intervention procedure. Content validity was tested with a panel of experts using the Delphi method. In total, 226 patients were recruited for psychometric tests using the revised instrument. Expert authority coefficient was 0.92, and content validity index was 0.95. The internal consistency reliability was demonstrated by Cronbach's α coefficients (0.86 for the total score, 0.66-0.74 for the dimensions). The newly developed 19-item, five-dimension instrument has shown satisfactory validity (face/content validity and construct validity) and internal consistency reliability. The instrument could help clinical nurses who have close contact with patients after a percutaneous coronary intervention to gain a better understanding of their empowerment needs and could help develop appropriate health education to address such needs.

目的 探讨在《老年护理学》教学中联合应用专题研讨课(Seminar)和案例教学法(Case-based teaching,CBT)的效果.方法 在《老年护理学》课程中实施Seminar-CBT教学法,采用自设问卷调查的形式,在课程结束后收集学生对《老年护理学》结合Seminar-CBT教学法的态度和学习效果的自我评价.结果 90.8％的学生认为Seminar-CBT教学法有助于提高自身对老年护理知识与技术的掌握程度;87.6％的学生认为该课程增进了师生间的互动和交流;提高了合作性学习能力(93％),对学习资源的利用能力(94.1％)和解决临床实践问题的能力(98.4％);相较于传统老年护理学理论授课模式,92.4％的同学表示更喜欢Seminar-CBT教学模式.结论 Seminar-CBT教学法应用于《老年护理学》教学,操作性和可行性强,有利于增进师生间的交流,提高学生灵活应用老年护理学知识的综合能力,从而能达到良好的教学效果.