Objective:The institutionalization of care for patients with dementia is becoming a trend. Understanding the burden on employed caregivers and exploring associated factors are of great importance in practice. Therefore, this study aimed to examine the relationship between basic attributes, caring ability, and caregiver burden in employed caregivers practicing in nursing homes. Methods:This cross-sectional study included 541 employed caregivers in 11 four-star nursing homes in Zhejiang Province from April to December 2022. Caregiver burden was assessed using the Zarit Burden Interview (ZBI). Demographic characteristics of participants, characteristics of the older patients with dementia, caring characteristics, training in dementia care, and caring abilities were collected for analysis of influencing factors. A hierarchical multiple regression analysis was conducted to explore the factors influencing the burden on employed caregivers in nursing homes. Results:The ZBI score of employed caregivers in nursing homes was 40.42 ± 10.18, representing a moderate caregiver burden. Factors such as age (U = 27.82, P < 0.001), residence (U = 7.89, P < 0.001), educational level (H = 55.81, P < 0.001), self-care of older patients with dementia (H = 85.21, P < 0.001), daily care hours (H = 73.25, P < 0.001), number of older people with dementia cared for (H = 14.56, P = 0.012) and training in dementia care (U = -9.43, P < 0.001) were significantly associated with caregiver burden.Caring ability was negatively associated with caregiver burden (r = -0.22, P < 0.01). Furthermore, after controlling for demographic characteristics, the characteristics of older people with dementia, caring characteristics, training in dementia care, and caring ability explained 8.5%, 5.8%, and 4.8% of the caregiver burden, respectively. Conclusion:The burden of employed caregivers on patients with dementia in nursing homes can be attributed to various factors. We recommend tailored interventions, such as dementia care training and reviewing the number and duration of hours worked to reduce the burden experienced by caregivers.

Objective:To integrate the best evidence of non-drug intervention of urinary incontinence in elderly women and to formulate practical recommendations.Methods:In this systematic review study, using “elderly woman”,“urinary incontinence”,“bladder training”,“pelvic floor muscle training”,“enuresis”,“leakage of urine” as the key words, the 6S evidence resource pyramid model was used to search in British Medical Journal best practice, Uptodate, World Health Organization, Guidelines International Network, National Institute for Health and Care Excellence, Chinese Medical Association, Scottish Intercollegiate Guideline Network, Registered Nurses Association of Ontario, Cochrane Library, The Joanna Briggs Institute (JBI), New Zealand Guidelines Group, Polish Society of Gynecologists and Obstetricians, PubMed, Embase, Medline, Web of Science, SinoMed, China National Knowledge Infrastructure, WanFang Data, etc. The evidence retrieved included evidence-based knowledge base resources, clinical practice guidelines, expert consensus, systematic review, etc. Data were retrieved from January 1, 2017 to May 1, 2022, and collated from May 2, 2022 to May 25, 2022. Two researchers independently evaluated the quality of literature and extracted data using the AGREE Ⅱ and JBI evidence-based health care center assessment tools. The JBI evidence-based health care center′s evidence pre-rating system and evidence recommendation rating system were applied to rank the evidence; and under the guidance of the evidence structure of JBI, the strength of evidence recommendation was determined and the best evidence was extracted and summarized in combination with the study group discussion and expert opinion.Results:A total of 9 articles were retrieved, including 7 guidelines and 2 systematic reviews; and 6 guidelines were classified as Grade A and 1 as grade B; both 2 systematic reviews were rated as Grade A; 84% (27/32) of the items were evaluated as “Yes”. Evidence were summarized as 34 pieces of best evidence from 6 dimensions, including “overall recommendation, evaluation of type and degree of urinary incontinence, lifestyle change, behavioral therapy, prevention of precipitating factors, intervention in special population”; the flow chart of screening, evaluation, special symptoms, life style and behavior therapy was combed, and the practical suggestions were formed.Conclusions:The overall quality of the literature on non-drug intervention of urinary incontinence in elderly women is high, and the level of evidence is high. Early identification of urinary incontinence types and assessment of disease severity, lifestyle changes, avoidance of predisposing factors and behavioral therapy are the key to non-drug treatment of urinary incontinence in those patients.

目的 编制护理人员对间歇经口管饲的知信行问卷,并检验其信效度.方法 基于知信行理论,在文献分析、小组讨论的基础上,通过德尔菲专家函询和预调查形成问卷.2022 年 10 月至 11 月,选取浙江省 6 个市 10 家三级甲等医院的 328 名护理人员进行调查,测定问卷的信效度.结果 形成的问卷包括知识、态度、行为 3 个维度,共计 33 个条目.探索性因子分析共提取 3 个公因子,累计方差贡献率为 77.316%,问卷平均内容效度指数为 0.970.总问卷的Cronbach's α系数为 0.969,折半信度为 0.755,重测信度为 0.936.结论 编制的护理人员对间歇经口管饲的知信行问卷信度和效度良好,可用于护理人员对间歇经口管饲相关知识、态度和行为现况的调查.

目的 评价神经根型颈椎病(CSR)患者采用压力生物反馈介导的颅颈屈曲训练联合颈椎牵引的干预效果.方法 选择于2020-2021年在浙江医院康复医学中心就诊的60例CSR患者为研究对象,随机分配至对照组和干预组各30例,均予以颈椎牵引治疗,干预组同时实施压力生物反馈介导的颅颈屈曲训练,连续干预4周.采用视觉模拟量表(VAS)、颈椎功能障碍指数(NDI)和颈部屈曲无痛范围主动活动度(AROM)评价干预效果;采用重复测量资料的方差分析比较两组患者干预前后差异.结果 干预组男性15例,年龄为(49.47±5.33)岁,病程为(5.53±2.89)个月,干预前VAS评分为(4.73±1.39)分;两组患者的性别、年龄、病程和干预前VAS评分比较,差异均无统计学意义(P＞0.05).干预4周后,干预组和对照组的VAS评分(2.13±1.01、2.93±1.11)和NDI评分(12.17±2.12、15.23±2.39)均较干预前(4.73±1.39、4.90±1.21、20.20±3.78、19.60±3.30)降低,颈部屈曲AROM(42.87°±2.99°、41.80°±3.61°)较干预前(37.50°±2.80°、38.07°±2.99°)增大;时间与组间均存在交互作用,干预组的改善效果均优于对照组(FVAS=5.119,P=0.027;FNDI=15.473,P＜0.001;FAROM=11.443,P＜0.001).结论 压力生物反馈介导的颅颈屈曲训练联合颈椎牵引可有效缓解CSR患者颈部疼痛,改善AROM,对患者颈椎功能的改善较单纯颈椎牵引更为明显.

对Vivifrail多组分运动的概念、作用机制、实施要素以及在老年人中的应用效果进行综述,为国内老年人开展Vivifrail多组分运动相关研究提供参考.

目的 对国内老年人虐待研究现状进行文献计量学分析,以期为今后深入研究提供参考与建议.方法 检索中国知网、万方数据知识服务平台、维普资讯中文期刊服务平台和中国生物医学文献数据库建库至2021年12月31日收录的老年人虐待相关文献进行分析.结果 共纳入237篇文献,发文量整体呈上升趋势;载文量前9位的期刊以医学类期刊为主;文献合作度2.35,合著率45.15％;研究类型以综述及经验总结类和调查性研究为主;研究热点主要集中于照顾者、影响因素和痴呆患者.结论 国内老年人虐待研究仍处于起步阶段,尚存在研究类型单一、缺乏干预性研究等问题,今后应加强多学科、多机构间的合作,进一步延展老年人虐待研究的深度和广度.