儿科实习护生职业获益感的调查分析

[目的]了解儿科实习护生职业获益感水平,为护生实习期间给予客观的评价和有效的职业引导提供依据。[方法]采用便利抽样方法选取苏州某三级甲等儿童医院420名实习护生为研究对象,采用职业获益感量表进行儿科实习护生职业获益感调查。[结果]儿科实习护生职业获益感总体得分处于较高水平(146.39分±13.54分);自身成长维度得分最高(4.54分±0.42分),良好护患关系维度得分最低(2.30分±0.22分);"看到病人饱受病痛折磨,我更珍惜生命、知足所有"条目得分最高(4.65分±0.56分),"亲友因获益于我的职业而非常支持我的工作"条目得分最低(4.10分±0.80分);学历、是否定向实习是影响儿科实习护生职业获益感的因素。[结论]儿科实习护生职业获益感较好,但是由于儿科护理的特殊性,多种因素影响护生的职业获益感的培养,应加强对实习期护生职业认知评价干预,引导护生切实感受职业获益,以增进儿科护理实习的信心。     

肿瘤专科医院实习护生临床学习环境与职业获益感相关性研究

目的 探讨肿瘤专科医院实习护生临床学习环境及职业获益感的相关性。方法 采用便利抽样法于2020年11月至2021年3月对5所肿瘤专科医院141名实习护生采用一般人口学资料调查表、护理临床学习环境评价量表及实习护生职业获益感量表进行调查，分析两者的相关性。结果 共回收有效问卷141份。141名肿瘤专科医院实习护生临床学习环境评价得分为（181.82±26.40）分，处于较高水平，单因素分析显示，与父母关系、选择护理专业的方式、择业意向不同的实习护生在临床学习环境得分上差异有统计学意义（P＜0.05）；职业获益感总分为（127.89±17.34）分，处于中等偏上水平，单因素分析显示，当前学历、择业意向不同的实习护生在职业获益感得分上差异有统计学意义（P＜0.05）。Pearson相关分析显示，肿瘤专科医院实习护生临床学习环境总体得分与职业获益感呈现正相关（r=0.780，P＜0.05）。结论 肿瘤专科医院护理教育者可通过提高实习护生临床学习环境来提高其职业获益感。     

心理资本在实习护生情绪智力与职业获益感的中介效应

目的 探讨心理资本在实习护生情绪智力与职业获益感的中介效应。方法 采用便利抽样的方法,选取于2018年6月—2019年6月在空军军医大学第二附属医院、西安北环医院完成实习任务的255名护生作为研究对象。采用一般资料调查问卷、职业获益感问卷、心理资本问卷、情绪智力量表对其进行调查,采用依次检验法进行中介效应分析。结果 本组实习护生职业获益感、心理资本、情绪智力总分分别为（125.41±18.21）分、（95.38±13.29）分、（122.36±16.89）分;职业获益感与心理资本、情绪智力总分均呈正相关（r=0.646,0.688,均P<0.01）;心理资本在情绪智力和职业获益感之间起到了部分中介作用,中介效应值为40.3%。结论 实习护生职业获益感处于较高水平,心理资本在情绪智力与职业获益感间起部分中介作用。建议管理者采取针对性措施提高实习护生情绪智力和心理资本水平,进而提升其职业获益感。     

本科实习护生人文关怀能力与职业获益感及主观幸福感的相关性分析

目的 探讨本科实习护生人文关怀能力与职业获益感及主观幸福感相关关系。方法 采用一般资料问卷、关怀能力评价量表、护生职业获益感量表、总体幸福感量表对某三级甲等医院94名本科实习护生进行调查。结果 94名本科护生人文关怀能力总分为(193.79±23.97)分,处于中等水平;职业获益感总分为(125.83±15.00)分;主观幸福感总分为(83.28±13.11)分;本科实习护生人文关怀能力与职业获益感、主观幸福感总分均呈密切正相关(r=0.611~0.711,均P<0.01)。结论 本科实习护生人文关怀能力处于中等水平,人文关怀能力与护生职业获益感、主观幸福感呈密切正相关。护理教育者及管理者应关注实习护生职业获益感与主观幸福感水平,并加以干预,从而间接提高其人文关怀能力。     

心理资本在实习护生学习动机和职业获益感间的中介作用

目的 探讨心理资本在实习护生学习动机和职业获益感间的中介作用.方法 采用一般资料调查表、护士职业获益感问卷、教育参与量表、心理资本问卷对4所医院280名实习护生进行问卷调查.结果 实习护生职业获益感总分为(122.11±17.06)分,学习动机总分为(107.15±15.72)分,心理资本总分为(96.77±14.07...     

实习护生职业获益感与自我效能感现状调查及其相关性研究

目的：了解实习护生职业获益感与自我效能感的现状,分析二者相关性,为提升护生职业获益感提供参考。方法：便利抽取郑州市3所三甲医院的487名实习护生为研究对象,应用职业获益感量表和自我效能感量表进行调查。结果：实习护生职业获益感得分为（3.86±0.63）分,自我效能感得分为（27.79±4.85）分,职业获益感各维度及总分与自我效能感均呈正相关（r=0.305~0.571,P＜0.05）。结论：实习护生职业获益感和一般自我效能感得分均处于中等偏上水平。护理教育者应重视护生的职业兴趣培养和提高职业认同感,医院管理者应通过优化临床带教方法和营造良好护患关系等途径提高护生职业获益感。     

本科护生实习前后职业认同的现状及影响因素分析

[目的]研究护生实习前后职业认同的现状、差异及影响因素。[方法]对河南省某高校164名护生在实习前后分别采用护生职业认同问卷进行调查。[结果]护生职业认同总分实习后较实习前下降(P0.01),留职获益与离职风险这个维度实习后得分有明显下降(P0.01);实习前对护生职业认同有影响的因素有独生子女、担任学生干部和入学志愿;实习6个月后的影响因素有入学志愿。[结论]临床实习对护生职业认同有重要影响。护生实习后职业认同水平低于实习前,提示护理教育者应注重课堂教学与临床实践的衔接,关注护生实习期间的心理状态,积极给予心理调适,帮助护生提高其职业认同感。     

本科护生实习后期职业获益感对工作敬业度的影响研究

目的:探讨本科护生实习后期职业获益感对其工作敬业度的影响,以期为临床护理管理者引导护生感受职业获益、促进职业健康、提高工作敬业度提供参考依据。方法:运用职业获益感量表和工作敬业度量表对120名实习后期的本科护生进行调查。结果:护生工作敬业度总分为(26.76±4.99)分,职业获益感总分为(118.07±13.01)分,两者呈正相关(r=0.492,P<0.01),分层回归分析显示,控制人口学变量后,亲友认同、团队归属感共可解释工作敬业度的48.8%。结论:护理管理者应引导护生感受职业获益感,增强实习工作敬业度,促进护理职业健康发展。     

本专科护生实习后职业认同感状况调查

目的 了解本、专科护生实习后的职业认同感状况,分析影响职业认同感的因素并提出相应的对策.方法 利用自行设计的问卷对在广州3家三级甲等医院实习后的78名本科、专科护生的职业认同现况进行调查.结果 本科护生职业认同总体得分(2.71±0.76)分,专科护生(3.30±0.87)分;不同志愿选择和学历的护生.职业认同感差异有统计学意义;不同学历护生在职业认同感的3个维度中,职业自我概念维度得分无统计学意义,在职业获益感和职业动力感维度差异有统计学意义.结论 护生职业认同感总体水平中等偏低,但专科护生的职业认同感高于本科护生.志愿选择、学历对职业认同感有一定影响.     

310名实习护生触摸舒适感现状及影响因素分析

目的 调查实习护生对触摸的舒适感现状,分析其影响因素。方法 采用便利抽样法,于2018年1—5月选取南京2家三级甲等综合性医院的实习护生作为研究对象。采用一般资料问卷、护生对触摸的舒适感量表和艾森克人格问卷简式量表对抽取的310名实习护生进行调查,采用多元线性回归分析实习护生触摸舒适感的影响因素。结果 310名实习护生的触摸舒适感得分为（35.48±7.35）分,人格特质（内外倾向和神经质）、对护理的态度和自评实习适应情况是影响实习护生触摸舒适感的主要因素（P<0.05）,共解释实习护生触摸舒适感的56.3%。结论 实习护生的触摸舒适感处于较低水平,内外倾向和神经质、对护理的态度和实习适应情况是实习护生触摸舒适感的影响因素。针对内外倾向得分低、神经质得分高、对护理的态度为不喜欢及自评实习适应不良的实习护生,学校和医院的护理教育者应关注实习护生的内心体验,通过情景模拟、心理疏导、职业价值观引导等措施,顺利实现实习护生的角色转变,从而提高其触摸舒适感。     

Putting policy into practice: pre- and posttests of implementing standardized languages for nursing documentation

Aims and objectives. To describe the change in documentation of the nursing process in all inpatient wards in a 900‐bed university hospital. Major research question was what are the differences between before and after implementation of documentation policy related to the steps of the nursing process? Background. Implementation of standardized languages has been shown to be difficult to accomplish in clinical practice. Patients are the source of data and their conditions, responses and well‐being should be reflected in the nursing record. As such, nursing documentation can create the premises for the development of new knowledge in nursing and the improvement of nursing performance and can provide data and information necessary for nursing researchers to evaluate the quality of interventions and participate in the formulation of healthcare policy. This study is part of longitudinal project to prepare nurses for electronic documentation within the interdisciplinary health record and to improve documentation of nursing using standardized languages. Design and method. A cross‐sectional study design was used: a pretest (n = 355 nursing records) for baseline status of nursing documentation, an intervention and a post‐test (n = 349 nursing records) to obtain data on nursing documentation. The year‐long intervention comprised planned work in groups, and educational and supporting efforts. Results. A statistically significant improvement was found in the use of Functional Health Patterns for documentation of nursing assessment, NANDA for nursing diagnoses and Nursing Interventions Classification for nursing interventions in documentation of daily nursing care for inpatients. Conclusion. At all organizational levels intervention aimed at putting policy regarding documentation into clinical practice considerably improved daily use of standardized nursing languages. Relevance to clinical practice. Nurses need to use standardized language to document patient care data in the electronic health record and to demonstrate contributions to nursing care.     

Structure and content in Norwegian nursing care documentation.

In 1994, the Norwegian Board of Health (NBH) published recommendations for nursing care documentation. The two-fold purpose of the present study was to see if 5 wards in 2 Norwegian hospitals fulfilled the proposed NBH recommendations and guidelines regarding documentation, and to evaluate them in terms of the proposed structure and key words of the VIPS model. Results showed that all nursing records (n = 55) had an admission assessment. A nursing care plan was present in 62% of the records. Nursing goals were lacking in the remaining 38%, diagnosis and planned interventions were absent in 18%, and 45% of the diagnoses lacked information concerning patient progress or outcome. The nursing care plans were updated in only 40% of the records and discharge notes were present in 35%, confirming that NBH recommendations were not met in this sample. The key words of the VIPS model covered all information present in the records, and high interrater reliability was obtained for the majority of key words categorized by two independent researchers. It is suggested that the VIPS model components and key words can contribute to a reliable and uniform model for nursing care documentation and enhance comprehensive and systematic documentation, which is presently lacking in Norwegian records.     

Research and the configuration of nursing services

• ? This paper is concerned with the way in which nursing research has influenced changes in the organization of nursing services, particularly the shift from so-called traditional nursing to new nursing. To this end published research and professional literature are selectively reviewed.
• ? The case is made to support the view that change in nursing has been driven forward by the evangelical zeal of opinion leaders rather than evidence.
• ? It is suggested that holistic care as embodied in new nursing is no longer affordable. Market pressures have precipitated a revisiting of the task basis of nursing. An effective anchor would have been a solid body of research evidence pointing up the value new nursing may have. Regrettably not enough research was done prior to the diffusion of new nursing. What was done was not always adequate, and what was adequate was not effectively deployed by nurse leaders.
• ? Nursing is the largest workforce in the NHS and has attracted a great deal of policy interest. It is suggested that it will become increasingly important for nursing to be more strategic, and develop its own professionally driven research agenda.
• ? The future of the nursing profession is uncertain. It is clear that evidence-based practice is centre stage, and there is a need for nursing to re-negotiate its professional boundaries and to develop intellectual partnerships in order to move the knowledge base of practice forward.

     

Towards an aesthetics of nursing

Towards an aesthetics of nursing This paper re-appraises the work of Barbara Carper on aesthetics and the art of nursing. It identifies serious flaws in Carper's original arguments and the way in which she and subsequent authors have conflated the concepts of art and aesthetics in nursing. The paper explores a broader approach to aesthetics and proposes a way in which a theoretical approach to nursing aesthetics could be developed. The paper concludes that nursing is a fit object of aesthetic appreciation and that aesthetic quality is a necessary attribute of good nursing practice.     

提升护理服务综合价值的研究

目的:研究护理综合价值的提升。方法:分析护理价值研究背景,阐述护理价值研究进展结果:提出护理价值研究途径。结论:有利于达成一种共识,使广大护理人员认识护理价值、研究护理价值、开发护理价值,重视护理综合价值研究和提升。 护理服务价值是护理服务劳动产品的价值和服务本身所创造的价值的总和,即使用价值与价值的统一。目前日本、美国、德国和中国都在加强护理价值研究的探索,但仍存在使用价值与价值研究分离问题。因此,我们应不断加强护理综合价值研究,以适应卫生事业改革对护理管理的挑战。本研究主要在分析国内外护理价值研究的基础上,提出综合护理价值研究途径,以达到合理评价护理价值的目的。     

基层医院整体护理的实施与对策

目的:总结实施整体护理的经验,提高护理质量。方法:全面综合分析实施整体护理的对策和措施。结果:经验:领导的高度重视和大力支持,是实现整体护理模式转变的坚实基础;提高人员整体素质,确保整体护理的有效开展;多做少写,以点带面,实行非模式病房开展整体护理工作;积极开展健康教育,巩固整体护理效果;实施整体护理质量管理的措施。体会:领导的重视和支持,是开展整体护理工作的根本保证;提高了社会公众对护理工作的认可程度和护士的社会地位;显示了护士的自身价值;改善了护患关系,提高了病人满意度,同时也密切了医护关系;护理队伍整体素质提高,敬业精神增强。结论:实施整体护理,促进了护理学科的发展。     

我国护理行业的改革与发展

从我国护理行业的现状、卫生体制改革以及基本国情出发 ,着重探讨护理管理、护理教育、护理环境、护理经济与管理体系、护理立法等方面的发展途径     

Innovations in United States genetics nursing: Practice and research

Aim: Clinical and research applications from human genome discoveries are growing and creating both opportunities and challenges to the integration of genetic concepts into practice and research. Nurses have a long history of caring for individuals, families, and groups with genetic conditions. In the past two decades, a small group of nurses in the USA have used a variety of strategies to further develop the field of genetics nursing. In this paper we identify innovative approaches to identifying genetics‐related nursing roles and opportunities, as well as successful collaborative efforts beyond nursing to address the emerging health and societal challenges related to human genetics discoveries. Methods: The information presented here comes from a variety of sources where the authors or genetics nurses directly participated, including: (i) a systematic literature review of genetics nursing; (ii) a comprehensive research study of models of delivering clinical genetics services and the roles of health professionals; and (iii) participation in numerous national research, planning, programmatic, and advisory groups involved with clinical genetics‐related health services, research, education, and public policy. Results: Genetics nurses in the US have developed innovative responses to genetics‐related challenges within and beyond the profession of nursing. These include: (i) establishing an organization for nurses in genetics and gaining formal recognition of genetics as a specialty of nursing; (ii) defining the scope of genetics nursing practice and developing a new genetics nursing credential; (iii) establishing a multiprofessional genetics education coalition and defining genetic competency for health‐care practice; (iv) creating new clinical practice roles for nurses that integrate emerging genetics concepts and skills into diverse clinical practice areas; (v) expanding nursing involvement in genetics‐related research; and (vi) participation in high‐level genetics advisory groups. Conclusions: The US experience shows that nurses have made substantial progress in expanding their involvement in genetic services through visionary leadership, innovative approaches to challenges, establishing support with nurse colleagues, and engaging in multiprofessional efforts. The most important first step is developing a supportive environment for nurse advancement. In the US, the genetics nurses’ organization known as the International Society of Nurses in Genetics (ISONG) has provided this base.     

整体护理病房三级护理查房的体会

我院自1999年7月开始在整体护理模式病房中实施三级护理查房。1年多来,对800例危重病人进行了护理查房,查房的形式为责任护士每天查,主管护师或护士长每周查,副主任护师以上或科护士长每月抽查,护理部主任每季抽查。通过查房,明显提高了危重病人的护理质量,病人得到了更为优质的服务,护理服务满意率提高;对护理人员来说,提高了业务水平,锻炼了口头表达能力;对护理管理来说,及时了解护士对护理程序的应用情况,掌握危重病人的护理质量,对护理中存在的不足及时提出指导意见。     

晨间护理缺陷分析及对策

目的提高晨间护理质量。方法通过向住院病人和护士发放问卷调查及每周不定期检查各病区晨间护理质量,了解晨间护理工作中存在的缺陷,提出整改的措施。结果晨间护理工作中存在的主要缺陷:51.8%的病人认为护士与病人的沟通少,进病房时未向病人问好,整理病房时未向病人解释,口腔清洁率70.3%,头发清洁率45.3%,皮肤清洁率69.5%,病房安静整洁率67.3%,床单位整洁率86.5%,病情关注情况67.9%,健康教育执行情况48.6%,协助生活不能自理的病人进食、入厕、更衣、床上排便等占75.4%,时间安排满意度75.6%,护士认为晨间护理重要的占30%,晨间护理内容知晓率占60.9%,认为工作量大来不及做的占56.7%。结论提高护士对晨间护理的认识,规范晨间护理内容和程序,加强与病人的沟通,提供符合个体化需要的晨间护理,合理安排护理人员、工作重点和时间,持续质量改进,有助于提高晨间护理质量。