护士职业压力及其对护士身心健康影响研究现状

对护士职业压力的相关因素及其对护士身心健康影响进行综述,提出护理管理者应把护士的压力管理作为职责之一,制订相应的制度和措施,建立护士自己的支持组织.护士自身应以积极的方式应对压力,寻求支持,运用放松疗法、自我分析法缓解压力,提高压力应对能力.     

新时期护士压力应对调查分析与对策

目的：探讨新形势下护理人员对工作压力的应对行为，寻求减轻工作压力的良好途径。方法：采用问卷调查法对186名护士进行调查。结果：护士多以积极的方式应对压力，寻求支持、身体放松法、自我分析等是克服压力的有效策略。结论：减轻护士工作压力，除了学会良好自我调适外，提高管理者的支持是影响工作人员心理健康的有效途径。     

综合医院护士职业倦怠与工作压力、自尊及控制点的关系研究

目的探讨综合医院护士职业倦怠与工作压力、应对策略、护理效能感、自尊、控制点及社会支持的关系，为护理管理、护理行政决策提供依据。方法选用职业倦怠问卷、护士工作压力量表、工作压力应对策略调查表、护士效能感量表（简表型）、自尊量表、成人Nowicki—Strick-Land内-外控制量表、社会支持评定量表，对综合医院330名临床一线护理人员进行调查。结果护士职业倦怠评分为63．83±13．23，其职业倦怠与工作压力、应对策略、控制点呈正相关（r=0．291、0．423、0．510，均P〈0．01）；与自尊、护理效能感、社会支持呈负相关（r=-0．501、-0．527、-0．212，均P〈0．01）。上述诸因素对护士职业倦怠有显著影响（均P〈0．01）。结论综合医院护士的职业倦怠发生率较高，护士的工作压力、应对策略、护理效能感、自尊、控制点和社会支持对其职业倦怠有一定的预测作用。     

合同护士工作倦怠影响因素的相关性研究

目的了解合同护士工作倦怠现状及相关影响因素。方法采用护士工作倦怠问卷、护士工作压力源量表、简易应对方式问卷、社会支持评定量表、明尼苏达满意度问卷（压缩版）对130名合同护士进行问卷调查。结果合同护士情感衰竭、去人性化维度得分显著高于国内护士（均P〈0.01）,而个人成就感维度得分显著低于国内护士（P〈0.01）;合同护士情感衰竭的主要影响因素为患者护理方面的问题、消极应对、积极应对、总体工作满意度;去人性化的主要影响因素为患者护理方面的问题、支持利用度;个人成就感的主要影响因素为积极应对、患者护理方面的问题及客观支持。结论管理者应关注合同护士工作倦怠的状况,通过缓解工作压力,提高积极应对能力、社会支持水平及其工作满意度,降低合同护士的工作倦怠水平。     

接种门诊护士职业倦怠及与工作压力、自尊、社会支持的相关性

目的探讨接种门诊护士的职业倦怠现状及其与工作压力、自尊、社会支持的相关性,为管理人员决策提供依据。方法采用职业倦怠量表、工作压力量表、工作压力应对策略调查表、自尊量表、社会支持量表,对76名接种门诊护士进行调查。结果 42.11%接种门诊护士处于高度职业倦怠水平,分别有42.11%和10.53%护士感到"非典"后工作有了较大和很大的压力;职业倦怠与工作压力、消积应对策略呈正相关;与积极应对策略、自尊、社会支持呈负相关(P0.05,P0.01)。结论接种门诊护士职业倦怠程度较高,"非典"后工作压力加大,高自尊、积极的应对策略、有效的社会支持对缓解职业倦怠起到重要的作用。     

合同护士工作倦怠影响因素的相关性研究

目的 了解合同护士工作倦怠现状及相关影响因素.方法 采用护士工作倦怠问卷、护士工作压力源量表、简易应对方式问卷,社会支持评定量表、明尼苏达满意度问卷(压缩版)对130名合同护士进行问卷调查.结果 合同护士情感衰竭、去人性化维度得分显著高于国内护士(均P<0.01),而个人成就感维度得分显著低于国内护士(P<0.01);合同护士情感衰竭的主要影响因素为患者护理方面的问题、消极应时、积极应对、总体工作满意度;去人性化的主要影响因素为患者护理方面的问题、支持利用度;个人成就感的主要影响因素为积极应对、患者护理方面的问题及客观支持.结论 管理者应关注合同护士工作倦怠的状况,通过缓解工作压力,提高积极应对能力、社会支持水平及其工作满意度,降低合同护士的工作倦怠水平.     

新护士转型冲击与应对方式及社会支持的相关性研究

目的了解新护士转型冲击现状,并探讨其与应对方式、社会支持的相关性,为减轻新护士压力,制定针对性的管理措施提供参考。方法对武汉市2所三级甲等医院的新护士521名,采用一般情况调查表、新护士转型冲击评价量表、简易应对方式问卷、社会支持评定量表进行调查。结果新护士转型冲击总均分为86.35±17.45,得分率为63.96%。新护士转型冲击与社会支持、积极应对呈负相关,与消极应对呈正相关(P0.05,P0.01)。结论新护士转型冲击总体处于中等偏高水平,新护士转型冲击与社会支持及应对方式相关。医院管理者应对新护士提供专业支持和心理指导,以降低新护士转型冲击水平,促进新护士顺利完成角色转换。     

综合医院护士职业倦怠与工作压力、自尊及控制点的关系研究

目的 探讨综合医院护士职业倦怠与工作压力、应对策略、护理效能感、自尊、控制点及社会支持的关系,为护理管理、护理行政决策提供依据.方法 选用职业倦怠问卷、护士工作压力量表、工作压力应对策略调查表、护士效能感量表(简表型)、自尊量表、成人Nowicki-Strick-Land内-外控制量表、社会支持评定量表,对综合医院330名临床一线护理人员进行调查.结果 护士职业倦怠评分为63.83士13.23,其职业倦怠与工作压力、应对策略、控制点呈正相关(r=0.291、0.423、0.510,均P＜0.01);与自尊、护理效能感、社会支持呈负相关(r=-0.501、-0.527、-0.212,均P＜0.01).上述诸因素对护士职业倦怠有显著影响(均P＜0.01).结论 综合医院护士的职业倦怠发生率较高,护士的工作压力、应对策略、护理效能感、自尊、控制点和社会支持对其职业倦怠有一定的预测作用.     

合同制护士心理健康和工作压力状况及其与社会支持的相关性

目的探讨合同制护士心理健康和工作压力状况及其与社会支持的相关性调查。方法采用抑郁自评量表(SDS)、焦虑自评量表(SAS)、工作压力测量表和社会支持评定量表(SSRS),对武汉市5所医院223名合同制护士进行调查。结果合同制护士抑郁、焦虑程度显著高于常模(均P0.01);合同制护士得分前5位的压力源分别是工作量妨碍到工作质量、工作负荷太重、晋升机会少、周围冲突应对无力和工作影响家庭生活;合同制护士学历与工作压力呈显著正相关(P0.05);护龄与心理健康呈显著正相关(均P0.01);社会支持与工作压力、心理健康呈显著负相关(P0.05,P0.01)。结论合同制护士工作压力较大,其心理健康水平和工作压力受较多因素的影响,需给予积极的社会支持。     

护士面临的工作压力及其分析

护士作为医院临床一线的主力军,他们承担着越来越多的挑战和压力.他们的工作负荷重,人员少.处于劣势的工作环境中.他们的工作性质决定了护士的工作压力有几大方面.同时社会的、心理的支持不足,复杂的人际关系和多变的人际冲突,均使其身心疲劳,出现了不同程度护士心理调节能力的下降和慢性疲劳综合征.这些使得护士身心疲惫,影响了工作热情和效率,影响了护理工作质量.呼吁全社会支持和关心护理事业,对护士的正面形象给予大力的积极的宣传,提高护士的社会地位,同时也要引起医疗卫生管理部门的高度关注.应减轻和缓解护士的工作压力,提高护士的应对水平.保证护士们的身心健康.     

Perioperative and long-term morbidity and mortality after above-knee and below-knee amputations in diabetics and nondiabetics

We performed a retrospective review of a vascular surgery quality assurance database to evaluate the perioperative and long-term morbidity and mortality of above-knee amputations (AKA, n = 234) and below-knee amputations (BKA, n = 720) and to examine the effect of diabetes mellitus (DM) (181 of AKA and 606 of BKA patients). All patients in the database who had AKA or BKA from 1990 to May 2001 were included in the study. Perioperative 30-day cardiac morbidity and mortality and 3-yr and 10-yr mortality after AKA or BKA were assessed. The effect of DM on 30-day cardiac outcome was assessed by multivariate logistic regression and the effect on long-term survival was assessed by Cox regression analysis. The perioperative cardiac event rate (cardiac death or nonfatal myocardial infarction) was at least 6.8% after AKA and at most 3.6% after BKA. Median survival was significantly less after AKA (20 mo) than BKA (52 mo) (P < 0.001). DM was not a significant predictor of perioperative 30-day mortality (odds ratio, 0.76 [0.39-1.49]; P = 0.43) or 3-yr survival (Hazard ratio, 1.03 [0.86-1.24]; P = 0.72) but predicted 10-yr mortality (Hazard ratio, 1.34 [1.04-1.73]; P = 0.026). Significant predictors of the 30-day perioperative mortality were the site of amputation (odds ratio, 4.35 [2.56-7.14]; P < 0.001) and history of renal insufficiency (odds ratio, 2.15 [1.13-4.08]; P = 0.019). AKA should be triaged as a high-risk surgery while BKA is an intermediate-risk surgery. Long-term survival after AKA or BKA is poor, regardless of the presence of DM.     

Body composition assessment and methodology in nonathletic and athletic adolescent and adult males and females

The purpose of this review is to outline methodology for assessing body composition utilizing anthropometric and densitometric techniques. The objective of body composition assessment is to measure body fat and lean body mass. The quantity of these components varies due to growth, physical activity, dietary regimens, and aging. Anthropometric techniques incorporate selected skinfolds, circumferences, skeletal widths, or other variables to estimate body composition within k2.0-4.0%. These techniques are adequate for field testing of groups or individuals, but are population specific. Densitometry measures body volume irrespective of physique, sex, or age. This laboratory technique estimates body composition within 1.0-2.0%, is more difficult to administer, but is not population specific. Some limitation exists with any present technique due to biological variability and incomplete research of reference body composition in children, females, and the aged. J Orthop Sports Phys Ther 1984;5(6):336-347.     

Postoperative nausea and vomiting and opioid-induced nausea and vomiting: guidelines for prevention and treatment

Postoperative nausea and vomiting (PONV) causes patient discomfort, lowers patient satisfaction, and increases care requirements. Opioid-induced nausea and vomiting (OINV) may also occur if opioids are used to treat postoperative pain. These guidelines aim to provide recommendations for the prevention and treatment of both problems. A working group was established in accordance with the charter of the Sociedad Espa?ola de Anestesiología y Reanimación. The group undertook the critical appraisal of articles relevant to the management of PONV and OINV in adults and children early and late in the perioperative period. Discussions led to recommendations, summarized as follows: 1) Risk for PONV should be assessed in all patients undergoing surgery; 2 easy-to-use scales are useful for risk assessment: the Apfel scale for adults and the Eberhart scale for children. 2) Measures to reduce baseline risk should be used for adults at moderate or high risk and all children. 3) Pharmacologic prophylaxis with 1 drug is useful for patients at low risk (Apfel or Eberhart 1) who are to receive general anesthesia; patients with higher levels of risk should receive prophylaxis with 2 or more drugs and baseline risk should be reduced (multimodal approach). 4) Dexamethasone, droperidol, and ondansetron (or other setrons) have similar levels of efficacy; drug choice should be made based on individual patient factors. 5) The drug prescribed for treating PONV should preferably be different from the one used for prophylaxis; ondansetron is the most effective drug for treating PONV. 6) Risk for PONV should be assessed before discharge after outpatient surgery or on the ward for hospitalized patients; there is no evidence that late preventive strategies are effective. 7) The drug of choice for preventing OINV is droperidol.     

Similarities and differences between female and male sexual functions and dysfunctions

Men and women have 23 pairs of chromosomes. They share 22 of them. In physiologic conditions they differ systematically in only one pair, the sexual one. Females (normally) have what is called an “XX” on the 23rd pair of chromosomes, whereas males have an “XY” pair. The striking sexual differences –anatomic, functional, reproductive, psychological and sociocultural - between men and women depends on or derive from the difference in one critical chromosome out of 46, which contains on average 2% of all the genetic code. Biochemical, neuroendocrine, hormonal, vascular, nervous, and metabolic similarities that both sexes share, based on the common 45 chromosomes and related biologically determined similarities contributing to the secret sexual symmetry between genders, is reviewed. Furthermore the role of the genetically determined brain and somatic gender dymorphism, contributing to gender sexual differences is analyzed. Neuroplasticity and psychoplasticity are praised as basic mechanisms that bridge together and re-shape the individual biological and psychological world through the continuous interaction with the environment. Enhancement of sexual differences in behaviour, meaning of, and motivation to sex by cultural constructs, by religious and social dynamics, and the continuous interaction of each person with a usually role-polarized society during the whole life span will be finally acknowledged. To contribute to a better understanding of the shared biological sexual similarities between genders and their dialectic and continuous relation with biological and socioculturally related sexual differences is the ultimate goal of this introductory article and the following papers of the series.