助理护士的职业价值观与社会支持的调查分析

目的:了解助理护士职业价值与社会支持的状况,探讨助理护士职业价值观与社会支持的相关性,为护理管理者对助理护士进行规范化管理提供参考.方法:采用职业价值观量表(Nursing Professional Values Scales-Revised,NPVS-R)和社会支持评定量表(Social Support Rate Scale,SSRS)对湖南省某三级甲等医院的120名助理护理人员进行问卷调查.结果:120名助理护士的职业价值观得分为(95.17±18.77)分,处于中等水平;社会支持得分为(36.98±7.57)分,低于中国护士常模得分;助理护士职业价值观和社会支持呈正相关(r=0.323,P<0.05).结论:提高社会支持度有利于改善助理护士职业价值观,调动其工作的积极性,提高护理服务质量,优化护理服务.     

湖南省医院手术室专科护士离职意愿及其影响因素

目的探讨湖南省医院手术室专科护士离职意愿与社会支持水平的相关性,并对其影响因素进行分析。方法 2015年5-12月,采用便利抽样法选取湖南省56所医院的1305名手术室专科护士为研究对象,应用自制一般资料调查表、离职意愿量表(turnover iintention questionnaire,TIQ)和社会支持评定量表(social support rating scale,SSRS)对其进行调查。结果湖南省医院手术室专科护士TIQ得分为(14.29±3.63)分,离职意愿处于较高程度以上者达69.7%;SSRS得分为(45.26±6.90)分;离职意愿与社会支持呈负相关(P0.05);影响手术室专科护士离职意愿的因素为年龄、医院重视程度、医院等级、社会支持水平和工作年限。结论手术室专科护士具有较高的离职意愿,护理管理者应进行针对性的专科人才管理,以提高手术室专科护士队伍的稳定性。     

组织支持与社会支持对骨科护士护理质量及职业认同感的影响

目的分析组织支持与社会支持对骨科护士护理质量及职业认同感的影响。方法 2018年1-6月选取该院32名骨科护士作为研究对象,采用横断面问卷调查法,分别以组织支持感知量表、社会支持评定量表(SSRS)评估其组织支持与社会支持水平,以骨科护理质量考核评分标准、护士职业认同评定量表评定其护理质量及职业认同感,并进行统计学分析。结果本问卷有效回收率为100%。32名骨科护士组织支持感知量表、SSRS总分为(89.33±13.46)分、(22.31±4.71)分,均处于中度水平;骨科护理质量考核总评分、护士职业认同评定量表总评分为(71.30±10.83)分、(115.96±14.80)分,不同学历、不同职称护士骨科护理质量考核总评分、护士职业认同评定量表总评分比较差异有统计学意义(P0.05)。Pearson相关性分析显示,组织支持感知量表、SSRS各维度得分与骨科护理质量考核总评分、护士职业认同评定量表总分均呈正相关(P0.05)。分层逐步回归分析显示,职称、组织支持、社会支持各个维度均可影响骨科护士护理质量及职业认同感(P0.05)。结论组织支持、社会支持可影响骨科护士护理质量及职业认同感,护理管理者应在减轻护士工作压力的基础上注重提高骨科护士的组织支持和社会支持水平。     

精神科护士心理一致感与社会支持的相关性研究

目的了解精神科护士心理一致感水平及其与社会支持间的关系。方法采用一般资料调查表、心理一致感量表(SOC-13)与社会支持评定量表(SSRS)于2019年8月—2020年2月对两所精神专科医院的209名护士进行问卷调查,并应用SPSS 22.0软件对数据进行统计处理,分析精神科护士心理一致感与社会支持的关系。结果精神科护士的心理一致感得分为(58.79±11.34)分,社会支持得分为(40.87±8.94)分。心理一致感与社会支持及其三个维度均呈正相关(P0.05);回归分析显示,控制精神科护士的一般因素后,社会支持可以解释心理一致感46.8%的变异量。结论精神科护士心理一致感得分处于较低水平,医院管理者应提供较多的社会支持,提高精神科护士的心理一致感,从而促进精神科护士的心理健康。     

精神科护理人员焦虑抑郁状况与社会支持的调查分析

目的探讨精神科护士抑郁、焦虑状况及社会支持程度。方法采用自评焦虑量表(SAS)、抑郁自评量表(SDS)及领悟社会支持量表(PSSS)对109名精神科护士进行问卷调查。结果精神科护士焦虑、抑郁得分平均分别为(45.06±11.16)分和(42.05±8.10)分,明显高于国内常模,差异有非常显著性(P<0.01);焦虑检出率为31.2%,抑郁检出率为58.1%,中度抑郁情绪占30.3%;社会支持总分及各类支持分均较高,社会支持程度与焦虑水平高低、抑郁情绪严重程度呈负相关。结论精神科护士的焦虑、抑郁状况较严重,而社会支持程度较高,有较好和比较稳定的社会支持。精神科护士焦虑、抑郁状况与社会支持具有相关关系。     

护理本科生社会支持与职业认同的现状及其相关性

目的了解护理本科生职业认同与社会支持现状,探讨两者的相关性。方法采用护士职业认同评定量表、社会支持量表(social suport ratiing scale,SSRS)对286名护理本科生进行调查。结果护理本科生SSRS总分为(38.12±4.70)分,职业认同总分为(107.29±15.01)分,均处于中等水平;护理本科生社会支持总分与职业认同总分及各维度得分均呈正相关(P0.01或P0.05)。结论护理本科生社会支持与职业认同密切相关。应积极为护理本科生提供各种心理及行为支持,充分调动护理本科生身边可利用的社会资源,注重培养护理本科生的职业兴趣,以提升其职业认同感。     

精神科护士临床决策意识现状及其影响因素研究

目的调查精神科护士临床决策意识现状,并分析其影响因素。方法采用一般情况调查表和护理临床决策量表对绍兴市两所精神病专科医院220名精神科护士进行问卷调查。结果精神科护士临床决策意识总分为(136.31±12.06)分,各维度得分分别为寻找解决问题的方法(34.88±3.52)分,确定解决问题的目标(33.50±4.04)分,反复评价实施效果(34.69±3.76)分,再次搜索相关信息(33.79±3.85)分。工作年限、精神科专科护士和领导支持工作是主要影响因素。结论精神科护士临床决策意识偏低,护理管理者要加大专科护士的培养,提供更多的外出学习机会,重视人文关怀,构建多元化、多方位的支持系统提升精神科护士的临床决策意识。     

糖尿病专科护士职业价值观对核心能力的影响研究

目的了解糖尿病专科护士职业价值观和核心能力的现状,并分析职业价值观对核心能力的影响。方法便利选取安徽省234名糖尿病专科护士,应用一般资料调查问卷、护士职业价值观量表、糖尿病专科护士核心能力自评问卷对其进行调查。结果糖尿病专科护士职业价值观总均分为(3.86±0.62)分,核心能力总均分为(3.87±0.62)分;糖尿病专科护士职业价值观与核心能力呈正相关(r=0.523,P<0.001),职业价值观可独立解释核心能力总变异的18.6%。结论糖尿病专科护士的职业价值观处于中等偏上水平,核心能力总体处于高等水平,二者呈正相关。护理管理者应采取积极策略提高糖尿病专科护士职业价值观水平,进而提高其核心能力。     

精神科护士职业应激及效应的调查分析

[目的]了解精神科护士工作紧张及应激效应状况,为改善精神科护士的工作环境和提升身心健康水平提供科学依据。[方法]以江苏省精神专科医院118名精神科护士为研究对象,采用职业紧张因素量表、职业应激反应量表、社会支持量表和焦虑评估量表进行调查,并与181名其他临床科室护士进行职业工作紧张分析比较。[结果]精神科护士的工作紧张因素中的工作控制、工作单调、工作冲突、工作压力、工作危险、工作需求得分高于其他科室护士得分,差异有统计学意义(P0.05);职业应激中心理健康感、工作满意感得分低于其他科室护士得分,每日紧张感及焦虑状态得分高于其他科室护士得分,差异有统计学意义(P0.05);社会支持得分低于其他科室护士得分,差异均有统计学意义(P0.05)。[结论]精神科护士职业应激水平、焦虑水平高于其他科室护士,心理健康和工作满意感低于其他科室护士。     

210名血液净化专科护士职业认同感的调查研究

目的调查血液净化专科护士的职业认同感现状。方法采用护士职业认同量表中文版,对北京市16所医院210名血液透析专科护士进行调查。结果血液净化专科护士职业认同得分为(5.50±0.75)分,处于较高水平;其中把握感、有意义感、一致感、患者影响感及组织影响感得分高于普通护士,差异具有统计学意义(P<0.01或P<0.05)。结论血液净化专科护士的职业认同感处于较高水平,高于一般护士群体。     

现代残疾康复理念、政策与社区康复体系研究

本研究分析了当代残疾康复的理念和理论架构,构建了以国际公约、决议和政策、国内法律和政策以及操作性工具3个层次的康复理论体系;运用包容性发展,分析探讨了当代社区康复的体系和特点;就发展康复事业、为残疾人提供全面系统的康复服务提出相关的政策建议。     

国内外唇腭裂专科护理发展现状的文献研究及分析

目的了解和分析国内唇腭裂专科护理工作发展的现状。方法检索并分析万方医学网、中国知网、Springer Link及PubMed英文数据库近6年有关唇腭裂手术的围术期护理、患儿的喂养、手术安全管理、围术期疼痛研究以及心理护理的相关文献。结果共检索出国内文献89篇(核心期刊20篇)、国外文献22篇,其中围术期护理38篇、患儿的喂养16篇、手术安全管理10篇、围术期疼痛研究10篇、心理护理15篇。结论与国外文献相比,国内论文总结和回顾性居多,应增加研究探讨性论文,从而促进唇腭裂临床护理工作专科化的发展。     

城乡学童个性行为特征调查

目的探讨农村与城市儿童的个性行为特征。方法将97名农村学龄儿童设为农村组,97名城市学龄儿童设为城市组,采用艾森克个性问卷一儿童版和Achenbach’s 行为量表一儿童版进行评定分析。结果两组学龄儿童艾森克个性问卷各维度评分均无显著性差异（P均〉0．05）,且与全国常模相一致（P均〉0．05）;农村组男学童Achenbach’s行为量表违纪行为、攻击行为及外向型因子分均显著高于城市组,女学童退缩、社交问题因子分均显著高于城市组（P〈0．05或0．01）,其他因子分均无显著性差异（P均〉0．05）。结论农村与城市儿童个性无显著差异,而农村儿童存在较多的行为问题,可能与其所受教养和生活方式有关。     

Comparison of short-term and long-term protocols for stabilization and preservation of RNA and DNA of Leishmania, Trypanosoma, and Plasmodium

Molecular tools continue to be important in the prevention and control of parasitic diseases. However, using these techniques directly in the field remains a major challenge. Therefore, the preservation of clinical samples collected from endemic field areas for later analysis remains an important preanalytical process. This study aimed at identifying a suitable protocol for stabilization and preservation of RNA and DNA in bioclinical specimens for Trypanosoma, Leishmania, and Plasmodium research. Both spiked and unspiked blood samples were preserved in 7 protocols (different media; storage temperatures). Samples were evaluated for possible degradation of DNA and RNA along the storage duration up to the 10th week. Nucleic acid targets were assessed as follows: (i) Trypanosoma and Plasmodium RNA analysis was done using real-time nucleic acid sequence-based amplification (RT-NASBA) for 18S rRNA and for stage-specific Pfs25 mRNA, respectively; (ii) Trypanosoma DNA assessment analysis was conducted by using a conventional PCR for 18S rDNA; (iii) Leishmania RNA analysis was performed with a quantitative NASBA for 18S rRNA and Leishmania DNA assessment with an RT-PCR for 18S rDNA. Findings suggested that a newly developed L3™ buffer proved to be reliable and suitable for both short- and long-term preservation of parasite nucleic acid material. This buffer is envisaged to be suitable for utilization in field situations where resources are limited.     

Rates and risks of transmission of smallpox and mechanisms of prevention

In 1980, the World Health Organization declared smallpox eradicated from the world; the last known natural case had occurred in Somalia in 1977, and the United States had stopped routinely vaccinating its citizens in 1972. However, with increasing concerns regarding domestic and international terrorism, smallpox has resurfaced as a potential threat to global health. We review the direct and indirect modes of smallpox transmission and how patterns of transmission vary substantially, depending on the severity of circulating disease, vaccination status, environmental and socioeconomic factors, and the setting of an outbreak. We examine mechanisms for controlling outbreaks of disease and preventing further transmission in the event of an outbreak, with an emphasis on smallpox vaccination.     

Prevalence and severity of nausea and vomiting of pregnancy and effect of vitamin supplementation.

OBJECTIVE: Although nausea and vomiting of pregnancy is the most common medical condition during pregnancy, there are many unanswered questions regarding its cause, epidemiologic features and optimal management. The objectives of this study were to ascertain the prevalence of nausea and vomiting in a sample of Canadian women, to characterize the distribution of their severity and to investigate the role of vitamin B6 deficiency in their etiology. DESIGN: Prospective study. SETTING: Antenatal counselling service for pregnant women. PATIENTS: Three cohorts of women: a prospective, population-based cohort of 193 women, to estimate the rate and severity of nausea and vomiting (cohort A); a cohort of 555 women who sought advice for nausea with or without vomiting, to study the correlation between the maximal daily number of episodes of vomiting and maximal weight loss (cohort B); and a prospective cohort of 301 women who reported vomiting, to correlate vitamin supplementation with vomiting (cohort C). INTERVENTIONS: All 3 cohorts were interviewed during the counselling session, and cohort B was followed up prospectively. OUTCOME MEASURES: Frequency of nausea and vomiting, weight loss, maximal number of daily episodes of vomiting, rate of multivitamin supplementation. RESULTS: Overall, 67% of the women in cohort A reported experiencing nausea or vomiting, or both; 22% reported vomiting, and 9% experienced weight loss. In cohort B there was a significant correlation between the maximal number of daily episodes of vomiting and maximal weight loss, although there was wide variation (r2 = 0.25, p < 0.001). There was a highly significant correlation between the number of daily vomiting episodes and mean weight loss (r2 = 0.99). In cohort C, vomiting was significantly associated with lack of supplementation with multivitamins before 6 weeks' gestation (p = 0.002). CONCLUSIONS: The relation between number of daily vomiting episodes and mean weight loss may serve as a clinical tool to assess the severity of nausea and vomiting in pregnancy and the success of anti-emetics and rehydration regimens. Further study is needed to elucidate the biologic basis of the observed association between vomiting and lack of multivitamin supplementation in early pregnancy.     

History of violence and subjective health of mother and child

Objective: To study the self-reported prevalence of experienced violence among a cohort of women about two years after giving birth, their health during pregnancy, pregnancy outcomes and their experience of their child’s health.

Setting and subjects: In 2011, a total of 657 women participated in phase III of the Childbirth and Health Cohort Study in Icelandic Primary Health Care, 18 to 24 months after delivery. The women had previously participated in phase I around pregnancy week 16 and phase II 5–6 months after delivery. Data were collected by postal questionnaires.

Main outcome measures: Women’s reported history of experienced violence, sociodemographic and obstetric background, self-perceived health, the use of medications and their child’s perceived health.

Results: In phase III, 16% of women reported experiencing violence. These women felt less support from their current partner (p?p?p?p?p?p?=?0.008).

Conclusions: Our study confirms that a history of violence is common among women. A history of violence is associated with various maternal health problems during and after pregnancy, a higher rate of caesarean sections and maternal reports of health problems in their child 18–24 months after birth.

• KEY POINTS

• Violence is a major concern worldwide. Understanding the impact of violence on human health and developing effective preventive measures are important elements of any public health agenda.

• ??The reported prevalence of experiencing violence was 16% among women attending antenatal care in the primary health care setting in Iceland.

• ??Women with a history of violence reported worse health in general during pregnancy and delivered more often by caesarean section, compared to women with no such history.

• ??Mothers with a history of violence also evaluated the general health of their child as worse than women with no such history.

• ??The findings of this study support the importance of recognizing and addressing experienced violence among women in primary care.

     

我院文职护士管理和培训的实践与体会

目的构建文职护士培训、使用及管理的科学方法。方法通过规范管理、科学施训、作为骨干大胆任用等多种管理方式,使文职护士得到充分的发展。结果文职护士群体成长为医院优秀骨干,首批满3年的文职护士顺利通过续聘考核。结论科学的管理培训是文职护士成长的重要基石,对医院护理管理有着重要作用。     

通用设计原则与产品研发策略

本文介绍了通用设计的概念和设计原则,并阐述了根据此原则实施通用设计的产品研发策略。通用设计惠及的不仅是残疾人,也惠及了包括普通公众在内的广泛人群,以及企业。应将通用设计的原理应融入政府相关政策和未来发展的规划中,为残疾人以及更多人群提供合理便利的通用设计产品。     

骨脂肪瘤及血管脂肪瘤的CT及MRI表现:9例报告并文献复习

目的探讨骨脂肪瘤及血管脂肪瘤的CT及MRI表现。方法收集手术病理证实的9例骨脂肪瘤及血管脂肪瘤的临床及影像学资料,9例术前8例接受CT扫描,3例接受MRI检查。结果9例中骨脂肪瘤6例,骨血管脂肪瘤3例。6例骨脂肪瘤发生于骨内4例,骨旁2例。骨内脂肪瘤跟骨1例,距骨1例,眶骨1例,肱骨1例。骨旁脂肪瘤颅骨1例,股骨1例。骨血管脂肪瘤发生于肋骨1例,颅骨1例,椎骨1例。骨内脂肪瘤CT显示病变骨质呈轻度膨胀性改变,边缘见轻度硬化环,病灶内见脂肪密度及条弧形、结节状钙化,MRI显示病灶T1WI呈高信号,PDWI及T2WI抑脂序列呈低信号。骨旁脂肪瘤CT呈不均匀高密度团块,MRI显示病灶T1WI呈高信号,T1WI及T2WI抑脂序列呈低信号。3例骨血管脂肪瘤CT显示病变骨质呈显著膨胀性改变,骨破坏边缘及内部见多发骨嵴及粗大骨小梁,高密度骨针呈放射状、簇状或不规则排列。结论骨内脂肪瘤及血管脂肪瘤CT及MRI表现均以脂肪成分为主要特征,骨旁脂肪瘤CT以骨化性团块为特征,骨血管脂肪瘤骨质膨胀性改变较骨内脂肪瘤显著,病灶边缘及中心以多发骨嵴及粗大骨小梁为特征。