仿真模拟教学系统对护理教学有效性的系统评价

目的采用Meta分析评价仿真模拟教学系统对护理教学的效果。方法计算机全面检索国内主要的医学数据库中有关仿真模拟教学的干预性研究。按照纳入及排除标准筛选文献,提取资料并评价纳入研究的方法学质量后,采用Rev Man 5.0分析软件进行Meta分析。结果共纳入12篇文献,合计2465名护理专业学生。Meta分析结果显示:仿真模拟教学系统在提高护理专业学生理论及操作技能方面优于对照组(P<0.01)。结论仿真模拟教学系统应用于护理教学中的效果优于传统护理教学法。但因纳入研究的质量不高,仍需大样本高质量的随机对照试验进一步验证。     

翻转课堂应用于护理课程教学的文献计量分析

目的：了解翻转课堂应用于护理教学的研究现状,明确目前翻转课堂应用于护理课程教学的研究存在的问题,为促进翻转课堂在护理教学中的良性发展提供参考。方法从中国期刊全文数据库、万方、维普、中国生物医学文献数据库和PubMed检索自建库至2016年3月的相关文献,提取相关文献并采用计量方法进行分析。结果共纳入96篇文献,2013年后文献数量呈逐年增长趋势。实证研究居多,共40篇,占42%。短视频、微课及网络平台等被广泛应用于翻转课堂多门课程的教学实践中,教学效果多以组间对比终末成绩与教学评价作为最终的评价指标。结论翻转课堂可提高护生自主学习能力,改善教学质量,促进护生综合素质的全面提升,在护理课程教学中持续应用和发展具有一定优势,值得进一步推广和应用。但是目前研究中仍存在一些问题,如实证研究仍缺乏规范的科研设计,课时设置不明确,技术支持尚待跟进,评价指标与教学模式不相适应,需要后续更多更有深度和广度的研究进一步完善。     

翻转课堂教学在高职高专基础护理教学中的作用

目的:探讨在高职高专基础护理教学中应用翻转课堂教学的作用。方法:在某医学院2013级护理专科1,2班基础护理教学中:对1,2班194名学生随机分为98名学生为试验组和96名学生为对照组,试验组采用翻转课堂教学模式教学,对照组采用传统教学模式教学,两组问卷调查和考核评价。结果:通过问卷调查回收分析和期末考核成绩比较有显著差异。翻转课堂教学的应用能让护理教学的特点更加突出,让学生的职业能力得到有效提升。结论:论证了翻转课堂教学在护理基础教学中的重要作用,分析了翻转课堂教学在高职高专基础护理教学中的应用,并提出了翻转课堂教学在实际应用中需要注意的问题。     

微课结合翻转课堂对手术室实习护生学习能力影响的Meta分析

目的 系统评价微课联合翻转课堂教学对手术室实习护生学习能力的影响。方法 检索中国知网、万方、维普、PubMed、Web of Science和Cochrane Library等数据库中与手术室实习护生带教模式相关的文献,检索时限为建库至2022年5月。由2 名研究员根据纳入和排除标准独立进行文献筛选、数据提取并进行质量评价,运用RevMan 5.3软件进行Meta分析。结果 本研究最终纳入9篇文献,共包含研究对象833人。Meta分析结果显示,微课结合翻转课堂教学法可显著提高手术室实习护生的理论成绩[MD=8.48,95%CI(1.61～15.35),P＜0.00001],操作技能成绩[MD=10.24,95%CI(4.26～16.23),P＜0.00001],实习护生对教学方法的满意度[RR=1.16,95%CI(1.10～1.22),P＜0.00001]以及护生的学习能力[RR=1.20,95%CI(1.08～1.33),P＜0.00001]。结论 微课联合翻转课堂教学法可以提高手术室实习护生的理论知识水平、操作技能及护生学习能力,护生认可度高。     

基于翻转课堂的混合式教学模式在《护理理论》课程中的应用研究

目的:探讨翻转课堂在《护理理论》教学中的应用效果。方法:选择河南省某高校一年级33名护理专业硕士研究生为研究对象,实施翻转课堂。课前通过学习通等平台观看教学视频,测试题提前预习,课堂上分组演示文稿(PPT)汇报讨论,答疑解惑等教学方法进行翻转课堂。通过投票及讨论的形式来了解学生对翻转课堂教学的评价。结果:教师对翻转课堂教学改革的整体评价较好,学生对翻转课堂的满意度为94.8%。结论:翻转课堂教学模式能有效提高《护理理论》课程的教学效果,同时也调动了学生学习积极性,但还需要进一步完善,以期达到更好的教学效果。     

翻转课堂教学模式在药理学课程线上线下应用之评价

目的 探讨基于模拟药房的情景式翻转课堂教学模式和基于网络平台的小规模限制性在线课程（SPOC）翻转课堂教学模式在药理学课程的应用效果比较。方法 以江苏卫生健康职业学院2017级五年制药学专业105名学生为授课对象，在两学期内分别采用不同形式的翻转课堂教学模式开展药理学课程教学实践，对学生进行课程和教学模式的满意度调查，评价应用效果。结果 学生满意度调查结果显示，基于模拟药房的情境式翻转课堂教学模式增强了学生的团结协作能力、实践操作能力、沟通表达能力；基于网络平台的SPOC翻转课堂教学模式有助于学生批判思维能力、分析解决问题能力、自主学习能力的培养。结论 两种翻转课堂教学模式虽各有侧重，但均能有效提高学生的学习成绩，提升教学效果，提高人才培养质量，期待有机融合二者优势，推广线上线下混合式翻转课堂教学模式的开展。     

翻转课堂在护理人际沟通中的应用研究

目的探讨翻转课堂在护理人际沟通课程中的应用效果。方法选择我校2013级和2014级护理专业本科学生,其中2014级共88名学生作为试验组,采用翻转课堂教学法进行教学;2013级学生共73名作为对照组,采用传统教学方法。通过分析情境模拟大赛成绩及教师的课堂反馈情况,评价翻转课堂教学模式的应用效果。结果两组学生情境模拟大赛成绩进行比较,试验组高于对照组,差异具有统计学意义(P<0.05);试验组教师对学生的课上表现反馈良好。结论翻转课堂教学模式能够提高教学效果,培养学生的沟通能力和团队凝聚力。     

肌萎缩侧索硬化症患者营养管理的最佳证据总结

目的 检索、评价和总结肌萎缩侧索硬化症(ALS)患者营养管理的最佳证据。方法 采用PIPOST确定循证问题,按照“6S”证据检索模型自上而下依次检索国内外数据库及网站关于ALS患者营养管理的证据,检索时限为建库至2022年9月1日。由2名研究人员对纳入文献进行质量评价、证据提取及汇总。结果 共纳入15篇文献,包括1篇临床决策、2篇指南、2篇系统评价、2篇随机对照试验、2篇队列研究、1篇专家共识和5篇专家意见,共提取出7个维度共28条证据。结论 本研究对ALS患者营养管理最佳证据进行了总结,可为临床医护人员开展ALS患者营养管理提供循证依据。     

翻转课堂在护理管理学教学中的应用与效果

目的探讨翻转课堂在护理管理学教学中的应用和效果。方法选取62名全日制护理本科三年级学生实施翻转课堂教学。课前通过教学视频,幻灯片预习和自测题,课堂上通过汇报讨论,重点知识讲解,案例教学和总结反馈等实施翻转课堂。采用自制的教学效果评价表了解学生对翻转课堂教学的评价。结果学生考核成绩均分为(90.47±3.26)分,超过90%的学生认可本次翻转课堂的教学模式及具体教学内容,并有超过96.8%学生表示翻转课堂对学习有促进作用。结论翻转课堂教学模式能够促进护理管理学的教学效果,但在具体实施中仍需进一步完善,以取得更好的实践效果。     

体位翻转对胃镜检查中黏膜清晰度影响的文献研究

目的对胃镜检查前患者服用祛除胃内黏液药物后采取体位翻转干预对检查中黏膜清晰度影响的文献进行评价研究。方法检索Cochrane Library、Embase、PubMed、Web of Science和中国知网、万方医学等数据库,根据纳入和排除标准筛选文献,运用澳大利亚JBI循证卫生保健中心随机对照研究质量评价标准对纳入研究的文献质量进行评价,并进行描述性分析。结果共纳入5篇文献,3篇中文、2篇英文,涉及8种不同的体位干预措施。5篇文献均采用视野下内镜黏膜清晰度评分,干预后以食管、胃体、胃窦和十二指肠作用较为明显,3篇文献对内镜检查时间进行了测量,其中2篇文献提示观察组检查时间短于对照组。结论体位翻转有利于改善内镜下黏膜清晰度,缩短内镜检查时间,但仍需更多大样本、多中心随机对照试验进行更为精确的效果判断。     

在康复治疗学专业运动疗法方向教学中开设双语教学的设想

在康复治疗学专业中开展双语教学具有重要的意义，也是教学方法改革的必然趋势。作者通过分析在康复治疗学专业运动疗法方向教学中开展双语教学的必然趋势，探讨开展双语教学存在的问题和对策，以及对课程的选择和对教师与学生的具体要求，提出双语教学实施的具体方案。     

The effectiveness of conservative management for disabled throwing shoulder in baseball: a systematic review of Japanese-language primary studies

Background: Conservative management is often the first-choice treatment for baseball players with disabled throwing shoulder (DTS). Considering the high popularity of baseball in Japan, we suspected that there might be some evidence regarding this topic in the Japanese-language literature.

Objective: This study aimed to systematically review Japanese-language primary studies investigating the effectiveness of conservative management for DTS in baseball.

Methods: Eight databases were systematically searched from inception to 7 April 2016. Data on authors, publication years, sample characteristics, types of interventions, outcome measures and results were extracted. Data were synthesised qualitatively.

Results: Seven studies with low evidence level and low-to-moderate study quality were included. Interventions examined in the included studies were downward throwing, combined physiotherapy interventions and joint distension. Forming correction, stretching for posterior shoulder muscles and strengthening exercises to improve scapular/trunk stability were commonly used in combined physiotherapy interventions. Downward throwing and combined physiotherapy interventions corresponded with expert opinions described in the English-language literature. Due to the lack of studies with high level of evidence, however, it was difficult to determine the genuine effects of these interventions.

Conclusion: Our systematic review found limited evidence about the effectiveness of any conservative management for baseball players with DTS. Although downward throwing and combined physiotherapy interventions might be appropriate management in some cases, further studies of higher level of evidence and greater methodological rigour are required.     

Teaching physiotherapy students to “be content with a body that refuses to hold still”

In recent decades, physiotherapists have become concerned with cultural, economic, philosophical, political, and social questions and have been exploring more flexible ways of speaking about and practicing physiotherapy. While recognizing the need to embrace a broader range of perspectives, physiotherapy educators and other medical educators have been at a loss as to how to best achieve this. Drawing on two examples from South Africa and New Zealand, we seek to illustrate possibilities and barriers to teaching social sciences to physiotherapy students, specifically theories of embodiment as an alternative to the biopsychosocial model. We review each educator’s choice of embodiment theory in curriculum design and the role of the educator’s disciplinary background on teaching, learning, and assessing that learning. Against this background, we explore physiotherapy students’ experiences with theories of embodiment and possible transformative implications for their self-worth and/or professional practices. We suggest that students were able to explore physiotherapy’s relation to the body and the profession’s historical inattention toward the body as a philosophical/theoretical construct. From the lessons learned, some can perhaps be usefully passed onto others thinking of introducing a more diverse and inclusive approach of the body; one that we argue will be needed in the future.     

Case series research: a case for qualitative method in assembling evidence

Evidence-based practice is in vogue in the health care disciplines generally, and no less in physiotherapy specifically. Although the hierarchy of evidence favours quantitative methods, there is a place for rigorous, systematically undertaken qualitative research methods in the assembling of evidence. It is becoming increasingly acceptable to seek to enhance knowledge development by using mixed research approaches, where the qualitative method of the social sciences is called on to illuminate findings derived from quantitative studies. This article acknowledges the value of qualitative method used in this manner and argues further that there is a particular instance where this method can do more, in that it can stand alone in the gathering of evidence. This instance comes under the banner of case series research. Inductively derived findings from a series of carefully and systematically undertaken case studies have an important role in the assembling of evidence for more effective practice, especially in a discipline such as physiotherapy where interventions are more often context-dependent and complex.     

A Systematic Review of Methods to Measure Balance and Walking Post-Stroke. Part 1: Ordinal Scales

Abstract

The rehabilitation of balance and walking is a cornerstone of stroke physiotherapy and our main interest is to assess the effectiveness of physiotherapy interventions. We therefore reviewed the literature to seek outcome measures which would be suitable for such a purpose. This article is limited to ordinal scales. CINAHL, Medline and Embase databases were searched for measurement tools which measured balance and/or walking post-stroke and could be used in clinical settings. They were assessed for reliability, validity, sensitivity to change, scale development, suitability for use in clinical settings and with a wide range of stroke severity. Twenty-six measurement tools were identified. All had some information about their psychometric properties but few had been rigorously tested. They were generally reliable and valid, but sensitivity to change was poor or untested and few showed a true hierarchy. None of the measurement tools fulfilled all the assessment criteria.     

Incentive spirometry following thoracic surgery: what should we be doing?

Background

Thoracic surgery may cause reduced respiratory function and pulmonary complications, with associated increased risk of mortality. Postoperative physiotherapy aims to reverse atelectasis and secretion retention, and may include incentive spirometry.

Objectives

To review the evidence for incentive spirometry, examining the physiological basis, equipment and its use following thoracic surgery.

Data sources

MEDLINE was searched from 1950 to January 2008, EMBASE was searched from 1980 to January 2008, and CINAHL was searched from 1982 to January 2008, all using the OVID interface. The search term was: ‘[incentive spirometry.mp]’. The Cochrane Library was searched using the terms ‘incentive spirometry’ and ‘postoperative physiotherapy’. The Chartered Society of Physiotherapy Resource Centre was also searched, and a hand search was performed to follow-up references from the retrieved studies.

Review method

Non-scientific papers were excluded, as were papers that did not relate to thoracic surgery or the postoperative treatment of patients with incentive spirometry.

Results

Initially, 106 studies were found in MEDLINE, 99 in EMBASE and 42 in CINAHL. Eight references were found in the Cochrane Library and one paper in the Chartered Society of Physiotherapy Resource Centre. Four studies and one systematic review investigating the effects of postoperative physiotherapy and incentive spirometry in thoracic surgery patients were selected and reviewed.

Conclusion

Physiological evidence suggests that incentive spirometry may be appropriate for lung re-expansion following major thoracic surgery. Based on sparse literature, postoperative physiotherapy regimes with, or without, the use of incentive spirometry appear to be effective following thoracic surgery compared with no physiotherapy input.     

Real Time Ultrasound: An Objective Measure of Skeletal Muscle

Abstract

Objective measurement of muscle size is an important aspect of physiotherapy, but current clinical assessment methods are unreliable. Whilst not in widespread clinical use, real-time ultrasound has the potential to determine accurately both the linear dimensions and crosssectional area of skeletal muscle, providing evidence for the effectiveness of physiotherapy interventions. This systematic review of current literature was undertaken to investigate the validity and reliability of real-time ultrasound as an objective measure in physiotherapy practice, to discuss the implications for practice and to identify future research requirements. Eight current databases were searched for studies that measured skeletal muscle. Eleven articles were identified which specifically met the search criteria, and these were reviewed systematically. All of the articles found real-time ultrasound to be a valid and reliable tool for measuring skeletal muscle size under controlled conditions; however, confounding variables, such as fat, fascia orientation, muscle shape and pathology, were identified which may affect the validity of measurements in the general population. Further research is needed into deep and irregular muscles, and into the wider population, including obese, physically trained and symptomatic subjects to validate its use as a generalised tool. Furthermore, the use of a strict protocol was highlighted to ensure valid and reliable measurements in clinical practice.     

肌萎缩侧索硬化症4类动物模型建立的研究进展

目的肌萎缩侧索硬化症是选择性侵犯上、下运动神经元的慢性进行性变性疾病,其病因及发病机制一直未能完全明确,其研究多借助于动物模型,目前肌萎缩侧索硬化症动物模型的建立有多种方法,其各自的特点、实用性及价值有所不同.资料来源应用计算机检索Medline数据库1980-01/2003-12期间的相关文章,应用题名检索,检索词"amyotrophic lateral sclerosis,model",限定文章语言种类为英文.资料选择对资料进行初审,选取以肌萎缩侧索硬化症动物模型研究为主的文献,然后筛除应用肌萎缩侧索硬化症动物模型进行药物疗效观察与发病机制研究的文献,对剩余的文献开始查找全文作为纳入标准.资料提炼共收集到96篇以"amyotrophiclateral sclerosis,model"为题名检索的文献,15个试验符合纳入标准.排除的81篇试验中,75篇为应用肌萎缩侧索硬化症模型药物疗效观察与发病机制的研究文献,6篇为重复性试验的研究,资料综合选入文献建立了肌萎缩侧索硬化症疾病的神经毒性动物模型、免疫介导的动物模型、自然发病动物模型、转基因动物模型,并对模型建立机制、特点、实用性及其价值进行研究.结论上述文献中模拟肌萎缩侧索硬化症疾病症状或发病机制动物模型的建立,能够作为肌萎缩侧索硬化症疾病研究的参考模型,为肌萎缩侧索硬化症发病机制的研究及治疗方案的确定提供了动物实验学基础.     

Enhancing students learning experiences in nursing programmes: An integrated review

Nursing as a profession is both fragmented and complex. The education setting is demanding, and prepared students are more clinically and academically robust. Therefore, nursing programmes should implement high-quality teaching based on the best available scientific evidence to improve learning quality and students’ experience. This study aimed to identify the teaching tools used to enhance students’ perceived experiences in undergraduate nursing programmes. Nine databases were systematically searched to identify quantitative and qualitative studies regarding the teaching tools utilised across nursing education programmes. Results were summarised following a systematic integrated review framework. The searches identified 15,886 citations, and after title/abstract/full-text screening, 66 primary research studies were included comprising data from 4,411 participants with a mean sample size of 66 (range 6–447). Educators utilising a student-centred wrapping approach exploiting knowledge building and self-development were found to improve students’ experiences; however, consensus on success factors was lacking. The findings indicate that educators’ knowledge and pedagogical skills used in a flexible way, tailored and sensible to students and the learning context, enhance student experiences. Nursing educators should identify learning situations that make students vulnerable and pay particular attention to the students’ learning experiences. We identified several tools accommodating the students' experience.     

利妥昔单抗联合FC方案治疗慢性淋巴细胞白血病的疗效和安全性系统评价

目的系统评价利妥昔单抗与氟达拉滨和环磷酰胺(FC)组成的FCR方案对慢性淋巴细胞白血病(CLL)的治疗效果和安全性。方法计算机检索PubMed、Cochrane Library、SpringerLink、CNKI和CBM数据库2000～2011年期间发表的关于FCR方案和FC方案比较治疗CLL的随机对照试验(RCT)。由两位研究者独立进行文献筛选、资料提取和质量评价后,采用RevMan 5.0软件进行Meta分析。结果共纳入3个RCT,共1 623例患者。Meta分析结果显示:FCR方案与FC方案相比,两者无进展生存期(P<0.001)、总体生存率[OR=1.94,95%CI(1.49,2.53),P<0.000 01]、完全缓解率[OR=2.54,95%CI(2.00,3.22),P<0.000 01]、Ⅲ/Ⅳ级中性粒细胞减少症发生率[OR=1.60,95%CI(1.33,1.92),P<0.000 01]、总的Ⅲ/Ⅳ级不良反应发生率[OR=1.72,95%CI(1.35,2.20),P<0.000 1]差异均有统计学意义;而两者部分缓解率[OR=0.74,95%CI(0.35,1.55),P=0.43]、Ⅲ/Ⅳ级血小板减少症[OR=0.97,95%CI(0.74,1.27),P=0.83]、自身免疫性溶血性贫血[OR=0.86,95%CI(0.59,1.27),P=0.45]发生率差异均无统计学意义。结论利妥昔单抗联合氟达拉滨和环磷酰胺组成的FCR方案可明显延长CLL的无进展生存期,提高总体生存率和完全缓解率。但部分患者也会出现Ⅲ/Ⅳ级中性粒细胞减少症、血小板减少症、自身免疫性溶血性贫血、恶心呕吐等不良反应。