ObjectiveTo formulate the Chinese version of Fear of Progression Questionnaire-Short Form/Caregiver Version (FoP-Q-SF/C) and examine the reliability and validity of the scale.MethodsA questionnaire survey of FoP-Q-SF/C was conducted among the caregivers of melanoma out-patients in West China Hospital of Sichuan University from June 2019 to March 2020. Convenient sampling method was adopted. The validity and reliability of the scale were analyzed.ResultsA total of 247 caregivers of melanoma out-patients were investigated by the FoP-Q-SF/C, and 101 valid questionnaires were finally collected. The Cronbach’s α of the FoP-Q-SF/C scale was 0.919, and the Guttman Split-Half coefficient was 0.906. Using exploratory factor analysis to extract 3 common factors, the cumulative explainable total variation was 73.964%. The model fit was as follows: chi-square/degree of freedom was 1.950, standardized root mean square residual was 0.067, goodness of fit index was 0.859, incremental fit index was 0.939, comparative fit index was 0.938, Tucker-Lewis index or non-normed fit index was 0.918, and the root-mean-square error of approximation was 0.097.ConclusionsThe FoP-Q-SF/C scale formulated in this study is divided into three dimensions, which has good reliability and validity, meanwhile, it is relatively simple and can be used to clinically screen melanoma caregivers’ FoP-Q-SF/C levels. However, the application of this scale in other diseases still needs further testing.
The UK's National Institute for Health and Care Excellence (NICE) published guideline of mental wellbeing at work on March 2, 2022. The guideline covers how to create the right conditions for mental wellbeing in the workplace, with the aim of promoting supportive and inclusive workplace environments and helping people with or at potential risk of mental health problems. This review will interpret the guidelines in detail.
Objective To investigate nosocomial infection rate in Intensive Care Unit (ICU), its risk factors and the pathogenic characteristics of multidrug-resistant bacteria through targeted monitoring, in order to provide scientific references for reducing nosocomial infection. Methods Targeted monitoring was performed on the patients who were admitted to the comprehensive ICU between July 2014 and June 2016. Results Nosocomial infection occurred in 312 of the 4 991 patients. The case infection rate was 6.25%, and case infection rate per day was 19.03‰. After the adjustment, the case infection rate per day was 6.77‰. The ventilator-associated pneumonia infection accounted for 30.78‰; catheter-related bloodstream infection occupied 0.30‰; and catheter-associated urinary tract infection accounted for 0.27‰. The respiratory tract was the major part of nosocomial infection, accounting for 90.38%. Gram-negative bacilli were the major bacteria accounting for 92.74%, in whichAcinetobacter baumannii accounted for 36.29%. Conclusions Through targeted monitoring to keep abreast of the current situation of nosocomial infection in ICU, management and interventions can be targeted. It is an important way to reduce nosocomial infection in ICU.
ObjectiveTo discuss the demands for nursing knowledge among family caregivers for elderly people, in order to provide a basis for nurses to provide effective education for these people. MethodsBetween May and June 2012, a questionnaire which contained the condition of demands for nursing knowledge and the burden of care was used to investigate 1 600 family caregivers for the elderly people. ResultsThe caregivers had a demand for nursing knowledge, which may include the knowledge on medicine, disease and caregiving. The demand for knowledge was correlated with relationship between the caregivers and care recipients, health condition of the caregivers and care burden. ConclusionThe demands for nursing knowledge are higher in those who have spouse and high burden of care, without disease and symptom; we should pay more attention on them and take measures to reduce their burden of care.
ObjectiveTo understand the status and risk factors of care ability among main caregivers of stroke patients.MethodsA total of 395 stroke patients and their main caregivers were enrolled in the Department of Neurology, West China Hospital, Sichuan University from August 2017 to February 2018. General data of the patients and their main caregivers were collected. The caring ability of the main caregivers was assessed by the family care test inventory. Connor- Davision Resilience Scale and Mishel Uncertainty in Illness Scale-Family Member Form were used to assess the psychological resilience and uncertainty illness of caregivers. Single factor analysis and multiple linear regression analysis were all used to explore the risk factors.ResultsThe care ability of the main caregivers of stroke patients was basically at a high level. Multivariate analysis showed that patients’ age [non-standardized partial regression coefficient (b)=−0.051, 95% confidence interval (CI) (−0.079, −0.024), P<0.001], family income [b=−0.455, 95%CI (−0.770, −0.141), P=0.005], and activities of daily living ability at admission [b=−0.017, 95%CI (−0.029, −0.006), P=0.003], and caregivers’ sleeping status [b=0.636, 95%CI (0.340, 0.932), P<0.001], scores of resilience [b=−0.143, 95%CI (−0.202, −0.083), P<0.001] and illness uncertainty [b=−0.127, 95%CI (−0.153, −0.100), P<0.001] were influencing factors of caregivers’ care ability.ConclusionsThe main caregivers of stroke patients have good care ability. The older the patients are, the higher the family income is, and the better the ability of activities of daily living at admission is, the better the caregivers’ care ability they have. The better the caregivers’ sleep is, and the stronger the caregivers’ psychological resilience and uncertainty of disease are, the better the caring ability they have. It is suggested that we should pay more attention to the physical and mental status of caregivers, raise their awareness of stroke, teach them relevant knowledge and care skills, so as to lighten the physical and mental burden of caregivers, improve the prognosis of patients and finally improve the quality of life of patients and their caregivers.
ObjectiveTo explore the psychological pressure in Intensive Care Unit (ICU) nurses and the sources of their pressure. MethodWe investigated the ICU nurses in West China Hospital with a self-designed psychological pressure questionnaire from March to September 2013. ResultsThe total stress level of ICU nurses was 2.89±0.86. The top five sources were low salaries and welfare benefits (3.37±0.61), high frequency of night work (3.31±0.88), wide need of knowledge (3.22±0.41), heavy workload (3.20±0.80) and chronic fatigue syndrome (3.19±0.75). ConclusionsGreat psychological pressure exists in ICU nurses. We urgently need effective approaches to relieve the stress of ICU nurses in order to improve the efficiency and quality of nursing service.
ObjectiveTo investigate the incidence of nosocomial infection and device-related infection in the Intensive Care Unit (ICU), analyze its related risk factors, and search for effective measures to prevent and control nosocomial infection. MethodsBy prospective objective monitoring method, we surveyed 294 patients hospitalized in the ICU for at least 48 hours between January and December 2012. The doctor in charge filled in relevant information of the patients to complete the questionnaires, and hospital infection management staff was responsible for tracking, judging, and statistical analysis. ResultsIn the 294 patients, 61 had hospital infections, and there were 78 cases. The hospital infection rate was 20.75%, and the case infection rate was 26.53%. The day incidence of patient infection was 16.01‰, and day infection rate was 20.47‰ for infection cases. After average severity of illness score adjustment, the day case infection rate was 7.48%, ventilator associated pneumonia (VAP) infection rate was 27.27‰, central venous catheter associated bloodstream infection rate was 6.58‰, and catheter associated urinary tract infection rate was 3.15‰. ConclusionICU has a high risk of hospital infection. In the device related infections, VAP infection rate is the highest. Continuous improvement can be achieved through monitoring and discovering problems, strengthening hospital infection management training for the medical personnel of the hospital, close communication between doctors and hospital infection management staff, and strict implementation of hospital infection management measures.
ObjectiveTo explore the effectiveness of lung ultrasound-guided pulmonary rehabilitation training in ICU patients on mechanical ventilation.MethodsPatients on mechanical ventilation admitted to the ICU of a tertiary A-level hospital in Hefei city from July 2022 to December 2023 were selected and randomly divided into a control group and an experimental group using a random number table method. The control group received conventional pulmonary rehabilitation training, while the experimental group underwent lung ultrasound-guided pulmonary rehabilitation training. The differences in lung ultrasound scores, oxygenation index, diaphragm function, weaning success rate, and mechanical ventilation time were compared between the two groups on the 1st, 3rd, 5th, and 7th days of intervention.ResultsThe study was completed with 48 cases in the experimental group and 46 cases in the control group. Repeated measures ANOVA showed statistically significant intergroup effects, time effects, and interaction effects on lung ultrasound scores, oxygenation index, diaphragm mobility, and diaphragm thickness variability rate (P<0.05). The weaning success rate was higher in the experimental group than in the control group, and the mechanical ventilation time was shorter, with statistically significant differences (P<0.05).ConclusionsThe lung ultrasound-guided pulmonary rehabilitation training program can effectively improve the pulmonary status, oxygenation, and diaphragm function of ICU patients on mechanical ventilation, increase the success rate of weaning, shorten the mechanical ventilation time, and accelerate patient recovery.
Objective To compare the advantages between SmartCare weaning and protocoldirected weaning in COPD patients regarding five aspects including comfort degree of COPD patients in weaning stage, workload of medical staff, weaning success rate, weaning time, and complications associated with mechanical ventilation. Methods COPD patients who’s planning to receive ventilation weaning were randomly divided into a SmartCare weaning group ( SC group) and a protocol-directed weaning group ( SBT group) . The comfort degree of patients and workload of medical staff were assessed by the visual analogue scale ( VAS) as the weaning plan started. 0 was for the most discomfort and maximal workload, and 10 was for the most comfort and minimal workload. Data fromthe following aspects had been recorded: times of blood gas analysis, weaning success rate, weaning time, self-extubation rate, the rate of re-intubation within 48 hours, and ventilator-associated pneumonia ( VAP) incidences. Results 40 patients were selected and divided into the SC group ( n =19) and the SBT group ( n =21) . There was no significant difference in the enrolled age and APACHEⅡ between two groups. The VAS scores was higher in the SC group than that in the SBT group in the first three days ( Plt;0.01) . The weaning time was shorter in the SBT group than that in the SBT group [ ( 4.7 ±2.7) days vs. ( 5.5 ±3.2) days] , without significant difference between two groups ( P gt;0.05) . There were no differences in times of blood gas analysis, weaning success rate, weaning time, self-extubation rate, the rate of re-intubation within 48 hours, and ventilator-associated pneumonia ( VAP) incidences between two groups ( P gt; 0.05) .Conclusion As compared with protocol-directed weaning, SmartCare weaning can increase comfort degree of patients and reduce the workload of medical staff with similar weaning success rate, weaning time, and complications associated with mechanical ventilation.
Aiming at the shortcomings in the theory and practice of integrated elderly care and medical services in China, using the methods of literature analysis and comparative analysis, we summarize four typical models of integrated elderly care and medical services, namely, the American commercial pension model, the British national tax financing system pension model, the Japanese national security transformation, and the German long-term care insurance system, and compare the four models systematically from the aspects of system overview, service principle, operation mode, financing supervision, etc. The enlightenment for the policy and practice development of integrated elderly care and medical services in China is obtained: firstly, the service concept should be innovated; secondly, it is important to improve the relevant legal protection and supporting measures; thirdly, the refinement of the integrated elderly care and medical service projects are supposed to be promoted; fourthly, a multi-party linkage mechanism ought to be establishd; and fifthly, community endowment model should be advocated.