【摘要】 目的 了解结直肠癌患者术后发生抑郁、焦虑状况，分析其影响因素。 方法 2010年1-3月，采用Zung抑郁自评量表（SDS）、焦虑自评量表（SAS）和一般资料调查问卷，结合病历资料及心理评估，对64例结直肠癌术后患者进行测评，采用SPSS 13.0软件对数据进行统计分析。 结果 64例患者SDS（47.02±10.38）分，SAS评分（42.42±7.96）分，均高于国内常模（Plt;0.001）。抑郁和焦虑发生率分别为42.2%、20.3%。造口患者抑郁得分高于非造口患者（P=0.004），Miles术患者抑郁得分高于非造瘘根治术患者（P=0.039），姑息术患者抑郁得分高于非造瘘根治术患者（P=0.007）；家庭月收入≤1 000元者抑郁得分高于1 001~3 000元及gt;3 000元者（P=0.040，0.017）。不同情况患者焦虑得分差异无统计学意义（Pgt;0.05）。SDS与SAS呈正相关（Plt;0.001）。 结论 结直肠癌术后患者存在不同程度的抑郁和焦虑。护理人员尤其应关注造口术后、晚期患者及收入低下患者，并进行针对性健康教育和心理干预。【Abstract】 Objective To evaluate the postoperative anxiety and depression of patients with colorectal cancer and investigate its related factors. Methods From January to March 2010, 64 patients who were diagnosed to have colorectal cancer and received therapeutic operations were investigated with self-rating depressive scale (SDS), self-rating anxiety scale (SAS) and self-made related questionnaire respectively. Psychological assessment and medical records gathering were also carried out. The data collected were analyzed by SPSS 13.0. Results The total score of SDS (47.02±10.38) and SAS (42.42±7.96) of the 64 patients were both higher than those of the general population (Plt;0.001). The incidence rate of depression and anxiety was 42.2% and 20.3% respectively. Patients without stoma had lower SDS scores than those with stoma (P=0.004); patients undergoing Miles operation had higher SDS scores than those receiving non-fistula formation radical operations (P=0.039); patients receiving palliative treatment had higher SDS scores than those receiving non-fistula formation radical operations (P=0.007); patients with family monthly income less than 1 000 RMB had higher SDS scores than those with more than 3 000 RMB and between 1 001-3 000 RMB (P=0.017, 0.040). SAS scores among different patients were not significantly different (Pgt;0.05). SDS had positive correlation with SAS (Plt;0.001). Conclusions Patients with colorectal cancer have higher emotions of anxiety and depression after operation than those in the general population. It is suggested that more psychological consultation, treatment and nursing should be carried out to promote the overall physical and mental rehabilitation of the patients, especially for those having undergone stoma formation, late-stage patients and those with a low income.
Objective To evaluate the level of nursing professional competence of fulltime system graduated nurses in Sichuan province and determine its influencing factors, so as to provide references for nursing high-education reform and nursing human resource management. Methods With a self-designed questionnaire and stratified cluster sample method, both graduated nurses and their direct nursing managers were investigated and asked to evaluate nursing professional competence. Results The mean scores of nursing professional competence of the nurses’ self-evaluation and their managers’ evaluation were 69.90±10.27 and 68.96±11.33, respectively. Factors influencing nursing professional competence included individual interest in nursing, graduated institution, working position, and training provided by employer. Conclusion The professional competence of the nurses graduated with full-time bachelors of clinical nursing in Sichuan province is close to the intermediate level, and it still needs to be improved on the whole, especially in the aspects of nursing research and management. Besides, nursing institutions should further enhance the construction of inner teaching environment and the professional thoughts education of nurse students, while the employer should offer more professional development opportunities, so as to improve the professional self-identity and competence, and to finally lay the talent foundation for the development of nursing disciplines.
目的 总结多导睡眠监测的监测方法及护理要点。 方法 2010年3月－2011年3月采用美国伟康多导睡眠呼吸监测仪对睡眠中心78例患者进行不少于7 h的整夜连续监测和护理。 结果 76例患者顺利完成监测，确诊阻塞性睡眠呼吸暂停低通气综合征73例（重度17例，中度31例，轻度25例），单纯鼾症3例。1例因环境陌生、导联多无法入睡而监测失败，另1例因鼻气流导管脱落而监测失败。 结论 对症有效的护理方法是多导睡眠监测得以顺利完成的根本保证。
Objective To explore the certification management of specialty nurses in China based on the existent problems to provide evidence for practice and decision making for management of the specialty nurses. Methods The modified Delphi technique was applied in this study from July to December 2017. A structured consultation questionnaire based on expert interview and literature review was designed, and modified after preliminary experiment. Then the questionnaires were delivered to 32 nurse experts to complete 3 rounds of Delphi process, which reached consensus gradually. Results The response rates of three round consultations were 96.9% (31/32), 100.0% (31/31), and 96.8% (30/31), respectively. The suggestion rates were 25.8% (8/31), 16.1% (5/31), 0% (0/31), respectively. The familiar coefficient, adjustment coefficient and authority coefficient was 0.82, 0.87 and 0.85, respectively. The experts had the agreement finally for all of the 16 items in the consultation questionnaire, and they formed an expert opinion draft on specialty nurse certification and registration. Conclusion It’s crucial and essential to establish a certification and registration system in China and renew the credentials regularly to promote the management and construction of specialty nurse team.
Objective To evaluate the level of nursing competence of clinical nurses and determine its influencing factors so as to provide scientific information for nursing human resource management. Methods A cross-sectional survey was conducted on 1 042 nurses from 8 hospitals by using the Nursing Competence Scale. Results The mean score of nursing competence was 73.99±9.81. Factors influencing the nursing competence included personal interest in nursing, working experience, working position, educational background, hospital level, teaching activities and marital status. Conclusion The surveyed clinical nurses have been equipped with basic nursing competence, however, still needs to be improved. The nursing human resource management should be based on nurses’ competence.
Objective To survey the knowledge of hand hygiene among nurses and to identify factors influencing the performance of hand hygiene.Methods A questionnaire of hand hygiene developed according to the Guideline for Hand Hygiene in Health Care Settings was used to investigate nurses’ knowledge about hand hygiene.Results The average score for nurses’ knowledge about hand hygiene was 18.59±2.19 out of a possible maximum score of 21. Knowledge about hand hygiene among nurses varied significantly in different departments (P=0.004). The main self-reported factors influencing the performance of hand hygiene were irritation and dryness caused by hand-washing agents (73.44%) and busy workload (65.53%).Conclusions Nurses generally have good knowledge about hand hygiene but are less aware of some hand hygiene indications. Effective measures are needed to improve compliance with hand hygiene among nurses.
Objective To explore the effects of the centralized management of bed use in a large-scale integrated hospital. Methods We selected the staff with good quality for centre work after setting up the bed use centralized management centre in the West China Hospital. Then, we formulated unified an admission principle and incorporated it into the systematic management and control, made a short instructional video for rolling show in the centre so as to let the patient know basic conditions of this hospital before admission; and regulated the admission process for patients’ convenience. Results After more than one year, the centre simplified the in-patient admission procedures, regulated the process, saved nursing manpower (24 persons), and increased patients’ satisfaction (from 89.30% to 93.25%). Meanwhile, the bed use rate was increased and the average length of stay was shortened the to some extent, which improved the order in wards. Conclusion Unified bed use management centre established in large-scale integrated hospitals, can save nursing manpower, simplify the admission process of patients, and meet the need for the development of hospitals, which is worthy of promoting application.
During the medical rescue of Wenchuan earthquake, the Nursing Department of West China Hospital of Sichuan University immediately initiated the emergency response plan, reasonably dispatched nurses of the medical teams from West China Hospital, other provinces and foreign countries. Meanwhile, the Nursing Department set up the medical team for emergency treatment, provided the basic information of the wounded, established the flow of rapid registration and rapid preview, formulated and optimized the flow of the admission of the wounded, and improved the flow of information-collecting. What’s more, the nursing department adjusted the current work according to the situation of hospitalization of the wounded in different stages to ensure the efficient running of medical rescue. Moreover, the routine nursing practice was also maintained and none of the inpatients other than those from the disaster area got involved in any unexpected accident.
【摘要】 目的 分析临床实习对护理本科生专业认同的影响，探讨提高专业认同的措施。 方法 2010年6—10月，对某综合性大学60名2007级普通全日制护理本科生进行抽样调查，评价其实习前1个月和实习后3个月的专业认同情况，比较实习前、后的变化并分析影响因素。 结果 实习后专业认同的专业价值观得分[（3.13±0.85）分]高于实习前[（2.78±1.00）分]，实验专业期望得分[（12.09±2.13）分]低于实习前[（13.13±1.30）分]，差异有统计学意义（P=0.045，0.002）；而专业认识、情感、意志、技能和专业认同总分方面，实习前、后差异无统计学意义（Pgt;0.05）；其影响因素由强到弱依次为:带教老师（37.04%）、实际的护理工作（33.33%）、实习科室（22.22%）、他人态度（7.41%）。 结论 临床实习可提高护理本科生的专业价值观，带教老师及实际护理工作对专业认同影响较大。【Abstract】 Objective To analyze the effect of clinical practice on student nurses’ professional identity and explore measures to develop their professional identity. Methods Convenience sampling was used to select 60 general full-time student nurses who entered a comprehensive university in 2007. Then we assessed their professional identity at the time of one month before, and three months after clinical practice, compared the two results, and analyzed the related factors. Results The score of professional value dimension after clinical practice was higher than before (3.13±0.85 vs. 2.78±1.00, P=0.045), while the professional expectation dimension was lower than before (12.09±2.13 vs. 13.13±1.30, P=0.002), and the differences in above-mentioned indexes were statistically significant. There was no statistical difference before and after clinical practice in professional knowledge, professional affection, professional volition, professional skill dimensions, and total score of professional identity (Pgt;0.05). The related factors in a order from b to weak were clinical teacher (37.04%), practice work (33.33%), training department (22.22%), and others’ attitudes (7.41%). Conclusion Clinical practice may improve professional values but impair professional expectations of the student nurses, and clinical teacher and practice work have a great effect on student nurses’ professional identity.