上海市骨科患者需入住康复护理床位的病种及入住、转出标准研究

目的确定骨科患者需人住康复护理床位的病种，并制定各病种患者人住、转出评准。方法采用质性访谈的方法对6名骨科专家、1名康复学专家和2名护理学专家进行半结构式深入访谈；采用Delphi法对15名骨科专家就骨科患者需人住康复护理床位的病种及入住、转出标准进行2轮专家函询。结果经过质性访谈，初步选定骨科患者需人住康复护理床位的病种，并制定各病种的入住、转出标准；经过专家函询，最终确定病种及评估标准。结论通过明确各病种入住、转出评估标准，为骨科康复护理床位的顺利运转提供依据。     

上海市康复护理床位外科患者入住、转出评估标准的研究

目的 制定上海市康复护理床位外科患者入住、转出评估标准.方法 采用质性访谈的方法对7名临床外科专家、1名康复学专家和2名护理学专家进行半结构式深入访谈;采用Delphi法对上海市15家综合医院105名外科专家就初拟的上海市康复护理床位外科患者入住、转出评估标准进行2轮专家函询.结果 经过质性访谈,初步拟定上海市康复护理床位入住、转出评估标准.结论 经过函询,对初拟标准进行修订,最终确定该评估标准.     

上海市康复护理床位外科患者入住、转出评估标准的研究

目的制定上海市康复护理床位外科患都入住、转出评估标准。方法采用质性访谈的方法对7名临床外科专家、1名康复学专家和2名护理学专家进行半结构式深入访谈;采用Delphi法对上海市15家综合医院105名外科专家就初拟的上海市康复护理床位外科患者入住、转出评估标准进行2轮专家函询。结果经过质性访谈,初步拟定上海市康复护理床位入住、转出评估标准。结论经过函询,对初拟标准进行修订,最终确定该评估标准。     

神经外科康复护理床位入住与转出标准的定性研究

目的了解神经外科专家、护理学专家和康复学专家对神经外科需入住康复护理床位的病种及各病种入住、转出标准的看法。方法采用定性研究半结构式访谈的方法,对某三级甲等医院7名神经外科专家、2名护理学专家和1名康复学专家进行半结构式深入访谈。访谈内容主要包括神经外科需入住康复护理床位的病种,各病种的入住和转出标准,神经外科康复护理床位顺利运行可能遇到的问题以及解决方法。结果专家认为,神经外科设置康复护理床位对患者和医院都十分有益,入住和转出标准应围绕病情、治疗方案和生理功能的恢复状况制定。结论设置康复护理床位非常必要,而入住及转出标准的制定,是保证其顺利运行的重要条件。     

骨科需入住康复护理床位的病种及入住、转出标准的定性研究

目的 了解骨科专家、护理学专家、康复学专家对骨科需入住康复护理床位的病种及各病种入住、转出标准的看法.方法 采用定性研究半结构式访谈的方法,对某三级甲等医院6名骨科专家、2名护理学专家和1名康复学专家进行半结构式深入访谈.访谈内容主要包括骨科需入住康复护理床位的病种,各病种的入住、转出标准,骨科康复护理床位顺利运行可能遇到的问题以及解决方法.结果 各学科专家提出了各自的看法,对专家意见进行整理分析.结论 为制定可顺利实施的骨科康复护理床位提供参考依据.     

外科病人入住、转出康复护理床位评估标准的定性研究

为了解外科临床医疗专家、护理专家、康复学专家对外科病人入住、转出康复护理床位评估标准的观点和意见,采用定性研究方法,对某三级甲等医院7名外科临床医疗专家、2名护理学专家和1名康复学专家进行半结构式深入访谈,访谈内容包括外科需入住康复护理床位的病种分布、入住及转出的标准、如何顺利执行该标准.访谈内容可为制订外科病人入住、转出康复护理床位评估标准提供参考依据.     

外科病人入住、转出康复护理床位评估标准的定性研究

为了解外科临床医疗专家、护理专家、康复学专家对外科病人入住、转出康复护理床位评估标准的观点和意见,采用定性研究方法,对某三级甲等医院7名外科临床医疗专家、2名护理学专家和1名康复学专家进行半结构式深入访谈,访谈内容包括外科需入住康复护理床位的病种分布、入住及转出的标准、如何顺利执行该标准。访谈内容可为制订外科病人入住、转出康复护理床位评估标准提供参考依据。     

对内科疾病患者入住康复护理床位标准认知的质性研究

目的深入了解内科疾病患者入住康复护理床位的标准及适宜病种。方法采用深度访谈法对8位专家进行访谈,并用Colaizzi 7步分析法进行分析。结果目前治疗性床位使用率很高,多数慢性病患者可在急性期后入住康复护理床位,但尚无具体、统一的入住标准。结论进行床位分类管理,明确内科疾病患者入住康复护理床位标准有利于引导患者合理分流。     

内科患者入住、转出康复护理床位原则研究

目的：确定内科患者人住、转出康复护理床位的总原则。方法：在上海市三级和二级医院中选取内科病区临床专家120人,采用Delphi法进行2轮专家咨询,并对结果进行统计分析。结果：专家积极性系数较高（100％）,熟悉程度较高,咨询表Cronbach’s α系数均大于0．70,专家对研究的总体评价较好,人住、转出原则同意率较高。结论：专家对该研究持肯定态度,形成了内科患者入住、转出康复护理床位的总原则。     

基于Delphi法的适宜入住康复护理床位内科病种研究

目的探讨适宜入住康复护理床位的内科病种。方法2007年10—11月成立研究小组,在上海15所综合医院选取120名临床内科专家,发放专家咨询表,采用Delphi法,对结果进行统计分析。结果2轮咨询专家积极性系数较高（100％）,专业熟悉程度较高,咨询表Cronbaeh’sAlpha系数均大于0．70,Kendall协同系数P值均小于0．05,在内科8个专科中筛选出适宜入住康复护理床位的48个内科病种,主要为慢性病。结论通过筛选出适宜入住康复护理床位的病种,有利于各级各类医疗机构功能互补,资源共享,引导患者合理分流,最大限度地保障医疗卫生资源的效率。     

乳腺癌围手术期患者健康教育路径实施效果评价指标构建之研究

目的:确立乳腺癌围手术期健康教育路径实施效果评价的量化指标,以获得较为科学的路径效果评价工具。方法:在访谈和回顾大量文献的基础上先确立备选指标,通过专家会议法初步确定后,采用Delphi法对23名专家进行3轮专家咨询,采用AHP法对确定的各指标建立判断矩阵以量化评价指标。结果:4次专家咨询调查问卷回收应答率均为100%,4次专家权威程度α系数分别为0.8244、0.8597、0.9256和0.8434,咨询结果具有可信度。专家一致性系数为0.8279、0.8532、0.8767和0.8987。权重判断矩阵符合一致性检验。结论:运用Delphi法确定评价指标后采用AHP法量化,根据权重系数所占比重排序评价指标项目依次为术后指导、术晨指导、化疗指导、康复指导、总体评价、入院指导、术前指导、出院指导。临床护理人员应根据健康指导对患者生存质量重要性的影响程度对其进行健康教育,从而进一步提高患者健康教育实施的效果。     

Listening to patients: choice in cardiac rehabilitation.

BACKGROUND: The benefits of cardiac rehabilitation (CR) after myocardial infarction (MI) are increasingly recognised and is recommended in national guidelines. AIMS: To explore patients' experience of MI and to identify the factors which influence the choice patients make given the option of hospital or home-based CR after MI. METHOD: Qualitative study using semi-structured interviews and interpretive phenomenological analysis (IPA). This study was embedded within a randomised trial with preference arms. RESULTS: Seventeen participants were interviewed before their rehabilitation programme. Ten expressed a preference for home-based and seven for hospital-based rehabilitation. Common to both groups was shock and disbelief, which led to a loss of confidence. They expressed a strong desire to make lifestyle changes and looked for specific advice, guidance and support from knowledgeable experts. The hospital-based group had an emphasis on supervision during exercise, needed the camaraderie of a group, were willing to make travel arrangements and believed they lacked self-discipline. The home-based group believed that their CR should fit in with their lives rather than their lives fitting in with the rehabilitation programme and were self-disciplined. They disliked groups and expressed practical concerns. CONCLUSIONS: Understanding the factors that influence patient's choices may help professionals guide them to the most appropriate CR method and hence improve uptake.     

Reliability and construct validity of the client-centred rehabilitation questionnaire

Purpose. A key component in assessing the performance of rehabilitation services is the client's perspective. The purpose of this paper is to report on the development of a publicly available measure of client-centred rehabilitation (CCRQ) that can be used for discriminative and evaluative purposes.

Method. Mixed qualitatative and quantitative methods were used. Phase 1: Identification of seven domains of client-centred rehabilitation based on a literature review, focus groups with clients, and review by content experts. Phase 2: Item generation for the seven conceptually derived subscales and cognitive interviews with inpatient rehabilitation patients. Phase 3: Psychometric testing for internal reliability, test-retest reliability and discriminative construct validity using data from a mailed, self-administered survey to 1568 patients discharged from two large inpatient rehabilitation facilities.

Results. The seven conceptually derived subscales all have strong internal (0.72 - 0.87) and test-retest reliability (0.74 - 0.85). Discriminative construct validity is demonstrated by the ability of subscales to identify significant differences between programs within two rehabilitation facilities.

Conclusions. The results for the reliability and validity of this measure support its value for use in clinical and quality improvement work as well as research.     

Dyskinesias: nursing care and surgical intervention

The dyskinesia syndromes are a group of physically, socially and psychologically debilitating diseases. Many patients may be helped through medical management consisting of drugs, physical and speech therapy, and vocational rehabilitation. However, when medical management fails to palliate symptoms, surgical intervention may be the patient's alternative. The ultimate goal of therapy is to lead an improved quality of life. As a neurosurgical nurse, you have an important role in achieving that goal.     

上海市康复医疗资源调查报告

目的:上海对本地区现有的康复医疗资源现状进行调研,为卫生行政部门启动康复医疗服务体系的试点工作提供科学循证的决策依据.方法:采用问卷和实地走访的方式调研,各单位在完成《上海市康复医疗资源调查表》填写后需加盖单位公章确认.结果:上海市共有463家医疗机构,其中180家(38.88％)设有康复医学科,31家(6.7％)设有康复病床,康复医师585人,康复治疗师754人.康复医师具有研究生及以上学历者占26.32％,康复治疗师具有研究生及以上学历者占3.71％.结论:目前上海康复从业人员数量和专业质量都未达到卫生部对康复医学科设置的基本标准,尤其康复人才匮乏凸显.多种形式多种渠道,规范培养康复人员非常紧迫.