体验式教学在失智老人照护者培训中的应用研究

[目的]探讨体验式教学在失智老人照护者培训中的应用效果。[方法]应用体验式教学法对2016年1月—6月入院治疗的52名失智老人照护者进行培训,采用老年人态度量表(KAOP)、自行研制的失智老人照护知识调查问卷分别于培训前后调查照护者对老年人的态度、照护知识的掌握情况。[结果]KAOP量表培训前评分为(150.92±18.91)分,培训后评分为(164.00±20.35)分,培训前后比较差异有统计学意义(P0.05);培训后专业照护相关知识(3.59分±0.60分)、痴呆的精神行为症状(BPSD)照护相关知识(3.62分±0.60分)、康复活动相关知识(3.62±0.64分)评分高于培训前(2.97分±0.68分、3.02分±0.78分、2.44分±0.71分),培训前后比较差异有统计学意义(P0.01)。[结论]体验式教学可有效改善照护者对老年人的态度,提高照护者的照护知识水平和能力,改善失智老人生活质量。     

四川省护士对老年人跌倒干预指南知识及态度调查

[目的]调查四川省护士对老年人跌倒干预指南知识掌握情况及对指南态度的现况。[方法]采用跌倒干预指南知识问卷、中文版指南态度量表对四川省8所二级综合医院和8所三级综合医院的784名护士进行调查。[结果]护士老年人跌倒干预指南知识得分为(9.69±2.82)分,知晓率为26.3%。不同医院级别和岗位的护士老年人跌倒干预指南知识合格率比较差异有统计学意义(P0.05)。护士对指南态度得分为(51.24±6.20)分,不同医院级别和既往是否学习过老年人跌倒干预指南的护士指南态度得分比较差异有统计学意义(P0.05)。护士对老年人跌倒干预指南知识得分与对指南态度呈正相关(P0.001)。[结论]四川省护士对老年人跌倒干预指南知识知晓率低,对指南的态度积极。建议利用护士对指南的积极态度进行老年人跌倒干预指南培训,尤其是二级医院护士和岗位为普通护士的培训,以预防住院老年人跌倒的发生。     

老年病房护士预立医疗照护计划的知信行现状调查

目的 :调查老年病房护士对预立医疗照护计划的认知、态度、行为状况并进行相关影响因素分析。方法:采用自设问卷,便利选取北京市三级甲等综合医院和老年专科医院的老年病房护士进行调查。结果 :老年病房护士知识得分正确率为84.0%,经历过丧亲以及接受过相关培训的护士知识掌握较好(P0.05);调查对象对预立医疗照护计划的态度得分为(4.16±0.56)分,较高职称及护理过临终患者的护士所持态度更加积极(P0.05);调查对象行为得分为(2.73±0.90)分,其中所在病房是老年专科护士培训基地和接受过相关培训的护士行为得分更高(P0.05)。结论 :老年病房护士对预立医疗照护计划知识掌握较好,但仍可进一步提高,所持态度较积极,但工作中开展预立医疗照护计划的行为较少。     

照护失能老年人养老护理员照护知识、态度及能力的调查研究

目的:了解养老护理员对老年人照护知识的掌握、照护态度及能力状况,为护理员队伍建设的相关对策提供实证依据,为护理员队伍的可持续发展提出建议。方法:采用方便取样法,对照护失能老年人的150名护理员进行问卷调查。结果:养老护理员照护知识薄弱,91.33%的护理员对照护知识不了解或者不清楚。护理员的性别不同,在照护知识、职业态度和职业能力方面无统计学意义;服务年限不同者职业态度和照护能力得分不同,服务年限长者得分高(P0.05);文化程度不同者态度和能力得分不同,文化程度高者得分高(P0.05);是否接受护理员专业培训与知识、态度和能力得分接受培训者高于未接受培训者(P0.05)。结论:养老护理员总体的水平有待提高,应加强对养老护理员的规范化培训,以提高失能老年人的照护质量。     

143名规范化培训护士跌倒预防知识、态度、行为的现状调查

目的 调查规范化培训护士预防住院患者跌倒知识、态度、行为现状,为制定培训策略提供依据.方法 采用便利抽样方法,于2017年2月抽取我院2016年7月入院参加规范化培训的143名护士,采用一般资料及规范化培训护士跌倒预防知识、态度、行为问卷对其进行调查.结果 规范化培训护士预防跌倒知识均分为(3.59±0.93)分;预防跌倒态度均分为(3.99±0.87)分;预防跌倒行为均分为(3.83±0.61)分.其中知识维度得分最低的3个条目为对易导致患者跌倒特殊药物的掌握、排泄评估标准的掌握及活动能力评估标准的掌握.态度维度得分最低的3个条目为跌倒预防主要责任是护士、高危患者每1~2d进行跌倒动态评估及跌倒后无损伤可以不上报.行为维度得分最低的3个条目为对患者及家属宣教后评估其依从性,对患者及家属的落实情况进行评估,对高危患者使用警示标识.结论 规范化培训护士预防跌倒知识、态度、行为得分均处于中等水平.建议医疗机构在培训工作中,应针对知识薄弱环节,强化规范化培训护士对用药风险的掌握.帮助其树立跌倒防控的责任心,提高法律意识,纠正认知误区.通过改进沟通策略了解患者及家属预防跌倒的依从性,有效落实跌倒预防措施,从而全面提高规范化培训护士跌倒防控能力,树立安全文化意识.     

社区老年人主要照顾者预防跌倒知信行及与老年人跌倒相关性调查

目的调查社区老年人主要照顾者跌倒预防知识、态度、行为情况并分析其与照顾期间老年人跌倒发生的关系。方法采用横断面调查法,自设预防老年人跌倒知-信-行调查问卷于2012年2—3月对北京市某社区112名老年人主要照顾者进行调查。结果共发放问卷112份,回收有效问卷112份,问卷有效回收率为100％。社区老年人主要照顾者预防跌倒知识正确率为19．6％,态度和行为得分的优秀率分别为69．6％和23．2％;以知信行总分为因变量,以社区老年人主要照顾者年龄、性别、文化程度、职业、照顾时间以及是否获取跌倒相关知识为自变量进行多元逐步回归分析,结果表明,主要照顾者的文化程度和是否接受过培训是其知信行的主要影响因素（P〈0．01）。照顾期间社区老年人跌倒发生率为31．25％,不同组别照顾老年人年龄、自理能力以及主要照顾者照顾时间等因素下的老年人跌倒发生率比较,差异无统计学意义（P〉0．05）。以社区老年人照顾期间跌倒发生情况为因变量,以照顾者年龄、性别、职业、与照顾者的关系、照顾时间、文化程度、获取跌倒预防相关知识情况跌倒预防知识、态度、行为总分、文化程度、获取跌倒预防相关知识情况、被照顾者年龄和自理能力为自变量进行Logistic回归分析,结果表明,照顾者知识总分和获取跌倒预防相关知识进入回归方程。老年人主要照顾者获取相关知识的主要途径为个人经验和电视网络（42．8％）,通过专业途径获取到相关知识（18．9％）,有85．7％照顾者希望通过社区能够给予专业的跌倒相关预防知识的指导。结论社区老年人主要照顾者跌倒预防知-信-行水平低,建议社区卫生工作者采取有效措施提高其知识水平,从而改善其行为,以减少老年人跌倒的发生。     

新护士对住院病人跌倒预防知识-态度-行为水平的调查分析

[目的]调查了解新护士对住院病人跌倒预防的知识、态度、行为现状,为新护士的规范化培训提供依据。[方法]采用方便抽样法,选择某三级甲等医院2017年7月份入职的200名新护士作为调查对象,使用自编病人跌倒预防知识态度行为水平调查问卷进行调查。[结果]新护士在跌倒预防知识、态度、行为3个维度得分为(30.03±3.05)分、(14.46±2.18)分、(11.06±1.23)分,得分率依次为75.08%、72.30%和92.17%。学习过跌倒预防知识的新护士在知识维度得分为(29.82±3.04)分,低于没有学过的新护士(31.57±2.68)分,使用过Morse评估表的新护士在知识维度得分(29.55±3.02)分,低于没使用过的新护士(31.14±2.84)分,差异均有统计学意义(P0.05)。新护士的态度与行为得分呈正相关(r=0.333,P0.01)。[结论]新护士对于住院病人的跌倒预防知识存在不足,特别是对跌倒高风险人群的识别和跌倒评估的时机把握上有严重欠缺,且跌倒预防知识、态度与行为不匹配。另外,新职工以往所获得的不系统、不规范的跌倒预防知识反而带来了消极影响。为保证住院病人安全,帮助新护士尽快适应临床工作,有必要对新护士进行统一规范的跌倒预防培训。     

综合病例站点式培训对提高规培护士防跌倒能力的效果

目的探讨综合病例站点式培训对提高规培护士防跌倒能力的效果。方法选取2016年7月至2017年7月我院入职的规培护士62名作为调查对象,随机将其等分为对照组和观察组,观察组采用综合病例站点式培训进行干预,对照组实施常规流程式培训,比较两组培训后护士防跌倒相关知识、态度及行为变化。结果培训后,两组护士防跌倒相关知识掌握水平评分明显升高(P 0. 05),观察组患者因素、特殊药物、大小便以及活动能力评分高于对照组;两组护士防跌倒态度评分均明显升高(P 0. 05),观察组预防责任承担、多部门联合参与、高危患者定期评估、跌倒后如实上报以及转科时积极评估等态度评分高于对照组;两组防跌倒行为评分均明显升高(P 0. 05),观察组患者和家属依从性评估、高危患者安全转运和高危患者卧床护理等行为评分高于对照组(P 0. 05)。结论综合病例站点式培训可提高规培护士跌倒知识掌握水平,改善防跌倒工作态度并熟悉跌倒护理工作流程,全面提高其防跌倒能力。     

脑血管疾病病人伴侣照顾者跌倒知识、态度、行为调查

[目的]掌握脑血管疾病伴侣照顾者跌倒知识、态度、行为状况,为指导照顾人员掌握预防脑血管疾病病人跌倒措施提供参考。[方法]采用一般资料调查表和住院脑血管病人照顾者跌倒知识、态度、行为问卷对我院神经内科住院的脑血管疾病病人伴侣照顾者139人进行问卷调查。[结果]脑血管疾病伴侣照顾者跌倒知识得分为35.01分±4.99分,态度得分为34.01分±3.99分,行为得分为57.89分±7.01分;其跌倒知识、态度与行为相关(P0.05)。[结论]脑血管疾病伴侣照顾者态度、行为状况较好,其跌倒知识、态度与行为相关,脑血管疾病照顾者一般资料对跌倒知识、态度、行为无影响。建议为脑血管疾病伴侣照顾者或其他人员照顾者提供跌倒知识培训或面对面指导。     

家庭医生制度下IMPACT培训模式对居家长期照护者照护知识和技能的影响

[目的]探讨家庭医生制度下IMPACT培训模式对居家长期照护者照护知识和技能的影响。[方法]采用IMPACT培训模式对200名居家照护者进行为期4周的培训,培训前后评价居家照护者对老年人照护常识的自评情况,对老年保健知识、安全知识、疾病知识、护理知识4个模块护理专业知识的考核情况和培训后护理操作技能的合格率,并分析其居家照护知识掌握情况的主要影响因素。[结果]实施IMPACT培训模式后,居家照护者对大多数老年人照护常识的自评高于培训前(P0.01);培训后保健知识、安全知识、疾病知识、护理知识4个模块的考核成绩高于培训前(P0.01),护理操作技能合格率达96.5%;高中以上学历的照护者护理知识的得分高于初中以下学历者(P0.05),有过培训经历的照护者保健知识、安全知识和护理知识的得分高于无培训经历者(P0.05)。[结论]家庭医生制度下的全科团队利用IMPACT培训模式可有效提高居家照护者对老年人照护常识的知晓度、居家照护专业知识和照护技能。     

Motivation of primary care physicians for participating in early intervention for psychosis in Japan

People with psychosis as represented by schizophrenia experience lengthy delays between the onset and the start of treatment. This duration is called Duration of Untreated Psychosis (DUP). Since it has been indicated that shorter DUP leads to their better prognosis, early intervention has been a hot topic for decades in clinical psychiatry. In Japan, as any patient can visit either specialists or primary care physicians using medical insurance, a considerable portion of psychosis patients are supposed to visit the latter first. Thus, a role of primary care physicians seems keys of success in implementation of early intervention system in the Japanese society. In this study, to clarify the motivation of physicians to participate in early intervention, we sent postal questionnaires to 4030 private clinics throughout Japan, inquiring physicians' situations around psychiatric disorders. Seven hundred and fourteen questionnaires were used for analysis (17.7%). Among these 714 respondents, 364 (51.0%) reported that they have willingness to participate in early intervention. Similarly, 494 (69.2%) were interested in psychiatric disorders, whereas only 168 (23.5%) were confident in identifying schizophrenia. The interest in psychiatric disorders was most strongly associated with their willingness to participate (Odds ratio = 3.54 by logistic regression analysis). These results, therefore, suggest that the interest in psychiatric disorders motivates them to participate in early intervention for psychosis; this has considerable implications for future approach to build up early intervention system in Japan.     

外科病区护士循证护理技能的培训方法研究

目的 探讨外科病区护士循证护理技能的培训方法.方法 选择2个外科病区的护士共计43人作为培训对象,根据循证护理4个步骤,制订提出问题、寻找循证支持、进行循证观察、临床循证应用的培训流程,按照流程对护士进行循证护理能力的培训.评价培训后的护士循证护理技能;护士获取信息资源能力;护士满意度调查.结果 培训前后护士循证护理技能比较,差异有统计学意义(P＜0.01);培训前后护士获取信息资源能力比较,差异有统计学意义(P＜0.01);95%的护士认为经过培训后提高了自身循证护理能力.结论 通过对外科病区护士进行循证护理能力的培训,达到了提高护士循证护理技能;提高护士获取信息资源能力的目的,对促进循证护理的推广应用有一定的指导意义.     

Novel method for screening for the presence of haemoglobin S in blood

A high-performance liquid chromatography (HPLC) method designed for the measurement of haemoglobin (Hb)A(1c) in blood was investigated for use as a screening method for the presence of HbS in blood. In the Bio-Rad VARIANT II HbA(1c) method, HbS was found to have a specific retention time and percentage Hb value that enabled the detection of HbS in blood. Other Hb variants did not have the same combination of retention time and percentage Hb as HbS. The HPLC method was superior to the HbS solubility test in ease of performance and readability. Also, the proposed method showed less interference than the solubility test and could be used with samples from all age groups. The proposed method takes 3 min per sample to perform and is thus suitable for large-scale screening.     

神经内科住院患者体温测量方法的探讨

目的探讨使用红外线耳温计测量神经内科住院患者体温的可行性。方法测量2009年9—12月神经内科316例住院患者的耳温、口温、腋温,对比同组患者左右耳的温度,比较耳温与口温、腋温的差异。结果患者左右两耳温度差异无统计学意义(P>0.05),患者耳温、口温和腋温3者之间差异有统计学意义,同时任何两组之间的差异均有统计学意义(P<0.05)。结论红外线耳温测量仪可以应用于神经内科住院患者测量体温,能较好反映患者体核温度,且操作简单方便,值得临床推广应用。     

外科病区护士循证护理技能的培训方法研究

目的探讨外科病区护士循证护理技能的培训方法。方法选择2个外科病区的护士共计43人作为培训对象，根据循证护理4个步骤，制订提出问题、寻找循证支持、进行循证观察、临床循证应用的培训流程，按照流程对护士进行循证护理能力的培训。评价培训后的护士循证护理技能；护士获取信息资源能力；护士满意度调查。结果培训前后护士循证护理技能比较，差异有统计学意义（P〈0．01）；培训前后护士获取信息资源能力比较，差异有统计学意义（P〈0．01）；95％的护士认为经过培训后提高了自身循证护理能力。结论通过对外科病区护士进行循证护理能力的培训，达到了提高护士循证护理技能；提高护士获取信息资源能力的目的，对促进循证护理的推广应用有一定的指导意义。     

Guideline for diagnosis and management of hyperlipidemia for prevention of atherosclerosis in Japan

Coronary heart disease (CHD) mortality and plasma cholesterol level have increased in Japan. There has been evidence indicating that cholesterol-lowering is effective in secondary and primary prevention of CHD. Hypercholesterolemia has been defined as over 220 mg/dl, and over 140 mg/dl for LDL-cholesterol. These levels were determined on the base of the evidence observed in Japan. The subjects are divided as follows, A: no CHD and no other risk factors, B: no CHD and at least one risk factor, C: manifest CHD. The treatment levels of LDL-cholesterol are 140 mg/dl for category A, 120 mg/dl for B and 100 mg/dl for C. Although drug therapy may be necessary when LDL-cholesterol level is over 120 mg/dl in category C, life-style modification is most important in category A and B.     

Networking for the advancement of nursing research in Europe for twenty-five years

The Work Group of European Nurse Researchers (WENR) has been networking for advancement of nursing research in Europe for 25 years. The most well-known activity of WENR is its biennial conferences organized in all parts of Europe. They have provided a unique opportunity for nurses to come together to discuss nursing research and clinical practice. Recently, WENR has published a position paper in order to reinforce its own and International Council of Nurses, World Health Organization and The Standing Committee of Nurses of the European Union (PCN) aims. The Work Group of European Nurse Researchers recommends that the recommendations of The Council of Europe report be adopted formally by national nurses associations. Future activities of WENR include promotion of infrastructures and research capacities in member countries, and planning of new scientific activities.     

Projection of the supply of and demand for board-certified nephrologists for ESRD in Taiwan

Objective Taiwan is the country where end‐stage renal disease (ESRD) is most prevalent. The purpose of this study was to investigate whether the rising demand for dialysis or transplantation as a result of ESRD can be balanced by the supply of board‐certified (B‐C) nephrologists. Methods Two Markov processes were applied for the projection of the supply of B‐C nephrologists in ESRD and for the projection of the demand from ESRD in 2020, assuming linear, exponential growth and no increase. Results The supply of B‐C nephrologists was projected at 1346 in 2020. To make allowance for the share of total time of professional activities in full‐time equivalent (FTE) for B‐C nephrologists, the demand was 1556, 962 and 2652 with assumptions of steady, linear and exponential growth, respectively. By the year 2020, 210 and 1306 additional FTE nephrologists will be required to meet, respectively, a linear and an exponential increase in demand from ESRD. Conclusions The projection of the supply of and the demand for B‐C nephrologists was made in this study using two Markov processes. The methods and results can be adopted as a reference for health manpower planning on B‐C nephrologists.