实习阶段本科护生心理健康状况调查分析

目的了解实习阶段本科护生的心理健康状况,为护理学专业临床带教工作提供参考。方法采用问卷调查法,对正在实习的46名五年制护理学本科生进行心理健康状况调查。结果本科护生实习期间总体心理健康状况较好,但就个体的健康因子分值来看,有11%左右的护生处于亚健康状态。护生心理健康与应激水平呈高度正相关。结论实习阶段本科护生心理健康状况较好,应激可以对护生的心理健康产生影响。     

106名实习后期实习护生心理健康状况调查分析

目的:调查实习护生的心理健康状况,为加强实习护生管理工作和提高实习护生心理素质提供依据。方法:用心理健康诊断测验表(CAS)随机调查广西中医学院第一附属医院实习护生106人。结果:(1)实习护生心理健康构成比比较存在差异(P<0.05);(2)汉族与少数民族实习护生心理健康比较尚未存在民族差异(P>0.05);(3)不同学历层次实习护生心理健康状况存在差异(P<0.05)。结论:本科实习护生心理健康状况较好,临床实习应重视实习护生心理健康状况和心理辅导工作,尤其对专科以下的实习护生更是如此。     

本科实习护生职业应激现状及其原因分析

目的了解本科护生实习阶段的职业应激现状,分析其影响因素,为学校教育者和临床带教者了解学生压力状况,进行有针对性的心理干预提供理论依据。方法采取问卷调查的方法,对200名本科实习护生进行职业应激的调查。结果本科实习护生职业应激各维度中,与护理工作期望有关的应激源得分最高为(10.69±6.22)分,其次是与工作负荷有关的应激源为(9.80±5.83)分,与接触病人有关的应激源得分最低为(7.83±3.82)分。结论学校教育者及临床带教者应充分了解护生的应激水平,指导护生采取积极的应对策略面对压力。     

护理本科实习生心理健康状况与应激性事件的相关性研究

目的 探讨护理本科实习生心理状况特点及影响因素.方法 随机抽取三所医学院校护理专业本科应届毕业生165人.用大学毕业生应激性事件量表(CSSS)和症状自评量表(SCL-90)进行5次跟踪调查.结果 ①本科护生实习期间不同测试时点,SCL-90各因子分低于全国青年常模(P＜0.05);②不同测试时点护生的心理健康状况不同,实习第三个月末的心理健康水平最高,SCL-90总分最低,[(110.16±22.89)分](P＜0.05);③实习不同阶段,应激性事件频率的变化与SCL-90总分变化之间存在显著正相关,其相关系数为第一阶段学习压力(r=0.167)、人际关系(r=0.229)及重要生活事件频率(r=0.218)(P＜0.05);第二阶段学习压力(r=0.306)、求职压力(r=0.226)、人际关系压力(r=0.375)、日常生活困扰(r=0.354)及重要生活事件频率(r=0.322)(P＜0.01);第三阶段学习压力(r=0.329)、求职压力(r=0.211)、人际关系压力(r=0.342)、日常生活困扰频率(r=0.216)(P＜0.05).第四阶段学习压力(r=0.263)、求职压力(r=0.289)、人际关系压力(r=0.225)、日常生活困扰频率(r=0.220)(P＜0.01).结论 ①与全国青年常模相比,本科护生在不同测试时点心理健康状况较好;②不同的测试时点本科护生心理健康状况不同;③不同实习阶段影响护生心理健康状况变化的因素不同.     

本科护生心理健康现状分析及健康教育对策

目的 掌握临床本科护生的心理健康状况,分析存在的主要心理问题,并进行健康指导.方法 2010年9月-11月采用症状自评量表(SCL-90)对武汉三甲医院120名本科护理实习生的心理健康状况进行调查分析.结果 临床本科护生心理健康状况低于全国正常青年人群水平,主要心理问题表现为强迫和抑郁.结论 护理本科生在进入临床实习阶段,心理健康状况较差.这与学生从社会关系较为简单的学校环境向关系复杂的社会环境过渡有关,同时也与实习生面对的择业压力等有关.根据临床本科护生心理健康状况的特点,针对性地开展心理健康教育非常必要.     

本科实习护生共情疲劳现状及相关因素分析

目的：调查本科实习护生共情疲劳的影响因素。方法：采用一般资料问卷、中文版专业生活质量量表、杰斐逊共情量表(护生版)及灵性健康简化量表对浙江某本科院校临床实习的400名护生进行问卷调查。结果：喜欢护理学专业、共情能力、灵性健康水平是共情满意的影响因素；喜欢护理学专业、共情能力、灵性健康水平等是职业倦怠的影响因素；被带教老师认可、胜任目前实习等是继发性创伤应激的影响因素；差异均有统计学意义(P<0.05)。结论：本科实习护生共情满意、职业倦怠和继发性创伤应激水平受共情能力、灵性健康水平、专业认同度及临床实习环境的影响。护理教育者应重点关注这些影响因素，并制定相应预防措施。     

我院本科护生生产实习前强化技能训练的实践与思考

临床生产实习是本科护理学专业教育的重要阶段,也是本科护生专业实践的重要环节。为了提高本科护生临床生产实习的质量,保证毕业生的优良素质,齐齐哈尔医学院护理系采取了积极有效的生产实习前强化技能训练工作,为社会提供合格的高级护理人才。     

实习前本科护生焦虑情绪及其应对方式的研究

护生面对即将开始的临床实习,由于学习环境、人际关系、学习方式等方面都会发生改变,护生可能会出现情绪上的波动和行为上的改变。本文旨在了解本科护生在实习前的焦虑心理状况及应对方式,为心理健康指导者提供参考依据。     

浅析我院护生实习前强化训练的模式与效果

临床实习是护理教育教学过程中对护生进行综合训练的重要阶段，是完成教学计划实现培养目标的最后教学阶段，是整个专业教学计划的重要组成部分。因此，抓好进入临床实习前的强化训练，保证临床实习的效果，是护理教育中必须解决的课题。我院护理学专业经过几届护生实习前强化训练教学实践，取得了一些成绩。为进一步探讨护生实习前强化训练的模式，提高强化训练教学效果，笔者对我院2006年护理学专业接受实习前强化训练教学的349名学生进行调查分析。现报告如下：     

护生实习前心理健康状态与知识能力的相关性分析

目的调研实习前护生心理健康状况与知识和能力缺乏的相关性,分析影响实习前护生心理健康问题的知识和能力等相关因素。方法通过焦虑状态-特质问卷量表（STAI）和BECK抑郁自评问卷量表（BID）检测实习前护生的焦虑和抑郁状况,采用自行设计的调查问卷,检测实习前护生知识和能力缺乏状况,对100名即将参加临床实习的护理本科生进行测试,采用SPSS13.0统计软件分析实习前护生心理健康状况与知识能力缺乏的相关性。结果实习前护生存在一定程度的心理健康问题。相关分析表明,实习前护生的焦虑和抑郁状态主要与自测量表一级指标中的职业知识相关,进一步分析发现学生担心的法律知识不足与病人发生医疗纠纷,学校教学与临床实际发生差距的问题,角色转变的适应能力慢等是影响护生心理健康的主要因素。结论实习前护生焦虑、抑郁状态与知识和能力缺乏呈正相关,应加强实习前护生该方面知识教育。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.