家庭为中心的护理现状调查

目的 调查在儿科护理工作中，以家庭为中心的护理实施情况。方法 采用波士顿儿童医院设计的“家庭为中心的护理量表”，经对35位家长预调查，内部一致性系数为0．76，随后对全院180位患儿陪护家长进行调查，用SPSS软件进行统计。结果 护士的服务意识增强，能满足患儿及家长的基本需要，但护士与家长的沟通不够，对于患儿疾病的认识、转归等告知甚少，双方对儿童住院引起的心理和行为方面的问题都未予以重视。结论 转变观念，承认家长在孩子患病过程中的重要作用，护士应提高沟通技巧及心理知识的学习，取得家长的合作，得到家长的支持，对患儿疾病的康复有着重要的作用。     

家长对"以家庭为中心护理"的认识

目的探讨家长对护理人员提供"以家庭为中心护理"的认识.方法目的抽样选择180例住院患儿的家长,采用美国波士顿儿童医院的"以家庭为中心护理"量表,在患儿出院前1天对其家长进行一对一调查.结果护士提供"以家庭为中心护理"的一致性与家长认为的重要性之间的平均匹配系数为0.59,范围在0.29～0.88.结论我院护士提供的以家庭为中心的护理措施,能满足家长和孩子生理上的需求及孩子和家长在一起的需求,能让孩子感觉受到很好的照顾.在关注孩子及家庭的心理、行为,为家长提供信息和心理支持,以及鼓励家长参与性方面与美国波士顿儿童医院的现况存在一定距离.     

家长对“以家庭为中心护理”的认识

以“家庭为中心护理”理念强调护理需要重视家庭和谐与健康，需要重视家庭成员为维护健康的重要参与者，要指导家长如何妥善地照顾患儿，满足家长和孩子在一起的需要，认同家长在孩子患病过程中的重要作用，并为孩子及家长提供适当的需要和护理。本研究通过对180名家长采用“以家庭为中心护理”量表进行调查，其结果显示“以家庭为中心护理”措施能满足儿童生理上的需求，能满足孩子和家长在一起的需求，能让儿童感受到很好的照顾。要把“以家庭为中心护理”理念变成具体的护理实践，必须对儿科护理人员进行有关“住院孩子行为和情感变化”及“疾病对家庭心理社会影响与应对”方面的培训，以便今后将其在儿科护理工作中落实。     

长期发热患儿家长的心理状况分析及护理干预

目的:探讨长期发热患儿家长的心理状况并进行护理干预,以取得良好的护理效果。方法:采用症状自评量表(SCL-90)对38例长期发热患儿家长进行心理健康状况调查,同时采用非标准化访谈调查家长所关注和担忧的问题。结果:长期发热患儿家长SCL-90总分和躯体化症状、强迫、焦虑、恐怖、抑郁、敌对、饮食睡眠因子均明显高于国内常模(P<0.05)。结论:通过对长期发热患儿家长心理状况分析,实行以家庭为中心的医疗护理模式,提高患儿家长对患儿疾病的认识,做好基本知识宣教,加强医师、护士、家长之间的沟通等护理干预,提高家长的疾病知识和抗压能力,促进患儿的康复。     

沟通技巧在儿科病房中的应用

沟通是护理实践中的重要内容，护患沟通是护士与患者之间的信息交流及相互作用的过程。对儿科护士来说，与儿童或婴幼儿及其家长进行沟通有着特殊的工作含义，护士只有运用良好的沟通技巧，与患儿家长进行有效的沟通，才能取得患儿及家长的信任，从而获得有关患儿的全面信息，为患儿制定个体化的护理计划，以满足患儿生理、心理、社会等多方面的需要，促进患儿早日康复。     

哮喘儿童家庭护理现状及护理需求的研究

目的探讨哮喘儿童家庭护理中存在的问题以及患儿家庭对医疗护理服务的需求,旨在为患儿提供针对性的医疗护理服务并为实施以家庭为中心的护理提供依据。方法应用质性研究中的现象学研究法,对14位哮喘儿童父母进行深入访谈,采用Colaizzi的现象学资料7步分析法对资料进行分析、整理。结果哮喘儿童的照护现状及护理需求主要存在5个方面的问题,即患儿家长对疾病缺乏正确的认识,依从性较差,忽视哮喘对患儿心理的影响,家庭应对失败,家庭承受着心理和经济压力。结论医护人员应经常对患儿照顾者进行哮喘知识宣传教育,鼓励他们参与患儿的治疗、护理方案的制定,并有针对性地对患儿照顾者采取个性化的教育、指导。     

家庭护理

931267浅谈慢性疾病患儿在家庭中的心理护理:附38例慢性疾病患儿的家庭调查/孙荣一刀天津医学院学报.-1992,16(3)。66~68 通过问卷方法,对38名患慢性疾病,并在家庭中接受治疗和护理的儿童家长进行调查,了解患慢性疾病儿童的心理状态。结果表明:不同年龄阶段的慢性疾病患儿的最大乐趣与希望均不同.3岁以下的患儿最愿意与母亲或亲人在一起,而3岁以上患儿则以游戏、玩耍为最大乐趣,3~6岁患儿最大希望是不住院、不打针、不吃药;7~15岁患儿则盼望疾病及早治愈。根据不同年龄阶段患儿的心理需求,提出在家庭中应注意的心理间题及应采取的心理护理措…     

有效沟通在儿科护理工作中的应用

儿科护理人员在从事护理工作时,不仅要为患儿进行技术护理,更要做好心理护理及对患儿家长的解释、咨询、安慰等工作,所以,护士与患儿及患儿家长的有效沟通能促进良好护患关系的建立,帮助患儿适应环境,从而解决患儿的健康问题。1沟通内容包括对病区环境、规章制度的宣传,对主管医生、护士、科主任、护士长的介绍。了解儿童患病后家长的忧虑和担心,及患儿、家长对治疗护理的特殊需要及愿望,与家长共同商量对个体护理所实施的护理措施,并取得家长的支持与合作。2影响沟通的因素2.1家长的心理反应特点如沟通者的表达能力、理解能力、文化程度、性格特征、心理素质等,这些内部因素直接关系到沟通的成功与失败。2.2情绪反应孩子生病后,家属容易产生焦虑、烦躁等情绪,对医院的期望值也过高。     

家长对以患儿和家庭为中心护理的评价及其影响因素分析

[目的]对家长对以患儿和家庭为中心护理过程的评价进行调查,并分析其影响因素。[方法]采用自行编制的问卷对入选的450名患儿家长对以患儿和家庭为中心的护理过程的评价进行调查。[结果]患儿家长对于以患儿及家庭为中心护理过程的总体评分为2.88±0.76,“常规信息支持”“信任和被信任”被认为是发生频率最高的2个维度,患儿家长对护理过程评价的影响因素为长期居住地、家长性别、是否为居家主要照顾者。[结论]护士应提供有针对性的护理服务,鼓励家长建立社会支持系统和多元的信息平台,增强家长做决策和照顾患儿的能力。     

如何与婴幼儿进行有效沟通

沟通是人与人之间信息传递与交流的过程。儿科护士护理活动的目的是满足患儿及其家长生理、心理及社会的需要。护士有责任帮助患儿把他们机体及心理的痛苦减少到最小程度，这就需要与患儿及其家长进行有效沟通，由于儿童语言表达能力和理解能力有限，尤其是与婴幼儿沟通非常困难，很难达到预期的效果和目标，如何才能与婴幼儿进行有效沟通，通过18年的儿科护理工作，总结了一些经验，现总结如下。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Modified micro-superior percutaneously-assisted total hip: early experiences & case reports

Because of the extensile nature and familiarity of the standard posterior-lateral approach to the hip, a family of "micro-posterior" approaches has been developed. This family includes the Percutaneously-Assisted Total Hip (PATH) approach, the Supercapsular (SuperCap) approach and a newer hybrid approach, the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach. Such approaches should ideally provide a continuum for the surgeon: from a "micro" (external rotator sparing) posterior approach, to a "mini" (external rotator sacrificing) posterior approach, to a standard posterior approach. This could keep a surgeon within his comfort zone during the learning curve of the procedure, while leaving options for complicated reconstructions for the more practiced micro-posterior surgeons. This paper details one author's experiences utilizing this combined approach, as well as permutations of this entire micro-posterior family of approaches as applied to more complex hip reconstructions.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Structure and function of "metalloantibiotics"

Although most antibiotics do not need metal ions for their biological activities, there are a number of antibiotics that require metal ions to function properly, such as bleomycin (BLM), streptonigrin (SN), and bacitracin. The coordinated metal ions in these antibiotics play an important role in maintaining proper structure and/or function of these antibiotics. Removal of the metal ions from these antibiotics can cause changes in structure and/or function of these antibiotics. Similar to the case of "metalloproteins," these antibiotics are dubbed "metalloantibiotics" which are the title subjects of this review. Metalloantibiotics can interact with several different kinds of biomolecules, including DNA, RNA, proteins, receptors, and lipids, rendering their unique and specific bioactivities. In addition to the microbial-originated metalloantibiotics, many metalloantibiotic derivatives and metal complexes of synthetic ligands also show antibacterial, antiviral, and anti-neoplastic activities which are also briefly discussed to provide a broad sense of the term "metalloantibiotics."