本科护生评判性思维与临床决策能力的相关性研究

目的探讨四川省护理本科生评判性思维与护理临床决策能力的关系。方法利用评判性思维态度倾向性调查表(中文版)和护理专业大学生临床决策能力测量工具,调查四川省四所大学2008年护理专业毕业实习10～12个月的本科生。结果四川省护理本科生评判性思维能力总平均分为287.37±32.52;四川省护理本科生临床决策能力总平均分为72.86±4.53;评判性思维与临床决策能力总分、确定目标、决断方案、实施决策呈显著正相关(P0.01～0.05)。结论本科护生评判性思维与护理临床决策能力呈正相关,评判性思维能力越强,护理临床决策能力越强。     

高职护生评判性思维能力与临床沟通能力的相关性研究

目的 探讨高职护生评判性思维能力与临床沟通能力之间的相关性.方法 采用评判性思维态度倾向性调查表(中文版)、临床沟通能力量表对漳州卫生职业学院2009级至2011级1135名高职护生进行调查,并对结果进行分析.结果 高职护生评判性思维能力平均得分为(278.54±25.98)分;高职护生临床沟通能力平均得分为(86.07±10.06)分;高职护生评判性思维能力与临床沟通能力总分及其各因子之间呈正相关.结论 高职护生评判性思维能力与临床沟通能力之间呈正相关,评判性思维能力越强,临床沟通能力越强.     

临床护士评判性思维现状及其影响因素研究

目的:探讨综合性教学医院临床护士评判性思维的现状及相关影响因素,为临床护理人员继续教育提供依据。方法:利用评判性思维倾向调查表(CTDI-CV)、评判性思维相关知识调查表及评判性思维相关因素调查表对619名临床护理人员评判性思维现状进行调查,并对影响因素进行相关性分析。结果:临床护士评判性思维的平均得分为(275.84±29.06)分,属于中等偏下水平;不同年龄、护龄、学历及临床科室的护士得分差异有统计学意义(P<0.01、P<0.05),而不同职称和不同个性特征的护士得分差异无统计学意义(P>0.05)。年龄、护龄、学历及临床科室是影响临床护士评判性思维倾向的相关因素。结论:为进一步提高临床护理人员评判性思维水平,建议临床相关部门在继续教育中合理设计强化护士评判性思维的教育活动,并为护理人员创造有利于评判性思维发展的工作环境。同时,积极培养在校护生的评判性思维能力,以达到使我国护士整体评判性思维能力上升的目的。     

综合性教学医院临床护士评判性思维的现状及其影响因素

目的探讨综合性教学医院临床护士评判性思维的现状及其影响因素,为提高护理人员评判性思维能力提供依据。方法采用分层随机抽样方法对619名临床护理人员评判性思维现状进行调查,并分析其可能的影响因素。结果临床护士评判性思维的平均得分为(275.84±29.06)分,其中认知成熟度、开放思想和寻找真相三个维度的得分为正性评判性思维。不同年龄、护龄、学历及临床科室间护士的得分差异有统计学意义(P<0.01、P<0.05),而不同职称护士的得分差异无统计学意义(P>0.05)。结论临床护士评判性思维的平均得分属于中等偏下水平,护理管理者必须加强临床护士评判性思维能力的培养。建议临床相关教育部门在临床继续教育中强化护士评判性思维的教育活动,并为护理人员创造有利于评判性思维发展的工作环境,以有效提高临床护士的评判性思维能力。     

临床护理人员评判性思维现状的调查分析

目的调查并分析临床护理人员评判性思维的现状,以期为有针对性地对其进行评判性思维能力的训练,提高其评判性思维能力提供依据。方法 2010年10月,采用评判性思维态度倾向性调查表-中文版(critical thinking disposition inven-tory-Chinese version,CTDI-CV)对兰州军区兰州总医院46个临床科室的100名护士进行问卷调查。结果护士评判性思维能力总得分为(290.25±2.21)分,7个特质方面的得分分别为:寻找真相(40.03±0.49)分、开放思想(41.74±0.65)分、分析能力(41.95±0.63)分、系统化能力(41.50±0.72)分、自信心(38.12±0.89)分、求知欲(42.17±0.70)分、认知成熟度(40.67±0.62)分。结论临床工作中,需加强对护理人员评判性思维能力的训练,尤其是培养临床护理人员的自信心特质。     

临床护士评判性思维态度倾向性与护理伦理决策能力的相关性研究

目的 了解临床护士评判性思维态度倾向性和护理伦理决策能力的现状及影响因素,分析两者之间的相关性.方法 在四川省5所三级甲等综合性医院中分层随机抽取359名临床护士进行问卷调查,问卷由一般情况调查表、护理伦理决策量表(JAND)及中文版评判性思维态度倾向性问卷(CTDI-CV)3部分组成.结果 临床护士CTDI-CV总均分为(285.06:±26.79)分,JAND总均分为(267.91±16.62)分.护理伦理决策能力的影响因素为学历、获取专业知识的途径、护理伦理决策培训.评判性思维态度倾向性与护理伦理决策能力呈正相关.结论 临床护士护理伦理决策能力及评判性思维态度倾向性得分处于中等水平,两者呈正相关,在学校教育和医院继续教育中,可通过加强对护士评判性思维态度倾向的培养来提高其护理伦理决策能力.     

医学本科生自我导向学习能力与评判性思维的相关性

目的探讨医学本科生自我导向学习能力与评判性思维的关系,以期为医学院校教学改革提供参考依据。方法采用评判性思维态度倾向性调查表(中文版)和自我导向学习量表,调查第三军医大学122名五年制四年级医学本科生的评判性思维能力及自我导向学习能力,并分析其相关性。结果第三军医大学医学本科生评判性思维能力总平均分为(300.71±29.22)分,自我导向学习能力总平均分为(168.89±17.65)分;自我导向学习能力总分与评判性思维总分、寻找真相、解放思想、分析能力、系统化、自信心、求知欲、认知成熟度均呈显著正相关(P<0.01或P<0.05)。结论 医学本科生有正向的评判性思维能力,自我导向学习能力与评判性思维呈显著正相关,自我导向学习能力越强,评判性思维能力越强。     

责任制整体护理模式下护士评判性思维能力现状与影响因素调查分析

目的调查分析责任制整体护理模式下护士评判性思维能力及影响因素,为临床护士核心能力的培养提供依据。方法采用护士一般资料问卷和加利福尼亚评判性思维倾向中文版问卷对388名护士进行调查,并对调查数据进行分析。结果 388名护士评判性思维能力得分平均(286.8±21.88)分,其中280~350分229人、350分2人。不同工作阶段护士评判性思维能力存在差异,工龄越长评判性思维能力分数越高(P0.05),内科护士评判性思维能力得分高于外科护士(P0.001),主动学习的护士评判性思维能力得分高于被动学习者(P0.001),经常阅读的护士比较少阅读者评判性思维能力得分高(P0.001)。结论责任制整体护理模式下护士具有正性评判性思维性格,但仍有很大提升空间,其影响因素与护士工作年限、所处科室、主动学习能力和阅读习惯有关。     

护理本科生自主学习能力及评判性思维的相关性分析

目的:探讨护理本科生自主学习能力与评判性思维的相关性,为护理本科生评判性思维能力的培养提供参考依据。方法 :选取我市某医学院校122名护理本科生为研究对象,采用评判性思维能力(中文版)测量表和自主学习能力量表调查护理本科生的评判性思维能力和自主学习能力,并分析其相关性。结果 :护理本科生的评判性思维能力总分为(296.45±30.87)分;自主学习能力总分为(85.34±6.01)分;自主学习能力总分与寻求真理、分析能力、系统化能力、评判性思维的自信心、求知欲、认知成熟度、评判性思维总分呈显著正相关(P0.05)。结论:护理本科生有正向的评判性思维能力,自主学习能力与评判性思维有相互促进的作用,自主学习能力越强,评判性思维能力越强。     

基层医院临床护士评判性思维与自主学习能力的现状及相关性分析

目的：了解基层医院临床护士评判性思维能力与自主学习能力的现状并探讨两者间的关系,为医学继续教育提供理论依据和参考。方法采用一般资料调查问卷、中文版评判性思维能力测量表（CTDI-CV）和护理人员自主学习能力评价量表,对3所县级医院345名临床护士进行调查。结果基层医院临床护士评判性思维能力总分为（276．08±34．31）分,自主学习能力总分为（121．40±18．42）分;除认知成熟度与任务分析和自我监控及调节无关外,评判性思维能力与自主学习能力的总分及其他维度均呈正相关（P＜0．05）。结论基层医院临床护士评判性思维能力和自主学习能力均有待提高,两者间相互正性影响;护理管理者应采取多种方法和措施,双管齐下,培养和提高基层医院临床护士评判性思维能力和自主学习能力。     

Rofecoxib: clinical pharmacology and clinical experience

BACKGROUND: Rofecoxib is a member of a subgroup of nonsteroidal anti-inflammatory drugs (NSAIDs) known as cyclooxygenase-2 (COX-2)-selective inhibitors. It has been studied in adult and elderly patients in a number of painful conditions (primary dysmenorrhea, acute pain after dental and orthopedic surgery, osteoarthritis [OA], and rheumatoid arthritis). OBJECTIVE: This review discusses the clinical pharmacology of and clinical experience with rofecoxib, and the role of COX-2-selective inhibitors in clinical practice. METHODS: Pertinent studies were identified through searches of MEDLINE and EMBASE, as well as the Web sites and proceedings of relevant scientific meetings. RESULTS: Although the published literature is limited, the data indicate that rofecoxib is an effective analgesic agent for the painful conditions in which it has been studied. As a COX-2-selective inhibitor, rofecoxib offers safety advantages over traditional NSAIDs. In clinical trials, gastrointestinal (GI) toxicity, including mucosal damage, perforation, ulcers, and bleeding, occurred significantly less often in healthy volunteers and patients treated with rofecoxib than in those who received NSAIDs such as ibuprofen, naproxen, or diclofenac (all comparisons, P < 0.001). In terms of renal toxicity, rofecoxib does not appear to offer a safety advantage over traditional NSAIDs. Rofecoxib has not been shown to affect platelets (bleeding time and platelet aggregation), unlike traditional NSAIDs. CONCLUSIONS: Rofecoxib is an appropriate choice for patients who do not obtain adequate analgesia with acetaminophen and those who have not obtained adequate analgesia from, cannot tolerate, or are at risk for GI toxicity with traditional NSAIDs. Patients who require chronic analgesic medication (ie, those with OA), including those who take other medications daily for comorbid conditions, may also benefit from the once-daily dosing regimen of rofecoxib.     

Enhancing clinical effectiveness among clinical nurse specialists

This article describes the findings of an exploratory study which aimed to discover how clinically effective nursing care is fostered among clinical nurse specialists (CNSs) and nurse practitioners (NPs) in an NHS trust in East London. The study was funded by the Central and East London Education Consortium in January 1999. Qualitative approaches included non-participant observation of practice, interviews during observaton and focus group meetings, Findings from the research identify areas that both foster and hinder the ability of the CNSs and NPs to engage in and provide clinically effective nursing care.     

The clinical imperative in clinical nursing research.

Conducting preliminary clinical fieldwork to update clinical knowledge in preparation to plan and perform relevant, meaningful, credible and feasible clinical research is imperative. Clinical nurse investigators cannot generate relevant questions to study a current phenomenon with which they are not experienced. The nurse researcher's early involvement in the clinical world of health care as a prerequisite of proposal development not only contributes to the design of a study that has rigor and significance, but it also augments his or her competence and commitment to the improvement of patient outcomes.     

Laboratory clinical effectiveness: pathologists improving clinical outcomes

This article calls on pathologists to take a larger role in improving the performance of the American health care system. To improve outcomes for populations and individuals require that pathologists increase their activities outside of the traditional laboratory in interdisciplinary collaborations, outcomes research, health care systems development, and clinical care.     

Adherence in clinical trials and in clinical practice

The degree of patient adherence is increasingly recognized to be a key factor in the success of highly active antiretroviral therapy (HAART). HAART regimens are also among the most complex ever prescribed and low adherence is directly related to treatment complexity. Physicians prescribing HAART need to make adherence a priority both in clinical practice and in the design and interpretation of clinical trials if HAART really is to succeed in the long term.     

Antiplatelet therapy from clinical trials to clinical practice

A platelet-rich clot at the site of severe coronary stenosis, plaque erosion, or a recent plaque rupture is the common etiology of acute ischemic syndromes. Thus, antiplatelet therapy is the cornerstone in the management of these conditions. Aspirin in a dose ranging from 160 to 325 mg once daily should be administered to virtually all patients. In patients with severe disease, particularly those who have no acute angiography, clopidogrel (Plavix, Bristol-Myers Squibb/Sanofi Pharmaceuticals) in a dose of 75 mg once daily should add to the benefit of aspirin for up to a year after the event. Clopidogrel also is an alternative to aspirin where a true aspirin allergy exists. Intravenous platelet glycoprotein IIb/IIIa receptor inhibitors demonstrated a robust benefit when used in conjunction with coronary intervention and thus far have no role in medical therapy alone. Oral platelet glycoprotein IIb/IIIa receptor inhibitors are of no clinical value.