对急诊科护士心理健康状况的调查研究

通过便利抽样,调查了国内9所综合医院92名护士的心理健康状况。结果表明样本的SCL-90总均分和各因子分均显著高于国内常模评分。常见的心理障碍包括焦虑、敌对等。作者对此进行了讨论。本研究的结果可以为急诊科护士心理保健和心理治疗提供一定的信息。     

儿科护士心理健康状况和应对方式的研究

[目的]探讨儿科护士的心理健康状况及应对方式,以提高护理质量。[方法]采用症状自评量表(SCL-90)、特质应对方式问卷(TCSQ),对福州市58名儿科护士及59名普通科室护士进行心理健康状况和应对方式的调查。[结果]儿科护士SCL-90的强迫、抑郁及焦虑因子分高于普通科室护士因子分,差异有统计学意义(P<0.05);TCSQ的消极应对均分高于普通科室护士均分,差异有统计学意义(P<0.05);其中,儿科护士工作年限≤5年、>20年者多采用消极应对方式。儿科护士的SCL-90总均分及部分因子分与消极应对方式均分呈正相关,差异有统计学意义(P<0.05)。[结论]儿科护士存在一定的心理健康问题,应注重应对方式与心理状态的调整,以提高护理质量。     

成都市某三级甲等医院护士心理健康状况调查

[目的]了解成都市某三级甲等医院护士的心理健康状况及其影响因素.[方法]对该医院247名护士进行症状自评量表、人口统计学特征调查表等测评并分析.[结果]研究对象的SCL-90的总分及除人际关系外的各症状因子高于常模,差异有统计学意义(P<0.01);30岁以上年龄组护士的躯体化因子和抑郁因子分高于30岁内年龄组,差异有统计学意义(P＜0.05);工作10年以上的护士的躯体化因子和抑郁因子分高于工作10年以内组,差异有统计学意义(P<0.05);ICU、外科手术室护士的躯体化因子分高于病房组,差异有统计学意义(P<0.05).[结论]某三级甲等医院护士心理卫生问题发生率高,30岁以上年龄组护士的心理卫生问题发生率高于30岁以内组;工作10年以上的护士的躯体化因子和抑郁因子分高于工作10年以内组;ICU、外科手术室护士的躯体化因子分高于病房组.     

精神科临床护士工作压力与心理健康调查分析

[目的]了解精神科临床护士工作压力与心理健康的相关性。[方法]采用一般情况调查表、护士工作压力源量表和症状自评量表,对精神科156名护士进行问卷调查。[结果]精神科护士工作压力较大,依次体现在工作环境及资源方面、病人护理方面、工作量及时间分配方面、护理专业及工作方面、管理及人际关系方面。症状自评量表各因子得分均高于国内常模（P〈0.01）。工作压力与症状自评量表各因子之间存在显著相关性（P〈0.05或P〈0.01）。[结论]精神科护士处于高强度的工作压力中,严重影响了护士的身心健康。建议管理者采取有效的措施缓减护士的工作压力,护士应正确对待工作压力,掌握适合自己的减压方式。     

Assisted dying and end-of-life symptom management

This qualitative study aimed to describe symptom management strategies oncology nurses have used in responding to and preventing requests of terminally ill patients with cancer for assisted dying (AD). The study involved secondary analysis of written stories from 36 nurses who agreed to describe their experiences with a request for assisted dying. Of the 36 nurses, 12 refused to support patient requests for AD and described their attempts to control the circumstances of dying by controlling symptoms. The remaining 24 nurses denied ever receiving requests for AD and described symptom management practices believed to prevent such requests. Data were analyzed using Denzin's process of interpretive interactionism. Two themes emerged from the participant's stories: alternative strategies for AD and prevention of requests for AD. The participants shared many examples of clinical interventions and other features of nursing responses to relieve or prevent suffering including physical, emotional, and spiritual care practices; comfort and medication management; and service as teacher-advocate. Both the nurses who had received requests for AD and those who had not used a variety of similar symptom management approaches to alleviate suffering. In doing so, these nurses upheld current standards of both their professional and specialty organizations.     

Towards a comprehensive theory of nurse/patient empowerment: applying Kanter's empowerment theory to patient care

spence laschinger h.k., gilbert s., smith l.m. & leslie k. (2010) Journal of Nursing Management 18, 4–13
Towards a comprehensive theory of nurse/patient empowerment: applying Kanter's empowerment theory to patient care
Aim  The purpose of this theoretical paper is to propose an integrated model of nurse/patient empowerment that could be used as a guide for creating high-quality nursing practice work environments that ensure positive outcomes for both nurses and their patients.
Background  There are few integrated theoretical approaches to nurse and patient empowerment in the literature, although nurse empowerment is assumed to positively affect patient outcomes.
Evaluation  The constructs described in Kanter's (1993) work empowerment theory are conceptually consistent with the nursing care process and can be logically extended to nurses' interactions with their patients and the outcomes of nursing care.
Key issues  We propose a model of nurse/patient empowerment derived from Kanter's theory that suggests that empowering working conditions increase feelings of psychological empowerment in nurses, resulting in greater use of patient empowerment strategies by nurses, and, ultimately, greater patient empowerment and better health outcomes.
Conclusions  Empirical testing of the model is recommended prior to use of the model in clinical practice.
Implications for Nursing Management  We argue that empowered nurses are more likely to empower their patients, which results in better patient and system outcomes. Strategies for managers to empower nurses and for nurses to empower patients are suggested.     

Barriers to effective symptom management in hospice

The barriers to effective symptom management in hospice are not well described. We surveyed nurses of hospices affiliated with the Population-based Palliative Care Research Network (PoPCRN) to identify barriers to the effective management of common symptoms in terminally ill patients. 867/1710 (51%) nurses from 67 hospices in 25 U.S. States returned surveys. Of 32 symptoms, nurses reported agitation (45%), pain (40%), and dyspnea (34%) as the 'most difficult to manage.' The most common perceived barriers to effective symptom management were inability of family care providers to implement or maintain recommended treatments (38%), patients or families not wanting recommended treatments (38%), and competing demands from other distressing symptoms (37%). Patterns of barriers varied by symptom. These nurses endorsed multiple barriers contributing to unrelieved symptom distress in patients receiving hospice care. Interventions to improve symptom management in hospice may need to account for these differing barrier patterns.     

新毕业护士的心理状态调查分析及对策

为了了解新毕业护士的心理状态,采用90项症状自评量表(SCL-90)对64名新毕业护士的心理状况进行了调查。结果发现新护士在SCL-90中的各因子分均高于国内常模,主要表现为焦虑、人际关系敏感。及时了解新护士的心理状态,通过扎实基本功,培养独立处事能力,帮助新护士增强自信心,树立良好的职业意识,才能顺利度过工作适应期。     

A protocol for treating acute constipation in the community setting

Constipation is a distressing symptom, common in many patient groups and traditionally treated by nurses. Ambiguity concerning limits of the nurse's role in treating constipation exists and guidelines are scarce. Theoretically constipation is largely preventable, but acute episodes arise for a number of reasons and often need prompt treatment. This article describes the development of a local protocol which empowers appropriately trained community nurses to treat adult patients with acute constipation. A flow chart was used to define the guidelines. Implementation of the protocol is briefly discussed in relation to other current local initiatives.     

护患纠纷中护士心理健康状况及其影响因素的调查分析

目的探讨护患纠纷中护士心理健康状况及其影响因素,以寻找有针对性的干预对策。方法在护患纠纷事件发生l周内,分别对36名当事护士进行症状自评量表（SCL-90）、简易应对问卷（SCSQ）、社会支持量表（PSSS）等问卷调查,将其心理健康状况与国内成人常模及普通护士进行对比分析,并对影响因素进行相关性分析。结果纠纷组护士SCL-90各因子分及总均分均显著高于国内成人常模及普通组护士,其心理健康状况与其应对方式及社会支持显著相关。结论护患纠纷中护士心理健康水平较一般人群和普通护士低,并明显受应对方式及社会支持的影响。管理者应高度重视当事护士的心理健康状况及其影响因素的正向作用,从多层面人手进行有针对性的干预,以应对压力性事件带来的不良情绪影响。     

团体心理干预在遭受职业场所暴力后精神科护士的应用研究

目的探讨团体心理干预在遭受职业场所暴力后精神科护士心理干预中的应用效果。方法选择上海市二级甲等精神专科(长宁、静安)医院遭受过工作场所暴力的注册精神科护士60例为研究对象,随机分为对照组与观察组,各30例。对照组给予常规心理疏导,观察组由专业心理咨询师进行团体心理干预,所有护士均使用症状自评量(SCL-90)、焦虑自评量表(SAS)、抑郁自评量表(SDS)进行测量,比较2组干预前后测量结果变化。结果观察组护士SCL-90量表中躯体化、强迫症状等维度评分、SAS、SDS评分均显著低于对照组(P0.05)。结论团体心理干预有助于改善遭受职业场所暴力后精神科护士的心理状况,缓解焦虑、抑郁情绪,提高工作质量。     

ICU护士心理健康状况及其需求的调查分析

[目的]了解ICU护士心理压力状况及其产生的原因,缓解ICU护士心理压力,从而促进护理质量的提高。[方法]应用症状自评量表(SCL-90),通过问卷调查方式,对北京市大兴地区两所二级甲等医院101名护士进行问卷调查,并对调查结果进行对比分析。[结果]ICU护士症状自评量表的总均分、阳性项目数以及各因子分明显高于普通科室护士。[结论]与普通病房护士比较,ICU护士显示较多的心身问题,导致ICU护士心理问题较多的原因是多方面的,如ICU护士严重缺编、工作量大、病人病情危重、年轻护士较多、临床经验少、业务知识缺乏及护理记录不完善等。     

门诊护士工作场所暴力调查与分析

目的了解门诊护士遭受医院工作场所暴力情况及其心理健康状态。方法采用自设调查问卷和症状自评量表对106名门诊护士遭受工作场所暴力及其心理健康状况进行调查。结果76．42％的门诊护士在过去一年中遭受过工作场所暴力;门诊护士的心理健康状况在各方面症状评分均高于常模（P〈0．01）;遭受工作场所暴力的门诊护士心理状况更差（P〈0．01）。结论门诊护士遭受工作场所暴力的问题较为严重,应加强法律法规、应对工作场所暴力的培训及心理疏导,以有效防范医院工作场所暴力的发生,维护门诊护士的身心健康。     

An integrated approach to symptom management

Symptom management is a challenging experience for patients, families and health-care professionals. When a person has a symptom that is troublesome and not being properly managed they may become so focused on that symptom that they cannot enjoy a good quality of life. Nurses know symptoms that are problematic for patients are usually problematic for nurses as well; however, not every nurse knows how to effectively manage patients’ symptoms. In response to these challenges, we propose an Integrated Approach to Symptom Management (IASM) that can be used for a variety of patient populations in an effective, efficient and consistent manner. The focus of the IASM is on the patient and is designed to be used by nurses to promote patient self-care symptom management abilities.     

The role of the outpatient clinic nurse in monitoring opioid therapy

Outpatient clinical nurses specialize in patient care in a particular area of nursing practice. Typically, the registered nurse also holds a professional certification in that specialty or subspecialty. The only nursing certification related to pain and symptom management is the Hospice and Palliative Care certification. Managing the patient with chronic pain is a common clinical challenge, especially when opioid therapy is indicated. Chronic pain often is undertreated in patients with cancer and in those with non-malignant conditions. Because chronic pain can be complex, successful long-term treatment is more difficult for providers. Professional nurses are the primary team members who assess, coordinate, direct, and evaluate patient care needs during times of illness. A nurse is one of the first contacts in the health care system that the patient encounters. Nurses must possess unique qualifications and be able to deal compassionately with a demanding and sometimes hostile group of patients. How the patients are accepted into a pain medicine practice and managed is discussed in this article.     

精神科临床护士工作压力与心理健康调查分析

[目的]了解精神科临床护士工作压力与心理健康的相关性。[方法]采用一般情况调查表、护士工作压力源量表和症状自评量表,对精神科156名护士进行问卷调查。[结果]精神科护士工作压力较大,依次体现在工作环境及资源方面、病人护理方面、工作量及时间分配方面、护理专业及工作方面、管理及人际关系方面。症状自评量表各因子得分均高于国内常模(P<0.01)。工作压力与症状自评量表各因子之间存在显著相关性(P<0.05或P<0.01)。[结论]精神科护士处于高强度的工作压力中,严重影响了护士的身心健康。建议管理者采取有效的措施缓减护士的工作压力,护士应正确对待工作压力,掌握适合自己的减压方式。     

Advancing Oncology Nursing Practice Through the Adoption of Patient Monitoring Digital Tools

ObjectiveThe objective of this paper is to describe the use of oncology digital symptom monitoring and patient self-management coaching tools, how nurses and nurse practitioners (NPs) can optimize their use as an adjunct in improving oncology care and discuss issues and strategies needed for adoption within a variety of clinical settings.Data SourcesA review of the research literature regarding digital health in oncology symptom management in PubMed provided the foundation for this paper.ConclusionDigital symptom monitoring technology provides a variety of opportunities for oncology nurses and NPs to efficiently extend and improve symptom management in multiple settings including cancer patients at home between clinic visits, at clinic visits, and during inpatient stays. Digital monitoring and patient engagement make possible frequent symptom assessments, just-in-time personalized self-management reinforcement, and judiciously alert nurses and NPs about key times for follow-up with patients supported with evidenced-based guidelines. Oncology nurses at all levels have the opportunity to be leaders in the adoption and expansion of digital tools to enhance their practice.Implications for Nursing PracticeOncology nurses and NPs can lead practice changes that improve patient outcomes through understanding and shaping the use of digital tools.     

临床护士心理健康状况与应对方式的相关性研究

目的　了解临床护士心理健康状况与应对方式的关系 ,为临床护理和人员管理提供依据。方法　采用SCL 90症状自评量表和应对方式问卷调查 ,对我院 89名临床护士进行检测 ,并分析差异与相关性。结果　样本的SCL 90症状自评的阳性项目数、躯体化、焦虑和恐怖具有统计学意义 (P <0 .0 5 ) ;消极应对与SCL 90症状自评因子的躯体化、强迫、人际关系、抑郁、焦虑、敌对、恐怖、偏执和精神病性呈显著正相关 (r =0 .2 3～ 0 .38)。结论　临床护士的心理健康状况较一般人群差 ,心理健康状况与应对方式存在明显的相关性 ,在某种程度上影响着临床护士的心理健康状况     

Limit-setting and decision-making in the management of aggression

BACKGROUND: Several published research studies have suggested that inpatient aggression against nursing staff may be directly precipitated by common nurse-patient interactions. This study sought to examine the structure of nurses' judgements in situations of conflict. METHOD: Seventy practising United Kingdom psychiatric nurses were presented with a number of conflict scenarios and were asked to rate a range of intervention options for each scenario according to how appropriate they perceived those interventions to be. Their responses were analysed using multidimensional scaling techniques. RESULTS: The results suggest that issues associated with limit setting and autonomy were perceived as most important by the nurses and that these issues are most likely to lead to disagreements in judgement between nurses of different status. Nurses of higher grades (levels) showed a significantly greater preference for respectful and autonomy-confirming interventions than their more junior nurses. These results have training and policy implications and further research should examine the effects of such nursing judgements on patient care.