《艾滋病护理临床实践指南》简介

<正>由复旦大学循证护理中心和上海市(复旦大学附属)公共卫生临床中心共同合作构建的《艾滋病护理临床实践指南》于2019年3月在复旦大学循证护理中心网站(http://nursing.ebn.fudan.edu.cn/)发布。该指南以JBI循证卫生保健模式为概念框架,以循证医学的方法论为基础,通过对31位艾滋病照护相关利益关联人的质性访谈、对423例艾滋病患者的问卷调查,以及采用ADAPTE方法对30份国内、外艾滋病护理相关临床实践指南的改编,采用系统评价再评价方法对44份国内、     

《经外周静脉置入中心静脉导管(PICC)置管临床实践指南》简介

正由复旦大学附属肿瘤医院与复旦大学循证护理中心共同合作构建的《经外周静脉置入中心静脉导管(PICC)置管临床实践指南》正式在复旦大学循证护理中心网站(http://nursing.ebn.fudan.edu.cn/)发布。该指南以JBI循证卫生保健模式和渥太华研究应用模式作为概念框架,在现场调查、系统评价及国外静脉输液相关指南内容分析的基础上,构建《PICC置管临床实践指南》草案并形成证据汇总信息册,根据"AGREE临床实践指南评估系统",通过书面和现场论证的形式对指南草案     

上海市循证护理中心成立

<正>由复旦大学牵头、上海市四大高校护理学院及33所知名医院加盟的上海市循证护理中心,近日在复旦大学挂牌。上海市循证护理中心主任、复旦大学护理学院院长胡雁教授介绍,该中心成立后,将加强国际化循证护理人才的培养,利用循证护理国际平台优势和资源优势,每年组织1次~2次国家级继续教育培训项目,培养循证护理专门人才;在循证时间方法论指导下,组建项目团队,制定基于证据的临床护理实践系列指南,为护理学科发展提供科学依据和政策咨询;应用科学评估手段,对现有护理技术和新     

临床实践指南的发展与应用

循证实践指南是证据与实践之间的桥梁,基于证据的临床实践指南的构建、应用和更新是循证医学理念下全球医疗卫生发展的必然趋势。本文回顾了国内外护理领域临床实践指南的发展,并以"艾滋病临床实践指南的构建和应用"为例,就临床实践指南对提升护理实践有效性和提高护理决策科学性的意义进行反思。     

《成人癌因性疲乏临床护理指南》的构建研究

[目的]构建《成人癌因性疲乏临床护理指南》。[方法]复旦大学JBI循证护理合作中心组织专家,以JBI循证卫生保健模式为理论框架,结合国内外指南构建方法,构建形成本土化的《成人癌因性疲乏护理指南》,并进行试点应用,从系统、护士和病人3个层面评价指南的应用效果。[结果]形成的《成人癌因性疲乏护理指南》主要包含癌因性疲乏症状筛查和评估、干预(一般性干预措施、对症处理、支持治疗)等方面的推荐意见,该指南在AGREE系统6个维度的标准化总分均高于85%,且临床实施过程具有可行性。[结论]遵循规范的指南构建方法形成了《成人癌因性疲乏护理指南》,经临床试用有一定的可行性,推广性有待进一步的研究。     

行业动态

<正>国内首家RNAO-BPSO循证护理研究中心落户北京中医药大学加拿大安大略省注册护士协会(RNAO)下设的最佳实践指南中心(BPSO)是全球权威的循证护理指南机构。该机构成立于1999年,现在全球有450个分站点,主要致力于循证护理指南的制定、实施、评价和传播。经评估,2015年4月,RNAO在其年会上正式宣布将在北京中医药大学成立中国第一家RNAO-BPSO循证护理研究中心,并于近日在北京中医药大学举行揭牌仪式。RNAO-BPSO循证护理研究中心的成立     

上海举办“循证护理理论与实践”研讨班

为全面推广循证护理的理论，加强临床循证护理的实践。让更多的临床护理人员掌握循证护理的应用，上海市护理学会与复旦大学护理学院于2006年11月13日～17日举办了“循证护理理论与实践”的研讨班。内容包括：循证护理概述和实施步骤；件查询的方法；系统综述、Meta分析；护理献的评价护理证据的应用和循证护理实践等，并授予国家Ⅰ类继续护理学教育学分（14学分）     

《2021版儿童静脉输液治疗临床实践循证指南》解读

儿童静脉输液治疗临床实践循证指南工作组于2021年2月发布了《儿童静脉输液治疗临床实践循证指南》。该指南基于严谨、科学的循证研究制定,立足为儿科静脉输液临床问题提供切实有效的实践指导。文章在介绍指南概况的基础上,针对其中组建静脉输液治疗团队,静脉输液装置的选择、置入和拔除等核心内容进行解读,以期为临床护理工作者更好地理解和实施指南提供参考。     

应用循证方法开发成人内镜微创保胆护理指南的过程

目的应用循证临床指南的开发策略形成成人内镜微创保胆护理指南,以指导内镜微创保胆手术的临床护理。方法参考SIGN50和NICE2009等循证指南开发方法学手册,应用循证临床指南开发策略开发成人内镜微创保胆护理指南,以指导内镜微创保手术的临床护理。结果循证护理问题10个,形成推荐意见101条,并通过指南开发的方法学评价。结论该指南以循证医学为基础,较好地反映了目前内镜微创保胆手术患者的核心护理问题与最佳证据支持的相应护理措施,具有临床实用和推广价值。     

《艾滋病临床护理实践指南》在临床应用实践中的质性研究

目的了解《艾滋病临床护理实践指南》在艾滋病病房中的应用情况以及护士应用该指南的促进因素和阻碍因素。方法 2020年6-7月,选取上海市、南宁市、昆明市3所艾滋病定点医院住院病房中的一线临床护士及护理管理者为研究对象,通过半结构式访谈收集资料,采用内容分析法进行资料分析,借助Nvivo 11.0软件对访谈资料进行编码。结果共纳入16名研究对象,归纳出3个主题。分别为指南应用下护理实践的内容、护士应用指南的促进因素和阻碍因素以及指南更新的建议。结论护士应用指南的促进因素和阻碍因素包括指南相关因素、卫生系统因素以及护士个人因素。建议在更新指南时扩大关注人群,将非HIV相关慢性病管理纳入更新目录。     

The Nursing Research Center on HIV/AIDS Health Disparities

This report describes the partnership between the schools of nursing at the University of California San Francisco and the University of Puerto Rico to address the need for nursing research on HIV/AIDS health disparities. The partnership led to the creation of the Nursing Research Center on HIV/AIDS Health Disparities with funding from the National Institutes of Health/National Institute of Nursing Research. We provide background information on the disproportionate impact of the HIV/AIDS epidemic on racial and ethnic minorities, describe the major predictors of health disparities in persons at risk for or diagnosed with HIV/AIDS using the Outcomes Model for Health Care Research, and outline the major components of the Nursing Research Center. The center's goal is to improve health outcomes for people living with and affected by HIV/AIDS by enhancing the knowledge base for HIV/AIDS care.     

HAART治疗后病毒学治疗有效组和失败组患者血浆比较蛋白质组研究

目的 筛选AIDS患者血浆中与HAART疗效相关的特异性生物标志物,为临床疗效评估提供新型检测分子,指导AIDS治疗的预后判断.方法 收集2008年6月至2009年2月由上海市公共卫生临床中心感染一科收集的艾滋病患者血浆,包括病毒学治疗有效组10例(病毒载量＜ 50拷贝/ml)和病毒学治疗失败组11例(病毒载量＞50拷贝/ml),入组患者年龄22 ～ 63岁.血浆样品用Bio-rad公司血浆高丰度蛋白质去除试剂盒处理,去除血浆中的白蛋白和免疫球蛋白IgG.处理后的血浆蛋白质样品通过二维凝胶电泳(2DE)进行分离,采用ImageMaster软件分析获得的电泳图谱,找到与疗效相关的差异蛋白质.差异蛋白质点经过胰酶酶切后,通过在线纳升级反向液相色谱串联电喷雾离子阱质谱分析鉴定.结果 血浆经过高丰度蛋白去除试剂盒处理后,低丰度的蛋白质得到了有效的富集.共发现了6个在治疗有效组和治疗无效组血浆样品中表达差异的蛋白质点.这些差异蛋白质经液相色谱串联质谱分析得到准确鉴定,包括血清转铁蛋白、血清β纤维蛋白原等.结论 通过蛋白质组学研究发现,血清转铁蛋白等蛋白质在艾滋病患者血浆中表达水平与治疗过程中病毒载量相关,它们可能是评价抗病毒治疗疗效的潜在生物标志物.     

"体卫结合"工作模式下对2型糖尿病患者运动干预的疗效评价

目的评价"体卫结合"工作模式下有氧及抗阻运动相结合的运动方式对2型糖尿病患者血糖及体质的疗效.方法随机选取社区2型糖尿病患者库中符合条件的受试者50例,建立"1+2+1"的模式干预小组,以有氧运动及抗阻运动相结合的方式规律运动干预6个月,以配对t检验比较受试者干预前后空腹血糖、血压、心率、体质量及脂肪量等相关体质指标的改变.结果经过6个月的运动干预后,受试者空腹血糖从(8.58±4.40)mmol/L下降至(6.29±1.72)mmol/L(P=0.032);体质量从(62.44±7.35)kg下降至(60.70±7.54)kg(P=0.008),其体成分中脂肪量明显下降,蛋白质含量明显上升,肌肉量及去脂体质量差异无统计学意义;此外,受试者运动干预后握力及坐位体前屈度均明显上升.干预后受试者体成分综合评分从(73.25±5.65)分上升至(75.48±5.04)分(P=0.010).结论有氧运动与抗阻运动相结合的运动干预方式能够有效降低血糖、体质量及脂肪量,增加肌肉力量及机体柔韧性,增强患者体质.这也反应了以社区为主导的"体卫结合"工作模式是慢性病管理及增强居民体质的有效手段.     

Reflections on the child being and on the nursing care in AIDS context

This article is the result of reflections on the study carried out for the completion of the Nursing School at the Federal University of Santa Maria-RS, Brazil. It relates to the Nursing Care on Health Education to the child being that lives with the HIV/AIDS and was developed at the Pediatric Infectious Disease Service of Santa Maria University Hospital-RS, Brazil. Trying to find subsidies in order to make a reflection on the child-being, one resorted to the Humanistic Nursing Theory by Paterson and Zderad that enlightened the followed way, and provided a reflection on the Nursing knowledge, its purpose and its direction in the care science.     

Incidence and spectrum of infections among HIV/AIDS patients with lymphoma during chemotherapy

Introduction Lymphoma is the most common cancer in HIV/AIDS patients. Chemotherapy regiments recommended for lymphomas in HIV-negative patients are also used for lymphomas in HIV/AIDS patients. Little is known about the infections among HIV/AIDS patients with lymphoma undergoing chemotherapy.Methods This retrospective study investigated the incidence, spectrum of and risk factors for infections during chemotherapy in 164 HIV/AIDS patients with lymphoma admitted to Shanghai Public Health Clinical Center from July 2013 to December 2020.Results The median age of the patients was 43 years old; 90.9% (149/164) were male. A total of 112 (68.3%) patients had a CD4 count < 200 cells/μL at lymphoma diagnosis. Diffuse large B-cell lymphoma (56%, 91/164) and Burkitt lymphoma (28%, 46/164) were the two most common subtypes of lymphoma. Among the 137 patients who underwent chemotherapy (total cycles = 749), 58.4% (80/137) of patients experienced a total of 153 episodes of infection, with an incidence rate of 20.4% (153/749). The most commonly seen infections were lung infection (29.2%, 40/137) and febrile neutropenia (27.0%, 37/137). Multivariate analysis showed that grade 4 neutropenia during chemotherapy (OR = 7.128, 95% CI 3.051–16.654, p < 0.001) and duration of antiretroviral treatment at lymphoma diagnosis <6 months (OR = 3.520, 95% CI 1.432–8.653, p = 0.006) were independent risk factors for infection during chemotherapy.Conclusions A large proportion of HIV/AIDS patients with lymphoma may be at risk of infection during chemotherapy. Effective measures should be taken for patients with high risk factors to prevent the occurrence of infection.     

定点医院收治奥密克戎儿童的临床护理实践

目的 探讨上海新一波疫情期间新冠住院患儿的现况和临床护理实践。方法 回顾性分析2021年12月至2022年5月在上海市复旦大学附属儿科医院金山公卫儿科病房的COVID-19感染病例的临床资料及临床的护理实践方法。分析患儿的基本人口学资料、疫苗接种比例、临床症状、护理实践、核酸转阴的时间等。结果 共纳入868例患儿进行临床分析，男性475例（54.7%），女性393例（45.3%），感染呈家庭聚集性，一岁以下的患儿占14.2%，一岁以上12岁以下占71.9%。868例患儿中有338例（38.9%）的患儿接种了疫苗，患儿核酸转阴的平均时间为（13.7±7.0）d，所有患儿均顺利出院，无重症和死亡病例。868例患儿中有573例（66.0%）表现出各种症状，其中症状发生率最高的是发热475例（54.7%）和咳嗽240例（27.6%）。提供的护理实践主要是症状护理提升舒适度、感染控制护理、以家庭为中心的护理、游戏护理几个方面。结论 Omicron变体导致的COVID-19社区传播更快，低年龄感染的患儿更多，疫苗接种不能阻止感染的高发，但是重症病例少见，主要临床症状以发热、咳嗽为主，重视对儿童和新生儿的体温管理是重点，其次要重视家庭为中心的护理以及各种治疗性游戏干预措施的临床应用，提升患儿和家庭的适应性。     

The role of a domiciliary nursing service in management of AIDS.

The Royal District Nursing Service in Melbourne has been providing domiciliary nursing care to persons with HIV/AIDS since 1985. This paper outlines the development of the RDNS AIDS Nursing Program and gives an overview of the role of RDNS in management of HIV/AIDS in the community.     

BOOK REVIEWS

Book reviewed in this articles:
A Strategy for Nursing. A Report of the Steering Committee
Patient problems: A Research Base for Nursing Care by Jenifer Wilson-Barnett & Lynn Batehup.
Psychological Care in Nursing Practice by Michael E. Hy land & Morag L Donaldson.
Reading Research (Or How to Make Research More Approachable) by M. Ogier.
Griffiths and the Nurses — A National Survey of CNAs by J. Robinson, P. Strong & R Elkan.
Making General Management Work in the National Health Service by Warren Kinston & Ralph Rowbottom.
Clinical Education in Perspective by Lyn Martin.
Nursing Concepts for Health Promotion by Ruth Beckman Murray & Judith Proctor Zentner
AIDS: Scientific and Social Issues. A Resource for Health Educators
Learning About AIDS. Exercises and Materials for Adult Education about HIV Infection and AIDS. (9 pages + 134 pages of exercies.) by Peter Aggleton, Hilary Homans, Jan Mojsa, Stuart Watson & Simon Watney.
Community Midwifery — A Practical Guide by M. Cronk and C. Flint.     

The DNP/MPH Dual Degree: An Innovative Graduate Education Program for Advanced Public Health Nursing

Strong professional priorities, evolving Affordable Care Act requirements, and a significantly limited public health nursing workforce prompted the University of Colorado College of Nursing to collaborate with the School of Public Health to implement one of the first Doctor of Nursing Practice/Master of Public Health dual degree programs in the nation. Federal grant funding supported the development, implementation, and evaluation of this unique post‐baccalaureate dual degree program, for which there were no roadmaps, models, or best practices to follow. Several key issues emerged that serve as lessons learned in creating a new, novel higher education pathway for Advanced Public Health Nursing. This paper highlights two of those: (1) marketing, admission, and matriculation across two programs, and (2) enhancing curricula through distance coursework and interprofessional education. When collaboration with a school of public health is possible, the Doctor of Nursing Practice/Master of Public Health dual degree is an efficient way to prepare public health nurses' with the highest level of public health knowledge, practice, and leadership expertise.     

University of California, San Francisco International Nursing Network for HIV/AIDS Research

AIM: The University of California, San Francisco International Nursing Network for HIV/AIDS Research (the Network) is an international group of nurse scientists dedicated to research and education for the purpose of improving HIV/AIDS nursing care around the world. This article describes the evolution of the Network, as well as its structure, achievements and challenges. BACKGROUND: Although HIV/AIDS has been around for over 25 years, millions of people are still affected by the disease every year. Joint United Nations Programme on HIV/AIDS (UNAIDS) reported that in 2005, there were 38.6 million people living with HIV around the world. In many parts of the developed and developing world, nurses are the primary caregivers for people living with HIV/AIDS, and they need up-to-date information about the daily management of the disease. The Network was established to respond to the need of HIV/AIDS nurses for relevant information to inform clinical care. The Network's main activity is a series of international multi-site collaborative research studies. Past studies have addressed issues such as medication adherence, symptom management and self-care for people living with HIV/AIDS. The Network also hosts semi-annual meetings as well as a biannual international nursing science conference. CONCLUSION: The Network's flexible structure has proven to be one of its greatest assets, as well as a challenge. Although the Network faces challenges, it has proven to be a useful framework for conducting international collaborative activities related to HIV/AIDS and nursing science.