手术室护士工作压力源、职业疲溃感与留职意愿的相关性研究

目的：探讨手术室护士工作压力源、职业疲溃感与其留职意愿的关系,为制定护士留职策略提供依据。方法：采用问卷调查法,从天津市4所三甲医院手术室便利抽取127名护士采用护士留职意愿问卷,护士工作源量表、护士职业疲惫感量表进行调查。 结果：手术室护士留职意愿与工作压力、职业疲溃感各条目均分别为（3.38±1.30）、（2.43±0.48）、（4.07±0.82）。手术室护士留职意愿与个人无成就感,年龄、职称、等级、月收入呈正相关,与实践分配及工作量问题、工作环境及仪器设备问题,情感耗竭、工作冷漠感、聘任方式呈负相关。工作压力与职业疲惫感、情感耗竭、工作冷漠感呈正相关,与个人无成就感呈负相关。结论：手术室护士留职意愿处于中等水平,工作压力与职业疲溃对留职意愿有负向预测作用。     

厦门市三级综合医院工作环境对护士留职意愿的影响

目的了解厦门市三级综合医院护士的工作环境及留职意愿。方法于2017年4月10日-4月17日方便抽取厦门市三级综合医院的临床护士进行护理工作环境、留职意愿及一般资料的问卷调查。结果厦门市三级综合医院护理工作环境和留职意愿得分处于中等水平。得分最低的是自主性(2.4718±0.8704)分,得分最高的是系统维持与变革(4.4286±0.7753)分;留职意愿得分为(18.0368±3.1410)分。自主性、权利与保障、工作负荷、工作年限、领导与管理、认可度、职称、子女情况对护理人员的留职意愿有显著影响。结论医院管理者可以根据护理人员的工作年限、职称和子女情况提供更多的工作自主性、权利与保障;降低工作负荷,提高管理层的领导与管理能力,提高护理人员的留职意愿,减少人才流失。     

医院工作场所暴力与护士工作压力的相关性研究

目的了解护士遭受医院工作场所暴力的情况,探讨医院工作场所暴力对护士工作压力的影响。方法使用医院工作场所暴力调查表和护士工作压力源量表,调查三级甲等综合性医院工作至少1年的946名护士,了解医院工作场所暴力发生情况和护士的工作压力水平。结果医院工作场所暴力总发生率为55．07％。遭受暴力组护士的工作压力及5个维度得分较未遭受暴力组的护士高,差异具有统计学意义（P〈0．01）;单纯心理暴力组护士工作压力得分明显低于其他组的护士,心理＋身体＋性暴力组护士的工作压力得分明显高于其他组护士,差异具有统计学意义（P〈0．01）。结论护士在医院工作场所遭受暴力的风险较高,对护士的工作压力造成了深刻的影响,有必要采取相关措施减少医院工作场所暴力的发生。     

护理工作环境与护士留职意愿相关性研究

目的:探讨护理工作环境与留职意愿的相关性,为提高护士留职意愿提供理论依据。方法:采用盖普洛工作场所调查问卷和护士留职意愿问卷,并通过方便抽样对3所综合医院的196名护士进行问卷调查。结果:护士留职意愿得分为(19.73±3.85)分;护理工作环境得分为(42.18±6.60)分。护士对工作环境认可度与其留职意愿呈正相关(P<0.01);在控制一般资料的影响下,护士对工作环境认可度是预测护士留职意愿的独立因素(P<0.001)。一般资料中护士的婚姻状况、工作年限、聘用方式、职称及所属单位均对护士的留职意愿产生影响(P<0.05)。结论:积极的工作环境有益于提升护士留职意愿水平,管理者应推动并促进护士积极参与护理工作环境建设。     

儿科低年资护士培训中应用人文关怀对其留职意愿的影响

目的探讨在儿科低年资护士培训中应用人文关怀对其留职意愿的影响。方法 2012年7月,便利抽样法选取武汉同济医院儿科在岗的低年资护士(工作年限≤3年)85名为研究对象,在培训过程中融入人文关怀的理念,积极营造人文环境,对低年资护士在工作中照顾、生活上关心、科学排班、人尽其才;实施人文关怀前后分别采用护士留职意愿量表和护士工作满意度量表进行效果评价。结果人文关怀实施后,低年资护士留职意愿的得分高于人文关怀实施前,差异有统计学意义(P0.01)。人文关怀实施后,除工资及福利外,低年资护士的工作满意度及其他各因子的得分均高于人文关怀实施前,差异均有统计学意义(均P0.01)。结论儿科低年资护士培训中运用人文关怀,有助于提高低年资护士的工作满意度,提升其留职意愿。     

新型冠状病毒肺炎时期护士留职意愿的现状及影响因素

目的调查新型冠状病毒肺炎时期护士留职意愿及其影响因素。方法采用一般资料及护士留职意愿量表通过问卷星对新冠肺炎时期343名护士进行调查。结果新型冠状病毒肺炎时期护士留职意愿得分(3.77±0.87)分,性别、工作地区、工作年限、是否还会选择护理专业、是否愿意去一线抗疫、现在是否在一线抗疫是影响新型冠状病毒感染性肺炎时期临床护士留职意愿的主要因素(调整R 2=0.511)。结论新型冠状病毒肺炎时期护士留职意愿处于中等偏上水平;护理管理者在新型冠状病毒肺炎时期及后期应有针对性的采取干预措施,以增强护士留职意愿,稳定护士队伍。     

临床专科护士工作嵌入与留职意愿的现状及其相关性

目的了解临床专科护士工作嵌入、留职意愿现状,探讨两者之间的相关性。方法采用一般情况调查表、工作嵌入量表、留职意愿量表对200名临床专科护士进行调查。结果临床专科护士工作嵌入得分为(3.40±0.46)分,社区联结维度得分(3.68±0.67)分,组织牺牲维度得分(3.12±0.53)分;留职意愿得分为(3.69±0.80)分。临床专科护士工作嵌入及其社区匹配、社区牺牲维度与留职意愿呈正相关(P0.05或P0.01)。社区匹配可以作为预测专科护士留职意愿的主要因素。结论临床专科护士留职意愿和工作嵌入处于中等偏上水平,护理管理者应重视专科护士需求,提供专科护士相互交流的平台等,以提高专科护士工作嵌入水平,从而提高其留职意愿。     

杭州市三级医院临床护理人员留职意愿的现状调查

目的：调查杭州市三级医院临床护士留职意愿的现状,为政府部门制订相关政策提供依据。方法分层抽样选取杭州市5所三级医院临床护士458名,采用护士留职意愿问卷和工作满意度量表进行调查。结果临床护士留职意愿的得分为（3．37±0．8）分;60．5％的护士表示如果有其他合适岗位,会考虑脱离临床护理岗位;不同工作年限的护士留职意愿比较,差异有统计学意义（ F＝5．147,P＜0.05）。护士总体工作满意度得分为（3．11±0．91）分;护士对工作量与工作负荷、护理工作认可度、工资及福利方面表示不满意。结论临床护理工作量大、工作负荷重、护理工作不被认可、工资及福利待遇低是当前临床护理工作存在的主要问题。政策决策者应重视解决护理队伍稳定问题,同时制定相关扶持政策,减轻护士工作量和负荷,提高护士工资及福利待遇等问题,进一步激发护士的工作积极性。     

手术室专科护士工作嵌入与留职意愿相关性研究

目的了解手术室专科护士工作嵌入、留职意愿现状,探讨二者之间的相关性。方法抽取黑龙江省手术室专科护士126名进行问卷调查。采用专科护士一般资料调查表、工作嵌入量表、护士留职意愿量表进行调查。结果专科护士工作嵌入总均分为(3.68±0.38)分,以社区联结维度得分最高,组织牺牲维度得分最低。留职意愿总均分为(3.67±0.65)分。手术室专科护士工作嵌入与留职意愿呈正相关性。学历和社区匹配可以作为预测专科护士留职意愿的主要因素。结论专科护士留职意愿处于中等水平,护理管理者应重视专科护士需求,有针对性制订专科护士留职措施,以提高专科护士工作嵌入水平,提高其留职意愿。     

儿科护士心理资本和职业紧张与留职意愿的相关性研究

目的 了解儿科护士心理资本和职业紧张状况及其影响因素,分析二者与留职意愿的相关性.方法 采取便利抽样法,应用一般资料调查问卷、心理资本量表、付出-回报失衡问卷(ERI)、中文版留职意愿量表对河南省6所医院的382名在职儿科护士进行调查.结果 儿科护士心理资本总均分为(3.94±1.28)分;ERI付出、回报、内在投入得分分别为(17.72±4.28)分、(26.47±9.35)分、(16.30±4.31)分;留职意愿的总均分为(3.37±0.30)分.心理资本与留职意愿呈现正相关(P<0.05),职业紧张与留职意愿呈现负相关(P<0.05).结论 儿科护士处于高度职业紧张状态,留职意愿呈中等水平.提高儿科护士心理资本是预防其职业紧张、稳定儿科护士队伍的有效途径.     

Music, Noise, and the Human Voice in the Nurse-Patient Environment

Sound is an essential and constant component of the human environment. Nurses have a responsibility to therapeutically manipulate the environment, but some have not fully recognized the significance of noise, voice, or music in the nurse-patient milieu. This literature review provides a starting point for new studies that acknowledge the perception of sound as well as the physiological and psychological effects of sound on patients' well-being     

Characterization of the rate-dependent effects of ethmozine on conduction, in vivo, and on the sodium current, in vitro, in the newborn heart.

We evaluated the effects of ethmozine on resting conduction intervals, myocardial refractory periods and His-Purkinje and intraventricular conduction in vivo in 11 neonatal dogs aged 7 to 16 days. Ethmozine produced significant prolongation in resting sinus cycle length (P < .05), in the atrioventricular nodal (P < .001) and His-Purkinje conduction time (P < .01) intervals and in the QRS duration (P < .01). Ventricular, but not atrial refractory periods were significantly prolonged (P < .05). Rate-dependent changes in His-Purkinje and intraventricular conduction were demonstrated after ethmozine by direct pacing of the bundle of His and right ventricular pacing. The development of steady-state conduction delay at a paced cycle length of 200 msec was characterized by a time constant (tau on) of 23.5 beats. The time constant of diastolic recovery (tau off) from rate-dependent conduction delay, determined during His bundle extrastimulation, was 171 msec. Ethmozine was highly proarrhythmic. A total of 7 arrhythmias were induced in 6 out of 12 neonates after administration of ethmozine. We also characterized ethmozine block of cardiac sodium channels in isolated neonatal canine ventricular myocytes using the whole cell variation of the patch clamp technique. Ethmozine (1.3-40 microM) produced a use-dependent block of cardiac Na channels that was dependent upon both drug concentration and pulse duration. Drug binding to inactivated channel states accounted for the observed use-dependent block. The time constant of recovery from use-dependent block ranged between 10 and 30 sec at 16 degrees C.(ABSTRACT TRUNCATED AT 250 WORDS)     

Staff views on the Resident Assessment Instrument, RAI/MDS, in nursing homes, and the use of the Cognitive Performance Scale, CPS, in different levels of care in Stockholm, Sweden

Multidimensional functional assessment is the basis of individualized care. It is especially important in the care of elderly, with the complexity of symptomatology and often with cognitive impairment present. An assessment instrument for elderly persons, used in this study, is the Resident Assessment Instrument/Minimum Data Set (RAI/MDS) and its incorporated MDS Cognitive Performance Scale (CPS). The purposes of the study were to demonstrate the cognitive performance in elderly persons in different levels of care by using the CPS and to elicit the views of staff on use of the RAI/MDS. Cognitive impairment was found in 1276 elderly persons in six levels of care studied, an important factor to consider when organizing care of elderly. An intervention study was carried out for 1 year in three nursing home wards, with training and supervision in implementation of the RAI/MDS including individualized and documented care. Part of a questionnaire was used to evaluate staff ( n =50) views on using the instrument. A majority of the staff thought that the RAI/MDS could contribute to the improvement of quality of care, documentation in nursing records, and in co-operation and engagement. Further research is necessary to elicit more knowledge on the usefulness and benefits of the instrument.     

Variation in the salivary peptide, maxadilan, from species in the Lutzomyia longipalpis complex

Maxadilan is an approximately 7kDa peptide that occurs in the saliva of the sand fly Lutzomyia longipalpis. This peptide is a potent vasodilator and may also have immunomodulatory effects related to the pathogenesis of leishmanial infections. Variation in the primary DNA and inferred amino acid sequence of maxadilan is reported. Differences were found within and among natural field populations as well as among sibling species. Extensive amino acid sequence differentiation, up to 23%, was observed among maxadilan from different populations. This is a remarkable degree of polymorphism considering the small size of this peptide. The vasodilatory activity of maxadilan was equivalent among recombinant maxadilan variants. All maxadilan variants induce interleukin-6. Predicted secondary structure and hydrophobicity plots suggest that these characteristics are conserved among variant peptides. However, profiles based on the antigenic index do differ among peptides.     

Rationing in the emergency department: the good, the bad, and the unacceptable

Objectives: Waiting times in emergency departments (EDs) are an important government priority. Although substantial efforts are currently being made to reduce waiting times, little attention has been paid to the patients' view. We used qualitative methods to explore patients' perspectives on waiting times and other approaches to rationing and prioritisation.     

Brain injury in the infant: the old, the new, and the uncertain

Although neonatal brain injury occurs most frequently after a perinatal hypoxic-ischemic insult, recently studies have noted that variable causes such as metabolic and reperfusion events can result in, or aggravate, a brain insult. Current data suggest that about 2 to 5 of 1,000 live births in the United States and more so in developing countries experience a brain injury Approximately 20% to 40% of infants who survive the brain injury develop significant neurological and developmental impairments. The resulting impact on the child, family, and society presents a formidable challenge to health care professionals. Although several important insights have been gained in the last several years about the epidemiology, diagnosis, and mechanism of brain injury, management remains mostly a cocktail of controversial trials. This article provides a comprehensive review of the pathology, clinical manifestations, and timely management of infants with brain injury.     

Considerations in chronic toxicity testing: the chemical, the dose, the design

Rodent bioassay systems are widely used to detect those environmental substances most likely to be carcinogenic. Experience with these systems has revealed several shortcomings of an operational nature which may complicate evaluation and interpretation of the results. Paramount among these are purity of the test chemical, dose selection, and experimental design. Special attention must be given to potential impurities in test substances which may be responsible wholly or in part for the production of toxic effects. Proposals for handling this problem are discussed. It is recommended that test chemicals be studied carefully in the proposed animal species using pharmacokinetic procedures, so that doses may be selected that will not jeopardize the outcome of the test nor overload metabolic detoxification systems. Whether or not a bigenerational exposure is required to adequately evaluate the carcinogenicity of the test substance will depend upon its use pattern and pharmacokinetic and metabolic behavior in the mother and fetus.     

Superficially, longer, intermittent ozone theraphy in the treatment of the chronic, infected wounds

Background. Ozone therapy - i.e. the treatment of patients by a mixture of oxygen and ozone - has been used for many years as a method ancillary to basic treatment, especially in those cases in which traditional treatment methods do not give satisfactory results, e.g. skin loss in non-healing wounds, ulcers, pressure sores, fistulae, etc. Material and methods. In the Department of Phisiotherapy of the Medical Faculty and the Department of the Orthopedics and Traumatology of the Locomotor System at the Medical University of Warsaw in the period from January 2001 until November 2002, 23 patients with heavy,chronic, antibiotic resistants septic complications after trauma, surgical procedures and secundary skin infetions were treated with ozone. The ozone therapy was administered using an authorial technique of superficially, longer, intermittent ozone application. Results. In the wounds of the all experienced patients the inhibition of septic processes and wound healing was much faster than normal. Conclusions. Our data confirm the advantages wich result from the technique of superficially, longer, intermittent ozone theraphy in combined treatment for septic complications in the soft tissue, especially in the locomotor system. These technique makes posttraumatic infections and promotes quicker healing of post-surgical and post-traumal complications - chronic septic infections. This method also lowers the cost of antibiotic therapy and is sometimes the only available auxiliary technique to support surgical procedures.     

AIDS in the black community: The plague, the politics, the people

This paper was originally developed by Calu Lester, the founder of KWICFAN, which took a novel approach to grass roots AIDS education in the black community. Calu died of AIDS before completing the work and the paper was completed by Larry L. Saxxon, who was both a friend of Calu's and an AIDS program consultant.

The paper presents a critical perspective of black America's response to the AIDS epidemic. The findings are frightening. Denial within the black community, coupled with a lack of support from the agencies responsible for funding AIDS education, has created a potential epidemiological nightmare. IV drug use continues to be a critical problem of frightening magnitude, allowing an efficient vehicle of HIV transmission. Most sadly of all, the social conditions that create and perpetuate the problematic drug abuse patterns still continue in black America. Black people are clearly becoming the new face of AIDS.     

淡水淹溺致兔肺水肿模型肾素丙二醛心钠素一氧化氮血气等变化的研究

目的研究淡水淹溺致兔肺水肿模型(PE-W)发病后30 min动脉血浆肾素(AT1)、丙二醛(MDA)、心钠素(ANP)、一氧化氮(NO)、呼吸频率(RR)、血气多点变化.方法将淡水灌入兔肺内复制出淡水淹溺肺水肿模型,于灌水前后30 min取股动脉血查AT1、MDA、ANP、NO、血气,并记录RR.结果 AT1、MDA、NO、RR显著异常(P<0.05),酸碱平衡及血氧正常,ANP无显著异常(P>0.05).结论淡水淹溺致兔肺水肿早期,AT1增加并不导致ANP增加;尽管MDA增加较早,但由于机体自身调节能力,尚能维持血氧的正常,NO可能起到重要作用.