复治肺结核患者病耻感经历的质性研究

目的 了解复治肺结核患者患病期间的病耻感经历,并分析其应对措施。方法 选择2015年1月至4月我院就诊的复治肺结核患者22例作为研究对象,采用现象学研究方法和半结构式访谈方式进行深入访谈,对获得的访谈资料进行进一步整理分析,对病耻感经历的心理体验主题进行提炼。结果 22例患者均完成访谈,共提炼出4个主题,分别是对治疗结果怀疑和否认、对疾病的治愈失去信心、主动回避社会交往、对家庭有惭愧和内疚感。结论 对存在病耻感经历心理体验的复治肺结核患者,应根据其心理体验向指导患者采取主动积极的应对方式,并协助患者完善社会支持干预系统,从而减轻复治肺结核患者心理压力。     

炎症性肠病患者病耻感体验的质性研究

目的探索炎症性肠病患者的病耻感体验,揭示患者的病耻感经历及其影响因素,为医护人员开展针对性心理护理提供理论依据。方法采用目的抽样法,选取2017年3月—2019年7月在浙江省3家三级甲等医院消化内科门诊就诊和病房住院的16例炎症性肠病患者为研究对象,采用描述性质性研究的方法,对患者进行面对面半结构式访谈,运用传统内容分析法分析资料。结果分析得出炎症性肠病患者病耻感体验的4个主题,分别为感知病耻感、实际病耻感、内化病耻感及影响病耻感产生的因素。结论受疾病、治疗、自身心理状态及社会风俗文化等因素的影响,多数炎症性肠病患者确诊疾病后存在病耻感体验,但其具体表现形式及程度存在差异。医护人员应在了解患者病耻感体验的基础上,提供个体化的照护,并给予可行的病耻感应对策略。     

中青年糖尿病患者病耻感的质性研究

目的深入了解中青年糖尿病患者的病耻感体验及其来源与应对方式,以期为制订针对性的干预措施提供参考依据。方法 2017年1-5月,采用目的抽样法,选择某三级甲等院内分泌科收治的15例中青年糖尿病患者为研究对象,采用现象学研究方法对其进行半结构式访谈,现场录音,借助NVivo 7.0软件,根据Colaizzi的7步分析法对资料进行分析,提炼主题。结果中青年糖尿病患者的病耻感体验可归纳为3个类属10个主题。类属一:病耻感体验,即悔恨与愧疚、对刻板印象的认可、自卑感、被歧视的经历、遭受异样的眼光;类属二:病耻感来源,即亲友和同事、医护人员、公众;类属三:病耻感的应对,即隐瞒、回避。结论糖尿病患者存在较强烈的病耻感,医护人员应为其提供相应的心理支持,指导其采取正确的应对方式;同时社会媒体及各界人士,应积极正确地宣传糖尿病的相关知识,并为糖尿病患者创造宽松的社会环境。     

妇科恶性肿瘤患者术后病耻感的质性研究

目的 了解妇科恶性肿瘤患者术后病耻感体验,以期为医护人员通过有针对性的干预方案改善患者的心理状况提供依据。方法 采用最大差异抽样策略,抽取2021年1月—2022年8月南宁市某医院收治的19例妇科恶性肿瘤患者作为研究对象,采用现象学研究方法对其进行半结构式访谈,运用Colaizzi七步法对访谈资料进行归纳、分析,提炼主题。结果 19名妇科恶性肿瘤患者的术后病耻感情况可归纳为3个主题：病耻感体验(自责与沮丧、对刻板印象的认可、经济方面的自我歧视)、病耻感来源(家人、亲朋好友)、病耻感的应对策略(自我接纳、隐瞒与回避)。结论 妇科恶性肿瘤患者在术后具有较强的病耻感,医护人员应加强对患者心理状况的关注,并予以适当的心理支持。同时,应积极传播科学、正确的妇科恶性肿瘤相关知识,减少患者面临的社会歧视,为患者营造宽松的社会环境。     

糖尿病足患者病耻感的质性研究

目的:深入了解糖尿病足患者病耻感的真实体验、来源和应对方式,以期为临床护理人员制订针对性的干预措施提供参考依据。方法:采用目的抽样法,于2021年1—4月,选取贵州中医药大学第一附属医院内分泌科的12例糖尿病足患者作为研究对象。采用质性研究中的现象学研究方法对患者进行深度访谈,借助Nvivo 12.0软件,根据Cola...     

肥胖症病人病耻感的质性研究

目的:了解肥胖症病人的病耻感体验,为临床医护人员制订针对性的干预方案提供理论依据。方法:2021年3月—2021年5月,采用目的抽样法,选择同济大学附属第十人民医院内分泌减重代谢中心收治的16例肥胖症病人为研究对象,采用现象学研究方法对其进行半结构式访谈,使用Nvivo 11.0软件,且根据Colaizzi现象学资料分析法对资料进行分析、提炼主题。结果:肥胖症病人的病耻感体验可归纳为3个类属9个主题。类属一:病耻感体验,即自责与愧疚,负面的刻板印象,自卑感,遭受歧视的经历;类属二:病耻感来源,即亲人、朋友、同学和同事,社会公众;类属三:病耻感的应对,即接纳,社交回避,重塑形象。结论:肥胖症病人存在强烈的病耻感,医护人员应关注肥胖症病人的病耻感体验,予以适当的心理支持,指导其采取正确的应对方式;同时传播正确、科学的肥胖症相关知识;相关部门需制订肥胖症病人相关权益的政策或制度,为肥胖症病人创造人性化的社会环境。     

养老机构慢性病失能老人病耻感心理体验的质性研究

目的:探讨养老机构慢性病失能老人病耻感的心理体验,以期为制定有针对性的干预措施提供依据,从而提高其生活质量。方法:采用目的抽样法选取太原市4家养老机构共10名慢性病失能老人进行半结构式访谈,采用现象分析法分析资料,提炼主题。结果:经分析,归纳慢性病失能老人病耻感为2个类属、6个主题,类属一病耻感的体验,包括悔恨与愧疚、羞耻与排斥、恐惧与绝望;类属二病耻感的危害,包括家庭破裂、自杀、回避就医。结论:慢性病失能老人存在不同程度的病耻感,医护人员应重视其心理健康,给予相应的心理支持,从而提高慢性病失能老人的生活质量。     

首发精神疾病患者家属病耻感的质性研究

目的了解首发精神疾病患者家属病耻感的心理体验及其应对方式。方法采用现象学研究法,以半结构式的开放性访谈方式,访谈了12例住院首发精神疾病患者家属,并将获得的资料进行整理归纳。结果首发精神疾病患者家属病耻感体验包括:因亲人患精神疾病而沮丧、因心理压力过大而无自我、被别人歧视而无奈;家属对病耻感的应对方式是刻意隐瞒病情和主动回避社会交往。结论在首发精神疾病患者住院期间,精神科医务人员应及时向其家属提供针对病耻感的各种支持和指导,降低患者家属病耻感,促进患者康复。     

脑卒中患者病耻感的质性研究

目的:探索脑卒中患者病耻感及病耻感的应对方式。方法:选取深圳市中医院共13例脑卒中患者进行半结构式的访谈,用现象学分析方法分析资料。结果:将被访谈者的病耻感归纳为对所患疾病的羞耻感、受歧视的经历以及病耻感的应对3个相关概念。结论:医护人员应在治疗患者疾病的同时,积极帮助患者正确地应对病耻感,制定出个性化的干预措施,促进患者康复及生活质量的提高。     

恶性肿瘤病人免疫治疗并发中重度免疫相关不良反应体验的质性研究

目的:探讨恶性肿瘤病人免疫治疗后并发中重度免疫相关不良反应的真实体验，为护理人员采取针对性干预和支持以及构建护理方案提供借鉴。方法:采用质性研究方法，对12例免疫治疗后发生中重度免疫相关不良反应的恶性肿瘤病人进行深入的个体化半结构化访谈，使用Colaizzi分析法对资料进行分析、整理并提炼主题。结果:发生中重度免疫相关不良反应的恶性肿瘤病人体验归纳为6个主题：生理不适及痛苦、精神心理多元体验（恐惧、焦虑、不甘心、癌症宿命论、病耻感）、日常生活受到困扰、经济压力沉重、药物相关知识缺乏及多元化的需求。结论:免疫治疗后并发中重度发免疫相关不良反应的恶性肿瘤病人承受着复杂的身心痛苦和多维的疾病应对困扰，医护人员应该着重关注病人身心不适和护理需求，针对性提供干预和指导，预防和纠正不良应对方式，提高护理质量。     

Stigma towards patients with mental illness: An online survey of United States nurses

People with mental illness experience significant health disparities, including morbidity and premature mortality. Evidence suggests that stigma is a contributing factor to these observed inequities. The tripartite conceptualization of stigma proposes that three problems underlie stigma: problems of knowledge (ignorance), attitudes (prejudice) and behaviour (discrimination). There is limited prior research concerning stigma towards mental illness among nurses in the United States (US). The aims of this study were to assess stigma among US nurses towards patients with mental illness, compare the stigma expressed by nurses working in medical/surgical settings with mental health settings, and identify factors associated with stigma. Participants were recruited online from national professional nursing organizations in the US. We collected demographic data and administered measures of mental health stigma and stigma-related mental health knowledge. Mental health nurses demonstrated comparatively lower levels of stigma and higher levels of knowledge than the medical/surgical nurses. Nursing speciality and personal contact with mental illness were the most significant predictors of stigma and knowledge. Knowledge was found to partially mediate the relationship between nursing speciality and stigma. We found support for the ‘contact hypothesis’, that is, having a personal experience of mental illness or a friend or family member who has a mental illness is associated with lower stigma towards mental illness. These findings support the development of contact-based and educational anti-stigma interventions for nurses in order to reduce stigma towards mental illness.     

低年资临床护士循证护理知信行现状及影响因素分析与实践障碍研究

目的:探讨低年资(护龄≤5年)临床护士循证护理(EBN)知信行与循证实践(EBP)障碍现状及相关性,分析影响EBN知信行的因素,为EBN实践的有效开展提供依据。方法:2020年4月1日~6月1日采用方便抽样法,选择济南市3所三甲医院407名低年资(护龄≤5年)临床护士作为研究对象,采用一般资料问卷、循证护理知信行量表(EBPQ)、循证实践障碍量表进行问卷调查。结果:407名低年资临床护士EBPQ问卷均分为(4.61±1.10)分,循证实践障碍问卷各维度得分为开展循证护理的资源条件(29.15±6.82)分、科研报道的质量(25.28±6.51)分、护士对循证护理的主观态度及能力(23.81±5.45)分、研究报道的时效性与系统性(18.69±4.66)分;经单因素分析显示,性别、人事关系、职称、是否为带教老师、工作中感受到的压力、是否有过护理科研经历、阅读文献情况、对学习循证护理是否感兴趣、在临床工作中是否有必要开展循证护理方面EBN知信行得分比较差异有统计学意义(P<0.01,P<0.05);多元线性回归分析显示,性别、对待护理的职业态度、对学习循证护理是否感兴趣为EBN知信行的影响因素。结论:低年资护士EBN知信行水平仍有待提高,造成实践障碍的因素包含各个方面,需要进一步进行针对性的措施加以改进。     

Nursing Students’ Attitudes about Psychiatric Mental Health Nursing

The purpose of this study was to describe Masters entry nursing students’ attitudes about psychiatric mental health clinical experiences; preparedness to care for persons with mental illness; students’ perceived stigmas and stereotypes; and plans to choose mental health nursing as a career. A 31-item survey was administered to pre-licensure graduate nursing students who were recruited from a Masters entry nursing program from a university in a large city in the Midwestern US. Results indicated that clinical experiences provide valuable experiences for nursing practice, however, fewer students think that these experiences prepare them to work as a psychiatric mental health nurse and none plan to pursue careers as psychiatric mental health nurses. The findings support conclusions from other studies that increasing the amount of time in the clinical setting and adding specific content to the curriculum, particularly content related to the importance of psychiatric mental health nursing and the effects of stigma, may assist the profession's efforts to recruit and retain psychiatric mental health nurses. Further research is needed to determine the effectiveness of these strategies and to identify the best ways to implement them.     

LIVING WITH SCHIZOPHRENIA: THE FAMILY ILLNESS EXPERIENCE

Mental health nurses have the opportunity to provide parents and siblings of a schizophrenic family member with information, empowering them to care for themselves and their ill loved one. By understanding the emotional reaction families have to the illness and the effects of social stigma, nurses can help families overcome the barriers to care by establishing a supportive practice. This article describes schizophrenia in terms of its impact on parents and siblings, including novel implications for nursing practice and research.     

Living with schizophrenia: the family illness experience

Mental health nurses have the opportunity to provide parents and siblings of a schizophrenic family member with information, empowering them to care for themselves and their ill loved one. By understanding the emotional reaction families have to the illness and the effects of social stigma, nurses can help families overcome the barriers to care by establishing a supportive practice. This article describes schizophrenia in terms of its impact on parents and siblings, including novel implications for nursing practice and research.     

抗击新型冠状病毒肺炎疫情临床一线支援护士心理体验的质性研究

目的:了解抗击新型冠状病毒肺炎疫情临床一线支援护士的心理体验,旨在为临床制订相应干预措施提供建议和依据。方法:于2020年1月25—27日对参与抗击新型冠状病毒肺炎临床一线支援的10名某三级甲等医院护士应用现象学研究方法进行半结构式访谈,并采用Giorgi现象学分析方法对访谈资料进行分析。结果:本研究临床一线支援护士心理体验可归纳为3个主题,分别为负性心理体验(恐惧、担忧和疲惫)、应对突发公共卫生事件能力不足(对疾病认知不足和应急救援护理技能不足)、对抗击疫情的理性认识(使命感和信心坚定)。结论:临床一线支援护士存在不同程度的负性心理体验,应对突发公共卫生事件能力不足,医院应加强对临床一线支援护士的心理援助和人文关怀,推进应急灾害救援护理培训,提升医院应急管理能力与水平,保障救援工作高效进行。     

Promoting the Value of Mental Health Nursing: The Contribution of a Consumer Academic

Mental illness is known to occur frequently in the general population and is more common within the general health care system. High-quality health care requires nurses to have the skills, knowledge and attitudes to provide care for people experiencing mental illness or mental distress. Research suggests health professionals, including nurses, tend to share similar negative attitudes to mental illness as the general population, and consequently, mental health nursing is not a popular career path. These two factors signify a need to influence more positive attitudes toward mental illness and mental health nursing among nursing students. A qualitative exploratory research study was undertaken to examine the experiences, opinions and attitudes of an academic and research team to the introduction of a consumer academic within an undergraduate mental health nursing subject. In-depth interviews were conducted with teaching and research team members. The importance of mental health skills emerged as a major theme and included sub-themes: mental health across the health care system; contribution of consumer academic to nursing skills; addressing fear and stigma, and inspiring passion in mental health nursing. Findings suggest academic input from people with lived experience of recovery from mental illness can influence the development of mental health nursing skills and enhance the popularity of mental health nursing as a career.     

Self-assessed learning needs of oncology nurses caring for individuals with HIV-related disorders. A national survey

A national survey of 10% of the members of the Oncology Nursing Society (ONS) was conducted to determine the knowledge and experience of oncology nurses caring for individuals with HIV-related disorders. This information was to serve as the framework for developing subsequent education and preparation of oncology nurses. A questionnaire containing 109 questions was mailed to 1,006 members of the ONS. Response rate was 70% (N = 693). Fifty-five of the 109 questions assessed clinical knowledge, experience, and care planning for adults. Additional questions elicited information about staff attitudes, problems in care delivery, priorities in nursing administration and research, and nurses' preferred methods of instruction. Results showed that oncology nurses are experienced in certain areas of importance to patients with AIDS but have educational and experiential deficits in the disease specifics associated with HIV-related disorders and in the nursing care of adults with multisystem involvement and in their treatment. Validity and reliability of this questionnaire were established (alpha = 0.93-0.97). Readers are encouraged to adapt this questionnaire to assess the learning needs of nurses in all specialty groups, and to develop appropriate educational programs to prepare nurses to provide care for this patient population.     

北京地区神经外科护士工作现状的调查

目的了解神经外科护士人员结构及使用情况现状,为规范神经外科护士的分层级使用提供理论基础。方法根据神经外科护理工作特点自行设计调查问卷,对北京地区144名三级甲等医院神经外科护士进行工作内容调查,进行统计学分析。结果初级职称护士占82．64％,专科及以下学历护士占76．38％,5年以下工作年限护士占40．28％;不同学历、职称、工作年限护士间基础护理及常规护理工作差异无统计学意义（P〉0．05）;不同学历、职称、年限护士护士在文件书写、康复训练、精密仪器操作及临床实习带教差异有统计学意义（P〈0．05）。结论专科护理安全存在隐患,全员参加基础护理工作,工作经验、业务水平与适当年龄共同兼备的护士成为专科护理和教学科研的主要力量。     

心内科聘用护士临床培训方法探讨

为了适应军队体制调整以及新的医学模式的要求,确保各项护理工作的完成,对聘用护士的使用和培训已成为护理继续教育的重要课题,抓好聘用关,带教老师严格把关,护士长综合考评,对聘用护士分阶段、分层次培训,达到熟练运用护理程序、实施整体护理和重症护理,熟悉介入治疗的新进展,从而进一步完善专科护士培训,通过培训有效提高护理质量,保证护、教、研工作的正常进行。