Ultrasonography and erythrocyte distribution width in patients with plantar fasciitis

BackgroundThe measurement of plantar fascia thickness with ultrasonography can be used for both for diagnosis and as a response-to-treatment parameter in plantar fasciitis. Furthermore, with the recent studies, red cell distribution width may be used as an inflammatory marker. Aim of this study is to investigate the association of red cell distribution width and ultrasonography on diagnosis and monitoring of treatment in patients with plantar fasciitis.MethodsClinically diagnosed 102 patients with plantar fasciitis between the dates January 2016 to July 2018 were analysed. Hemogram, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and plantar fascial ultrasonography were obtained on initial evaluation and in 1 month, 2 months and 3 months of the standard nonoperative treatment; American Orthopaedic Foot & Ankle Hindfoot Score (AOFAS) and Visual Analog Scale (VAS) scores were recorded. Posthoc and multivariate logistic regression analysis were used for statistical analysis on SPSS 21.0.ResultsRed cell distribution width was correlated with plantar fascia thickness by the end of the 1 month (r = 0.26, P = .013). Female sex, BMI over 30 kg/m², higher red cell distribution width and higher plantar fascia thickness were associated with plantar fasciitis on initial evaluation. Higher red cell distribution width together with higher plantar fascia thickness were also found to be a risk factor for both on initial evaluation and 1 month after treatment in plantar fasciitis.ConclusionThis study shows that association of red cell distribution width and plantar fascia thickness can be not only a diagnostic predictor but also an indicator of treatment response in plantar fasciitis.Level of clinical evidenceLevel IV     

Stress among student nurses: is it practical or academic?

Summary

• ? Previous research into stress among student nurses has only concentrated on the practical aspects of nursing and has ignored stress caused by the academic side of training. In comparing Registered General Nurse (RGN) and Diploma of Higher Education in Nursing (Dip. HE Nursing) students using a modified nurses stress scale, the intensity of stress was investigated.
• ? It was hypothesized that there would be a difference in the total stress scores between the two pre-registration education courses as well as within the practical and academic elements.
• ? Dip. HE Nursing students were significantly more stressed than RGN students, but equally for practical and academic elements. RGN students were significantly more stressed on the practical elements. Factors analysis clearly identified two factors: (i) the practical elements, and (ii) the academic elements of nursing. A third factor was also identified and this was related to stress induced by issues concerning death and suffering in the patient.
• ? These results have implications for the development of the nurse education course (Dip. HE Nursing) which is still in its infancy.

     

The impact of nurses' encounters with cancer on their attitudes towards the disease

Summary

• ? A study to develop understanding of nurses' knowledge, confidence and educational needs in relation to cancer care was undertaken.
• ? Data from this study on nurses' attitudes and the effect of professional encounters with cancer on such attitudes are presented.
• ? A cancer attitude scale was completed by 127 nurses, and 68 of the sample were interviewed in depth.
• ? Data presented reveal a pervasive negative attitude towards cancer amongst these nurses, and the important negative impact that professional encounters with cancer have on nurses' feelings about the disease.
• ? Data presented are taken from a larger study, which is reported elsewhere (Corner, 1990; Corner & Wilson-Barnett, 1992).

     

全国护士执业考试现状与发展方向

根据《中华人民共和国护士管理办法》的规定,卫生部在1994年试点的基础上建立了全国护士执业考试、执业注册管理制度。考试由卫生部国家医学考试中心组织实施。文章就考试现状等作一介绍,并研究探讨今后考试的发展方向。     

儿科常见护患冲突的管理对策

目的:减少护理纠纷的发生.方法:通过对儿科常见护患冲突原因的分析,更新护理理念,增强法律意识,注重沟通技巧,重视护理工作环节衔接.结果:有效预防、化解科内护患冲突.2003～2005年我科未发生护患纠纷.结论:通过不断总结经验,持续护理质量改进,护患冲突、纠纷明显减少.     

工作心理控制源、压力源对护士压力反应影响

目的 探讨工作心理控制源、压力源对护士工作压力反应的影响。方法 以377名护士为凋查对象，采用工作心理控制源量表、工作压力反应量表和护士工作压力源量表进行调查分析。结果 （1）工作心理控制源与压力反应及其3个维度评分呈正相关，相关系数分别为0．302，0．289，0．281，0．151；（2）外控性与内控性护士的压力反应得分差异有统计学意义（F=18．478，P〈0．001）。（3）工作心理控制源、压力源与压力反应得分存在交互效应，在高压力源情况下，外控性与内控性护士的压力反应差异有统计学意义（t=19．899，P〈0．001）；不同压力源水平下，外控及外控倾向性护士的压力反应差异有统计学意义（t=14．032，P〈0．001）。结论 优化归因方式可有效缓解护士的工作压力反应。     

性病诊治中护患关系的伦理学探讨

探讨影响性病诊治中护患关系的伦理学因素,并提出相应的护理对策,以期建立和谐的新型护患关系.护理道德义务、保护性病患者个人隐私、护士的职业进取心、性病患者的疾病知情权等因素是当前影响性病诊疗中护患关系的主要伦理学因素;因此,加强护士的职业道德教育、尊重患者的人格和隐私权、提高自身护理专业水平、普及健康教育等伦理学措施有助于改善护患关系,最终规范性病的诊疗.     

How nurses cope with patient death: A systematic review and qualitative meta‐synthesis

Aims and objectives

To review literature on nurses’ coping strategies with patient death.

Background

Dealing with the loss of a patient was viewed as one of the most demanding and challenging encounters in clinical practice. Those nurses who are not competent in coping with patient death may be inadequate in supporting dying patients and their family members, and minimise the quality of end‐of‐life care. To get a broader understanding of how nurses cope with patient death and to develop meaningful and effective interventions, a systematic review which would help underpin the multidimensional approaches is needed.

Design

A systematic review.

Methods

Exhaustive searching in ten databases: CINAHL Plus, EMBASE, MEDLINE, AMED, PsycINFO, ProQuest Health & Medical Complete, ProQuest Dissertations & Theses Global, Google Scholar, EThOS and CareSearch. Meta‐aggregation was used to synthesise the findings of the included studies.

Results

This systematic review aggregated ten categories from the sixteen qualitative studies included, and then two synthesised findings were derived: intrinsic resources and extrinsic resources. The intrinsic resources consisted of setting boundaries, reflection, crying, death beliefs, life and work experience, and daily routines and activity. The extrinsic resources were comprised of talking and being heard, spiritual practices, education and programmes, and debriefing.

Conclusion

This systematic review synthesised the findings about what resources nurses use when coping with patient death and made recommendations on future directions. Areas which could be developed to improve deficiencies that nurses had when faced with the losses of their patients were identified. Nurses need more support resources, which better assist them in coping with patient death.

Relevance to clinical practice

The results of this systematic review could provide evidence for nurses’ coping strategies when dealing with patient death, and the recommendations could be employed by nurses to cope with the losses of patients.     

终末期肾病患者对护理专业性社会支持体验及期望的叙事研究

目的了解终末期肾病患者住院期间对护理人员提供社会支持的体验及需求,为护士实施全面有效的社会支持提供依据。方法采用立意抽样法选取14例终末期肾病住院患者为研究对象,采用半结构式访谈提纲进行深入访谈并按三维度叙事分析法进行转录和分析。结果患者住院期间感受到的护理专业性社会支持主要有:护理帮助支持、情感支持、沟通和信息支持;患者期望获得及时的评价支持,更多的情感支持,针对性、多样化的沟通信息支持。结论护理人员为终末期肾病患者提供专业性社会支持时应关注患者的期望,提升护理服务效能。