767名护理人员生存质量及其影响因素的调查

目的 了解护理人员生存质量,分析其影响因素.方法 采用SF-36量表(shortForm 36 health survey questionnaire,SF-36)对767名护理人员进行调查,分析影响其生存质量的因素.结果 护理人员生存质量总得分为(70.80±12.99)分,生理方面得分为(74.65±13.07)分,心理方面得分为(67 09 ± 15.29)分.年龄、工龄和工作科室是影响护理人员生存质量的重要因素(均P＜ 0.05).结论 护理人员生存质量处于中等偏下水平.护理管理者应重视对护理人员精神心理、人际关系和社会适应方面的辅导和帮助,从而提高护理人员的生存质量.     

Health patterns of women with fibromyalgia

Using diaries, eight women documented how they were living with their fibromyalgia on a daily basis for 3 months. Aches and pains were the most common symptoms experienced on nine to 81 of the 84 days of data collection. Cross-correlations revealed significant patterns related to pain, sleep and weather conditions for individual women. The narrative portion of their diaries supports that pain is physical and mental, knowing the self helps to control the intensity of the illness, and distraction helps to decrease the associated discomforts. Use of diaries and active listening (validation) are supported as interventions for these women.     

Decision-making: initiating insulin therapy for adults with diabetes

Title.  Decision-making: initiating insulin therapy for adults with diabetes.
Aim.  This paper is a report of a study to describe nurses' perceptions of decision-making and the evidence base for the initiation of insulin therapy.
Background.  Several theoretical perspectives and professional's attributes underpin decision-making to commence insulin therapy. The management of type 2 diabetes is moving from secondary to primary care and this affects how clinical decisions are made, by whom and the evidence base for these decisions.
Method.  A postal survey was conducted with a stratified sample of 3478 Diabetes Specialist Nurses and Practice Nurses with a special interest in diabetes across the four countries of the United Kingdom. A total of 1310 valid responses were returned, giving a response rate of 37·7%. The questionnaire was designed for the study and pilot-tested before use. Responses were given using Likert-type scales. Data were collected during 2005 and 2006, and one reminder was sent.
Results.  People with diabetes are seen as having little influence in decision-making. Consultant physicians appear to be influential in most decisions, and the nursing groups held varying perceptions of who made clinical decisions. Nurses' identified different responsibilities for those working solely in secondary care from those working in both community and secondary care. Practice nurses were not as involved as anticipated.
Conclusion.  Nurses working with people with diabetes need to encourage them to become more active partners in care. Clinical guidelines can assist in decision-making where nurses are least experienced in initiating insulin therapy.     

工作场所暴力对护士护理伦理决策能力的影响

目的了解护士工作场所暴力和护理伦理决策现状,探讨工作场所暴力对护士护理伦理决策能力的影响。方法采用工作场所暴力问卷和护士护理伦理决策问卷对693名临床护士进行问卷调查。结果 1年内护士工作场所暴力发生率为66.09%,其中心理暴力占74.89%;身体暴力占18.12%;性暴力占6.99%。暴力组伦理选择、伦理行动和伦理决策能力总分均显著低于非暴力组,差异均具有统计学意义(P0.01);不同工作场所暴力形式及暴力频次护士护理伦理决策能力比较,差异具有统计学意义(P0.01)。是否遭受工作场所暴力和学历是护士伦理决策能力的影响因素。结论护士工作场所暴力发生率较高,遭受工作场所暴力的护士护理伦理决策能力下降,遭受暴力程度越严重、频次越多,护士护理伦理决策能力越差。     

The clinical landscape of critical care: nurses' decision-making

BACKGROUND: Many studies have tended to explore individual characteristics that impact on nurses' decision-making, despite significant acknowledgement that context is a major determinant in decision-making. The few studies that have examined environmental influences have tended not to study real decisions in the dynamic and complex clinical environment. AIMS: To investigate environmental influences on nurses' real decisions in the critical care setting. METHOD: Naturalistic observations and semi-structured interviews were conducted with 18 critical care nurses in private, public and rural hospitals. Observations and interviews were recorded, transcribed verbatim and coded for themes using content analysis. RESULTS: All clinical decisions were strongly influenced by the context in which the decision was made. Three main environmental influences were identified: the patient situation, resource availability and interpersonal relationships. Time and risk guided all clinical decisions. Nurses established the state of the situation, the time constraints on decisions and the level of risk involved for both patient and nurse. CONCLUSIONS: Decision-making is a manifestation of the landscape and although an increased understanding of the landscape is required, more important is the need to measure the impact of contextual variables on nurses' decision-making in order to improve health care outcomes.     

Burnout and its correlates among nursing staff: questionnaire survey

AIM: This paper is a report of a study to determine the burnout level and its correlates in nurses. BACKGROUND: Healthcare providers and especially nurses are generally considered a high risk group regarding work stress and burnout and this syndrome has been a major concern in the field of occupational health. METHOD: The study was carried out at a university hospital in Turkey during May-June 2005. A total of 418 nurses from the 474 working at the hospital at the time (88.2%) answered a self-administered questionnaire including the Maslach Burnout Inventory. FINDINGS: All the nurses were female, with a mean age of 30.6 (5.4) and a median age of 29 years. The mean score was 17.99(6.35) for the Emotional Exhaustion subscale, 5.72 (3.87) for the Depersonalization subscale and 19.83 (4.66) for the Personal Accomplishment subscale. Emotional Exhaustion decreased with increasing age (P < 0.05). Total time in the job, weekly working hours, shift-working and the unit where employed influenced burnout scores (P < 0.05). Not being happy with relations with superiors, not finding the job suitable, feeling anxious about the future, perceived poor health, problems with personal life and financial difficulties were also factors influencing burnout scale scores (P < 0.05). CONCLUSION: It is necessary to consider nurses having the characteristics shown as the correlates of burnout in this study as a target group, to screen periodically the burnout status and improve their working conditions, especially relationships with colleagues.     

Critical care nurses, ethical decision-making and stress

Considerable attention has focused on describing ethical issues that critical care nurses face in their practice; however, less attention has been directed at describing the process of ethical decision-making. Systematic research linking aspects of ethical-decision making and stress is lacking. This cross-sectional study examines the relationship between selected aspects of ethical decision-making, stress and selected nurse characteristics. Sixty-one critical care nurses completed the Nurse's Ethical Decision Making—ICU Questionnaire and the Health Professions Stress Inventory. Findings revealed that nurses who selected the patient advocacy model had significantly higher nurse autonomy scores, that perceived anxiety had a negative association with nurse autonomy, and that workplace restrictions and stress were related.     

中年女性健康知、信、行问卷初步编制及信、效度检验

目的：编制适用于城镇中年女性的健康知、信、行问卷,了解城镇中年女性的健康知、信、行现状。方法：在文献复习、实地调查及专家咨询的基础上初步编制了城镇中年女性健康知、信、行问卷,并用SPSS分析软件进行了信、效度检验。结果：问卷总的内部一致性信度为0.875,健康相关知识、信念、行为3个子问卷的内部一致性信度分别为0.862、0.763、0.714,健康知识部分复本信度为0.897,健康信念和行为部分重测信度分别为0.873、0.831;因子分析表明问卷有较好的结构效度,多数项目的共性方差超过0.5。结论：问卷的信、效度分析表明本问卷具有较好的稳定性和可靠性,可在实际工作中试用。     

Nurses and Internet health information: a questionnaire survey

AIM: This paper is a report of a study to identify the extent of postgraduate nursing students' information literacy skills in relation to electronic media and health information and barriers to accessing this information. BACKGROUND: The Internet is a key source of information for a significant group of patients. However, there is evidence of quality issues with some Internet health information sites. Nurses need to be aware of the range and quality of online health information so as to assist patients and families to locate and evaluate relevant and current information. METHOD: A questionnaire designed to collect quantitative and qualitative data was posted to a convenience sample of all students enrolled in a postgraduate nursing programme in December 2005. The response rate was 55.1% or 123 responses. RESULTS: Most respondents had Internet access at home and work and believed that access to online health information resources had improved their practice. However, some had difficulties in accessing computers at work and insufficient time to search for online health information. Concern was expressed about the quality of online information, but the majority of respondents did not assess patient use. Frequent users of online resources were more likely to assess patient use. CONCLUSION: The development of nursing competencies in accessing and using online resources is a key precursor to supporting patients and families' use of the medium. Access to Internet resources at work, along with training and time for searching, is necessary for the development of skills enabling effective use of information technology.     

The role of the neonatal intensive care nurse in decision-making: advocacy, involvement in ethical decisions and communication

Neonatal intensive care unit (NICU) nurses are often faced with complex clinical and ethical problems. Little is known about the role of the NICU nurse in ethical decision-making, or processes that inform decision-making in this setting. The purpose of this study was to explore and describe nurses' perceptions of their role as patient advocate, clinical situations that cause them concern and the extent of their involvement in ethical decision-making. A combined quantitative and qualitative research design was used. A questionnaire was administered to nurses working in the NICU of the sole perinatal tertiary referral centre of Western Australia, Australia. Findings showed that NICU nurses saw their role in ethical decision-making primarily as advocating for the best interests of the infant and family, that they used clinical knowledge and experience to guide ethical decision-making, they were able to clearly articulate ethical problems and respond to them according to the clinical scenario and, while being primarily assertive in presenting their views, some nurses took a more passive approach. These findings support the need for development of a multidisciplinary model for ethical decision-making, where the view of all team members are considered.     

孕产妇围产期服务需求量表的研制

目的 研制孕产妇围产期服务需求量表.方法 2007年11-12月对北京某妇产医院住院分娩后3～5 d即将出院的产妇进行访谈,根据访谈录音内容及书面记录结果整理形成孕产妇围产期服务需求量表.结果 孕产妇围产期服务需求量表包含60个条目,按内容归纳为4个维度,生理需求9项、心理需求8项、环境和设备需求15项、医院服务需求28项.量表的内容效度为0.877,内部一致性系数0.984.结论 孕产妇围产期服务需求量表具有较好的信效度,从孕产妇生理需求、心理需求、环境和设备需求及服务需求四个方面反映孕产妇在围产期的需求状况,可用于临床工作中评估孕产妇在围产期的需求,根据孕妇的意愿制定切实可行的服务计划,使围产期保健工作更加深入地开展.     

Recognizing and reporting child physical abuse: a survey of primary healthcare professionals

AIM: This paper reports a study of the self-reported ability and behaviours of primary healthcare professionals in Northern Ireland to recognise child physical abuse. A secondary aim was to assess the educational and training needs of these professionals. BACKGROUND: In the United Kingdom, 7% of children suffer serious physical abuse by a parent or carer, and two children aged under 15 years die from abuse each week. Recognizing child physical abuse depends on the knowledge and skills of a variety of healthcare professionals. METHODS: A stratified random sample of 979 nurses, doctors, and dentists working in primary care in Northern Ireland were sent a postal questionnaire; 419 responded, giving a 43% response rate. The data were collected in 2002-2003. FINDINGS: In their working lives 60% (251) said that they had seen a suspicious child physical abuse case; however, only 47% (201) had reported a suspicious case to the authorities, leaving a 13% gap in reporting. Although 74% (310) of respondents were aware of some of the mechanisms for reporting child physical abuse, 79% (332) requested further education on this topic. Ability to recognize and willingness to report abuse cases discriminated between the three professional groups. Compared with doctors or dentists, community nurses were statistically significantly more likely to recognize and report suspicions of child physical abuse, and were the group most aware of child abuse issues and the most willing to become involved in abuse cases. CONCLUSIONS: The findings suggest that professional fears and anxieties and lack of knowledge act as barriers to recognizing and reporting abuse and that more specific education and support for primary care professionals is required.     

妇幼专科医院孕产妇健康管理需求调查与对策研究

目的：探讨妇幼专科医院孕产妇健康管理需求情况,同时制定切实有效的管理对策。方法：以上海市长宁区妇幼保健院2020年6月-8月接收的孕产妇作为调查对象,以问卷调查法获得2778名孕产妇的问卷资料,并对调查资料进行统计分析。结果：初产妇与经产妇的健康管理需求、健康认知都存在明显差异,且差异有统计学意义（P<0.05）。根据Logistics回归分析,初产妇与经产妇健康管理需求主要与孕早期、孕中期、年龄、家庭年收入、既往史有关,差异有统计学意义（P<0.05）。根据Logistics回归分析,初产妇与经产妇健康管理认知主要与孕早期、孕中期、孕晚期、产褥期、年龄、文化程度、职业、家庭年收入、既往史有关,差异有统计学意义（P<0.05）。结论：孕产妇对健康管理有着较高的需求,且表现出经产妇、初产妇的认知差异,应当针对性的制定管理方案,提高妇幼保健工作的有效性。     

Women's attitudes to hormone replacement therapy in the aftermath of the Women's Health Initiative study

AIM: This paper is a report of a study conducted in 2004 on the determinants of attitudes towards hormone replacement therapy in the aftermath of the report on the findings of the Women's Health Initiative study. BACKGROUND: The unexpected findings of the Women's Health Initiative study, published in July 2002, showed that the risk of using combined hormones exceeded their benefits. This complicated women's decision-making about hormone use and made it important to study the determinants of their attitudes to hormone therapy, as these are likely to influence their behaviour. METHODS: A cross-sectional design was conducted with a sample of 561 women drawn from the National Registry of Iceland. A self-administered questionnaire, measuring attitudes towards hormone replacement therapy, attitudes towards menopause, extent and source of menopausal education, symptom experience, health and lifestyle and knowledge about the findings of the Women's Health Initiative, was used. The overall response rate was 56%. Attitudes to hormone replacement therapy were compared using anova, t-tests and correlations. RESULTS: Participants generally had positive attitudes. Knowledge about the Women's Health Initiative study was not associated with more negative attitudes. However, receiving the information from and discussing it with a doctor were associated with more positive attitudes. Positive attitudes towards hormone therapy were also associated with higher age, time since last menstrual period and current use of hormone replacement therapy. Negative attitudes were associated with use of natural remedies and receiving information from or discussing hormone therapy with family or friends. CONCLUSION: Research is needed to identify the dynamics of the medical interview, and the nature of input from friends, spouse and other family members. The content of these messages may be different and conflicting, for example, between doctors and family members. The nature of this conflict and conflicts of interests need to be identified in order to inform women's decision-making. In addition, action needs to be taken in order to strengthen the advisory role of nurses.