T管引流病人的心理分析及护理对策

目前 ,在胆道手术中 ,Ｔ管引流仍发挥着极其重要和不可替代的作用。由于胆汁分泌量大 ,Ｔ管引流时间长 ,患者可出现一些特殊的心理状况 ,在护理过程中 ,护士应全面了解Ｔ管引流病人的健康知识需求及心理反应 ,有目的、有计划地实施护理教育计划 ,促进病人配合 ,减轻不良的心理反应。现将我院调查 10 0例Ｔ管引流病人的心理状况及护理对策报道如下。1　方法和对象自 2 0 0 0年 1月～ 2 0 0 1年 9月 ,对胆道手术且带有Ｔ管引流的病人 ,在术后第 3天 ,采取问卷式调查 ,病人自行填写或由家属代填写《Ｔ管引流病人的健康知识需求调查》及《Ｔ管引…     

临终护理缺陷的调查分析

目的 :调查临床护士在临终护理中存在的缺陷 ,提出相应的管理措施。方法 :对从事临床护理工作的 10 2名护士进行有关临终关怀知识和临床实施情况进行问卷调查。同时对 90例住院死亡护理病历进行回顾性分析。结果 :①护士能正确回答临终护理内容的有 31人 ,占 30 .4 % ;主动关心临终病人并进行心理护理的有 5 4人 ,占 5 2 .9% ;与病人家属沟通 ,提供心理护理的 4 9人 ,占 4 8.0 % ;曾经与病人或家属讨论善终问题的有 8人 ,占 7.8% ;参加过临终关怀相关知识学习的 4 5人 ,占4 4 .1%。②病历中 ,对病人的心理护理有护理诊断、措施、效果评价的有 17份 ,占 18.9% ;对病人的心理护理有诊断、措施、没有效果评价的有 2 4份 ,占 2 6 .7% ;对家属有心理支持的有 10份 ,占 11.1%。结论 :重视对护理人员临终关怀相关知识教育 ,加强护理人员的培训 ,提高护士心理素质、业务素质 ,规范临终关怀的护理常规 ,对于保证临终病人得到全面的身心照顾是非常必要的     

护理病历中321个护理诊断在人类反应型态中分布的分析

对护理病历中321个护理诊断按人类反应型态分布进行分析。结果表明护士对病人存在的生理健康问题掌握较熟练,对病人因心理、社会等因素影响健康所提出的护理诊断较少。原因为临床护理人员在人文科学等知识方面不足或欠缺,通过强化护士整体观念,加强培训,重视继续教育拓宽护士的知识面,以适应整体护理的需要。     

护士存在的心理健康问题及对策

20世纪在90年代以前的研究中，心理护理的研究主要是涉及心理护理的重要性和如何对病人进行心理护理，但近些年来，人们愈发重视了对护护士的心理健康状况进行研究，因为护士心理健康状况的好坏决定着心理护理的质量和水平。我国目前处在计划经济向市场经济转换的最后阶段，也是社会变化最为活跃的时期，此时，护士所承受的来自各方面的压力越来越多，这直接影响着护士的心理健康水平，影响护理的质量，不利于病人的康复。针对目前的情况，深入分析我院影响护士心理健康原因，并提出相应对策，     

社区中风恢复期病人中医护理技术应用调查及影响因素分析

[目的]了解社区中风恢复期病人中医护理技术应用情况,探讨其影响因素。[方法]自行设计社区中医护理工作调查表和社区病人中风恢复期治疗调查表对136名护理人员和64例中风恢复期病人进行调查。[结果]136名护理人员同意在社区推进中医护理技术,同意率100%;愿意参加中医护理技术培训,参愿率100%;推进中医护理技术的影响因素为6类,构成比最高的是护士对技术不掌握,占23.32%;64例病人中愿意在社区就诊占比87.50%。[结论]中风恢复期病人愿意在社区就诊,但是目前社区能够为中风恢复期病人提供的中医康复护理偏少,不能够满足广大病人需求。应提升社区护士业务水平,加强中医护理知识培训,调动社区护士工作积极性,以推动当前社区中医护理工作的开展。     

护士工作压力源与心理亚健康状况的相关研究

目的探讨护士工作压力源、心理亚健康状况及其相关性。方法采用康奈尔医学指数(CMI)、护士工作压力源量表对三级综合医院的1500名护士进行问卷调查。结果护士心理亚健康发生率为36.7%;护士的主要压力源来自工作量及时间分配方面、护理专业与工作方面的问题;除工作环境与资源方面外,护士工作压力源各维度得分与MR分及绝大部分症状因子分均呈显著正相关。结论护士存在着多种压力源及影响心理健康的因子,应引起关注和重视,以提高临床护理质量,满足社会及病人对护理工作的需求。     

APN排班模式在临床排班中的应用

[目的]探讨连续排班模式(APN)对护士工作压力源、焦虑情况及病人对护理工作满意度的影响。[方法]2010年1月以普外科为试点实行APN排班模式,传统排班与APN排班实施6个月后对护士工作压力源、焦虑情况及病人对护理工作的满意度进行综合评价。[结果]传统排班护士压力源主要体现为工作量太大、护理管理者批评护理工作差、非护理性工作太多、没有时间对病人进行心理护理、医生批评护理工作、工作分工不明确6个方面,而实施APN排班6个月后,以上6方面均得到改善;传统排班与APN排班实施后6个月护士焦虑情况比较差异有统计学意义(P<0.05);病人对护理工作的满意度由实施前的82.1%上升到94.4%。[结论]APN排班能够减轻护士工作压力源,改善护士焦虑情绪,提高病人对护理工作的满意度,使护理人力资源的使用更科学、合理。     

知情同意的例外在急诊护理工作中的解读

知情同意的例外是指医生在没有获得病人同意的情况下,对病人实施他所认为的有利于病人的治疗和抢救,通常在紧急情况下实施。其实质是说明知情同意的程序在某些急诊情况下可以简化或省略,而不是知情同意原则本身可以免除。急诊护理工作是急救医疗的重要组成部分,即使在紧急救治病人的状况下,告知病人或其家属仍然是急诊护士必须承担的法律义务,也是义不容辞的责任。本文就知情同意的例外在护理工作中的告知的主体、内容、时间、程序、技巧等诸要素的变化做一简要解读。     

ICU病人家属心理需求的调查分析及对策

ＩＣＵ病人是各类重症及多系统功能衰竭者。ＩＣＵ病人的住院往往使家属处于一种危机状态 ,并产生不同程度的心理需求。在病人救治过程中 ,病人家属大部分时间被阻隔在病房外 ,护士忙于技术性工作 ,对家属的心理需求往往未给予足够认识和重视[1] 。疏忽了护理工作要围绕病人的同时也要围绕家属[2 ] 。家属是病人最有力的社会支持 ,家属的心理需求如果得不到解决可能影响病人疾病的恢复。因此 ,在整体护理框架下 ,了解家属的需求 ,以便为家属提供及时有效的帮助是非常重要的1　对象与方法1.1　对象　选取 2 0 0 1年 4月～ 2 0 0 1年 5月在北…     

护士存在的心理健康问题及对策

20世纪在90年代以前的研究中,心理护理的研究主要是涉及心理护理的重要性和如何对病人进行心理护理,但近些年来,人们愈发重视了对护护士的心理健康状况进行研究,因为护士心理健康状况的好坏决定着心理护理的质量和水平.我国目前处在计划经济向市场经济转换的最后阶段,也是社会变化最为活跃的时期,此时,护士所承受的来自各方面的压力越来越多,这直接影响着护士的心理健康水平,影响护理的质量,不利于病人的康复[1].针对目前的情况,深入分析我院影响护士心理健康原因,并提出相应对策,效果满意,现介绍如下.     

The stigma of a psychiatric diagnosis: prevalence, implications and nursing interventions in clinical care settings

The stigma associated with psychiatric and substance abuse disorders is a formidable barrier to the achievement of health and well-being for persons who carry such a diagnosis or who exhibit symptoms. Attitudes of nurses and treatment providers toward patients with comorbid psychiatric and substance abuse disorders can be influenced by stigma, which can have a negative impact on the therapeutic process and development of trust necessary to support good patient outcomes. Understanding the interrelated components of stigma, including labeling, stereotypes, and discrimination, can help nurses to reduce its impact in clinical care settings to improve the care experience for patients and nurses. Implementing interventions based on the core values of the nurse-patient relationship to enhance understanding, mutual trust, and acceptance of differences can contribute to improved communication and patient assessments in an effort to improve patient outcomes.     

SARS: caring for patients in Hong Kong

Aim and objective. To explore in depth the experiences of nurses' caring for SARS patients in Hong Kong. Background. Severe Acute Respiratory Syndrome (SARS) dramatically demonstrates the global havoc that can be wreaked by a newly emerging infectious disease. The current literature either has a predominantly biomedical focus or deals with the psychological impact on healthcare workers. Published studies on the lived experience of nurses caring for SARS patients are currently lacking. Design. A phenomenological design. Methods. Using methods consistent with Husserl's philosophy, eight Registered Nurses working in three regional hospitals in Hong Kong were invited to participate in sharing their lived experience of caring for SARS patients and data were analysed using Colaizzi's approach. Results. The three major themes explicated were: the various emotions experienced in caring for SARS patients, the concept of uncertainty and revisiting the ‘taken for granted’ features of nursing. Conclusion. These themes, when taken together, describe the essence of the voyage undertaken by nurses who cared for SARS patients during the outbreak. The findings of this study indicate that extensive and ongoing support is needed to prepare and enable nurses to care for SARS patients during a crisis and make it easier for nurses to deal with the various uncertainties. Relevance to clinical practice. The essence of caring for SARS patients is highlighted in this study. The experience of caring for SARS patients prompts nurses to find meaning in their experience(s), and to develop knowledge and attitudes on how best to care for patients and prepare for a new crisis in the future. This paper considers a more in‐depth understanding of the lived experience of nurses during the crisis and the relevance of this perspective for education and support of nurses.     

Parents' grief at the loss of a premature infant and approaches to their care

The more than 3,000 deaths of premature infants due to low weight in Taiwan cause deep personal grief in their parents, for whom there is no pain greater than losing a child. This loss, nearly always sudden and unexpected, is an issue often ignored by clinic nursing staff. The purpose of this paper was to consider various grief counseling theories in order to help nurses attend to the grief counseling needs of parents who lose a premature infant. Better understanding of parents' grief responses by nursing staffs will help nurses to accept and address such. Grief processes identified include: shock and numbness, searching and yearning, disorientation and reorganization. Grief responses include: feel, physiology and sense organs, cognition and behavior. The four tasks essential to grief recovery include: to accept the reality of the loss, to work through the pain of grief, to adjust to an environment in which the deceased is missing, and to emotionally relocate the deceased and move on with life. Coaching through grief counseling theory puts forward and looks after concrete measures, and provides three suggestions for the parents who lose a premature infant. These can be used as reference by clinical staffs, help promote nursing staff understanding of this topic, help improve care for grieving parents and improve care quality.     

The stigma of being a long-term foster carer

Stigma is a powerful social phenomenon with insidious health implications. Understanding stigma as it applies to various populations is imperative for nurses as it enables nurses to enhance individual patient care and nurses are well positioned to influence both social and health care policies which may exacerbate the experience of stigma. This article is a report of a study to explore the experiences of women who provide long-term foster care. Interviews were conducted with 20 women who provided long-term foster care in Australia. Data were coded according to the components of stigma described by Link and Phelan (2001). Findings reveal participants rejected the label of foster carer to avoid the negative stereotype. When unable to conceal their foster carer label, participants experienced social isolation and status loss. Moreover, participants felt marginalized and disempowered within the governing systems.     

Medical‐Surgical Patients’ and Registered Nurses’ Satisfaction and Comprehensiveness of Patient Assessment Using the Clinically Aligned Pain Assessment Tool

BackgroundThe pain experience is complex, and nurses are challenged to objectively assess and document patients’ subjective reports of pain. There is a clear need for an assessment tool that is easy to use and provides meaningful, actionable information for patients and nurses.AimsThis study explored nurses’ and patients’ satisfaction with the Clinically Aligned Pain Assessment (CAPA) as well as nurses’ charting.Setting and ParticipantsA convenience sample of adult patients and nurses on four medical-surgical units in one community hospital.MethodsA quantitative, two-group comparison design between patients and nurses using questionnaires to determine satisfaction and a retrospective chart review to determine comprehensiveness of nurse charting.ResultsNo significant differences existed between patients’ and nurses’ responses to seven of eight satisfaction questions The median score for seven of eight questions was 5 (using a 6-point Likert scale with 1 = strongly disagree and 6 = strongly agree), which demonstrated more than 80% agreement (somewhat agree, agree, strongly agree) among both groups that CAPA was superior to the NRS, based on individual responses. The one significant difference (p = 0.03) revealed patients were more likely to respond “agree or strongly agree” compared to nurses regarding the nurse thoroughly addressing patients’ needs using CAPA. Inter-rater reliability using CAPA was determined to be 89.5%, and a panel of clinical experts determined CAPA had strong content validity of 88.33%. In addition, 70.41% of nurses charted comprehensively using CAPA.ConclusionAs a result, CAPA was determined to be convenient, accurate, and valuable in guiding intervention decisions.     

SARS流行期间护士职业伦理观的调查分析

目的 了解护士对护理SARS患者的态度及其伦理认识。方法 采用随机抽样的方法，选择了江门市收治SARS患者的2所三级医院200名护士进行调查，使用无记名问卷，内容包括一般情况，护士对SARS患者的接纳态度及其对SARS的伦理认识3部分。结果 回收167份问卷显示，护士对护理SARS患者的信心不足，存在回避心理，反应矛盾的伦理观，不同护龄护士对SARS的态度及其伦理认识在某些方面存在一定的差异。结论护理SARS患者对护士产生的积极影响大于消极影响，但仍需强化护士的职业伦理道德，以利于应对日后特发的公共卫生事件。     

Spiritual care nursing: what cancer patients and family caregivers want

AIM: This paper presents findings from a study that was designed to understand, from the perspective of cancer patients and their family caregivers, what spiritual care is wanted from nurses. BACKGROUND: Distressing and transformative spiritual responses to living with cancer have been documented. Although there is momentum for providing spiritual care, previous research provides scanty and conflicting evidence about what are the clients' wishes or preferences with regard to receiving spiritual care from nurses. METHODS: A convenience sample of 156 adult cancer patients and 68 primary family caregivers, most of whom were Christians, independently completed the Spiritual Interests Related to Illness Scale and a demographic form, both of which were self-completed questionnaires. RESULTS: A variation in responses to items about nurses providing spiritual care therapeutics was observed; means and medians for these items mostly fell between 2 (disagree) and 3 (agree) on a scale of 1-4. Generally, therapeutics that were less intimate, commonly used, and not overtly religious were most welcomed. No significant differences were found between patient and caregiver preferences. A modest, direct correlation was observed between frequency of attendance at religious services and increased preference for nurse spiritual care. CONCLUSION: For both patients and caregivers, nurses must be sensitive to providing spiritual nurture in ways that are welcomed.     

护理SARS病人真实体验的质性研究

目的深入了解和探索香港护士照顾SARS病人的经验.方法运用了Edmund Husserl观点构成的质性研究,深入访问3家地区医院的8名注册护士.结果使用Colaizzi的分析程序,了解到护士在照顾SARS病人时得到的不同感受、不稳定的概念、关怀和照顾病人的新理念.结论需要对护士作出广泛而持续的支持,使他们更了解如何去照顾SARS病人,及走过他们不确定和难以预料的旅程.