亲属探视护理干预对首次住院精神分裂症病人病情的影响

[目的]观察亲属探视护理干预对首次住院精神分裂症病人病情的影响。[方法]将101例首次住院的精神分裂症病人随机分为两组,对照组50例采取随意探视,观察组51例进行亲属探视的护理干预。采用护士用住院病人观测量表(NOSIE)和简明精神病量表(BPRS)进行效果评定病人的精神症状。[结果]观察组病人入院2周、8周BPRS评分低于对照组(P<0.05);观察组病人NOSIE评分中激惹、抑郁及精神症状因子分低于对照组(P<0.05)。[结论]亲属探视护理干预对首次住院精神分裂症病人的病情有一定影响,适当选择探视时机探视,对改善病情有明显的辅助效果。     

护理干预在急性闭角型青光眼术后的应用研究

[目的]研究全面、个体化护理干预对急性闭角型青光眼手术病人眼压、情绪及生活质量的影响。[方法]选取2015年3月—2016年3月山西医科大学第一医院收治的40例青光眼术后病人(40眼),均为小梁切除术+虹膜周边切除术后病人,随机分为观察组与对照组各20例(20眼)。观察组给予全面、个体化护理干预,对照组给予常规围术期护理。采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、生活质量评分量表对两组病人进行测评,同时进行普通视力检查、非接触性眼压测量、前房深度测量。[结果]干预后观察组SAS、SDS评分低于对照组(P<0.05);生活质量评分高于对照组(P<0.05);观察组视力较对照组提高(P<0.05),眼压低于对照组(P<0.05)。[结论]全面、个体化护理干预可明显改善急性闭角型青光眼手术病人焦虑、抑郁等负性情绪,提高病人手术效果,改善病人术后生活质量。     

综合护理对鼻咽癌放疗病人的自我管理效能感及不良反应的影响

[目的]探讨综合护理对鼻咽癌放疗病人的自我管理效能感及不良反应的影响。[方法]选择进行放疗的112例鼻咽癌病人,随机分为观察组和对照组各56例,对照组给予常规护理,观察组给予综合护理,对两组病人干预后的自我管理效能感量表(SUPPH)评分、生活质量评分、不良反应发生率及不良反应程度进行比较。[结果]干预后观察组病人的SUPPH评分明显高于对照组(P0.05);干预后观察组病人的生活质量评分明显高于对照组(P0.05);干预后观察组病人的不良反应发生率明显低于对照组(P0.05);干预后观察组病人的不良反应程度明显低于对照组(P0.05)。[结论]对鼻咽癌放疗病人实施综合护理,可明显提高病人的自我管理效能和生活质量,降低不良反应的发生率。     

综合护理干预对长期住院精神分裂症病人康复效果的影响

[目的]探讨综合护理干预方案对长期住院精神分裂症病人康复效果的影响。[方法]将符合纳入标准同时不符合排除标准的100例精神分裂症病人随机分为观察组和对照组,在精神科药物剂量不变的情况下,对照组结合简单娱乐活动及常规护理措施,观察组在此基础上施行综合性护理干预。干预前后分别采用护士用住院病人观察量表(NOSIE)、自尊量表(SES)进行测试,并以NOSIE第32项得分高低来评估干预疗效。[结果]基于NOSIE的测评,观察组干预后在社会能力、社会兴趣、个人整洁、激惹、精神病性表现及抑郁情绪方面改善均优于对照组,而对于衰退症状,观察组和对照组干预前后未见明显差异,观察组干预的有效率为78%,而对照组的有效率为46%,两组差异有统计学意义(P<0.05);观察组干预后SES评分明显高于对照组。[结论]综合护理干预能提高临床疗效,减少激惹、抑郁等消极情绪,改善长期住院精神分裂症病人的认知功能,提高病人自尊心,改善其社会功能和生活质量。     

2型糖尿病病人的护理干预效果观察

[目的]观察2型糖尿病病人的护理干预效果。[方法]将90例2型糖尿病病人随机分为两组,观察组46例采取护理干预,对照组44例进行常规护理。采用汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)评定病人心理状态,比较两组病人的干预效果。[结果]观察组治疗后HAMD和HAMA评分低于治疗前(P<0.05),且均低于对照组(P<0.05);观察组治疗后空腹血糖(FBG)、餐后血糖(PBG)及糖化血红蛋白(HbA1c)降低(P<0.05),且均低于对照组(P<0.05)。[结论]2型糖尿病病人治疗后的焦虑和抑郁心理明显改善,护理干预能够改善2型糖尿病病人焦虑和抑郁状况,有效控制血糖。     

综合护理干预对精神分裂症合并糖尿病病人生活自理能力及生活质量的影响

[目的]探讨综合护理干预对精神分裂症合并糖尿病病人病情控制、生活自理能力及生活质量的影响。[方法]将62例住院的精神分裂症合并糖尿病病人采用随机数字表法分为干预组和对照组,每组31例,对照组给予常规的治疗和护理,干预组在常规的治疗和护理基础上给予综合护理干预。比较两组病人空腹血糖(FBG)、餐后2h血糖(2hPG)、生活自理能力评分ADL(Barthel指数)、生活质量(SF-36)评分及精神护理观察量表评分(NOSIE)。[结果]干预组病人干预后FBG、2hPG水平较干预前和对照组降低(P0.05),ADL评分、SF-36评分较干预前和对照组提高(P0.05),NOSIE评分较干预前和对照组改善(P0.05)。[结论]对精神分裂症合并糖尿病病人实施综合护理干预可有效稳定病人病情、控制血糖、改善精神症状、提高病人生活自理能力及生活质量。     

个体化护理干预对肝硬化上消化道出血病人不良情绪的影响

[目的]探讨个体化护理干预对肝硬化上消化道出血病人不良情绪的影响。[方法]将97例住院治疗的肝硬化上消化道出血病人随机分为观察组(n=49)和对照组(n=48),对照组病人采取肝硬化上消化道出血常规护理措施,观察组病人采取个体化护理干预措施,包括病房环境营造、救治过程护理、日常生活护理和心理护理。比较两组病人止血时间、再出血情况及住院时间;分别于干预前和干预后采用压力知觉量表中文版(CPSS)、焦虑自评量表(SAS)、抑郁自评量表(SDS)对病人压力、焦虑和抑郁情况评估;病人出院时调查病人对护理过程满意度。[结果]观察组病人止血时间和住院时间均短于对照组(P0.05);观察组病人再出血发生率低于对照组(P0.05);两组病人干预后CPSS评分、SAS评分和SDS评分均较干预前降低,观察组病人干预后CPSS评分、SAS评分和SDS评分均低于对照组(P0.05);观察组病人对护理过程满意度为95.9%(47/49),高于对照组的84.3%(39/48),差异有统计学意义(χ2=5.189,P=0.023)。[结论]对肝硬化上消化道出血病人应用个体化护理干预,有助于减轻病人不良情绪,提高病人对护理过程的满意度。     

舒适护理在剖宫产产妇护理中的应用

[目的]探讨舒适护理在剖宫产产妇护理中的应用。[方法]将130例行剖宫产产妇随机分为观察组和对照组,每组65例,对照组采用常规护理,观察组在对照组的基础上进行舒适护理。比较两组病人的护理干预效果,包括术后48 h疼痛程度、护理干预前后焦虑自评量表(SAS)评分、病人对护理服务的满意度。[结果]观察组病人术后48 h疼痛程度低于对照组(P<0.05);观察组病人护理干预后SAS评分低于对照组(P<0.05);观察组病人对护理服务的满意度高于对照组(P<0.05)。[结论]舒适护理可减轻剖宫产病人的焦虑程度、术后48 h疼痛程度,提高病人对护理服务的满意度。     

护理干预对脑卒中偏瘫病人日常生活能力的影响

[目的]探讨护理干预对脑卒中偏瘫病人日常生活能力(ADL)的影响。[方法]将113例脑卒中偏瘫病人随机分为对照组56例和观察组57例,对照组病人采用常规治疗和护理,观察组病人在常规治疗和护理的基础上给予护理干预,采用Barthel指数评定病人的ADL,并比较两组病人护理前后ADL评分的改变情况。[结果]与护理前相比,两组病人在护理后ADL评分均明显升高(P<0.05);与对照组相比,观察组病人护理干预后ADL评分明显升高(P<0.05)。[结论]对脑卒中偏瘫病人采取护理干预能够改善病人的ADL。     

心理护理干预改善精神分裂症后抑郁情绪的临床研究

[目的]观察并探讨心理护理干预用于改善精神分裂症后抑郁的临床效果。[方法]运用随机数字表法将96例精神分裂症后抑郁病人分为心理护理干预组和常规护理组,常规护理组进行常规护理,心理护理干预组则在常规护理的基础上行专业心理护理干预,分别于护理干预前及干预后2周、4周、6周、8周通过汉密尔顿抑郁量表(HAMD)评价临床效果。[结果]两组病人干预后2周、4周、6周、8周HAMD评分与治疗前相比均明显下降,组间比较差异有统计学意义(P<0.05);同时心理护理干预组病人同期HAMD评分明显低于对照组,组间比较差异有统计学意义(P<0.05)。[结论]心理护理干预用于改善精神分裂症后抑郁临床效果确切,能够有效缓解病人的抑郁症状。     

Putting policy into practice: pre- and posttests of implementing standardized languages for nursing documentation

Aims and objectives. To describe the change in documentation of the nursing process in all inpatient wards in a 900‐bed university hospital. Major research question was what are the differences between before and after implementation of documentation policy related to the steps of the nursing process? Background. Implementation of standardized languages has been shown to be difficult to accomplish in clinical practice. Patients are the source of data and their conditions, responses and well‐being should be reflected in the nursing record. As such, nursing documentation can create the premises for the development of new knowledge in nursing and the improvement of nursing performance and can provide data and information necessary for nursing researchers to evaluate the quality of interventions and participate in the formulation of healthcare policy. This study is part of longitudinal project to prepare nurses for electronic documentation within the interdisciplinary health record and to improve documentation of nursing using standardized languages. Design and method. A cross‐sectional study design was used: a pretest (n = 355 nursing records) for baseline status of nursing documentation, an intervention and a post‐test (n = 349 nursing records) to obtain data on nursing documentation. The year‐long intervention comprised planned work in groups, and educational and supporting efforts. Results. A statistically significant improvement was found in the use of Functional Health Patterns for documentation of nursing assessment, NANDA for nursing diagnoses and Nursing Interventions Classification for nursing interventions in documentation of daily nursing care for inpatients. Conclusion. At all organizational levels intervention aimed at putting policy regarding documentation into clinical practice considerably improved daily use of standardized nursing languages. Relevance to clinical practice. Nurses need to use standardized language to document patient care data in the electronic health record and to demonstrate contributions to nursing care.     

Structure and content in Norwegian nursing care documentation.

In 1994, the Norwegian Board of Health (NBH) published recommendations for nursing care documentation. The two-fold purpose of the present study was to see if 5 wards in 2 Norwegian hospitals fulfilled the proposed NBH recommendations and guidelines regarding documentation, and to evaluate them in terms of the proposed structure and key words of the VIPS model. Results showed that all nursing records (n = 55) had an admission assessment. A nursing care plan was present in 62% of the records. Nursing goals were lacking in the remaining 38%, diagnosis and planned interventions were absent in 18%, and 45% of the diagnoses lacked information concerning patient progress or outcome. The nursing care plans were updated in only 40% of the records and discharge notes were present in 35%, confirming that NBH recommendations were not met in this sample. The key words of the VIPS model covered all information present in the records, and high interrater reliability was obtained for the majority of key words categorized by two independent researchers. It is suggested that the VIPS model components and key words can contribute to a reliable and uniform model for nursing care documentation and enhance comprehensive and systematic documentation, which is presently lacking in Norwegian records.     

提升护理服务综合价值的研究

目的:研究护理综合价值的提升。方法:分析护理价值研究背景,阐述护理价值研究进展结果:提出护理价值研究途径。结论:有利于达成一种共识,使广大护理人员认识护理价值、研究护理价值、开发护理价值,重视护理综合价值研究和提升。 护理服务价值是护理服务劳动产品的价值和服务本身所创造的价值的总和,即使用价值与价值的统一。目前日本、美国、德国和中国都在加强护理价值研究的探索,但仍存在使用价值与价值研究分离问题。因此,我们应不断加强护理综合价值研究,以适应卫生事业改革对护理管理的挑战。本研究主要在分析国内外护理价值研究的基础上,提出综合护理价值研究途径,以达到合理评价护理价值的目的。     

Research and the configuration of nursing services

• ? This paper is concerned with the way in which nursing research has influenced changes in the organization of nursing services, particularly the shift from so-called traditional nursing to new nursing. To this end published research and professional literature are selectively reviewed.
• ? The case is made to support the view that change in nursing has been driven forward by the evangelical zeal of opinion leaders rather than evidence.
• ? It is suggested that holistic care as embodied in new nursing is no longer affordable. Market pressures have precipitated a revisiting of the task basis of nursing. An effective anchor would have been a solid body of research evidence pointing up the value new nursing may have. Regrettably not enough research was done prior to the diffusion of new nursing. What was done was not always adequate, and what was adequate was not effectively deployed by nurse leaders.
• ? Nursing is the largest workforce in the NHS and has attracted a great deal of policy interest. It is suggested that it will become increasingly important for nursing to be more strategic, and develop its own professionally driven research agenda.
• ? The future of the nursing profession is uncertain. It is clear that evidence-based practice is centre stage, and there is a need for nursing to re-negotiate its professional boundaries and to develop intellectual partnerships in order to move the knowledge base of practice forward.

     

我国护理行业的改革与发展

从我国护理行业的现状、卫生体制改革以及基本国情出发 ,着重探讨护理管理、护理教育、护理环境、护理经济与管理体系、护理立法等方面的发展途径     

Innovations in United States genetics nursing: Practice and research

Aim: Clinical and research applications from human genome discoveries are growing and creating both opportunities and challenges to the integration of genetic concepts into practice and research. Nurses have a long history of caring for individuals, families, and groups with genetic conditions. In the past two decades, a small group of nurses in the USA have used a variety of strategies to further develop the field of genetics nursing. In this paper we identify innovative approaches to identifying genetics‐related nursing roles and opportunities, as well as successful collaborative efforts beyond nursing to address the emerging health and societal challenges related to human genetics discoveries. Methods: The information presented here comes from a variety of sources where the authors or genetics nurses directly participated, including: (i) a systematic literature review of genetics nursing; (ii) a comprehensive research study of models of delivering clinical genetics services and the roles of health professionals; and (iii) participation in numerous national research, planning, programmatic, and advisory groups involved with clinical genetics‐related health services, research, education, and public policy. Results: Genetics nurses in the US have developed innovative responses to genetics‐related challenges within and beyond the profession of nursing. These include: (i) establishing an organization for nurses in genetics and gaining formal recognition of genetics as a specialty of nursing; (ii) defining the scope of genetics nursing practice and developing a new genetics nursing credential; (iii) establishing a multiprofessional genetics education coalition and defining genetic competency for health‐care practice; (iv) creating new clinical practice roles for nurses that integrate emerging genetics concepts and skills into diverse clinical practice areas; (v) expanding nursing involvement in genetics‐related research; and (vi) participation in high‐level genetics advisory groups. Conclusions: The US experience shows that nurses have made substantial progress in expanding their involvement in genetic services through visionary leadership, innovative approaches to challenges, establishing support with nurse colleagues, and engaging in multiprofessional efforts. The most important first step is developing a supportive environment for nurse advancement. In the US, the genetics nurses’ organization known as the International Society of Nurses in Genetics (ISONG) has provided this base.     

整体护理病房三级护理查房的体会

我院自1999年7月开始在整体护理模式病房中实施三级护理查房。1年多来,对800例危重病人进行了护理查房,查房的形式为责任护士每天查,主管护师或护士长每周查,副主任护师以上或科护士长每月抽查,护理部主任每季抽查。通过查房,明显提高了危重病人的护理质量,病人得到了更为优质的服务,护理服务满意率提高;对护理人员来说,提高了业务水平,锻炼了口头表达能力;对护理管理来说,及时了解护士对护理程序的应用情况,掌握危重病人的护理质量,对护理中存在的不足及时提出指导意见。     

基层医院整体护理的实施与对策

目的:总结实施整体护理的经验,提高护理质量。方法:全面综合分析实施整体护理的对策和措施。结果:经验:领导的高度重视和大力支持,是实现整体护理模式转变的坚实基础;提高人员整体素质,确保整体护理的有效开展;多做少写,以点带面,实行非模式病房开展整体护理工作;积极开展健康教育,巩固整体护理效果;实施整体护理质量管理的措施。体会:领导的重视和支持,是开展整体护理工作的根本保证;提高了社会公众对护理工作的认可程度和护士的社会地位;显示了护士的自身价值;改善了护患关系,提高了病人满意度,同时也密切了医护关系;护理队伍整体素质提高,敬业精神增强。结论:实施整体护理,促进了护理学科的发展。     

Towards an aesthetics of nursing

Towards an aesthetics of nursing This paper re-appraises the work of Barbara Carper on aesthetics and the art of nursing. It identifies serious flaws in Carper's original arguments and the way in which she and subsequent authors have conflated the concepts of art and aesthetics in nursing. The paper explores a broader approach to aesthetics and proposes a way in which a theoretical approach to nursing aesthetics could be developed. The paper concludes that nursing is a fit object of aesthetic appreciation and that aesthetic quality is a necessary attribute of good nursing practice.     

晨间护理缺陷分析及对策

目的提高晨间护理质量。方法通过向住院病人和护士发放问卷调查及每周不定期检查各病区晨间护理质量,了解晨间护理工作中存在的缺陷,提出整改的措施。结果晨间护理工作中存在的主要缺陷:51.8%的病人认为护士与病人的沟通少,进病房时未向病人问好,整理病房时未向病人解释,口腔清洁率70.3%,头发清洁率45.3%,皮肤清洁率69.5%,病房安静整洁率67.3%,床单位整洁率86.5%,病情关注情况67.9%,健康教育执行情况48.6%,协助生活不能自理的病人进食、入厕、更衣、床上排便等占75.4%,时间安排满意度75.6%,护士认为晨间护理重要的占30%,晨间护理内容知晓率占60.9%,认为工作量大来不及做的占56.7%。结论提高护士对晨间护理的认识,规范晨间护理内容和程序,加强与病人的沟通,提供符合个体化需要的晨间护理,合理安排护理人员、工作重点和时间,持续质量改进,有助于提高晨间护理质量。