心理资本在临床护士第二受害者安全事件创伤后痛苦与心理一致感间的中介效应

目的 探讨心理资本在临床护士第二受害者安全事件创伤后痛苦与心理一致感间的中介效应。方法 研究时间为2021年9月-2022年4月,应用便利抽样法从德阳市辖区3所医院选择495名于近期出现安全事件（采用自拟安全事件调查问卷评估）的临床护士为研究对象,通过自拟一般资料调查问卷收集性别、年龄等人口学信息,并采心理资本问卷（PCQ）、第二受害者经验与支持量表（SVEST）及心理一致感量表（SOC-13）进行调查,通过结构方程模型分析临床护士第二受害者安全事件创伤后痛苦与心理一致感间的关系以及心理资本的中介作用。结果 经Pearson分析,SVEST与PCQ-24、SOC-13均呈负相关（r=-0.600,-0.433）,PCQ-24与SOC-13呈正相关（r=0.367）;安全事件创伤后痛苦对心理一致感直接效应值为0.029(P>0.05),安全事件创伤后痛苦对心理资本、心理资本对心理一致感效应值分别为-0.512、-0.382(P<0.05)。安全事件创伤后痛苦对心理资本对心理一致感效应值为0.196,占总效应的87.11%。结论 心理资本在临床护士第二受害者安全事件创伤后痛苦与...     

基于文献计量学的我国第二受害者研究可视化分析

目的从文献角度分析我国第二受害者研究现状,为后续相关研究指明方向。方法以“第二受害者”为关键词在中国知网、维普、万方三大数据库中检索相关文献,利用文献管理软件NoteExpress、可视化分析软件VOSviewer对文献的外部特征和内容特征进行可视化分析。结果共纳入64篇文献,最早发表于2015年,2017年后发文量呈逐年递增趋势;发表在33种期刊上,主要有两个核心研究团队;研究热点可归纳为6类:第二受害者结局、影响因素、患者安全文化、综述、正念减压法的支持效果及相关量表。结论我国第二受害者研究起步较晚,现有文献量偏少,研究人群主要为护士。今后需扩大研究群体,进一步深化第二受害者结局方面研究,优化第二受害者经验和支持评价工具,探索患者安全文化与第二受害者之间的关系,以期为确保医务人员安全提供依据。     

认知能力评估工具的研究进展

认知能力评估是指运用一定的工具对个体认知能力进行定量化描述的过程，评估工具是影响评估结果的重要因素。认知评估工具的发展历经量表评估时期，目前正处于计算机化认知评估时期。本文综述了各时期常用的认知评估工具及其优缺点，着重介绍现阶段认知评估工具并分析其存在的问题；未来认知评估工具的研制应注重丰富评估内容，提高评估效率和生态效度。     

第二受害者的经验与支持调查:以某精神专科医院护士为例

目的调查患者安全事件中精神专科医院护士作为第二受害者的经验与支持现状，并分析影响因素。方法2020年9月便利抽取北京市某三甲精神专科医院的280名护士进行问卷调查，采用单因素方差分析、多元线性回归分析方法分析影响因素。结果精神专科医院护士第二受害者负性体验报告率较高，经验与支持得分较高的维度是“心理痛苦”和“离职倾向”。不同年龄段、不同工作年限、经历患者安全事件、直接经历次数不同的护士群体在经验与支持量表总分上有统计学差异（P＜0.05）；直接和间接经历患者安全事件是精神专科医院护士第二受害者经验与支持水平和离职倾向的共同影响因素；年龄＞45岁是精神专科医院护士第二受害者经验与支持水平和缺勤的共同影响因素。结论精神专科医院管理者应重视护士第二受害者的身心健康，建立支持型的安全文化和相应支持性项目，以确保其安全。     

心理韧性在护士第二受害者支持与职业生涯成功间的中介作用研究

目的探讨护士第二受害者支持、心理韧性和职业生涯成功三者间的关系。方法以广东省623名护士第二受害者作为研究对象,采用第二受害者经验与支持量表、心理韧性量表和职业生涯成功量表展开调查,采用SPSS 22.0软件对数据进行统计分析。结果护士第二受害者支持得分为（2.41±0.62）分,心理韧性得分为（3.55±0.67）分,职业生涯成功得分为（3.29±0.61）分。护士第二受害者支持与心理韧性和职业生涯成功呈正相关,心理韧性与职业生涯成功呈正相关。护士第二受害者支持可以直接预测职业生涯成功水平（β=-0.421,P＜0.001）,心理韧性在护士第二受害者支持与职业生涯成功之间有一定中介效应,其中介效应占总效应的47.50%。结论护士第二受害者支持不仅可以对职业生涯成功有直接作用,而且可以通过增强护士第二受害者心理韧性对职业生涯成功水平产生间接作用。     

衰弱指数和Fried衰弱表型 在社区老年人衰弱评估中的比较研究*

摘 要：目的：使用衰弱指数和Fried衰弱表型评估工具对参与社区健康体检的老年人进行衰弱评估，以期为促进开展 社区老年人衰弱评估及健康干预提供参考。方法：2022年 9—10月，采用方便抽样方法，收集上海市徐汇区斜土街道社区 ≥60岁老年人的健康体检数据和衰弱数据。使用衰弱指数和Fried衰弱表型两种评估工具进行衰弱评估，比较两种评估工具 的一致性和适用性。适用性方面，以日常生活活动能力作为效度评价标准，比较两种衰弱评估工具的预测效度，同时与老年 人体检结果进行相关性分析。结果：474例样本中，衰弱指数和 Fried衰弱表型评估的衰弱发生率分别为 37.1%、11.8%，两 者呈正相关。以日常生活活动能力下降为结局变量，衰弱指数和 Fried衰弱表型的 ROC曲线下面积分别为 0.747、0.778。衰 弱指数与身体质量指数、收缩压、空腹血糖、甘油三酯、尿酸、尿素、红细胞、血红蛋白呈相关性；Fried衰弱表型评估结 果与收缩压、舒张压、红细胞、血红蛋白呈相关性。结论：衰弱指数与Fried衰弱表型评估工具对社区老年人的衰弱识别有 差异，衰弱指数评估工具更为灵敏；与衰弱指数评估工具相比，Fried衰弱表型评估工具对日常生活活动能力下降的预测能 力更好，更适合评估老年人的身体衰弱状态；与Fried衰弱表型评估工具相比，衰弱指数评估工具的评估维度更广，更适合 评估社区老年人的综合衰弱和整体健康状态。     

第二受害者支持项目的比较研究

目的解读Scott第二受害者支持三级介入模式，为我国今后开发相关支持项目提供参考。方法利用文献分析法进行阐释和比较。结合第二受害者自然恢复历程变化解读该模式内在规律，将现有支持干预项目进行对比，辨别这类研究之间的联系和差异，深入了解该模式的影响。结果Scott第二受害者支持三级介入模式可加快第二受害者恢复历程，在实践中可较好地维护第二受害者支持项目运行。结论该模式理论符合第二受害者创伤恢复规律，对第二受害者支持项目的开发具有一定指导作用，值得借鉴。     

综合营养评估工具在心衰患者中的应用价值

目的 对心衰患者所采用的综合营养评估工具及应用价值进行综述，为我国心衰患者的营养相关研究提供理论基础。方法 以“营养”、“心力衰竭”、“nutrition”、“heart failure”等为关键词，查询PubMed、Web of Science、知网等数据库相关文献，综述材料。结果 对心衰患者运用的综合营养评估工具种类较多，各量表信效度较高，营养风险和营养不良检出率较好，但均为普适量表，测评内容不能与心衰患者的临床特征完全相符，开发针对心衰患者的营养评估工具处于起步阶段。结论 综合营养评估工具对心衰患者的营养评估效果较好，未来需要加强针对心衰患者营养量表的研究。     

宁夏孕产妇保健现状

为了解宁夏居民中孕产妇保健情况及目前我区的妇幼保健工作现状，以便更好地改进工作、加强服务、提高保健质量，我们在全自治区范围内进行了多级分层整群随机抽样调查，现将调查分析结果报告如下。１　调查对象和方法１１　调查对象：按照卫生部“第二次国家卫生服务调查设计方案”〔１〕，经多级分层整群随机抽样，确定银川市、中卫县、惠农县、隆德县的２０个乡镇（街道）、４０个行政村（居委会）的２４００户为调查单位，其户内前１年有妊娠结局的孕产妇均为调查对象。１２　调查内容：调查内容主要包括：妊娠结局、孕产妇保健、分…     

全身运动评估的临床应用研究进展

早产、脑损伤等小婴儿是神经系统发育异常的高危人群，目前评估神经系统功能的方法有很多，其中已有大量研究证实全身运动评估技术是超早期预测脑瘫等神经发育障碍可靠、有效的评估工具。全身运动评估包括整体评估和细化评估两大类。整体评估是一种定性评估，细化评估则是根据最优性评分将运动模式进行量化，既有利于观察婴儿运动发育轨迹的细小变化，评价早期干预效果，又有利于更加全面、精准地预测不同的神经发育结局。     

Measuring Kitchen Performance: What Assessment Should we Choose?

There are several published kitchen assessments currently available for use by clinicians. The main objective of this paper was to offer criteria for choosing standardized kitchen assessments, from a ''top-down'' cognitive perspective, in order to help clinicians in selecting the most appropriate kitchen assessment tools. Towards this objective, four standardized kitchen assessment tools were critically analyzed by means of six criteria: (1) frame of reference and theoretical basis; (2) cultural relevance; (3) clinical utility; (4) outcome measures; (5) psychometric properties; and (6) scoring methods. Each of the assessment tools was then analyzed according to ten executive function components. The advantages and disadvantages of each assessment tool are addressed in the final discussion. The main conclusion is that the Assessment of Motor and Process Skills (AMPS) is the most comprehensive tool for assessing occupational performance.     

Inter-rater reliability of the original and modified Barthel Index,and a comparison with the Functional Independence Measure

The Barthel Index (BI), the Modified Barthel Index (MBI) and the Functional Independence Measure (FIM) are all widely used by occupational therapists as assessment tools for clinical decision-making and outcome measurement. All of these tools have demonstrated validity and the BI and the FIM have demonstrated inter-rater reliability. The MBI has been modified to increase sensitivity; however, there have been no publications on the inter-rater reliability of this tool following the changes. The purpose of this research was to examine the inter-rater reliability of two versions of the Barthel Index, and draw some comparisons between this assessment tool and the FIM. Twenty-five patients with neurological and orthopaedic conditions were assessed by three occupational therapists using the three tools. The method of analysis selected was percentage agreement and intraclass correlation coefficient. The results indicated that both the original and modified versions of the Barthel Index possess good inter-rater reliability. As all three tools have demonstrated adequate reliability and validity, it is suggested that clinicians select the most sensitive tool that best meets their clinical needs, and use this assessment tool in its standardized format.     

Bias Assessment in Outcomes Research: The Role of Relative Versus Absolute Approaches

ObjectivesBias assessment tools vary in content and detail, and the method used for assessment may produce different assessment results in a study if not carefully considered. Therefore, taking an approach to the assessment of studies that produces a similar result regardless of the tool used for assessment (tool independence) is important.MethodsA preexisting study that used 25 different quality scales was assessed to examine tool dependence of 2 common approaches to bias assessments—absolute value judgments (defined as the qualitative risk of bias judgment based on a threshold across studies) and relative ranks (defined as the relative probability toward bias of a study relative to the best assessed study). Agreement between each of the 25 scales and a composite scale (that includes all unique safeguards across all scales) was computed (using the intraclass correlation coefficient [ICC]; consistency). Tool dependence was considered present when the ICCs were inconsistent across the 25 scales for the same study.ResultsWe found that using relative ranks for tools with different numbers and types of items produced consistent results, with only small differences in the agreement for the various tools with the composite tool, whereas consistency (measured by the ICC) varied considerably when using absolute judgments. Inconsistency is problematic because it means that the assessment result is linked to the scale and not to the study.ConclusionsTool independence is an important attribute of a bias assessment tool. On the basis of this study, the use of relative ranks retains tool independence and therefore produces consistent ranks for the same study across tools.     

Nutrition screening tools for hospitalized patients.

There is agreement among international nutrition organizations and healthcare accrediting organizations that nutrition screening is essential to identify patients needing further nutrition assessment to determine appropriate nutrition intervention. Numerous nutrition screening tools are used in hospitals, but many, if not most, have never been validated for the care setting, patient population, or outcome they strive to identify. Thus, it is unclear if they appropriately identify patients who truly need further nutrition assessment and, potentially, intervention. Several nutrition screening tools reported in the literature have been validated in a variety of care settings and patient populations and have been shown to achieve the desired outcome. These tools include the Malnutrition Universal Screening Tool, Nutritional Risk Screening 2002, Mini Nutritional Assessment, Short Nutritional Assessment Questionnaire, Malnutrition Screening Tool, and the Subjective Global Assessment. It is important for clinicians to understand how the tools were validated and for which population and care setting they were developed, and to determine if the tool might be appropriate for use in their institution.     

Iterative Evaluation of a Web-Based Health Information Resource

This article presents the research process and methods used to evaluate and improve a web-based health information resource, called “Community Connect to Research,” intended for the public. The research process was iterative and involved collaboration with many partners. Two formal evaluations were conducted in 2009 and 2010 using key informant interviews, usability interviews, focus groups, an online survey, and readability and suitability assessment tools. These methods provided users' perspectives on the overall design, content, and literacy demands of the website as well as valuable feedback on their interaction with the website. The authors subsequently redesigned Community Connect to Research, making significant improvements on the basis of what they learned from the evaluation. The second evaluation revealed that the redesign addressed many issues found in the first evaluation and identified additional areas of possible improvement. Overall, both evaluations suggested that participants believed that the website was useful and valuable, indicating that Community Connect to Research is a health information resource that provides patients and families with accessible, relevant, and high-quality information. Regular formal evaluation is an essential tool for effective ongoing enhancement of health information resources meant for the public.     

A survey of medical students' views about the purposes and fairness of assessment

OBJECTIVE: To survey medical students' views about the purposes and fairness of assessment procedures. METHOD: The survey used a 19-item questionnaire designed for self-completion. Respondents were invited to "strongly agree", "agree", "disagree" or "strongly disagree" with a series of statements about the purposes and fairness of assessment. There was space for free text comments relating to each statement. RESULTS: A total of 312 students out of a sample of 381 completed questionnaires (82% response rate). Whilst the majority of students (> 95%) agreed that ensuring competence, providing feedback and guiding student learning were important purposes of assessment, only half (51%) felt that assessment should be used to predict performance as a doctor. A clear majority of students (81%) agreed that, on the whole, assessment at Newcastle Medical School was fair. Data interpretation papers (comprising a combination of multiple true/false, "one best answer" and short answers) were perceived to be the fairest assessment tool; the assessment of clinical rotations by supervisors was perceived as the least fair. Differences in perception about the fairness of several assessment methods emerged between junior and senior students. A large number of respondents expressed desire for the provision of more feedback on performance in order to guide future learning. CONCLUSIONS: Whilst students' views about the fairness of specific assessment tools may sometimes be at variance with published research on assessment, their perceptions will influence the acceptability of assessment. Students would welcome the introduction of methods that provide meaningful assessment feedback.     

Development of a patient safety culture measurement tool for ambulatory health care settings: analysis of content validity

The development of patient safety culture in health care organizations is a necessary precursor to patient safety improvement. However, existing tools to measure patient safety culture are intended for implementation in hospitals. A new, abbreviated patient safety culture survey was developed for use in ambulatory health care settings. This survey was tested for content validity utilizing a panel of six experts. It had a clarity interrater agreement (IR) of 0.75, a clarity content validity index (CVI) of 0.95, a representativeness IR of 0.75 and a representativeness CVI of 0.95. The content validity analysis served as a useful tool for assessing the relevance and comprehensiveness of this survey of patient safety culture in ambulatory care organizations.     

Overview: what’s worked and what hasn’t as a guide towards predictive admissions tool development

Admissions committees and researchers around the globe have used diligence and imagination to develop and implement various screening measures with the ultimate goal of predicting future clinical and professional performance. What works for predicting future job performance in the human resources world and in most of the academic world may not, however, work for the highly competitive world of medical school applicants. For the job of differentiating within the highly range-restricted pool of medical school aspirants, only the most reliable assessment tools need apply. The tools that have generally shown predictive validity in future performance include academic scores like grade point average, aptitude tests like the Medical College Admissions Test, and non-cognitive testing like the multiple mini-interview. The list of assessment tools that have not robustly met that mark is longer, including personal interview, personal statement, letters of reference, personality testing, emotional intelligence and (so far) situational judgment tests. When seen purely from the standpoint of predictive validity, the trends over time towards success or failure of these measures provide insight into future tool development.