军队传染科护理人员心理应激状况的调查

目的调查军队传染科护理人员的心理应激状况并探讨应对策略。方法采用问卷调查的方法对某军区总医院感染科五年内的60名一线护理工作人员心理应激状况进行调查。结果问卷中身体化因子得分最高,恐怖因子得分最低,平均为2.13±0.78。总体来看人际关系敏感、抑郁、恐怖、焦虑、敌对五个因子得分相对较高。结论传染科护理人员存在比较严重的心理问题。建议医院和科室考虑制定相关方案进行心理干预,同时传染科护理人员也应主动学习一些心理应激知识,提高个人心理应激能力。     

Spaces and networks of genetic knowledge making: the 'geneticisation' of heart disease

The 'geneticisation' of health, medicine and the body is extending from single-gene to multi-factorial conditions such as heart disease. Adopting 'Actor Network Theory', the paper argues that the making of genetic knowledge occurs in spaces and networks where contested knowledges necessarily produce a geneticisation that is neither certain nor complete. Drawing on empirical research in a coronary care unit in Glasgow, Scotland, the paper sets out the network of consultants, rehabilitation nurses and people with heart disease and others who collectively, through contestation and the marshalling of knowledges by prominent social actors, produce an understanding of the role of genes in heart disease.     

Results of a questionnaire about nurse students' smoking habits and knowledges in an Italian teaching school of nursing

Six-hundred and sixty-two nurse students (aged 25.2 ± 4.11 years; 153 were males) answered a self-administered, anonymous questionnaire about smoking habits and knowledges in a large urban Teaching School of Nursing. The overall response rate was 88%. Current smokers were 336 (51%), former smokers 80 (12%). Nurse students claimed to know the dangers of tobacco and nurse training seemed to modify the preferential source of information about tobacco smoking towards medical fonts; however, only a quarter of nurse students considered medical smoking cessation approaches as useful for quitting and advised patients with tobacco-related diseases against soking.     

护理质量评价体系的改进及其软件开发

通过对《军队医院护理质量主要评价指标》在运用过程中存在不足之处的分析,结合实际对原评价体系的评价方法,评价内容进行了补充和完善,形成了一套既能从宏观上全面反映医院护理质量达标情况。又能从微观上具体反映各临床科室护理质量达标程度及名次排列的评价体系,使护理质量管理更具针对性。在此基础上又介绍了研制出的适合医院护理工作特点的《护理质量综合评价》软件。     

The rhizome and the tree: a response to Holmes and Gastaldo

Abstract  This paper both welcomes and explores the recent article in Nursing Philosophy by Dave Holmes and Denize Gastaldo. Holmes and Gastaldo's paper introduced us to Deleuze and Guattari's philosophical concepts of 'arborescent thought' and 'rhizomatic thought', respectively. These concepts were used to illuminate and critique certain aspects of contemporary nursing theory and educational practice. Arborescent thought is held to stifle and constrain the development of the discipline of nursing, while rhizomatic thought is presented as a more fitting way forward across a diversity of knowledges and methods of inquiry. We are thus urged to engage in a metamorphosis from an arborescent way of thinking to a rhizomatic one. The paper below, while applauding the introduction of these concepts into nursing thought, raises some questions as to their proposed utility and relationship as given in the paper by Holmes and Gastaldo. This is done in a spirit of collaboration, motivated by a desire to further explore the philosophy of Gilles Deleuze (and Felix Guattari).     

Nursing diagnosis: as a part of the nursing care process

This paper introduces some current criteria on Webster's (1974) Nursing Diagnosis (Dx) and that of Waechter-Blake which describe what the process of identifying the particular problems and needs of the patient are and assess the resources for helping decision-making. The differences between Medical Dx and Nursing Dx as different and at the same time similar elements that overlap and supplement each other are established. The usefulness of nursing diagnosis is pointed out since it identifies the needs and problems, achieves a shortened connection of information, as a future basis for research. The paper shows the process by which the nursing diagnosis is made, lists the nurse's skill when making the Nursing Dx and finally describes the difficulties in formulating the Nursing Dx.     

特殊人群性病艾滋病健康教育及行为干预探讨

目的　了解特殊人群 (性病门诊就诊者 )性病艾滋病防治知识的掌握情况以及避孕套使用情况。　方法　通过性病门诊的预防性咨询及大众媒介宣传等方法进行健康教育干预。使用问卷调查方法获取基础和干预后资料。　结果　干预前对艾滋病基本知识的知晓率最低为 2 1.2 % ,最高为 78.3% ,经干预后均有不同程度的提高 (P<0 .0 5 )。同情和愿意帮助艾滋病感染者或病人的人数分别有 34.5和 8.9增加到 84 .9和 2 8.9 (P<0 .0 5 )。与普通性伴、商业性性伴发生性关系时 ,安全套的使用率分别由 37.5和 2 2 .1上升至 6 6 .7和 6 8.9 (P<0 .0 5 )。　结论　性病门诊的预防性咨询和大众媒介宣传可明显提高特殊人群安全套的使用率 ,从而减少该类人群经性传播而感染性病艾滋病的机会     

The "Nursing Home Compare" Measure of Urinary/Fecal Incontinence: Cross-Sectional Variation, Stability over Time, and the Impact of Case Mix

Objectives. To assess the impact of facility case mix on cross-sectional variations and short-term stability of the "Nursing Home Compare" incontinence quality measure (QM) and to determine whether multivariate risk adjustment can minimize such impacts.
Study Design. Retrospective analyses of the 2005 national minimum data set (MDS) that included approximately 600,000 long-term care residents in over 10,000 facilities in each quarterly sample. Mixed logistic regression was used to construct the risk-adjusted QM (nonshrinkage estimator). Facility-level ordinary least-squares models and adjusted R ² were used to estimate the impact of case mix on cross-sectional and short-term longitudinal variations of currently published and risk-adjusted QMs.
Principal Findings. At least 50 percent of the cross-sectional variation and 25 percent of the short-term longitudinal variation of the published QM are explained by facility case mix. In contrast, the cross-sectional and short-term longitudinal variations of the risk-adjusted QM are much less susceptible to case-mix variations (adjusted R ²<0.10), even for facilities with more extreme or more unstable outcome.
Conclusions. Current "Nursing Home Compare" incontinence QM reflects considerable case-mix variations across facilities and over time, and therefore it may be biased. This issue can be largely addressed by multivariate risk adjustment using risk factors available in the MDS.     

Book Reviews

Book review in This Article:
Working with young people — legal responsibility and liability , 3rd edn. by The Children's Legal Centre.
Royal College of Nursing Manual of Family Health — everyday care in the home by the Royal College of Nursing.
Unplanned Pregnancy: making the right choicefor you by Klein D. & Kaufman T Penguin, Harmondsworth
Cerebral palsy — the child and young person edited by Lesley Cogher, Elizabeth Savage & Michael F. Smith.     

不同性格类型的女大学生经前期综合征相关知识及态度分析

目的:探讨不同性格类型的女大学生对于经前期综合征(premenstrual sysdrome,PMS)的相关知识及态度的差别。方法:以西安医学院1年级973名女大学生为研究对象。使用的研究工具包括:艾森克人格问卷(Eysenck Personality Questionnaire:EPQ)、月经态度问卷(Menstrual Attitude Questionnaire:MAQ)以及月经知识问卷。利用SPSS 15.0来进行统计学分析。结果:不同性格类型的女大学生PMS相关知识及态度存在差异。内外向不稳定性格的女大学生比内外向稳定性格的女大学生月经态度分数高,同时外向不稳定性格的女大学生的月经知识分数比内向稳定性格的分数高。结论:性格类型对女大学生PMS相关知识和态度有一定的影响。     

Decision‐making and accountability: differences of distribution

The cognitive and individual framing of clinical decision‐making has been undermined in the social sciences by attempts to reframe decision‐making as being distributed. In various ways, shifts in understanding in social science research and theorising have wrested clinical decision‐making away from the exclusive domain of medical practice and shared it throughout the healthcare disciplines. The temporality of decision‐making has been stretched from discrete moments of cognition to being incrementally built over many instances of time and place, and the contributors towards decision‐making have been expanded to include non‐humans such as policies, guidelines and technologies. However, frameworks of accountability fail to recognise this distributedness and instead emphasise independence of thought and autonomy of action. In this article I illustrate this disparity by contrasting my ethnographic accounts of clinical practice with the professional codes of practice produced by the General Medical Council and the Nursing and Midwifery Council. I argue that a ‘thicker’ concept of accountability is needed; one that can accommodate the diffuseness of decision‐making and the dependencies incurred in collaborative work.     

干部病房护生静脉穿刺遭拒的原因分析及对策

目的调查和分析干部病房实习护生静脉穿刺遭拒的原因，提出对策。方法对52名干部病房实习护生148次遭拒情况进行分析。结果实习护生静脉穿刺遭拒与患者及家属的认知有关，与实习护生自身素质有关。结论实习护生应尊重患者及家属的选择，努力提高穿刺技术，学习并熟练掌握静脉穿刺方法，技巧等，不断总结经验，力争取得更高的成功率。     

干部病房护生静脉穿刺遭拒的原因分析及对策

目的调查和分析干部病房实习护生静脉穿刺遭拒的原因,提出对策。方法对52名干部病房实习护生148次遭拒情况进行分析。结果实习护生静脉穿刺遭拒与患者及家属的认知有关,与实习护生自身素质有关。结论实习护生应尊重患者及家属的选择,努力提高穿刺技术,学习并熟练掌握静脉穿刺方法,技巧等,不断总结经验,力争取得更高的成功率。     

Nursing assistance to a patient with diabetes mellitus

It's a case study, developed in a Health Center, of the Federal District, with the purpose of describing the Nursing Attendance to a patient with Diabetes Mellitus. To develop this study the Nursing Process was applied, in the stages: Data Collection; Nursing Diagnoses; Planning; Interventions and Evaluation of the given assistance. It were found the following Diagnoses: Ineffective control of the therapeutic regimen; prejudiced Adaptation; disturbed image Corporal and Risk for the Integrity of Harmed Skin. The nursing assistance Planning sought mainly to contribute for the adhesion to the treatment and to reduce potential risks, making use of the health education. With the interaction and the use of the therapeutic communication, a small change was observed in the habits of the patient's life.     

On the tracks of ethnography: reflections on nursing knowledge

This study presents a reflection on ethnography, as a means for developing knowledge in nursing. From the anthropologic conception of ethnography, and the comparison of a few studies by nurses who have used ethnography as a method/methodology in their research, considerations are made about problem solving techniques, the theoretical framework, the option for ethnography as a methodological mean, the conception and involvement with fieldwork and the ethnographic text developed within the nursing care setting. A few implications are then presented, making possible to perceive a special way "ethnonursing" has to contribute towards the discipline of Nursing.     

汕头市1995-2005年甲乙类传染病流行趋势分析

目的为了解汕头市近11年甲乙类传染病的流行情况,分析发病特点及流行趋势,为传染病预防和控制措施提供科学的依据。方法收集1995-2005年汕头市甲乙类传染病疫情资料,采用描述流行病学方法进行分析。结果1995-2005年汕头市报告甲乙类传染病21种63993例,年平均发病率为131.96/10万;历年发病率波动在86.55/10万～160.84/10万之间;发病呈下降趋势。年均发病率居前五位的依次是肺结核、病毒性肝炎、淋病、痢疾、伤寒。肠道传染病由1995年的44.16/10万下降到2005年的19.71/10万,呈明显下降趋势;以肺结核为主导的呼吸道传染病波动较大,1998年和2005年出现二个发病高峰。2000年和2002年本市部分地区曾发生登革热局部流行。结论近11年来,汕头市甲乙类传染病发病情况呈下降趋势。疾病谱以肠道传染病为主转为以呼吸道传染病为主。本市今后传染病防制的重点是在加强以肺结核为主的呼吸道传染病的防治的基础上,进一步加大对以登革热为主的虫媒传染病的监测和防控力度。     

福建省青少年生殖健康相关知识调查

目的:了解青少年性传播疾病、艾滋病相关知识的知晓率与对性知识的需求,探讨预防性传播疾病与艾滋病的干预措施。方法:按性别及青春期年龄进行整群抽样,10～21岁青少年4 067人,男性1 931人,女性2 136人。相关资料用SPSS 13.0软件进行统计分析。结果:男、女性对性传播疾病与艾滋病相关知识的知晓率均随年龄的增加而增高;男、女性性传播疾病相关知识知晓率不同,差异有统计学意义(χ2=30.83,P<0.05);女性的艾滋病相关知识知晓率比男性高,差异有统计学意义(χ2=26.47,P<0.05)。青春晚期的男、女性对性知识的需求分别为59.9%、62.2%。35.96%的女性和63.39%的男性对婚前性行为持宽容态度。结论:青春期生殖健康教育的首要策略是满足青少年的性知识需求;预防性传播疾病、艾滋病的相关知识还需进一步深入校园。     

Making sense of 'gender': from global HIV/AIDS strategy to the local Cambodian ground

Interventions aiming to promote gender equality are a common feature of global HIV/AIDS policies. To develop effective interventions, it is important to understand how globally established concepts (e.g. 'gender') are (re)interpreted and legitimated locally. This paper examines what happens when the concept of 'gender' hits the local ground in the context of an internationally funded HIV/AIDS intervention in Cambodia. Interviews with participants reveal that 'gender' is itself understood to mean equal rights. Some elements of this concept are rejected as inapplicable in Khmer society, while others are hybridised with existing knowledges. The analysis demonstrates how relational, symbolic and material dimensions of the place into which HIV/AIDS programmes intervene shape not only what 'sense' participants make of new knowledge, but also their capacity to use it. Further, the paper argues that to achieve the desired health-enhancing outcomes, international health organisations must avoid essentialising local spaces as static and 'traditional'; rather, they must attend to and build on the ambiguities of existing knowledges and the changing dynamics of the places they enter.     

河北、广东省预防接种副反应监测试点培训效果评估

目的对2004年3月在河北、广东两个预防接种副反应(AEFI)监测试点省,举办的省、市级AEFI监测师资人员培训班的培训效果进行评估。方法对参加培训的省、市级计划免疫工作人员进行了培训前后现场问卷调查,采用统一设计的问卷以匿名方式评估培训效果。结果培训后河北、广东省的计划免疫工作人员对《AEFI监测试点工作指南》、AEFI报告与监测相关知识的掌握程度有显著提高,几乎所有参加培训的人员(97.25%)形成的共识是,有必要开展AEFI监测试点工作,但需要尽快完善相关法律、法规,并建立适用的补偿机制。结论开展AEFI培训十分必要,此次培训内容适合实际工作需要。但参加培训人员对部分知识和技能的了解仍存在着盲点,需要在今后的培训中进一步加强。