军队离退休人群社区护理需求及相关因素的调查

目的探讨军队离退休人群社区的护理需求。方法采用调查问卷形式对240例军队离退休人员社区护理需求进行统计分析。结果240例被调查者均有不同程度的社区护理需求,其中198例对社区护理需求较为急迫。对社区护理的需求量与月平均收入水平、文化程度呈显著正相关(P<0.05),与年龄呈显著负相关(P<0.05)。对社区护理需求的急迫程度与月平均健康消费水平、所患疾病对日常生活的影响呈显著正相关(均P<0.05)。结论军队离退休人群具有极高的社区护理需求。     

护理专业大专女生性观念与心理健康相关因素的分析

目的探讨护理专业大专女生性观念与心理因素之间的关系,为开展有效的青春期性教育提供科学依据。方法对1093名护理专业大专女生进行性观念问卷调查和症状自评量表（SCL-90）测试。结果本组有35．1％在谈恋爱,有38．2％赞同婚前性行为,有9．7％赞同婚外性行为。与国内常模比较,各心理因子分值均较高（P〈0．01）。进一步的多变量分析结果表明,偏执因子与本组恋爱行为呈显著正相关（P〈0．05）;敌对及偏执因子与本组婚前性行为观念呈显著正相关（P〈0．05）;偏执及精神病性因子与本组婚外性行为观念呈显著正相关（P〈0．05）,而人际关系敏感因子则呈显著负相关（P〈0．05）。结论在对护理专业大专女生进行青春期性教育时,不可忽视心理因素的影响;对偏执、敌对及精神病性因子较高的女生,需要结合其他形式进行教育。     

护理人员与患者对护理服务需求认知比较

【目的】探讨护理人员与患者两者之间对护理服务需求的认知。【方法】采用住院病人护理需求调查表,对本院100位护理人员进行护理服务需求认知调查,对109位患者进行护理服务需求认知及护理服务需求满意度调查。【结果】不同性别患者之间护理需求均无显著性差异（P均〉0．005）;文化层次高的病人自尊及自我实现的需要均显著高于文化程度较低者（P〈0.01,P〈0．05）;收入较高者自尊需求得分高于收入较低者（P〈0．05）;不同交费方式的两组各项评分均无显著差异性（P〉0．05）,按照（14～44）岁、（45～64）岁、65岁以上三个不同年龄段病人五个方面的需要比较均无显著性差异（P均〉0．05）;护理需求五大项中与护理提供各子项均有显著性差异（P〈0．01）。【结论】护理人员必须以患者的需求为导向,不断调整工作方法,规范护理服务行为,使护理水平得以全面的提高。     

军队离退休老年患者情绪状况与领悟社会支持的相关性研究

目的了解军队离退休老年患者领悟社会支持水平与其正负性情绪状况,并探讨两者之间的相关性。方法采用一般资料调查表、领悟社会支持量表、正性负性情绪量表对住院期间50名军队离退休老年患者进行调查。结果军队离退休老年患者正性情绪得分范围为10—43分,均值为（29．88±6．54）分;负性情绪得分范围为10—32分,均值为（14．33±4．84）分,正性情绪与负性情绪之间没有相关性（r=-0．22,P〉0．05）,说明正负性两种情绪是相对独立而并存的。正性情绪得分小于30分者占60％,说明该得分人群正性情绪得分不高。领悟家庭外支持与正性情绪呈显著正相关（r=0．451,P〈0．01）,而领悟家庭内支持则与负性情绪呈显著负相关（r=-0．268,P〈0．05）。结论军队离退休老年患者正性情绪相对不足,护理人员与军队相关部门应关注军队离退休老年患者的情绪状况,在已有的较好的家庭内支持的基础上,帮助建立良好的家庭外社会支持系统,以增长军队离退休老年患者的正性情绪,提高其生活质量。     

社区护理干预对糖尿病治疗效果的影响

目的：探讨社区护理干预对糖尿病治疗效果的影响。方法：将163例糖尿病患者随机分为研究组80例和对照组83例，研究组在药物治疗基础上给予社区护理干预，对照组仅给予药物治疗。3个月后随访，比较两组患者行为方式的改变和治疗效果。结果：研究组患者治疗3个月后生活方式明显优于对照组（P〈0．05，P〈0．01），各项生理指标及生活满意度显著优于对照组（P〈0．05，P〈0．01）。结论：针对性的社区护理干预能有效地提高糖尿病的治疗效果，提高患者的生活满意度，改善患者的生活质量。     

综合护理干预对离退休干部2型糖尿病患者降糖效果的影响

目的探讨综合护理干预对离退休干部人群中2型糖尿病患者的降糖效果的影响。方法选取来我院疗养且患有2型糖尿病的离退休干部80例,采用综合护理干预模式进行健康管理,比较干预前、干预后（出院前1d、出院后1个月、出院后3个月）空腹血糖（FPG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbAlc）及治疗依从性情况。结果干预后FPG、2hPG、HbAlc水平均较干预前有明显降低（P〈0．01）,治疗依从性指标均有明显提高（P〈0．01）,其中遵医用药、饮食控制差异有统计学意义（P〈0．01）。结论综合护理干预有利于提高离退休干部人群中2型糖尿病患者治疗的依从性,降糖效果明显。     

影响化疗患者心理健康相关因素调查与护理干预

目的探讨化疗患者的心理健康状况及其相关影响因素，为实施护理干预提供依据。方法采用症状自评量表及自拟调查问卷，对在我院接受化疗的30例恶性肿瘤患者（化疗组）和30例其他疾病住院患者（对照组）的心理健康状况进行测评分析。结果症状自评量表评分，两组总分及各因子分比较均无显著性差异（P〉0．05）；化疗组心理健康水平较差者占16．67％，症状自评量表评分前三位排序为躯体不适、强迫和抑郁；化疗组在接受化疗过程中出现的副作用与总分、总症状指数、阳性项目数、人际关系、抑郁、焦虑、偏执、精神病性得分均呈显著正相关（P〈0．01～0．05）；探视次数与总分、总症状指数、阳性项目数、躯体化、强迫症状得分呈显著负相关（P〈0．05）；病程长短及患病时的自理状况与躯体化因子分呈显著正相关（P〈0．05）。整体化护理及健康教育干预，能显著提高化疗患者的心理健康水平。结论恶性肿瘤患者在化疗过程中的副作用、探视次数、病程长短及自理状况对其心理健康状况均有不同程度的影响。深入开展整体化护理，有针对性的进行护理干预和健康教育，有利于提高患者的心理健康水平和生活质量。     

突发性耳聋患者护理需求调查报告

目的调查突发性耳聋患者护理需求,为临床护理提供依据。方法采用问卷调查对85例突发性耳聋的患者进行护理需求状况调查,并比较不同性别、年龄及学历患者护理需求的差异。结果患者总需求为（3．42±0．76）分,其中对听力恢复程度、疾病所需疗程及治疗方法的护理需求最高,分别为（3．77±0．43）分、（3．60±0．58）分,和总需求比较,差异有统计学意义（P〈0．05）。不同性别、年龄及学历护理需求差异有统计学意义（P〈0．05）。结论突发性耳聋患者护理需求较高且不同患者群体需求亦有不同,应根据人群的不同有针对性地加强心理护理。     

循证护理对气压弹道碎石术患者术后疼痛及并发症的影响

目的探讨循证护理对气压弹道碎石术患者术后疼痛及并发症的影响。方法选取住院治疗的肾结石患者100例,随机分为对照组和观察组,两组均采用气压弹道碎石术进行治疗。对照组患者气压弹道碎石术后采用常规护理,观察组在对照组的基础上采用循证护理,观察两组患者术后的疼痛程度、并发症的发生率、满意度和住院时间。结果观察组术后的疼痛程度显著低于对照组（P〈0．05）,并发症显著少于对照组（P〈0．05）,满意度显著高于对照组（P〈0．05）,住院时间显著短于对照组（P〈0．05）。结论循证护理有利于减少气压弹道碎石术患者术后疼痛程度和并发症,提高患者护理满意度。     

APACHE II评分在脊柱手术患者中的护理干预指导分析

目的探讨APACHEⅡ评分在脊柱手术患者中的护理干预指导方法与效果。方法脊柱手术患者30例在护理前进行APACHEⅡ评分,观察预后死亡情况,同时使用护理活动评分（NAS）对护理干预进行评价。结果经过治疗与护理后,存活27例,死亡3例,死亡率为10．0％。同时APACHEⅡ不同分数段脊柱手术患者病死率与NAS得分随着APACHEⅡ分值的升高而增加（P〈0．05）。通过Pearson相关分析,APACHEⅡ得分与NAS得分呈显著正相关（P〈0．05）。结论APACHEⅡ评分能较好地评估脊柱手术患者病情的严重程度,在预测护理工作量有较好的应用价值。     

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。     

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.     

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     

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。     

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。     

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。