家长参与式管理对代谢综合症出院患儿的影响

目的探讨家长参与式管理在代谢综合症出院患儿中的应用效果。方法按入院的先后顺序将46例代谢综合症患儿分为观察组和对照组,每组各23例,患儿住院期间实施健康教育和生活方式指导,出院后观察组实施家长参与式管理,对照组患儿定期到医院就诊。干预6个月后,评价两组患儿生活方式、体格指标和血压、生化指标的情况。结果观察组患儿生活方式优于对照组(均P0.01);腰围、血压、血清总胆固醇(serum total cholesterol,TC)、甘油三酯(trilaurate glycerin,TG)及低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)降低情况和高密度脂蛋白胆固醇(high density lipoprotein cholester,HDL-C)增高较对照组明显(均P0.01)。结论家长参与式管理可改善代谢综合症出院患儿生活方式,降低其体重和血脂水平,从而提高疾病治疗效果。     

临床护理路径用于剖宫产病人护理的可行性探讨

探讨临床护理路径在剖宫产病人护理中的可行性,阐述了临床护理路径实施的步骤以及临床意义。临床护理路径的应用确保了医疗护理质量,降低了医疗成本,提高了病人满意度。     

临床护理路径用于剖宫产病人护理的可行性探讨

探讨临床护理路径在剖宫产病人护理中的可行性，阐述了临床护理路径实施的步骤以及临床意义。临床护理路径的应用确保了医疗护理质量，降低了医疗成本，提高了病人满意度。     

Nurses' moral agency in negotiating parental participation in care

The purpose of this study was to investigate the issues for nurses in facilitating parental participation in the care of the hospitalized child. A qualitative study informed by grounded theory was undertaken. Nine nurses were recruited from an acute, high-dependency, 23-bed paediatric cardiac/renal unit in Melbourne, Australia. Data collection involved individual semistructured interviews, hospital policies related to family-centred care and a focus group interview. Constant comparative analysis was undertaken to develop an understanding of the data collected in the context of the nurses' experiences and the environment in which they work. Moral agency was identified as the central phenomenon of the study. Causal conditions related to this included the child's best interests, disputes about care and nurses' expectations. These causal conditions were seen to potentially lead to moral distress for the nurses. The coping mechanisms and strategies that affected moral agency have been identified.     

Hindrance for patient participation in nursing care

THE STUDY'S RATIONALE: Patients' influence in health care through participation, freedom of choice and information, is laid down in laws, national and local directives. In nursing care situations, the degree to which a patient participates depends on the nursing staff. Accordingly, hindrances for patient's participation during nursing care is an important question for the nursing profession. AIMS AND OBJECTIVES: The aim was to focus on Swedish Registered Nurses opinion of hindrances for patient participation in nursing care and to uncover the informants' perspectives in depth. METHODOLOGICAL DESIGN AND JUSTIFICATION: The study was limited to inpatient somatic care and has a qualitative approach. Data were collected through seven focus group interviews with 31 Registered Nurses from five hospitals. An analysis of the tape-recorded interview material was made, combining elements of content analysis with aspects of the Grounded Theory approach. ETHICAL ISSUES AND APPROVAL: The ethics of scientific work was followed. The participants gave informed consent. Verbal and written information was given as a guarantee that all information would be treated confidentially outside the focus group. Formal approval by ethical committee was not required according to national and local directives. RESULTS: Hindrance for patient participation in nursing care comprised three themes: Competence, Influence of significant others and Organization and work environment, and their seven underlying subthemes. CONCLUSIONS: The study clarified factors, which individually or combined may be hindrance for patient participation in nursing practice. Professional nurses must be able to find a balance for their patients' participation in nursing care activities through identification and coping with the hindrances. The three themes and seven subthemes here identified, can be used in patient care and its' evaluation, like also quality assurance of care and work organization and in nursing education. For further development replication studies are needed, like additional studies of patients and significant others.     

家长参与下互动式护理模式对小儿哮喘吸入剂治疗效果的影响

目的 探讨家长参与下互动式护理模式对小儿哮喘吸入剂治疗效果的影响。方法 纳入 2019 年 1 月至 2021 年 1 月支气管 哮喘患儿 74 例作为研究对象。随机分为对照组和干预组,每组各 37 例。对照组予以常规吸入剂用药指导,干预组予以家长参 与下互动式护理模式。观察对比两组吸入剂使用相关知识掌握情况、哮喘吸入剂不正确使用情况和满意度。结果 干预组吸入 剂使用相关知识掌握情况优于对照组,差异有统计学意义（P＜0.05）。干预组吸入剂不正确使用率（2.70%）低于对照组（18.92%）, 差异有统计学意义（P＜0.05）。干预组的护理满意度为 100.00%,显著高于对照组的 86.49%（P＜0.05）。结论 家长参与下互 动式护理模式可以促进吸入剂使用相关知识掌握,促进小儿哮喘吸入剂的正确使用,提高护理满意度高,值得推广。     

1岁内住院患儿父母参与照护现状的调查研究

目的:了解1岁内住院患儿父母参与照护的现状,探讨其影响因素.方法:采用一般资料问卷及住院患儿父母参与照护问卷对105名1岁内住院患儿父母进行调查.结果:1岁内住院患儿父母参与照护问卷总分为(87.00±12.19)分,基础护理维度得分为(22.90±3.33)分,信息支持维度得分为(26.85±4.54)分,情感支持维度得分为(37.25±4.97)分;与患儿的关系及是否为主要照顾者是影响患儿父母参与照护的主要因素.结论:1岁内住院患儿父母在基础护理的参与照护能力上较高,但在信息支持的参与照护能力上较低,与患儿的关系、是否为患儿主要照护者是影响父母参与照护能力的主要因素.儿科护理人员应加强与父母间的沟通,为父母与医护人员互相协作、共同完成患儿的护理工作提供机会.     

An investigation into the feasibility of remotely monitored computer therapy for people with aphasia

The advent of telecommunications software and increased access to the Web have made feasible delivery of therapy without face-to-face contact between the person receiving therapy and the therapist, that is, remotely. This study investigates the practicalities of remotely monitored therapy for people with aphasia. It reports a case series involving seven participants. All were given access to a computer, modem, and therapy and communications software at home. Progress made in home practice was monitored remotely on a monthly basis by the speech and language therapist, and new exercises were assigned. The study sought to evaluate whether people with aphasia were able and willing to participate in therapy delivered this way, whether transfer of data and new exercises was possible usingexisting technology, and whether this mode of therapy delivery was effective in reducing therapist input in terms of time. Results indicate that this mode of therapy delivery has potential benefits in terms of saving therapy time and increasing intensity of practice for some people with dysphasia. However, benefits were offset by time-consuming processes associated with data transfer. It is therefore recommended that new software be developed to automate such processes to the benefit of both usersand therapists.     

An investigation into the feasibility of fetal lung maturity prediction using statistical textural features

Fetal lung and liver tissues were examined by ultrasound in 240 subjects during 24 to 38 weeks of gestational age in order to investigate the feasibility of predicting the maturity of the lung from the textural features of sonograms. A region of interest of 64 x 64 pixels is used for extracting textural features. Since the histological properties of the liver are claimed to remain constant with respect to gestational age, features obtained from the lung region are compared with those from liver. Though the mean values of some of the features show a specific trend with respect to gestation age, the variance is too high to guarantee definite prediction of the gestational age. Thus, we restricted our purview to an investigation into the feasibility of fetal lung maturity prediction using statistical textural features. Out of 64 features extracted, those features that are correlated with gestation age and less computationally intensive are selected. The results of our study show that the sonographic features hold some promise in determining whether the fetal lung is mature or immature.     

An exploratory investigation into the nursing management of aggression in acute psychiatric settings

The management of aggression in inpatient psychiatric facilities is a major concern for nurses. Despite the prevalence of research on aggression within psychiatric settings, very few studies have tracked the clinical management of identified patients in a systematic manner. The overall aim of this study was to explore the clinical management of patients identified as potentially aggressive in psychiatric inpatient settings. A multimethod approach was used to collect the data. This included surveys, focus groups, and a file audit of patients identified from a random sample of completed aggression incident forms. The findings indicated that 88% of nurses who participated in the survey were assaulted and indicated the need for risk assessment; team management and review; and the importance of the first 5 days of admission as crucial for assessment and review. The development of support structures, formal preceptoring and supervisory arrangements and postincident supports were suggested as part of an overall strategy to support nurses working in acute inpatient settings.     

以家庭为中心的护理模式对风湿性疾病患儿心理及家长照顾能力的影响

目的探讨以家庭为中心的护理模式对风湿性疾病患儿心理及家长照顾能力影响。方法选择2019年2—8月就诊的50例风湿性疾病患儿作为对照组,2019年9月—2020年2月就诊患儿50例作为观察组。对照组采用常规护理,观察组在对照组基础上给予以家庭为中心的护理模式干预,干预时间为3个月,比较干预前后两组患儿及其家长心理状态;采用主观生活质量问卷(ISLQ)评价两组患儿干预前后生活质量;采用照顾者照顾能力测量表(FCTI)评价两组患儿家长干预前后对患儿的照顾能力。结果干预后,观察组患儿及其家长SDS、SAS得分明显低于对照组,差异有统计学意义(P<0.05);患儿干预结束时、干预后3月ISLQ得分明显高于对照组,差异有统计学意义(P<0.05);患儿家长干预结束时、干预后3月FCTI得分明显低于对照组,差异有统计学意义(P<0.05)。结论以家庭为中心的护理模式能明显调节风湿性疾病患儿及其家长的心理状态,可改善患儿生活质量,提高患儿家长照顾能力。     

An investigation into how the health care assistants perceive their role as 'support workers' to the qualified staff

This qualitative study investigates the support worker's role as perceived by health care assistants (HCAs) who have undergone some training and National Vocational Qualification assessments The findings suggest that the HCAs consider that they support the trained nurses by acting as a link in the communication chain between the patient and carers, and by providing 'time' for the trained nurse to use in therapeutic activities The indications are that the HCAs perceive little difference between then roles and those of qualified nurses, and that they experience ambiguity as to their proper role The researcher sought to apply role theory in an inductive approach to data interpretation, from which it is posited that the HCAs' role ambiguity arises because the qualified nurses' own role lacks clarity and this affects their expectations of the HCA's role Having had some training, the roles are more ambiguous now than before as the HCAs are no longer untrained carers but nor are they qualified professionals It is also suggested that the qualified nurses perceive the HCAs as a threat to their own roles in that the HCAs are seen as depriving them of their 'real' nursing role, thus they are experiencing 'role deprivation' Recommendations to clarify role expectations and reduce role ambiguities are suggested to alleviate an avoidable source of stress for both the qualified nurse and the HCA     

Promoting nursing participation within primary care groups

This article describes the evaluation of a scheme to improve communication between primary care nurses and newly established primary care groups. Findings suggest that the successes of the scheme were in part attributable to the appointment of experienced practitioners to a facilitator/link nurse role and the sustained support of the scheme by the NHS community trust. The article concludes by suggesting that, in a time of constant change within primary care, innovations such as these contribute to the development of practitioner participation in the organization and delivery of primary care services.     

Patients' perceptions of barriers for participation in nursing care

Scand J Caring Sci; 2011; 25; 575–582
Patients’ perceptions of barriers for participation in nursing care Background: In many Western countries as in Sweden, patients have legal right to participate in own care individually adjusted to each patient’s wishes and abilities. There are still few empirical studies of patients’ perceptions of barriers for participation. Accordingly, there is a need to identify what may prevent patients from playing an active role in own nursing care. Such knowledge is highly valuable for the nursing profession when it comes to implementation of individual patient participation. Aim and objective: To explore barriers for patient participation in nursing care with a special focus on adult patients with experience of inpatient physical care. Methodological design and justification: Data were collected through 6 focus groups with 26 Swedish informants recruited from physical inpatient care as well as discharged patients from such a setting. A content analysis with qualitative approach of the tape‐recorded interview material was made. Ethical issues and approval: The ethics of scientific work was adhered to. Each study participant gave informed consent after verbal and written information. The Ethics Committee of Göteborg University approved the study. Results: The barriers for patient participation were identified as four categories: Facing own inability, meeting lack of empathy, meeting a paternalistic attitude and sensing structural barriers, and their 10 underlying subcategories. Conclusions: Our study contributes knowledge and understanding of patients’ experiences of barriers for participation. The findings point to remaining structures and nurse attitudes that are of disadvantage for patients’ participation. The findings may increase the understanding of patient participation and may serve as an incentive in practice and nursing education to meet and eliminate these barriers, in quality assurance of care, work organization and further research.     

Nurse strategies for optimising patient participation in nursing care

The study’s rationale: Patient participation is an essential factor in nursing care and medical treatment and a legal right in many countries. Despite this, patients have experienced insufficient participation, inattention and neglect regarding their problems and may respond with dependence, passivity or taciturnity. Accordingly, nurses strategies for optimising patient participation in nursing care is an important question for the nursing profession. Aim and objective: The aim was to explore Registered Nurses’ strategies to stimulate and optimise patient participation in nursing care. The objective was to identify ward nurses’ supporting practices. Methodological design and justification: A qualitative research approach was applied. Three focus groups with experienced Registered Nurses providing inpatient somatic care (n = 16) were carried out. These nurses were recruited from three hospitals in West Sweden. The data were analysed using content analysis technique. Ethical issues and approval: The ethics of scientific work was adhered to. According to national Swedish legislation, no formal permit from an ethics committee was required. The participants gave informed consent after verbal and written information. Results: Nurse strategies for optimising patient participation in nursing care were identified as three categories: ‘Building close co‐operation’, ‘Getting to know the person’ and ‘Reinforcing self‐care capacity’ and their 10 subcategories. Conclusions: The strategies point to a process of emancipation of the patient’s potential by finding his/her own inherent knowledge, values, motivation and goals and linking these to actions. Nurses need to strive for guiding the patient towards attaining meaningful experiences, discoveries, learning and development. The strategies are important and useful to balance the asymmetry in the nurse–patient relationship in daily nursing practice and also in quality assurance to evaluate and improve patient participation and in education. However, further verification of the findings is recommended by means of replication or other studies in different clinical settings.