专业自我概念在护理人群中的应用现状

介绍了专业自我概念概述、在护理人群中的应用现状及提高专业自我概念的对策，旨在提高护理人群的专业自我概念，提升护理质量，更好地服务于临床。     

护理实习生专业自我概念的影响因素分析

目的调查护理实习生的专业自我概念水平,并分析心理困扰、自我效能对护理实习生专业自我概念的影响。方法采用护理专业自我概念量表、中文版简易心理状况评定量表以及一般自我效能感量表对262名护理实习生的专业自我概念、心理困扰以及自我效能水平进行问卷调查。结果护理实习生的专业自我概念水平整体趋于积极,学生干部经历、心理困扰和自我效能是护理实习生专业自我概念的影响因素(P<0.05)。结论护理教育者应当注重护理实习生的心理健康教育和自我效能提升,以帮助其提高护理专业自我概念水平。     

护理本科实习生前瞻适应与专业自我概念的相关性研究

[目的]探讨护理本科实习生前瞻适应与专业自我概念的关系,为护理教育者或管理者提高护生的专业自我概念提供参考意见。[方法]应用前瞻适应量表和护理专业自我概念量表对267名护理本科实习生进行调查。[结果]护理本科实习生前瞻适应条目得分为3.09分±0.41分,专业自我概念条目得分为2.83分±0.49分。护理本科实习生前瞻适应与专业自我概念呈正相关(P0.01),且前瞻适应能预测专业自我概念。[结论]护理本科实习生前瞻适应较好,专业自我概念积极,且前瞻适应能有效预测本科实习生的专业自我概念,护理教育者或管理者应加强实习护生的前瞻适应引导以加强专业自我概念建设。     

护理大专生临床实习环境与专业自我概念的相关性研究

目的了解护理大专生临床实习环境与专业自我概念现状,探讨二者之间的相关性。方法采用一般资料调查表、护理临床实习环境评价量表、护理专业自我概念量表对214名护理大专生进行问卷调查。结果护理大专生临床实习环境总分(118.08±17.27)分,处于较满意水平;护理专业自我概念总均分为(13.23±1.61)分,处于较积极水平;护理大专生临床实习环境与专业自我概念呈正相关(P0.01或P0.05)。结论临床实习环境对于专业自我概念具有正向预测作用,改善护理大专生客观临床实习环境,有助于提高其专业自我概念。     

三级甲等医院ICU护士工作沉浸体验与专业自我概念的相关性分析

目的：探讨三级甲等医院ICU护士工作沉浸体验与专业自我概念的关系,为护理管理者对ICU护士进行沉浸干预提供参考意见。方法对387名ICU护士应用？中文版沉浸体验量表？和？护理专业自我概念量表？进行测试。结果沉浸体验和专业自我概念分值为（4.01±0.45）分和（2.89±0.48）分,沉浸体验和专业自我概念呈正相关,以沉浸体验9个维度为自变量,专业自我概念为应变量,沉浸体验5个维度能预测专业自我概念。结论三级甲等医院ICU护士工作沉浸体验程度较高,专业自我概念大部分为积极;工作沉浸体验能预测专业自我概念,护理管理者应对ICU护士进行沉浸干预以提高其专业自我概念积极性。     

本科护生实习前压力与护理专业自我概念的相关性研究

[目的]了解本科护生实习前的压力状况和护理专业自我概念水平,探讨本科护生实习前的压力状况与护理专业自我概念的关系,为培养护生积极的专业自我概念及采取有效措施缓解护生实习前压力提供理论依据。[方法]采用护理专业本科生实习前压力源及压力水平量表、护理专业自我概念量表(PSCNI)对104名实习前本科护生进行问卷调查。[结果]本科护生实习前压力得分为2.43分±0.51分,处于中度压力水平;护理专业自我概念得分为2.84分±0.28分,具有较为积极的专业自我概念水平;本科护生护理专业自我概念与其实习前压力水平呈负相关(r=-0.290,P0.05)。[结论]护理专业自我概念对本科护生实习前压力水平有影响,学校和实习医院应积极培养本科护生良好的专业自我概念,采取针对性措施缓解本科护生实习前压力,帮助其树立良好心态,提高临床实习效果。     

供应室护士时间管理倾向与专业自我概念的调查研究

目的:探讨供应室护士时间管理倾向和专业自我概念的关系,为护理管理者提高护士的专业自我概念提供参考意见。方法:对151名供应室护士运用《时间管理倾向量表》和《护理专业自我概念量表》进行测试。结果:时间管理倾向均分(3.35±0.58)分;专业自我概念均分(2.95±0.44)分;时间管理倾向3个维度及总分与专业自我概念5个维度及总分呈显著正相关(P<0.05)。结论:供应室护士时间管理倾向为中等水平,专业自我概念是积极的;时间管理倾向与专业自我概念显著相关,护理管理者可对供应室护士提供必要的培训以进一步发展护士的专业自我概念。     

临床护理教师胜任力与专业自我概念的相关性研究

[目的]调查临床护理教师胜任力与专业自我概念现状,并了解二者的相关性,为提高临床护理教学质量提供依据。[方法]采用护理专业自我概念量表和临床护理教师胜任力量表对136名三级甲等医院临床护理教师进行调查。[结果]临床护理教师胜任力总分为140.81分±21.58分,其中职业素质得分最高,教学能力得分最低;专业自我概念总均分为84.04分±10.98分,处于积极水平;教师胜任力总分及各维度得分与专业自我概念总分呈正相关(P0.01)。[结论]医院应注重培养临床护理教师的专业自我概念,从而提高其胜任力,为保证临床护理教学质量、培养适应当今社会的应用型护理人才提供有力保障。     

珠三角地区口腔门诊护士专业自我概念工作满意度现状及相关性研究

目的了解口腔门诊护士的专业自我概念与工作满意度水平,并探讨两者的相关性,为提高护士积极的专业自我概念和工作满意度提供依据。方法采用护理专业自我概念量表、护士工作满意度量表对珠三角地区18家医院共283名从事口腔门诊工作的护士进行测评。结果本组护士专业自我概念总分为(88.54±9.68)分,工作满意度总分为(101.03±15.96)分;护士的专业自我概念总分及其技能、领导、沟通交流、灵活性、满意度5个维度得分与工作满意度呈正相关关系(r=0.171～0.502,P<0.01)。结论口腔门诊护士的专业自我概念和工作满意度水平较高,专业自我概念对其工作满意度有积极影响。医院应培养护士对护理专业的热爱,提高其职业意识,建立积极的专业自我概念,从而提高护士工作满意度,稳定护理队伍,为促进学科的发展奠定基础。     

艾滋病科护士专业自我概念与工作满意度相关性研究

目的:探讨艾滋病科护士专业自我概念与工作满意度的关系,为提高艾滋病科护士专业自我概念和工作满意度提供理论依据。方法:采用护理专业自我概念量表(PSCNI)、护士工作满意度量表(MMSS)对广东省6家艾滋病定点医院的188名护士进行问卷调查。结果:艾滋病科护士专业自我概念总分为(83.36±10.69)分,工作满意度总分为(94.39±15.54)分;工作满意度与专业自我概念的管理能力、专业技能、灵活性、满意度呈显著正相关(P0.01),与专业自我概念的沟通能力无相关性。结论:艾滋病科护士的专业自我概念水平和工作满意度较高。专业自我概念中管理能力、专业技能、灵活性、满意度是工作满意度的影响因素。医院应培养护士积极的专业自我概念,从而提高护士工作满意度,发挥护士工作积极性和创造性,促进艾滋病护理专业的发展。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

手转胎头术失败的原因与分娩结局临床分析

目的 探讨手转胎头术失败的原因与分娩结局.方法 选择2008年1月至2010年12月于我院住院分娩的持续性枕横位、枕后位产妇198例,根据行手转胎头术后结果分为成功组126例、失败组72例.比较两组分娩结局,对比分析失败原因.结果 失败组胎儿体质量≥3500 g的发生率[76.4％(55/72)]明显高于成功组[31.7％(40/126)],差异有统计学意义(x2=30.177,P=0.001)、失败组宫缩乏力发生率[58.3％(42/72)]高于成功组[38.1％ (48/126)],差异有统计学意义(x2=7.569,P=0.006)、失败组骨盆临界或轻度狭窄发生率[38.9％ (28/72)]高于成功组[23.8％(30/126)],差异有统计学意义(x2 =5.030,P=0.002)、失败组手转胎头时机不当(宫口开大＜6 cm、胎头位于坐骨棘上及宫口开大8～10 cm、胎头位于坐骨棘下≥2 cm)发生率[61.1％(44/72)]高于成功组[38.9％(49/126)],差异有统计学意义(x2=9.084,P=0.003).失败组母儿并发症(产后出血、产褥病率、胎儿窘迫、新生儿窒息)发生率高于成功组(x2 =9.586,P=0.002、x2=9.334,P=0.002、x2=5.910,P=0.015、x2=5.240,P=0.022)、失败组剖宫产发生率[72.2％(52/72)]明显高于成功组[34.1 ％(43/126),x2=26.641,P=0.001)].结论 手转胎头术能使难产变顺产,降低剖宫产率,减少母儿并发症,但须积极预防、处理导致手转胎头术失败的原因,对矫正失败后继续矫正及试产应慎重.