Awareness of music therapy practices and factors influencing specific theoretical approaches

The investigator identified music therapists' theoretical awareness of their practices and analyzed factors influencing their specific theoretical orientations and models. A 2-page survey was mailed to 500 board-certified music therapists in the United States; 272 returned surveys were analyzed. Data analysis revealed that respondents': (a) adoption of current theoretical approaches is contingent on the attended college, area of practice, and their age groups; (b) work satisfaction is not a function of involvement with theoretical orientations but rather of their area of practice and attendance at national music therapy conferences; (c) involvement in music making is not a function of theoretical orientations but of academic degrees; (d) emphasis on client's musical growth and aesthetic quality of music was not a function of theoretical orientations or any other investigated factor; (e) satisfaction with past education was not a function of involvement with theoretical orientations but of the area of practice; (f) desire to expand their theoretical knowledge was not a function of theoretical orientations but of academic degrees.     

临床护士护理伦理决策能力现状及影响因素研究

目的 了解临床护士护理伦理决策能力的现状及影响因素,为提高临床护士的护理伦理决策能力提供依据.方法 随机抽取四川省5所三级甲等综合性医院的359名临床护士为调查对象,应用2007版护理伦理决策问卷(JAND)进行调查.结果 临床护士的护理伦理决策问卷总分为(267.91±16.62)分;两个维度得分为伦理选择(145.66±9.47)分、伦理行动(122.25±8.84)分.进入多元回归方程,各因素中,获取专业知识的途径对总分的影响最大,其次是学历和护理伦理决策培训.结论 临床护士的护理伦理决策能力有待提高,护理教育者及临床管理者应根据影响因素,通过多种途径提高临床护士的护理伦理决策能力.     

呼吸支持治疗在新生儿重病监护病房的应用及影响因素分析

目的探讨新生儿重症监护病房(NICU)中新生儿窒息相关疾病患儿应用呼吸支持进行抢救的临床效果及影响因素分析。方法回顾性分析2006年1月至2010年12月NICU采用呼吸支持治疗321例患儿的临床资料,分析患儿的各项指标。结果早产儿占全部病例的55.45%,足月产儿占44.55%。极低体质量儿占51.71%,低体质量儿占33.96%,正常体质量儿占14.33%。患儿无创机械通气前后的治疗效果进行比较差异有统计学意义(P<0.05)。经χ2检验,不同疾病通过机械通气治疗效果,差异具有统计学意义(P<0.05);发病1 h～3 d、4～7 d和8～21 d的患儿治愈率比较,差异有统计学意义(P<0.05);极低体质量儿、低体质量儿和正常体质量的患儿治愈率比较,差异有统计学意义(P<0.05)。所有患儿发生呼吸机相关肺炎39例和肺不张27例。结论医护人员只有综合分析患儿的全面病情,配合正确使用机械通气就能够有效救治NICU的危重新生儿。     

护生伦理决策能力培养及其影响因素研究进展

从课程设置及安排、教学模式、师资力量、评估方法和测量工具方面综述了国内外护生伦理决策能力的培养现状及其影响因素,提出提高护生伦理决策能力培养方法的建议,对伦理决策伦理培养的发展趋势进行展望.     

精神科护士临床决策意识现状及其影响因素研究

目的调查精神科护士临床决策意识现状,并分析其影响因素。方法采用一般情况调查表和护理临床决策量表对绍兴市两所精神病专科医院220名精神科护士进行问卷调查。结果精神科护士临床决策意识总分为(136.31±12.06)分,各维度得分分别为寻找解决问题的方法(34.88±3.52)分,确定解决问题的目标(33.50±4.04)分,反复评价实施效果(34.69±3.76)分,再次搜索相关信息(33.79±3.85)分。工作年限、精神科专科护士和领导支持工作是主要影响因素。结论精神科护士临床决策意识偏低,护理管理者要加大专科护士的培养,提供更多的外出学习机会,重视人文关怀,构建多元化、多方位的支持系统提升精神科护士的临床决策意识。     

消化内镜诊疗患者参与临床决策期望现状及影响因素（护理管理专题管理人文）

目的 了解消化内镜诊疗患者参与临床决策期望现状并分析其影响因素。 方法 选取长沙市某三级甲等综合医院进行消化内镜诊疗的患者作为研究对象,采用患者参与临床决策期望量表和病人参与能力量表对其进行调查,并进行临床决策期望影响因素的单因素和多元线性回归分析。 结果 消化内镜诊疗患者参与临床决策期望的总得分为(51.34±5.09)分,病人参与能力的总得分为(112.69±14.94)分。多元线性回归分析显示：病人参与能力、年龄、文化程度和就诊类型是患者参与临床决策期望的影响因素,解释总变异为41.0%。 结论 消化内镜诊疗患者参与临床决策的信息需求和交流需求较高,而决策需求偏低。消化内镜诊疗患者参与能力处于中等水平。不同参与能力、年龄、文化程度和就诊类型的患者参与临床决策的期望不同。     

Comparison of different methodological approaches to identify risk factors of nosocomial infection in intensive care units

OBJECTIVE: Comparison of statistical methods and measurement scales to identify nosocomial infection risk factors in intensive care units (ICU). DESIGN: Prospective study in 558 patients admitted to the ICU of a referral hospital between February and November 1994. METHODS: Analysis using three logistic regression models, three standard Cox regression models, and two Cox regression models with time-dependent extrinsic factors. Different scales were used to measure exposures to risk factors (dichotomous, ordinal, quantitative, and time-dependent variables). RESULTS: The most appropriate models were those that measured exposure using dichotomous variables. Models using ordinal or quantitative variables estimated biased coefficients and/or failed to comply with the statistical assumptions underlying the analyses. The Cox regression model with quantitative time-dependent variables met all the statistical assumptions, obtained a precise assessment of risk by exposure time, and estimated unbiased coefficients. CONCLUSIONS: The Cox regression analysis with quantitative time-dependent variables is the most valid alternative for assessing the risk of nosocomial infection per day of exposure to an extrinsic risk factor in the ICU.     

Reestablishing health: factors influencing the child's recovery in pediatric intensive care

This article presents a conceptual framework that examines five factors affecting the rate of recovery and return to health for critically ill children in pediatric intensive care. Stress, coping, development, social support, and immunocompetence are analyzed from a biopsychosocial perspective to gain a clearer understanding of how these variables interrelate to affect the child's ability to recover. The conceptual framework will assist the nurse in recognizing which children are at greatest risk for setbacks and delays in recovery.     

Biological approaches to cancer therapy

Advances in the biological approach to cancer therapy are reviewed. The mechanisms of actions, clinical effects and uses of interferons, the first biological modifiers to be used, are reviewed first. The interleukins and monoclonal antibodies are also mentioned in detail. This review also covers the clinical use and production of lymphokine activated killer cells, which are used in conjunction with interleukin-2. A brief review of tumour infiltrating lymphocytes, which comprise a subset of lymphocytes found within solid tumours is given. In mice, tumour infiltrating lymphocytes have been shown to be more therapeutic than lymphokine activated killer cells. Tumour necrosis factor, a protein released by activated macrophages in response to stimulation by endotoxin, is also briefly mentioned although clinical data are disappointing. Finally, the role which oncogenes may play in cancer therapy and understanding is discussed.     

Supramolecular approaches to biological therapy

Supramolecular chemistry is a useful methodology for construction of nano- or micro-sized objects and can significantly contribute to nanotechnology through so-called bottom-up processing. In addition, supramolecular self-assembled structures can mimic some aspects of biological systems. Bio-related functions such as molecular sensing, controlled release, signaling and materials separations have been realized. Supramolecular chemistry is a multidisciplinary field that includes subjects such as molecular design and nanosized materials. In this article recent examples of supramolecular chemistry in the context of biological therapy are introduced and classified into five categories: small supramolecular systems; designer polymers; self-assembled structures; predesigned assemblies; and nanomaterials. Finally, hierarchic organization of supramolecular structures for advanced functions is introduced to illustrate future directions of investigation. We hope that scientists studying therapeutic applications receive inspiration from this review to exploit the opportunities offered by supramolecular chemistry in their respective research areas.     

山西省9所三级甲等医院聘用护士重症监护能力及影响因素调查

[目的]了解临床聘用护士重症监护能力现状及影响因素。[方法]采用分层整群抽样方法,选取在山西省9所三级甲等医院临床工作的330名在编护士及388名聘用护士,用中文版护理行为六维度量表进行调查。[结果]在编护士与聘用护士重症监护能力评分比较差异有统计学意义(P<0.01),影响聘用护士重症监护能力的因素主要有护龄、月收入、婚姻状况、年龄和参与教学情况。[结论]山西省三级甲等医院聘用护士重症监护能力总体得分低于正式在编护士,各医院应通过多种途径提高聘用护士的整体能力,进而提高护理质量。     

河南省护理本科生职业决策困难现状及影响因素研究

目的调查河南省护理本科生职业决策困难现状,并分析其影响因素。方法采用一般资料问卷、职业决策困难问卷和简易应对方式问卷,对河南省381名全日制护理本科生进行问卷调查。结果河南省护理本科生的职业决策困难总均分为(2.89±0.63)分,在3个维度中,不一致信息得分最高(2.93±0.63)。多元回归分析显示,消极应对方式、年级、有无明确的工作意向是职业决策困难的影响因素。结论河南省护理本科生职业决策困难总体上处于中等水平,说明护理本科生在面临职业决策时存在一定程度的职业决策困难。应针对其影响因素,提出解决对策,改变本科生的职业决策困难现状。     

普外科患者手术决策困难的现状及影响因素分析

目的：探讨普外科患者手术决策困难的现状,并对影响因素进行分析。方法：选择普通外科择期手术患者186例,采集患者人口学及临床资料,采用手术决定感知困难评分评价患者手术决策困难程度,分析影响手术决策困难的独立危险因素。结果：术前不同身体状况、手术危险程度、心理健康状况、婚姻状况、教育程度及医疗付费方式的患者,手术决策困难程度差异有统计学意义（P＜0.05）,其中SCL-90评分是影响手术决策困难的主要因素（P=0.001）。结论：术前不同身体状况、手术危险程度以及心理健康状况、婚姻状况、教育程度及医疗付费方式会导致患者难于做出手术决策,其中负性心理因素是其主要影响因素。建议术前针对患者负性心理进行干预,以降低患者手术决策难度。     

重症监护室护士护患沟通影响因素的质性研究

目的探讨影响监护室护士护患沟通的因素。方法采用质性研究中的诠释现象学理论,对10名监护室护士深入访谈,将获得的资料进行分析、整理,归纳出主题。结果影响监护室护患沟通因素有监护室患者病情危重、护士知识缺乏、护理工作量大、护士非语言沟通技能缺乏、沟通环境不良。结论监护室护患沟通存在诸多影响因素,提升护士主动沟通意识和沟通技能,以提高监护室护理服务质量。     

Relationships, trust, decision-making and quality of care in a paediatric intensive care unit

Objective  To assess the care-giving practices of health-care practitioners in the paediatric intensive care unit (PICU) through their qualitative insights, reflections and experience in participatory action research. Design and methods  Qualitative research in the form of ‘participatory action research’ was used to gather data from three sources within the unit: focus groups within disciplines, observations within the PICU, and semi-structured interviews. All staff members were active collaborators and equal stakeholders in the decision-making process, research and feedback. Setting  The paediatric intensive care unit (PICU) of the Red Cross War Memorial Children’s Hospital (RCWMCH). Participants  All staff members from various disciplines working in the PICU. Results  Staff members described problems with respect to relationships, trust and decision-making within care-giving practices. Conclusion  The study qualitatively describes how poor communication amongst staff members in respect of relationships and decision-making impacted on trust and how this tended to compromise care-giving practices in the PICU. The data suggested that this was more evident in informal rather than formal clinical decision-making procedures. The strength of the study was that the participatory action design in the research allowed staff members to address the very dynamics that they themselves cited as problematic.     

The sedation practices of paediatric intensive care unit nurses and the influencing factors in China

Nurses play a key role in administering sedation to mechanically ventilated children, which impacts children's psychological, physiological and cognitive changes in the paediatric intensive care unit. This study aimed to survey the sedation practices of paediatric intensive care unit nurses on mechanically ventilated children in China and explored the influencing factors. A cross‐sectional survey was conducted based on electronic questionnaires comprised of the Nurse Sedation Practices Scale (Chinese version) in 14 different types of paediatric intensive care units of 11 academic hospitals in China from 15 February to 15 April 2017. A convenience sample of 495 nurses [73·4% response rate, (674)] completed the survey. Seven units applied Ramsay Sedation Scale as a sedative assessment tool. The majority of the nurses used observed behaviours and physiological changes of the ventilated children as indicators to assess the sedation level, and they had a positive attitude and intention, which may influence practice positively, whereas high clinical workload and the lack of communication between the nurses and families might hinder practice. The practice of sedation varied greatly in different regions, and the respondents of the northwest region scored lower. Paediatric nurses in China rarely used a validated paediatric instrument to assess sedation, and most nurses relied on physiological and behavioural cues. The quality of sedation training, nursing workload and regional economic disparity affected the sedation practice. The restricted visiting policy and lack of clearly defined nursing responsibilities around sedation may hinder effective sedation assessment and management. This study found that there was no paediatric‐validated tool popularized in paediatric intensive care units in China and explored influencing factors. We suggest that a validated tool, high‐quality training and hospital's policy, such as visiting regulation, should be promoted to improve the sedation practice.     

影响轻中度高血压病人进行运动疗法的因素调查

[目的]了解轻中度高血压病人进行运动疗法的现状,分析影响其因素。[方法]应用自行设计的问卷调查表,对187例轻中度高血压病人进行调查。[结果]影响轻中度高血压病人运动疗法的因素为医务人员、文化程度、大众媒体、家庭支持系统、体重(P均<0.05)。[结论]医务人员应将运动疗法作为常规内容对病人进行健康教育,呼吁大众媒体加强运动疗法的宣传,提高家庭系统对病人的支持。