护理人员进阶N3个案报告写作之影响因素探讨

目的:探讨护理人员进阶N3个案报告写作的影响因素。方法:采用方便取样,通过个案报告调查表进行调查。结果:进阶N3个案报告写作障碍与准备行动呈负相关;晋升制度认同与个案报告写作态度呈正相关;从事护理工作的兴趣、教育程度、申报N3晋升与个案报告写作态度差异具有统计学意义;晋升制度认同、寻找辅导、接受辅导、参加训练与个案报告写作行动呈正相关。结论:进阶N3个案报告写作是件困难的事,在教育训练中应增加其辅导及安排辅导员,以提升护士进阶N3个案报告写作能力。     

实施护理投诉个案分析的做法

目的 :探讨引起护理投诉的原因 ,减少和防范护理投诉发生 ,制定相应的护理投诉处理措施。方法 :建立护理投诉分析小组 ,对护理投诉个案进行全方位分析。结果 :通过运用科学、合理的分析方法 ,严格把握护理投诉的关键环节 ,逐步完善应对措施。结论 :通过有效分析 ,制定切实可行的措施 ,减少了护理投诉发生     

21例伴意识障碍精神病司法鉴定分析

为了解急性起病伴意识障碍精神病司法鉴定病例的原因及特点,作者对21例精神病司法鉴定案例进行个案分析,报告如下.     

山东省济宁市36例狂犬病流行病学分析

目的通过对山东省济宁市2006年狂犬病进行流行病学分析，探讨流行上升因素和更为有效的预防控制措施。 方法收集全市2006年狂犬病病例个案调查资料，对暴露者咬伤部位、发病年龄、发病时间、伤口处理情况等进行综合分析。 结果36例狂犬病患者均为农业人口，发病年龄以中青年及老年人为主，发病时间主要集中在6-11月，伤人犬多为外观健康的家犬。暴露者伤口处理不及时、不规范，多数没有注射狂犬病疫苗、抗狂犬病病毒血清/抗狂犬病免疫球蛋白。 结论暴露者侥幸心理严重，伤后不及时去正规预防接种门诊处理伤口，不注射狂犬病疫苗和抗狂犬病血清/抗狂犬病免疫球蛋白，是造成发病死亡的主要原因。政府重视，各项措施落实，强化宣传教育，控制传染源，加强疫情监测，做好科学防护，疫苗预防是控制当今狂犬病的关键。     

39例狂犬病流行病学分析

狂犬病严重危害人民生命,病死率高。分析其发病情况和临床特征,探索其流行规律,可以为防治工作提供重要科学依据。现将1982～2004年云阳县发生的39例狂犬病的流行病学调查结果报告如下。1资料来源和诊断对云阳县1982～2004年传染病报告卡填报的狂犬病病例,采用全国统一的调查表,逐个进行病例个案调查,根据病例接触史、症状和体征等流行病学特征及临床资料进行分析。2结果2.1流行特征病例分布在15个乡(原建制),占全县乡数的18.99%(15/79)。病例全部来自农村。发病时间多在4～8月,占64.10%(25/39),见表1。最小年龄4岁,最大60岁。≤15岁15例占3…     

八个性爱失败的个案分析

差劲的性经验，也是男人不想面对的事实。 正所谓“知己知彼，百战不殆”，各位男士有没有想过自己是否真的能够为性伴侣带来快乐呢？常常学习正确的性知识固然重要，但从另一个角度看看女士们说出他们最差劲的性经验也是非常必要的。     

对轮岗护士实施个案模拟实践考核方法的探讨

为培养新毕业护士临床护理综合技能与应急能力，结合新护士岗前培训，轮岗期间分阶段实施临床个案模拟临床综合能力与应急能力考核。结果：采取分阶段个案模拟实践考核后，新护士临床护理技能与应急能力合格人数明显增加。提示对轮岗护士实施个案模拟实践考核，使其更快地适应临床护理工作的需要，是行之有效的。     

运用投射性绘画测验进行家庭式咨询的个案分析

目的:探讨运用投射性绘画测验进行家庭式咨询效果。方法:随机选取来咨询的1名儿童及其母亲作为研究对象。来访的母女在沟通上存在的障碍,严重影响了她们的日常生活。主要采用会谈法,并运用绘画测验进行沟通和分析,所采用的绘画测验主要包括画一个人(自己)测验,动态屋-树-人绘画测验和动态家庭图绘画测验。结果:咨询员利用她们各自的绘画,帮助来访者认识到了自己的问题所在,改善了母女的沟通。结论:运用投射性绘画测验进行家庭式咨询效果较好。     

中专护生临床整体护理能力考核方式探讨

为了更好地评价中专护生临床整体护理实习的效果,单纯对护生进行自选个案的整体护理考核已不能全面评价护生整体护理的能力。自1997年以来,我们根据院校教学考核计划对四年制中专护生整体护理能力考核采厢了自选个案考核与随机抽取个案考核相结合的方式,获得了较为满意的效果．提高了护生们应对问题、分析问题、解决问题的能力,现将方法介绍如下。     

个案护理教学对提高护生护理程序运用的探讨

目的 提高护生应用护理程序的能力、书写病历水平,增强工作责任感.方法 运用个案护理教学,指导护生运用护理程序完成个案护理,组织护生进行护理查房,书写护理病历.结果 护生运用护理程序的能力较对照组提高(p＜0.05)、病历质量较对照组提高(p＜0.01),工作责任感增强.结论 通过个案护理教学能使护生将理论与实践相结合,使逻辑思维能力、发现问题和解决问题的能力、业务知识和技能得到提高.     

论护理专业决策的分类和意义

护理专业决策研究是当前国际护理界关注的重点,本文对护理专业决策类型按护理工作 内容侧重点的不同进行了初步归类,认为其意义主要在于:有利于认识不同类型护理决策的特点,把握 决策的重点,促进决策类型的转化和确立护理决策研究的重点。     

患者决策辅助的临床应用现状与展望

随着以患者为中心医疗模式的不断深入,患者的知情权和选择权日益受到重视,"患者决策辅助"的概念也应运而生。文章从决策辅助的定义、形式与内容,决策辅助在国内外的应用现状及其影响因素等方面进行综述,并对目前国际上应用较广的基于移动医疗的决策辅助在我国的推广和应用予以展望,以期为推进医患共享决策、提升患者的决策参与提供参考。     

Decision making and quality of life in the treatment of cancer: a review

Introduction  Complexity in decision making for cancer treatment arises from many factors. When considering how to treat patients, physicians prioritize factors such as stage of disease, patient age, and comorbid illnesses. However, physicians must balance these priorities with the patient’s preferences, quality of life, social responsibilities, and fear of uncertainty. Although these factors are important, physicians are often unable to effectively judge their patients’ preferences. Patients are often unable to fully understand their prognoses and the treatment intent. Discussion  These differences influence how patients and physicians make treatment-related decisions. Partially due to these differences, patients are initially more likely than their physicians to accept greater risk for lesser benefit from treatment. As time progresses and as they experience treatment, a patient’s preference changes, yet little is known about this process since few studies have examined it in a prospective longitudinal manner. We present an overview of the literature related to patient and physician decision making and quality of life in patients with advanced cancer, and we propose approaches to future decision-making models in cancer treatment.     

Evaluation of an Online Education Resource on Radiation Therapy Created for Patients with Postprostatectomy Prostate Cancer and Their Caregivers

IntroductionRadiation therapy (RT) after prostatectomy is an important curative treatment option for patients with prostate cancer. It can be delivered immediately after surgery as adjuvant treatment, or after biochemical PSA failure as salvage treatment. There is currently a lack of consensus regarding whether salvage RT in the event of biochemical failure or immediate adjuvant RT is the optimal postprostatectomy RT treatment. Although both types of postprostatectomy RT are generally well tolerated, patients may develop some toxicity that can impact their quality of life and the duration and frequency of treatments can be challenging for patients. It is imperative that patients be provided with evidence-based information so that they are able to make a treatment decision most aligned with their values.MethodsTo help address patients' informational needs, an online education resource was created for patients with prostate cancer considering postoperative RT. Patients and their families were asked to evaluate the effectiveness of this resource using a validated purpose-based information assessment.ResultsNineteen patients were approached and 14 participated, but only five patients returned their evaluations (35%). Sixty percent found the information to be important with regards to each of the six commonly identified purposes in the purpose-based information assessment: organizing, understanding, decision-making, planning, emotional support, and discussing. Only one participant found the information hard to understand and had difficulty finding specific information.DiscussionPatients should be encouraged to actively participate in their treatment decision-making process involving postprostatectomy RT. For patients to make well-informed decisions, patients must be provided with clear and accessible information so that they may understand their disease and the treatment options.ConclusionAn online education resource has been developed that most study respondents found clear and helpful for a variety of identified purposes. Overall, this online education resource has the potential to reach a large number of patients and their caregivers who desire specific information and involvement in future treatment decisions.     

Neurogenic Shock: A Case Report

BackgroundNeurogenic shock is a life-threatening emergency associated with spinal cord injuries. Early cervical spine immobilization to reduce the risk of neurogenic shock is imperative. In addition, early recognition and treatment of neurogenic shock are essential to prevent hypoperfusion-related injuries and death.Case PresentationThis case outlines a 65-year-old male who experienced a cervical spine fracture after a motorcycle crash. The patient received stabilizing treatment by a flight crew consisting of both a registered nurse and paramedic. After assessment and stabilization, he was diagnosed as having neurogenic shock. Despite invasive treatment and resuscitation efforts, the patient succumbed to his injuries.ConclusionIt is important for emergency nurses to quickly identify the risk factors for cervical spine injuries and maintain cervical spine immobilization to minimize the risk of neurogenic shock.