关怀护理研究现状

从关怀概念、关怀护理的研究及关怀能力的研究方面,介绍了关怀护理研究现状,提出培养护理人员的关怀能力,必须重视关怀意识的培养和能力的评估.     

关怀护理研究现状

从关怀概念、关怀护理的研究及关怀能力的研究方面，介绍了关怀护理研究现状，提出培养护理人员的关怀能力，必须重视关怀意识的培养和能力的评估。     

关怀与护理专业

关怀是护理学中一个非常重要的概念。它对护理实践、护理教育、护理科研乃至护理专业本身的形成与发展有着非常深远的影响。有些护理学家认为护理的本质是关怀,甚至有些护理学家宣称护理就是关怀。目前,国外护理界对关怀的研究很多。重点论述关怀的意义、关怀的护理学理论、关怀与护理专业形成与发展的关系。     

关怀与护理专业

关怀是护理学中一个非常重要的概念。它对护理实践、护理教育、护理科研乃至护理专业本身的形成与发展有着非常深远的影响。有些护理学家认为护理的本质是关怀 ,甚则有些护理学家宣称护理就是关怀。目前 ,国外护理界对关怀的研究很多。重点论述关怀的意义、关怀的护理学理论、关怀与护理专业形成与发展的关系。     

浅谈精神病医院护理文化建设

阐述了护理文化的概念及内涵,强调了精神病医院护理文化建设的重要性,提出了建设精神病医院护理文化的内容和方法,总结了精神病医院护理文化应以安全护理、人文关怀为核心.     

人文关怀在胸心外科的实施

人文关怀是护理的核心概念和中心任务.人文关怀贯穿了住院的全过程,实施人文关怀后,病人的人格和权利得到了更多的尊重,解除了病人对疾病的恐惧、紧张,并能给病人以精神鼓励和信念支持,强化了治疗效果,病人认可了护士的专业价值.同时病人满意度提高,减少护理纠纷的发生.     

护理人文关怀概念的研究现状与分析

概念是对过去感性经验的理性总结,是重新认识的开端,是科学理论得以建立的基础.对概念的正确认识与理解是科学思想产生的来源,也是学科发展的行动指南.我国卫生部在<中国护理事业发展规划纲要(2005-2010年)>,以及全国护理工作会议上明确提出"加强护士队伍建设,将人文关怀融入护理工作中,服务于细微之处.营造关心病人、爱护病人、尊重病人、帮助病人的氛围"[1].近年来,"将人文关怀融入护理工作中",在我国护理行业内已基本达成共识.然而,对于护理"人文关怀"这一概念的认识与理解,却是见智见仁,莫衷一是.有鉴于此,本文运用概念分析法综述国内外学者对这一概念的认识,为临床护理及教育工作提供借鉴,也为本土化概念的深入研究提供帮助与参考.     

基于CiteSpace的国际护理人文关怀领域的可视化分析

目的 分析护理人文关怀研究现状,揭示其演变规律,为护理人文关怀的研究提供参考。方法 基于Web of Science数据库检索结果,采用可视化分析软件CiteSpaceⅢ对护理人文关怀类文献的载文情况、主要研究机、主要作者、研究国家、文献高被引情况、关键词、研究趋势等方面进行分析。 结果 护理人文关怀研究的发文量呈波浪状上升趋势,主要研究机构及主要研究者集中在欧美国家,研究热点集中于关怀概念、关怀测量工具、关怀理论、关怀效果评价等方面。 结论 护理人文关怀研究呈多元化发展特点,有待进一步加强和深化,循证护理、叙事医学和人文关怀的结合将成为今后研究的方向。     

护理人员的关怀照护能力及测评

综述了护理人员关怀照护的概念、内涵及测评方法。通过实施关怀护理,可以改善护患关系,提高护理质量。通过对护理人员关怀能力的测评,为培养新一代具有护理专业知识、技能及关怀能力的复合型护理人才提供依据。     

刍议我国关怀照护现状及对策

人文关怀又称人性关怀、关怀照护、关爱。所谓关怀照护，Cohen和Leininger认为是为了改善及促进人类的健康而直接去协助、支持及促进个人或团体的一种护理行为，而且会因文化差异而有不同的表现。关怀照护包括心理、文化及社会等层面，将人文关怀融入临床护理实践中，可提供全人护理（整体护理）。人文关怀是护理学科的核心和精髓。近些年，国外对关怀照护概念的探讨、理论的形成及相关的研究较多，但国内则相对较少。     

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.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.