老年住院患者跌倒风险评估量表的构建及验证

目的构建老年住院患者跌倒风险评估量表并进行测评验证,考察其应用价值。方法采用专家问卷咨询、专家座谈会及病例(246例65岁以上老年住院患者)对照研究相结合的方式构建老年住院患者跌倒评估量表,运用SPSS20.0软件对量表进行信、效度检验,并与Morse跌倒评估量表比较预测准确性。结果老年住院患者跌倒风险评估量表共纳入14个大条目35个赋值子条目;内容效度(CVI)为0.916;量表总体Cronbach′sα系数为0.757;测量者间客观信度0.894;量表的ROC曲线下面积为0.980,Morse跌倒评估量表为0.927;老年住院患者跌倒风险评估量表总分21分、41分及60分时特异度分别为0.38、0.71及0.96;Morse跌倒评估量表总分25分、45分及80分时特异度分别为0.27、0.50及0.82。结论本次构建的老年住院患者跌倒风险评估量表有较好的信效度,对老年住院患者跌倒风险预测准确性好,可应用于临床。     

社区老年人跌倒风险感知量表的编制及信效度检验

目的 编制社区老年人跌倒风险感知量表并检验信效度,为跌倒自我防范提供评估工具。方法 通过文献分析、专家函询、预调查、小组讨论等方式构建量表,选取浙江省某社区卫生服务中心259名老年人进行调查,检验量表信效度。结果 社区老年人跌倒风险感知量表包括跌倒生物行为易感性感知（8个条目）、跌倒社会环境易感性感知（4个条目）、跌倒严重性感知（5个条目）3个维度,共17个条目。探索性因子分析3个公因子累计方差贡献率为60.266%。量表内容效度指数为0.940,条目内容效度指数为0.800~1.000。量表的Cronbach′s α系数为0.913,各维度Cronbach′s α系数为0.814~0.858,重测信度为0.907。结论 社区老年人跌倒风险感知量表信效度良好,可用于老年人跌倒风险感知的评估。     

中文版Braden QD压力性损伤风险评估量表在患儿中的信效度研究

目的对Braden QD压力性损伤风险评估量表进行汉化并检验其信效度。方法在获得原量表作者授权后,对原量表进行翻译、回译、检译、跨文化调适以及预调查,形成中文版Braden QD量表;采用方便抽样法选取323例住院患儿进行问卷调查,以测量量表的信度和效度。结果量表的Cronbach′sα系数为0.760,折半信度为0.820,各条目删除后新的Cronbach′sα系数均较删除前的Cronbach′sα系数低,组内相关系数为0.991(P<0.01);量表水平内容效度指数和条目水平内容效度指数均为1.000,探索性因子分析共抽取2个公因子,累积方差贡献率为63.959%,验证性因子分析结果显示模型拟合良好。结论中文版Braden QD量表经验证后具有良好的信效度,可用于我国住院患儿压力性损伤风险评估。     

早产儿出院后父母角色适应评估量表的编制与信效度检验

目的 编制适用于早产儿出院后父母角色适应水平评估的量表，并检验其信效度。 方法 以WHO养育照护框架为指导，通过文献回顾、质性访谈、2轮专家函询进行量表编制。采用方便抽样法，选取380名早产儿父母开展问卷调查，采用项目分析法进行条目筛选并形成正式量表。采用探索性因子分析和验证性因子分析进行量表的效度检验，采用Cronbach′s α系数、折半系数评价量表的信度。 结果 探索性因子分析提取7个公因子共28个条目，累计方差贡献率为71.559%。验证性因子分析结果显示，χ2/df=1.882，GFI=0.820，CFI=0.912，IFI=0.914，TLI=0.899，RMSEA=0.067。总量表的Cronbach′s α系数为0.935、折半信度为0.822。 量表条目水平的内容效度指数为0.923~1.000，量表水平的平均内容效度指数为0.977。 结论 早产儿出院后父母角色适应量表具有良好的信效度，可作为早产儿出院后父母角色适应水平的评估工具。     

早产儿出院后父母角色适应评估量表的编制与信效度检验

目的 编制适用于早产儿出院后父母角色适应水平评估的量表，并检验其信效度。 方法 以WHO养育照护框架为指导，通过文献回顾、质性访谈、2轮专家函询进行量表编制。采用方便抽样法，选取380名早产儿父母开展问卷调查，采用项目分析法进行条目筛选并形成正式量表。采用探索性因子分析和验证性因子分析进行量表的效度检验，采用Cronbach′s α系数、折半系数评价量表的信度。 结果 探索性因子分析提取7个公因子共28个条目，累计方差贡献率为71.559%。验证性因子分析结果显示，χ2/df=1.882，GFI=0.820，CFI=0.912，IFI=0.914，TLI=0.899，RMSEA=0.067。总量表的Cronbach′s α系数为0.935、折半信度为0.822。 量表条目水平的内容效度指数为0.923~1.000，量表水平的平均内容效度指数为0.977。 结论 早产儿出院后父母角色适应量表具有良好的信效度，可作为早产儿出院后父母角色适应水平的评估工具。     

失智症家庭照护者社会资本量表的汉化及信效度检验

目的 汉化失智症家庭照护者社会资本量表，并检验其信度和效度。方法 对量表进行翻译、回译和跨文化调适，形成中文版失智症家庭照护者社会资本量表。采用方便抽样方法调查221名失智症家庭照护者，评估量表的信效度。结果 经跨文化调适和项目分析，中文版失智症家庭照护者社会资本量表共确立15个条目。探索性因子分析析出3个因子，累计方差贡献率为75.668%,3个因子为互惠性、信任度和邻里支持，与原量表一致，与相依关系量表的效标关联效度为0.419(P<0.05)。总量表的Cronbach′s α系数为0.936,3个因子的Cronbach′s α系数为0.859～0.947。结论 中文版失智症家庭照护者社会资本量表的信效度良好，适用于评估失智症家庭照护者的社会资本水平。     

护士伦理行为量表的汉化及信效度检验

目的 汉化护士伦理行为量表修订版(the Ethical Behavior Scale for Nurses-Revise),并检验其信效度。方法 获取原量表作者授权后，通过正译、回译、文化调适、认知性访谈和预调查对原量表进行汉化，形成中文版护士伦理行为量表。选取535名临床护士进行调查，以评价量表信效度。结果 中文版护士伦理行为量表包括3个维度、15个条目。条目水平的内容效度指数为0.890～1.000,量表水平的内容效度指数为0.985;探索性因子分析提取3个公因子，累计方差贡献率为60.952%。量表总的Cronbach′s α系数为0.892,3个维度的Cronbach′s α系数分别为0.897、0.870、0.838;Guttman分半信度为0.918。结论 中文版护士伦理行为量表具有良好的信效度，适合作为中国文化背景下护士伦理行为的评估工具。     

拉什顿道德复原力量表的汉化及在医务人员中的信效度检验

目的 汉化英文版拉什顿道德复原力量表，并检验其信效度，为医务人员道德复原力测量提供有效工具。 方法 采用Brislin模式进行翻译、回译，采用跨文化调适和预测试对拉什顿道德复原力量表进行修订，形成中文版量表。采用中文版拉什顿道德复原力量表、马氏职业倦怠量表服务版、心理弹性量表对372名医护人员进行调查，分析量表的信效度。 结果 中文版拉什顿道德复原力量表包括道德逆境应对、道德效能、关系完整性、个人完整性4个维度16个条目，量表条目水平的内容效度指数为0.820~1.000，量表内容效度指数为0.901；中文版拉什顿道德复原力量表得分与职业倦怠量表、心理弹性量表评分相关系数分别为-0.307、0.560（均P＜0.05）；经探索性因子分析累积方差贡献率为64.293%；验证性因子分析模型拟合良好（χ2/df=2.067，RMSEA=0.076）。量表Cronbach′s α系数为0.763，各维度Cronbach′s α系数为0.523~0.842。 结论 中文版拉什顿道德复原力量表具有良好的信效度，可作为医务人员道德复原力现况的测评工具。     

护士悲伤状态量表的汉化及信效度检验

目的 汉化护士悲伤状态量表(Grief State Scale for Nurses, GSSN)并在临床护士中检验信效度。方法 获得原量表作者的授权，严格按照Brislin模型对护士悲伤状态量表进行翻译、回译，通过文化调适后形成中文版护士悲伤状态量表。2022年12月采用便利抽样法选取湖州市2所三级甲等医院221名临床护士行正式调查，在调查2周后从中随机抽取30名护士再次填写量表，评价中文版护士悲伤状态量表的信效度。结果 中文版护士悲伤状态量表的Cronbach′s α系数为0.813,4个维度的Cronbach′s α系数分别为0.729、0.855、0.846、0.929;重测信度为0.915。总量表的平均内容效度指数为0.980,条目水平内容效度指数为0.833～1.000。探索性因子分析共提取出4个公因子，累积方差贡献率74.232%。结论 中文版护士悲伤状态量表具有良好的信效度，适用于测量护士职业悲伤水平。     

中文版乳腺癌患者性调节和身体意象量表的评价

目的测评中文版乳腺癌患者性调节和身体意象量表(Sexual Adjustment and Body Image,SABIS)的信效度。方法运用中文版SABIS对90例乳腺癌患者进行调查,并对其中的30例患者于2周后重测。采用t检验、相关性分析和因子分析检验量表的信效度。结果中文版SABIS中性调节量表的Cronbach′sα系数0.73,3个因子的累积贡献率为81.79%;身体意象的Cronbach′sα系数0.70,2个因子的累积贡献率为71.37%。结论中文版SABIS具有良好的信效度,可在临床中用于乳腺癌患者术后的性调节与身体意象评估。     

Risk Assessment Tool for Pressure Ulcer Development in Indian Surgical Wards

The aims of this paper were to compare the predictive validity of three pressure ulcer (PU) risk scales—the Norton scale, the Braden scale, and the Waterlow scale—and to choose the most appropriate calculator for predicting PU risk in surgical wards of India. This is an observational prospective cohort study in a tertiary educational hospital in New Delhi among 100 surgical ward patients from April to July 2011. The main outcomes measured included sensitivity, specificity, positive predictive value (PVP) and negative predictive value (PVN), and the area under the curve of the receiver operating characteristic (ROC) curve of the three PU risk assessment scales. Based on the cutoff points found most appropriate in this study, the sensitivity, specificity, PVP, and PVN were as follows: the Norton scale (cutoff, 16) had the values of 95.6, 93.5, 44.8, and 98.6, respectively; the Braden scale (cutoff, 17) had values of 100, 89.6, 42.5, and 100, respectively; and the Waterlow scale (cutoff, 11) had 91.3, 84.4, 38.8, and 97, respectively. According to the ROC curve, the Norton scale is the most appropriate tool. Factors such as physical condition, activity, mobility, body mass index (BMI), nutrition, friction, and shear are extremely significant in determining risk of PU development (p < 0.0001). The Norton scale is most effective in predicting PU risk in Indian surgical wards. BMI, mobility, activity, nutrition, friction, and shear are the most significant factors in Indian surgical ward settings with necessity for future comparison with established scales.     

Creatine kinaseBB-activity after head trauma related to outcome

Summary The brain-type isoenzyme of creatine kinase was determined in serum (S) and cerebrospinal fluid (CSF) in 37 patients with severe head injury, and a correlation was made with the Glasgow coma score and Glasgow outcome score. All patients with normal S-CK_BB and CSF-CK_BB activities had a coma score of 15,i.e., no neurological deficits, at six hours after the trauma and a good outcome. All 15 patients with a significant increase in the enzyme in serum and CSF had a coma score less than 15. The outcome was still good for five of these patients, while six were moderately disabled, two were severely disabled, and two died. There was no correlation between the individual CK_BB-values and the outcome.     

Statistical analysis of the factors affecting the outcome of extradural haematomas: 115 Cases

Summary 115 traumatic extradural haematoma cases who were treated surgically at Cerrahpasa Medical Faculty Neurosurgery Department between 1987 and 1992 are evaluated.When factors affecting the outcome were examined, a strong correlation was found between the result andGlasgow coma scale (GCS) (p<0.00001). The existence of a fracture, the interval between onset of haematoma symptoms and intervention and the existence of an intracerebral haematoma together with contusion accompanying intradural haematoma, affect the outcome in a negative direction. There was no statistical correlation between the outcome and the age of patient, localization of the haematoma and aetiology.     

Subjective Outcomes of Carpal Tunnel Release in Patients with Diabetes and Patients without Diabetes

Introduction  This study aims to compare the subjective outcomes of carpal tunnel surgery in the patients with diabetes and patients without diabetes, and it tries to determine the difference between insulin-dependent and noninsulin-dependent patients. Materials and Methods  This retrospective cohort study compares subjective outcomes of 35 patients with type 2 diabetes and 35 patients without diabetes who had a unilateral carpal tunnel release. None of the patients with diabetes had neuropathy. All the patients had surgery by a single surgeon with miniopen incision under local anesthesia. The patients were evaluated before surgery and 6 months after surgery using two Brigham and Women''s Carpal Tunnel Questionnaires Results  Carpal tunnel release was improved based on symptom severity scale (SSS) and functional status scale scores in patients with diabetes and nondiabetic patients. However, the mean SSS scores were higher in patients without diabetes 6 months after the surgery. Comparison between the mean SSS scores of the patients with diabetes showed higher scores in noninsulin-dependent patients. In patients with diabetes, SSS scores were positively correlated with carpal tunnel syndrome and diabetes durations. Conclusion  The outcomes of carpal tunnel release were improved in both patients with diabetes and patients without diabetes suffering from median nerve compression at the wrist. However, the duration of diabetes and its treatment can be related to the severity of the disease symptoms after the carpal tunnel releasing surgeries. In some diabetic patients, the severity of the symptoms was persistent. Level of Evidence  This is a prognostic level IV study.     

星状神经节阻滞治疗原发性痛经的临床研究

目的 探讨星状神经节阻滞(stellate ganglion block,SGB)对原发性痛经(primary dysmenorrheal,PD)的治疗效果及其作用机制.方法 选择2007年10月-2011年6月,某医学院校护理学专业PD患者76例,采用SGB治疗.于行经前7d开始,月经来潮3d后停止,每日1次,左右交替进行,共治疗3个月经周期,即3个疗程.比较治疗开始前上次月经来潮24h内(T0)、第1疗程月经来潮24h内(T1)、第2疗程月经来潮24 h内(T2)、第3疗程月经来潮24h内(T3)、第3疗程结束后3个月月经来潮24 h内(T4)的视觉模拟评分法(visual analog scale,VAS)评分,睡眠影响指数(sleep interference scale,SIS)变化,同时于以上各时点静脉采血,酶联免疫吸附法(ELISA)测定血清前列腺素F2α(prostaglandin F2α,PGF2α)浓度、前列腺素F2α/前列腺素E2(prostaglandin F2α/prostaglandin E2,PGF2α/PGE2)比值.结果 T1、T2、T3、T4 VAS分别为(1.83±0.52)、(1.48±0.21)、(1.25±0.14)、(1.30±0.25),与T0(6.35±1.42)比较,明显降低,差异有统计学意义(P＜0.01).T1、T2、T3、T4 SIS分别为(1.52±0.41)、(1.40±0.22)、(1.12±0.11)、(1.33±0.24),与T0(6.55±1.32)比较,明显降低,差异有统计学意义(P＜0.01).T1、T2、T3、T4血清PGF2α分别为(5.1±1.1)、(4.9±1.2)、(4.8±1.6)、(4.9±1.7)μg/L,与T0(15.3 ±2.1)μg/L比较,差异有统计学意义(P＜0.05).T1、T2、T3、T4血清PGF2α/PGE2比值分别为(2.1±1.3)、(1.9±1.4)、(1.8±1.1)、(2.1±1.3),与T0(5.2±1.6)比较,差异有统计学意义(P＜0.05).结论 SGB治疗PD,具有降低疼痛、改善睡眠的临床效果,疗效相对稳定,其作用机制可能与SGB降低经期血清PGF2α浓度、PGF2α/PGE2比值有关.     

Development and initial validation of the Perceived Scarcity Scale

Though socio‐economic status (SES) partially explains the experience of stress and health outcomes, most research to date has relied on a small number of traditional indicators that fail to capture the full domain of socioeconomic factors. The recent reconceptualization of perceived scarcity is proposed as a subjective indicator of SES when attempting to predict both stress and health outcomes. Although a conceptualization of perceived scarcity has been advanced, a psychometrically sound scale is needed to assess the utility and scientific import of this concept. No such scale exists. Therefore, the current paper describes the development, psychometric properties, and initial validation of the Perceived Scarcity Scale (PScS). Four studies using traditional scale development processes were employed to develop (Studies 1 and 2) and provide an initial validation (Studies 3 and 4) for the PScS. Results support the existing model of perceived scarcity and indicate that the measure is valid. Moreover, the scale predicted concurrent perceived stress, as well as longitudinal ratings of perceived stress, global health, quality of life, and symptoms of depression and anxiety. The development of the new scale provides clinicians and researchers with a brief, validated measure that can assess the level of perceived scarcity individuals currently experience.     

整形美容患者心理状况分析

目的:研究整形美容患者的心理状况,为术前准备与术后治疗提供依据,并寻找相应的防治措施,减少患者对手术效果不满的发生率。方法:选用焦虑自评量表(SAS)与抑郁自评量表(SDS)对60例整形美容患者进行测验,同时用60例正常人作为对照组。术前3天进行测试,测试前说明目的与意义。结果:手术组SAS与SDS得分分别为47.24±5.67与50.34±4.28,标准分界值为50分,结果显示手术组得分明显高于对照组。结论:部分整形美容患者存在着明显的焦虑与抑郁。在临床工作中,我们应该学会正确识别该类型的患者,并积极探索心理治疗方法,使就医者能客观看待手术带来的外观上的变化,从而减少医疗纠纷的发生。     

三种血栓评分量表对老年髋部骨折后并发深静脉血栓的预测价值

目的:探讨Caprini、Wells及Autar 3种评分量表对老年髋部骨折后发生下肢深静脉血栓(deep venous thrombosis,DVT)的预测价值。方法:选择2018年1月至2022年9月收治的310例老年髋部骨折患者,根据患者下肢彩超检查结果,将并发DVT的患者作为血栓组(155例),男42例,女113例,年龄60～101(80.58±8.84)岁;未并发DVT的患者作为对照组(155例),男58例,女97例,年龄60～94(79.01±8.99)岁。收集并比较两组患者入院即刻的Caprini、Wells及Autar评分量表。采用受试者工作特征(receiver operating characteristic,ROC)曲线评价3种血栓风险评估表对老年髋部骨折后发生DVT的预测价值。结果:血栓组Caprini、Wells及Autar评分明显高于对照组(P<0.001)。ROC曲线分析结果显示:Caprini评分最佳截断值为8.5分,灵敏度46.5%,特异度99.4%,曲线下面积(area under the curve,AUC)为0.763;Wells评分最佳截...     

颜面部整形患者术前情绪状态测评

目的:研究颜面部整形美容患者术前的情绪状态,为术前准备和术后综合治疗提供依据。方法:用焦虑自评量表(SAS)和抑郁自评量表(SDS)对33例整形美容外科受术者进行术前测验,同时用33名正常人作为对照组。结果:手术组SAS 和SDS得分分别为49.75±6.59和54.02±9.79,以SAS和SDS≥50为界值,结果显示得分明显高于对照组。结论:颜面部整形美容患者在术前存在着较明显的焦虑和抑郁情绪反应。