护理本科实习生自我导向学习能力与人文关怀能力对护理临床决策能力影响的路径分析

目的:调查护理本科实习生自我导向学习能力、人文关怀能力与护理临床决策能力水平,探讨自我导向学习能力与人文关怀能力对护理临床决策能力的影响,并分析其影响路径.方法:采用自我导向学习评定问卷(SRSSDL)、人文关怀能力评价问卷(CAI)、护理临床决策测评问卷(CDMNS)对367名护理本科实习生进行调查.结果:护理本科实习生的SRSSDL总分为(170.99±54.16)分,CAI总分为(173.38±29.14)分,CDMNS总分为(113.99±17.47)分.自我导向学习能力总分及5个维度得分与护理临床决策能力总分及4个维度得分呈正相关,人文关怀能力总分及其认知维度得分与护理临床决策能力总分呈正相关,且人文关怀能力总分及3个维度得分与明确目标维度得分呈显著正相关.结构方程模型显示,人文关怀能力能正向预测自我导向学习能力和护理临床决策能力(β=0.07,0.08,P<0.05),人文关怀能力通过自我导向学习能力对护理临床决策能力的间接效应为0.06,总效应为0.14,由Bootstrap法得出自我导向学习能力在人文关怀能力与护理临床决策能力间的中介效应为42.86％.结论:护理本科实习生自我导向学习能力与人文关怀能力相对缺乏,护理临床决策能力处于中等水平,自我导向学习能力在人文关怀能力与护理临床决策能力间起部分中介作用.     

护理实习生情绪智力对临床沟通能力的影响

[目的]了解护理实习生临床沟通能力及情绪智力现状,并分析护理实习生情绪智力对临床沟通能力的影响。[方法]采用临床沟通能力问卷和情绪智力量表对西安市4所三级甲等医院291名护理实习生进行调查。[结果]护理实习生临床沟通能力得分为(81.27±8.79)分,情绪智力得分为(108.79±17.36)分,临床沟通能力得分与情绪智力得分呈正相关(r=0.53,P0.05)。分层回归分析显示,情绪智力能独立解释临床沟通能力总变异的33.6%(F=12.889,P0.05)。[结论]护理实习生的临床沟通能力及情绪智力均处于中等水平,临床沟通能力与情绪智力密切相关,情绪智力可以正向预测护理实习生的临床沟通能力。     

护理实习生医院关怀氛围感知与临床沟通能力的相关研究

目的调查护理实习生医院关怀氛围感知与临床沟通能力状况,分析二者的相关性。方法采用便利抽样法抽取正在临床实习的654名护理专业学生,采用医院关怀氛围感知量表和临床沟通能力测评量表进行调查。结果护理实习生医院关怀氛围感知量表总均分为(4.07±0.75)分,其中带教教师给予自己的关怀感知维度得分最低为(3.96±0.95)分;临床沟通能力测评量表整体得分为(3.09±0.38)分,护理实习生医院关怀氛围感知与临床沟通能力呈中度正相关(r=0.526,P<0.05)。结论护理实习生的医院关怀氛围感知与临床沟通能力均属于中等偏上水平,应重视对护理实习生的医院关怀,提升护理实习生沟通能力。     

护理本科实习生临床能力与自我效能感的关系研究

目的调查护理本科实习生临床能力与一般自我效能感水平,并分析自我效能感对临床能力的影响。方法采用护理本科生临床能力评价量表和一般自我效能感量表,对295名护理本科实习生进行问卷调查;采用回归分析,探讨一般自我效能对临床能力的影响。结果护理本科生的临床能力总均分为(3.95±0.02),处于中等偏上水平;一般自我效能感总均分为(2.46±0.03)分,处于中等水平。回归分析显示,一般自我效能感对临床能力有正性影响(β=0.247,t=4.365,P<0.01)。结论护理本科实习生临床能力处于中等偏上水平,一般自我效能感处于中等水平,二者相互影响。护理教育者应采取相应的对策,提升护理本科实习生的自我效能感,培养其综合临床能力,使其更快、更好地适应临床护理工作。     

应用自我导向学习方法提高护理本科实习生的循证能力

目的探讨应用自我导向学习方法提高护理本科实习生循证护理能力的效果。方法在临床实习阶段,74名护理本科生通过研究组编写的学习资料包和学习目标的提示,借助网络图书馆等资源,与同伴合作,应用自我导向学习方法,学习循证护理基本知识和实践方法。采用自行设计的问卷,调查学生应用自我导向学习方法前后循证护理基础知识水平和学习效果。结果应用自我导向学习方法后,学生的循证护理知识自评得分从(11.51±2.5)分提高到(17.11±3.3)分,差异有统计学意义(t=-11.64,P<0.01);72名(97.3%)学生对自我导向学习过程持满意态度。结论应用自我导向学习方法有利于激发护理专业学生的学习动机,提高其循证基础知识水平和自主学习能力。     

护理本科生自我导向学习能力与临床沟通能力的相关性

[目的]探讨护理本科生自我导向学习能力与临床沟通能力的关系,为护理临床教学改革提供参考依据.[方法]采用自我导向学习倾向量表和临床沟通能力测评量表,调查护理专业三年级本科生的自我导向学习能力及临床沟通能力,并分析其相关性.[结果]自我导向学习能力总分为（185.53±20.15）分,临床沟通能力总分为（81.48±10.21）分;自我导向学习能力总分与临床沟通能力总分及其维度（敏锐倾听、建立和谐关系、确认病人问题、传递有效信息）均呈正相关（P＜0.01或P＜0.05）.[结论]护理本科生有较明显的自我导向学习倾向,且自我导向学习能力越强,临床沟通能力越强.     

护理专科实习生临床能力自评现状研究

目的调查护理专科实习生临床能力自评现状,分析护理专科实习生临床能力现状与临床要求的差距,为护理专科实习生的培养提供依据。方法采用临床能力评价表,对334名护理专科实习生进行临床能力评价。结果护理专科实习生临床能力自评总分为(410.61±20.51)分,各维度得分由高到低依次为:职业价值观(89.96±2.08)、临床护理能力(81.58±3.62)、沟通与协作能力(81.47±3.89)、健康教育能力(79.96±4.19)、自主学习能力(77.64±5.30)。结论护理专科实习生健康教育能力和自主学习能力自评偏低。护理教育者可依据临床能力影响因素,针对现状采取相应的指导和教学策略,有效促进学生的临床能力。     

护理实习生共情能力及其与临床学习环境、自我同情的相关性研究

目的 了解护理实习生共情能力、临床学习环境与自我同情现状，探讨护理实习生临床学习环境、自我同情与共情能力的相关性。方法 2021年9月采用便利抽样方法选取国内4所院校437名护理实习生为研究对象，以一般资料调查表、杰弗逊共情量表（护生版）、临床实习环境监督量表和自我同情量表为调查工具收集资料，对数据进行单因素分析及多因素分析。结果 护理实习生共情能力、临床学习环境、自我同情得分分别为（85.91±10.44）、（135.53±18.95）及（76.90±9.24）分。护理实习生的临床学习环境、自我同情与共情能力之间均呈显著正相关（r=0.250,P<0.01;r=0.313,P<0.01）。学历、直系亲属有无医务工作者、带教形式、科室的教学氛围、过度沉迷和自我评判为护理实习生共情能力的主要影响因素，可解释总变异的22.2%。结论 被调查护理实习生共情能力处于中等水平，护理管理者和教育者可以基于实习生的背景进行个性化共情教育，从外部因素和个人因素两方面改善护理实习生临床学习环境并提升其自我同情能力，进而提高护理实习生的共情能力。     

护理本科实习生自主学习准备度与核心能力的相关性研究

目的了解护理本科实习生自主学习准备度和核心能力现状,并分析两者之间的相关性。方法运用方便抽样法,采用中文版自主学习准备度量表和中国注册护士核心能力量表对福建省3所护理本科院校的519名实习生进行调查。结果 1自主学习准备度总分为(148.55±18.46)分;各维度得分由高到低依次为:热爱学习、自我控制和自我管理。2核心能力总分为(142.31±30.39)分;各维度得分由高到低依次为:伦理/法律实践、人际关系、领导能力、专业发展、临床护理、评判性思维/科研能力和教育/咨询能力。3自主学习准备度与核心能力呈正相关(r=0.548),自我管理(r=0.504)、自我控制(r=0.533)、热爱学习(r=0.425)维度与核心能力呈正相关。结论护理本科实习生的自主学习准备度为中上水平,核心能力为中等水平;可尝试通过提高自主学习准备度促进核心能力的培养。     

护理实习生临床沟通能力与自尊水平的相关性研究

目的了解护理实习生的临床沟通能力和自尊水平,并分析两者的相关性。方法采用护理专业学生临床沟通能力测评量表和罗森伯格自尊量表对60名护理实习生进行调查。结果护理实习生临床沟通能力总分为(77.40±6.43)分,自尊总分为(24.20±3.32)分,沟通能力总分及各维度与自尊水平呈正相关(r值为0.610~0.885)。结论护理实习生沟通能力中等,敏锐倾听和有效传递信息的能力有待加强,临床沟通能力与自尊水平有较强的相关性。     

Rofecoxib: clinical pharmacology and clinical experience

BACKGROUND: Rofecoxib is a member of a subgroup of nonsteroidal anti-inflammatory drugs (NSAIDs) known as cyclooxygenase-2 (COX-2)-selective inhibitors. It has been studied in adult and elderly patients in a number of painful conditions (primary dysmenorrhea, acute pain after dental and orthopedic surgery, osteoarthritis [OA], and rheumatoid arthritis). OBJECTIVE: This review discusses the clinical pharmacology of and clinical experience with rofecoxib, and the role of COX-2-selective inhibitors in clinical practice. METHODS: Pertinent studies were identified through searches of MEDLINE and EMBASE, as well as the Web sites and proceedings of relevant scientific meetings. RESULTS: Although the published literature is limited, the data indicate that rofecoxib is an effective analgesic agent for the painful conditions in which it has been studied. As a COX-2-selective inhibitor, rofecoxib offers safety advantages over traditional NSAIDs. In clinical trials, gastrointestinal (GI) toxicity, including mucosal damage, perforation, ulcers, and bleeding, occurred significantly less often in healthy volunteers and patients treated with rofecoxib than in those who received NSAIDs such as ibuprofen, naproxen, or diclofenac (all comparisons, P < 0.001). In terms of renal toxicity, rofecoxib does not appear to offer a safety advantage over traditional NSAIDs. Rofecoxib has not been shown to affect platelets (bleeding time and platelet aggregation), unlike traditional NSAIDs. CONCLUSIONS: Rofecoxib is an appropriate choice for patients who do not obtain adequate analgesia with acetaminophen and those who have not obtained adequate analgesia from, cannot tolerate, or are at risk for GI toxicity with traditional NSAIDs. Patients who require chronic analgesic medication (ie, those with OA), including those who take other medications daily for comorbid conditions, may also benefit from the once-daily dosing regimen of rofecoxib.     

Enhancing clinical effectiveness among clinical nurse specialists

This article describes the findings of an exploratory study which aimed to discover how clinically effective nursing care is fostered among clinical nurse specialists (CNSs) and nurse practitioners (NPs) in an NHS trust in East London. The study was funded by the Central and East London Education Consortium in January 1999. Qualitative approaches included non-participant observation of practice, interviews during observaton and focus group meetings, Findings from the research identify areas that both foster and hinder the ability of the CNSs and NPs to engage in and provide clinically effective nursing care.     

Laboratory clinical effectiveness: pathologists improving clinical outcomes

This article calls on pathologists to take a larger role in improving the performance of the American health care system. To improve outcomes for populations and individuals require that pathologists increase their activities outside of the traditional laboratory in interdisciplinary collaborations, outcomes research, health care systems development, and clinical care.     

Adherence in clinical trials and in clinical practice

The degree of patient adherence is increasingly recognized to be a key factor in the success of highly active antiretroviral therapy (HAART). HAART regimens are also among the most complex ever prescribed and low adherence is directly related to treatment complexity. Physicians prescribing HAART need to make adherence a priority both in clinical practice and in the design and interpretation of clinical trials if HAART really is to succeed in the long term.     

The clinical imperative in clinical nursing research.

Conducting preliminary clinical fieldwork to update clinical knowledge in preparation to plan and perform relevant, meaningful, credible and feasible clinical research is imperative. Clinical nurse investigators cannot generate relevant questions to study a current phenomenon with which they are not experienced. The nurse researcher's early involvement in the clinical world of health care as a prerequisite of proposal development not only contributes to the design of a study that has rigor and significance, but it also augments his or her competence and commitment to the improvement of patient outcomes.     

Antiplatelet therapy from clinical trials to clinical practice

A platelet-rich clot at the site of severe coronary stenosis, plaque erosion, or a recent plaque rupture is the common etiology of acute ischemic syndromes. Thus, antiplatelet therapy is the cornerstone in the management of these conditions. Aspirin in a dose ranging from 160 to 325 mg once daily should be administered to virtually all patients. In patients with severe disease, particularly those who have no acute angiography, clopidogrel (Plavix, Bristol-Myers Squibb/Sanofi Pharmaceuticals) in a dose of 75 mg once daily should add to the benefit of aspirin for up to a year after the event. Clopidogrel also is an alternative to aspirin where a true aspirin allergy exists. Intravenous platelet glycoprotein IIb/IIIa receptor inhibitors demonstrated a robust benefit when used in conjunction with coronary intervention and thus far have no role in medical therapy alone. Oral platelet glycoprotein IIb/IIIa receptor inhibitors are of no clinical value.