基层医院男性护理工作者现状分析

目的:调查分析基层医院男性护士工作的现状,探讨现代护理岗位中男性的优势和作用,推动护理工作的持续和谐发展。方法:采用问卷调查和访谈法对基层医院620例住院患者、75名女护士,26名在岗男护士进行调查。结果:85%以上的患者不太赞同男性从事护理工作,90%的女护士接受男护士加入其中,47.2%的男性护士感到很大压力,52.6%希望改变工作现状。结论:尽管男性从事护理工作有很大优势,但现状不容乐观,需要全社会共同关注,促进护理工作的人本化发展。     

精神科男性护理人员临床综合能力的测评

目的 探讨男性护理人员在精神科护理工作中的综合能力。方法 选择在我院临床工作的医护人员30名对4名男护士和4名女护士进行护理综合能力测评,内容包括护理评估能力,护理诊断能力,护理计划能力等6个方面共45个项目。结果 在测评的45个项目中,男护士平均分值高于女护士的33项,占73．3％;男护士平均分值低于女护士的9项,占20．O％;男女护士平均分值持平的3项,占6．,％。尤其在病房管理能力和处理解决突发事件的能力方面,男性优于女性。结论 男性从事护理工作的综合能力明显高于女性,应鼓励更多男性从事护理工作。     

对不同性别护士专业认可度的调查

目的了解不同性别的护士对自身专业的认知情况和工作态度,为男护士的培养提供借鉴。方法采用自制调查问卷,对淮北职业技术学院62名已经在医院就业的男护士和86名女护士进行调查分析。结果男护士工作中心理压力、专业认同、继续从事护理工作情况3个方面结果均低于女护士。结论需要加强男护士专业思想教育,提高男护士职业角色认同感。领导要多找男护士谈心,多进行心理辅导,减轻其心理压力。     

临床开展优质护理服务对男护士需求的调查分析

目的 为了开展优质护理服务病房,了解住院患者对男护士护理工作接受程度,女护士对男护士护理工作的需求及男护士的专业认知态度。方法 通过问卷调查80位住院患者对男护士护理工作接受程度,80位女护士对男护士护理工作接受程度,30位男护士对专业的认知态度。结果 不同性别住院患者对男护士执行涉及隐私部位的护理操作、愿意向男护士倾述或请求帮助、认为男护士有很好的职业发展前景方面有显著差异(P<0.01)。对开展优质护理服务病房是否需要男护士,相同工作年限不同性别护士比较有显著意义(P<0.01)。而不同年限女护士比较无统计学意义(P>0.05)。男护士专业认知态度调查存在男护士流失的可能。 结论 随着护理服务模式的转变,临床对男护士的需求,如何稳定在岗的男护士,减少工作压力、降低人才流失是关键。     

我国男护士工作中优势与劣势的质性研究

【】 目的 探讨男护士在护士这一职业中的优势与劣势,为男性是否适合从事护理行业提供一些依据。 方法 采用质性研究中的现象学研究法对上海7所医院中的12名男护士,7名女护士进行半结构式深度访谈,通过对访谈结果进行类属分析,得出男护士的主要优势与劣势。 结果 男护士的优势主要集中在体力、性格以及动手能力这3个方面。而劣势则集中在粗心以及性别这2方面。 结论 男性从事护理工作的优势较劣势更为明显,社会大众应该改变固有的旧观念并且积极的接纳、肯定男护士这一群体的存在。同时,学校也应该加强与重视男护士的培养,为护理行业输送新鲜血液。     

云浮地区医院对男护士需求情况的调查与分析

目的了解云浮地区医院对男护士的需求及接受情况,为培养和使用男护士提供依据。方法采用分层抽样的方法,对云浮地区14所医院的医护人员、病人及其家属进行无记名问卷调查。结果认为比较需要男护士的科室分别是精神科(82.75%)、手术室(67.73%)、骨伤科(57.16%)、急诊科(48.40%);认为男病人更需要男护士护理的有373名,占51.88%。妇产科病人与其他科室病人对接受男护士护理的态度差异具有统计学意义(2=71.34,P<0.01)。在719名调查对象中,2.09%认为女护士优于男护士,其余均能正确看待男护士。结论男护士具有某些职业优势,医院对男护士有一定的需求,建议更新护理服务理念,吸引更多的男性从事护士职业,以更好地促进护理事业的发展。     

对男护士需求调查分析

目的：了解岳阳地区医院对男护士的需求及接受情况,为培养和合理使用男护士提供依据。方法：采用分层抽样的方法,对岳阳地区12所医院的760名医护人员、病人及其家属进行无记名问卷调查。结果：认为男护士的岗位接受率为92.5%;认为男护士可以在护理事业发展中发挥更好作用的为720名,占总数的94.7%;认为最需要男护士岗位的科室分别是精神科（82.7%）、急诊科（69.8%）、手术室（67.7%）、ICU（65.4%）、骨伤科（57.2%）和普通病房（32.3%）;妇产科病人与其他科室病人对接受男护士护理的态度差异具有统计学意义。在760名调查对象中,2.0%认为女护士优于男护士。结论：男护士具有某些职业优势,医院对男护士有一定的需求,建议更新护理服务理念,吸引更多的男性从事护士职业,充分发挥男护士的优势,以更好地促进护理事业的发展。（χ^2=71.34,P〈0.01）     

男护士专科优势的调查分析

目的通过研究男护士的工作优势,探讨男护士在护理工作中的重要性。方法加大男护士工作的宣传;提高男护士的报酬;男护士与女护士的工作适当分开;设制奖励制度;医院定期开展医护人员的集体活动与思想教育。结果根据统计看,近年来男护士的从业率在逐年上升。但是男护士的比例还是比较低。结论男护士在护理工作中占有非常重要的地位,具有体力与精力充沛、责任感强、性别优势、心理承受能力强、对医疗器械与设备掌握比较快,而且善于管理、对新鲜事物接受能力强等优势;男护士参与护理工作可以弥补许多女护士的不足,完善护理工作的开展,使医疗卫生事业得到更好的发展。     

不同性别护士对护理工作环境评价的对比研究

目的比较广东省二、三级综合医院不同性别护士对护理工作环境的评价。方法采用护理工作环境量表对广东省二、三级综合医院3 456名护士进行护理工作环境评价的调查,采用倾向性评分匹配法控制混杂因素,比较不同性别护士对护理工作环境的评价。结果男护士在三级医院、ICU和急诊科工作的人数较多,年龄、工作年限均低于女护士,单身、无编制、初始学历为大专及以上的人数高于女护士。经倾向性评分匹配法均衡男、女护士的基线资料后,发现男护士医护合作关系、高质量服务基础、护理管理者能力与支持3个维度的评价低于女护士,差异具有统计学意义(P0.05)。结论广东省男护士人数较少,主要分布在三级医院,工作科室以ICU、急诊科为主;相比女护士,其年资低、合同制占比高、专业初始学历高。男护士对护理工作环境的评价较女护士低,尤其是对医护合作关系、保障护理质量的基础支持、护理管理者的能力等方面。     

男护士职业压力现况调查及相关因素王杰 上海市浦东医院

目的：通过对照研究男女护士,以及不同科室男护士在职业压力上的差异性和相关情况,从而突出男护士的压力现况,为消除男护士的职业压力提供理论依据的重要意义。方法：采用李小妹修订的包含5个维度的中国护士压力源量表,在我市三甲医院中抽取90名男护士和女护士90名进行问卷调查,并将调查结果分别进行对照统计。结果：两者回收调查问卷均为88份,其中有效问卷也均为88份。男护士在护理专业及工作方面问题、时间分配及工作量问题方面男护士得分高于女护士;男护士年龄越大,职业压力得分越高;男护士学历越高,职业压力得分越高;男护士从事护士工作年限越高,职业压力得分越低。结论：男护士的职业压力现状比较严重,消除男护士的职业压力对于发挥男护士的独特优势,提高工作的积极性和稳定性是具有重要意义的。     

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.