肿瘤科护士应对死亡工作自我能力现状及影响因素分析

目的 了解肿瘤科护士应对死亡工作自我能力现状并分析其影响因素。方法 选取356名肿瘤科护士为研究对象,采用一般资料调查表、死亡工作自我能力量表、生命意义感量表、职业倦怠量表进行问卷调查。结果 肿瘤科护士应对死亡工作自我能力得分为(57.83±8.75)分,情绪应对自我能力得分率最低。多元逐步回归分析显示,生命意义感、个人成就、葬礼经历、参与死亡/濒死患者照顾是否造成影响、死亡相关课程培训是其主要影响因素(均P<0.05)。结论 肿瘤科护士应对死亡工作自我能力处于中等水平,影响因素较多,护理管理者需明确护士应对死亡工作中的需求,积极开展应对患者死亡工作相关培训。     

肿瘤科护士伦理行为现状及影响因素分析

目的 了解肿瘤科护士伦理行为现状,分析其影响因素,为制定针对性干预措施提供参考。方法 便利抽取郑州市3所三级甲等医院肿瘤科护士552人,采用一般资料调查表、护士伦理行为量表、拉什顿道德复原力量表、医院伦理氛围量表进行调查。结果 肿瘤科护士伦理行为得分为(75.85±10.75)分。多元线性回归分析结果显示,工作年限、道德韧性、医院伦理氛围是肿瘤科护士伦理行为的主要影响因素(均P<0.05),共解释总变异的50.0%。结论 肿瘤科护士伦理行为处于中等偏上水平。护理管理者可通过提升肿瘤科护士道德韧性水平,营造良好的医院伦理氛围,从而改善肿瘤科护士伦理行为。     

死亡应对量表的汉化及信效度检验

目的引进并翻译死亡应对量表并在肿瘤科护士中检验其信效度。方法按照Brislin翻译模式对英文版量表进行直译和回译,采用专家咨询及预试验对中文版量表进行初步检验;选取全国5所三级甲等肿瘤专科医院的446名肿瘤科护士进行信效度验证。结果中文版量表包括6个因子共28个条目,S-CVI为0.987,I-CVI为0.832~1.000;6个因子累积方差贡献率为60.800%。总量表的Cronbach′sα系数为0.905、折半信度为0.784、重测信度为0.973。结论中文版死亡应对量表具有良好信效度,可作为评估中国肿瘤科护士死亡应对能力的工具。     

广东省临床护士针刺伤现况及影响因素分析

目的 了解广东省医院临床护士针刺伤发生现况,分析其影响因素,为针对性干预提供参考。 方法 对广东省117所医院的10 853名临床护士,采用一般资料调查表、针刺伤现况调查表、护理职业生活质量量表及焦虑自评量表进行调查。 结果 2 414人（22.24%）近1年发生过针刺伤,其中1 317人（12.13%）被污染针刺伤。护理职业生活质量总分170.27±27.23,焦虑得分45.85±11.75,针刺伤组2项得分均显著低于未被针刺伤组（均P＜0.01）;Logistic回归分析显示,医院等级、婚姻状况、工作年限、工作科室、每月夜班数、职业防护培训频率、采血佩戴双层手套、了解患者感染状况、安全型针具使用、焦虑、工作环境是针刺伤发生的影响因素（P＜0.05,P＜0.01）。 结论 广东省临床护士针刺伤发生率较高,高频率轮值夜班、防护措施不到位、焦虑情绪等是其危险因素。管理者需采取针对性干预措施,创建有利于护士工作的职业环境,最大限度地降低针刺伤发生率。     

肿瘤科护士角色清晰度对体面劳动感的影响研究

目的 探讨肿瘤科护士角色清晰度对体面劳动感的影响,为采取针对性措施提高护士体面劳动感提供参考。方法 采用一般资料问卷、角色清晰度量表、体面劳动感知量表对湖南省5所三级医院336名肿瘤科护士进行调查。结果 肿瘤科护士角色清晰度得分（30.50±5.16）分、体面劳动感得分（47.98±6.09）分。角色清晰度与体面劳动感呈正相关（r=0.257,P＜0.05）,分层回归分析显示,是否接受过灵性教育培训、月收入、角色清晰度是肿瘤科护士体面劳动感的影响因素（均P＜0.05）,其中角色清晰度可独立解释5.4%体面劳动感的变异。结论 肿瘤科护士体面劳动感处于中等水平。管理者应及时引导护士,形成对自身角色的正确认知,提高其体面劳动感。     

肿瘤科护士正念自我照护现状及影响因素调查

目的 探索肿瘤科护士正念自我照护现状及其影响因素，为构建正念自我照护方案以改善肿瘤科护士心理健康提供参考。 方法 采用便利抽样法抽取辽宁省锦州市、沈阳市、大连市14所三甲医院的371名肿瘤科护士作为研究对象，采用一般资料调查表、中文版心理健康素养量表、领悟社会支持量表、自我同情量表和中文版简短正念自我照护量表进行调查，采用多因素分层回归分析探索影响肿瘤科护士正念自我照护水平的关键因素。 结果 肿瘤科护士的正念自我照护总分为（59.30±10.70）分；正念自我照护总分及其各维度得分与其心理健康素养、领悟社会支持、自我同情总分呈正相关（均P＜0.05）；控制一般资料后，心理健康素养、领悟社会支持、自我同情是影响肿瘤科护士正念自我照护水平的独立因素，能解释了39.6%的变异量（均P＜0.05）。 结论 肿瘤科护士正念自我照护水平处于较低水平，护理管理者应针对主要影响因素加以教育干预，以进一步提升肿瘤科护士的正念自我照护水平。     

综合医院护士职业倦怠与工作压力、自尊及控制点的关系研究

目的探讨综合医院护士职业倦怠与工作压力、应对策略、护理效能感、自尊、控制点及社会支持的关系，为护理管理、护理行政决策提供依据。方法选用职业倦怠问卷、护士工作压力量表、工作压力应对策略调查表、护士效能感量表（简表型）、自尊量表、成人Nowicki—Strick-Land内-外控制量表、社会支持评定量表，对综合医院330名临床一线护理人员进行调查。结果护士职业倦怠评分为63．83±13．23，其职业倦怠与工作压力、应对策略、控制点呈正相关（r=0．291、0．423、0．510，均P〈0．01）；与自尊、护理效能感、社会支持呈负相关（r=-0．501、-0．527、-0．212，均P〈0．01）。上述诸因素对护士职业倦怠有显著影响（均P〈0．01）。结论综合医院护士的职业倦怠发生率较高，护士的工作压力、应对策略、护理效能感、自尊、控制点和社会支持对其职业倦怠有一定的预测作用。     

肿瘤医院护士遭遇不文明行为现状及影响因素研究

目的 调查肿瘤医院护士遭遇不文明行为现状,分析其影响因素,为制定针对性干预措施提供参考。方法 方便抽取484名肿瘤医院护士为研究对象,采用一般资料调查问卷、护士遭遇不文明行为量表、拉什顿道德复原力量表及医护人员团队效能感问卷对其进行调查。结果 肿瘤医院护士遭遇不文明行为得分为（131.78±21.93）分;多元线性回归分析结果显示,工作年限、性别、团队效能感及道德复原力是肿瘤医院护士遭遇不文明行为的重要影响因素（均P＜0.05）,共解释总变异的41.0%。结论 肿瘤医院护士遭遇不文明行为处于中等水平,护理管理者应根据影响因素采取针对性干预措施,以减少肿瘤医院护士遭遇不文明行为。     

新入职护士死亡教育需求状况及影响因素分析

目的 了解新入职护士死亡教育需求状况并分析其影响因素,为医院管理者对新入职护士开展死亡教育培训提供参考.方法 以便利抽样法于2021年7～8月选取河北省11所医院的387名新入职护士,采用一般资料调查表、死亡教育需求量表、死亡态度描绘量表及死亡焦虑量表进行调查.结果 新入职护士死亡教育需求总分为171.76±40.83...     

患儿父母与儿科护士伙伴关系及影响因素分析

目的 探讨患儿父母与儿科护士伙伴关系现状及影响因素，为实施针对性护理干预提供参考。 方法 选取苏州市4所医院523名住院患儿父母为研究对象，采用一般资料调查表、中文版疾病不确定感家属量表、广泛性焦虑量表、中文版儿科护士与患儿父母伙伴关系量表进行调查。 结果 患儿父母与儿科护士伙伴关系得分为140.72±17.58。多元线性逐步回归分析显示，患儿父母性格、文化程度、居住地、健康状况、焦虑、疾病不确定感为患儿父母与儿科护士伙伴关系的影响因素（均P＜0.05）。 结论 患儿父母与儿科护士伙伴关系处于较高水平；患儿父母学历越高、性格越外向、家庭居住地为城市、在职、健康状况良好、焦虑水平越低、疾病不确定感越高，其与儿科护士伙伴关系水平越高。护理管理者应关注影响因素并积极干预，提高儿科护理满意度。     

Brain death

Summary Following the research of Giessen Neurosurgery on primary and secondary lesions of the hypothalamo-pituitary system and the brainstem over a period of more than 30 years, cerebral failure and death does not represent a uniform syndrome but consists of several, well characterized syndromes of irreversible hypothalamo-pituitary, mesencephalic and bulbar failure. The specific syndromes are described in detail. The diagnosis is based on establishing complete irreversible damage of specific vital basal functions such as hypothalamo-pituitary transmission, water-and electrolyte metabolism, temperature regulation, circulation and respiration. The common feature of all types is the irreversible break-down of the complex central neurogenous and/or neurohumoral regulatory system. The permanent and irreversible loss of central regulation and modulation means at the same time the complete cessation of the specific human cortical function, the death of the whole brain. Only in bulbar failure with primary irreversible cessation of respiration artificial respiration can maintain the autonomous functions of the heart for a limited time. It is indicated when organ explantation is to be considered. Complete and irreversible isolated loss of cortical function abolishes the normal human life, but does not mean death of the remaining vegetating human being.Presented at the meeting of the Working Group of the Pontificia Academia Scientiarum on The artificial prolongation of life and the exact determination of the moment of death, Vatican City, October 19–21, 1985.Dedicated to Prof. Dr. Jean Brihaye at the occasion of his 65th anniversary.     

Brain stem death

The concept of brain and brain stem death developed from the observation of apnoeic comatose patients. In the UK, the diagnosis of brain stem death is made by clinically testing brain stem function once specific preconditions have been met. The exact definition of brain death and some details regarding the tests required to make this diagnosis vary across the globe. However, the majority of tests carried out are similar to those in the UK. In this review we define brain stem death and the clinical tests used to confirm it. The use of ancillary testing can have a role in patients where clinical tests are not possible and this is also discussed.     

Permanent brain arrest as the sole criterion of death in systemic circulatory arrest

Historically, there has been a tendency to think that there are two types of death: circulatory and neurological. Holding onto this tendency is making it harder to navigate emerging resuscitative technologies, such as extracorporeal membrane oxygenation and the recent well-publicised experiment that demonstrated the possibility of restoring cellular function to some brain neurons 4 h after normothermic circulatory arrest (decapitation) in pigs. Attempts have been made to respond to these difficulties by proposing a unified brain-based criterion for human death, which we call ‘permanent brain arrest’. The clinical characteristics of permanent brain arrest are the permanent loss of capacity for consciousness and permanent loss of all brainstem functions, including the capacity to breathe. These losses could arise from a primary brain injury or as a result of systemic circulatory arrest. We argue that permanent brain arrest is the true and sole criterion for the death of human beings and show that this is already implicit in the circulatory-respiratory criterion itself. We argue that accepting the concept of permanent cessation of brain function in patients with systemic permanent circulatory arrest will help us better navigate the medical advances and new technologies of the future whilst continuing to provide sound medical criteria for the determination of death.     

Brain stem death

The concept of brain and brain stem death developed from the observation of apnoeic comatose patients. In the UK, the diagnosis of brain stem death is made by clinically testing brain stem function once specific pre-conditions have been met. The exact definition of brain death and some details regarding the tests required to make this diagnosis vary across the globe. However, the majority of tests carried out are similar to those in the UK. In this review we define brain stem death and the clinical tests used to confirm it. The use of ancillary testing can have a role in patients where clinical tests are not possible and this is also discussed.     

Traumatic death in urban children

Trauma has remained one of the leading causes of death in children in spite of improved medical care. A review of 911 pediatric trauma deaths which occurred over a 5 yr period in an urban setting revealed that almost 50% of these children died before receiving medical care. A significant improvement of the trauma mortality can thus only be accomplished by reducing the number of “DOAs”. We therefore analyzed the cause and type of injury and its relationship to age, sex, race, seasonal occurrence, and sociological circumstances. The following four categories are merely part of the overall material developed in this review. Even with improved medical care of trauma patients the overall pediatric trauma mortality cannot be significantly reduced unless the number of DOAs is decreased through prevention. Educational and family assistance programs can be designed for specific problem areas to reach identified susceptible groups through existing channels such as day care centers, schools, or welfare agencies. Statistical data, such as presented here (but not previously available) are essential to analyze the particular problems of specific geographic and sociologic areas. Since the vast majority of pediatric trauma deaths fall within the interest sphere of the pediatric surgeon, our active participation in accident prevention is essential to achieve a significant reduction of pediatric trauma mortalities.     

肾移植受者移植肾带功能死亡与失功能死亡原因比较

目的 分析肾移植受者移植肾带功能死亡与失功能死亡原因.方法 回顾分析我院2001年至2010年期间死亡的207例肾移植受者资料.将其分为移植肾带功能死亡组(102例)和失功能死亡组(105例),对两组死亡原因进行比较分析.结果 所有受者的死亡原因依次为感染(31.9％)、心血管疾病(21.3％)、肝功能衰竭(15.9％...     

The use of cerebral computed tomographic angiography as an ancillary investigation to support a clinical diagnosis of death using neurological criteria: a consensus guideline

This multidisciplinary consensus statement was produced following a recommendation by the Faculty of Intensive Care Medicine to develop a UK guideline for ancillary investigation, when one is required, to support the diagnosis of death using neurological criteria. A multidisciplinary panel reviewed the literature and UK practice in the diagnosis of death using neurological criteria and recommended cerebral CT angiography as the ancillary investigation of choice when death cannot be confirmed by clinical criteria alone. Cerebral CT angiography has been shown to have 100% specificity in supporting a diagnosis of death using neurological criteria and is an investigation available in all acute hospitals in the UK. A standardised technique for performing the investigation is described alongside a reporting template. The panel were unable to make recommendations for ancillary testing in children or patients receiving extracorporeal membrane oxygenation.