Factors which influence coping: home-based family caregiving of persons with advanced cancer

The findings from a qualitative study of how caregivers coped while they cared for a dying family member at home are presented. Fifteen family caregivers were interviewed twice following the death of their family member. Although it was not one of the original objectives of the research, coping emerged as a category needing further analysis. There were factors that either facilitated or interfered with caregiver coping. Those factors that facilitated their coping included characteristics of the caregivers themselves; contributions made by the dying person; and supportive networks, both formal and informal, available to the caregivers. Interfering factors related to caregiver experiences with informal and formal systems. From the more distant perspective of post-death reflections, the caregivers provided insight into how their coping was grounded in the meaning associated with their experiences.     

利用排班本与护士进行有效沟通

现代社会已进入信息时代,作为护士长经常要把上级的精神及自己的工作意图传达给护士,但因护士工作为倒班制,每天至少有二分之一的护士因轮休而不在岗,这样给工作的安排造成很大的不便。通过实践发现利用排班本把要传达的信息记录下来,可以有效地把这些信息在最短的时间、以最快     

Factors which influence blood platelet migration.

Migration of human blood platelets in vitro was investigated by a modification of the capillary-tube migration chamber technique used to study the migration inhibition factor of macrophages. Platelets were packed in capillary tubes and incubated in autologous platelet-free plasma (PFP). The extent of migration was quantified by planimetry (measurement of the area of platelet migration visible by stereomicroscopy). Among the various anticoagulants employed, sodium citrate was most suitable for studying platelet migration. Optimal migration occured at 22 degrees to 37 degrees C and pH 7.2 to 7.4. Migration was inhibited by metabolic inhibitors such as iodoacetic acid, sodium fluoride, and 2,4-dinitrophenol, and inhibition was proportional to the dose of the agent added to the incubation medium. Mobility was also inhibited by cytochalasin B, which disrupts cellular microfilaments, at 1 microgram/ml PFP, but not by colchicine, a microtubule inhibitor, even at 40 microgram/ml of PFP. Light and electron microscopy showed that this inhibition was not ascribable to platelet clumping. These observations suggest that platelet mobility is an active process. The possible significance of platelet migration in hemostasis is discussed.     

护士与癌症病人沟通的技巧

癌症是严重威胁人类缝康的身心疾病，其治疗复杂、病程长、开支多、预后差、病死率高，被人们视为“不治之症。”癌症病人承受着生理和心理的双重压力，有的病人家属为了减轻病人的思想负担，向病人保密，使病人不了解自己的病情，给护患沟通增加了难度。据文献报道，当前临床上80％的护患纠纷都是由于护士与病人沟通不良或沟通障碍引起。这部分纠纷是完全可以预防的，而一旦发生纠纷带来的不良后果是不可预料的。因此护士与癌症病人沟通，减轻病人痛苦，减少护患纠纷，建立和谐护患关系是十分必要的，也是当前时代所要求的。     

护士与癌症病人沟通的技巧

癌症是严重威胁人类健康的身心疾病,其治疗复杂、病程长、开支多、预后差、病死率高,被人们视为“不治之症。”癌症病人承受着生理和心理的双重压力,有的病人家属为了减轻病人的思想负担,向病人保密,使病人不了解自己的病情,给护患沟通增加了难度。据文献报道,当前临床上80%的护患纠纷都是由于护士与病人沟通不良或沟通障碍引起[1]。这部分纠纷是完全可以预防的,而一旦发生纠纷带来的不良后果是不可预料的。因此护士与癌症病人沟通,减轻病人痛苦,减少护患纠纷,建立和谐护患关系是十分必要的,也是当前时代所要求的。1癌症病人入院时的沟通技…     

Factors that influence nurses to use physical activities in the care of psychiatric patients

This study addresses the importance of promoting physical activities among psychiatric patients and its goals were to identify the changing behavior potential of the nurses as well as to identify the nurse staff beliefs regarding the benefits of physical activity with the patients, to characterize the way in which these activities are managed inside the psychiatric hospital and finally, to identify the factors which influence the promotion of these activities in the mentioned environment. The fourteen nurses interviewed believe in the benefits of physical exercise, but only nine of them do training. We have noticed that 50% of them are in the action stage, 42.9% are in contemplative stage and only 7.1% are in the pre-contemplative stage.     

The factors which influence nurses when weaning patients from mechanical ventilation: Findings from a qualitative study

The aim of the study was to describe the factors that influence critical care nurses when deciding to wean patients from mechanical ventilation. The study adopted a qualitative methodology, using semi-structured interviews and a vignette. An invited sample of critical care nurses (n = 24) from one Irish intensive care unit was employed. Each nurse was interviewed once and a vignette was used to structure the interview questioning. The findings were analysed using thematic content analysis. Six major themes influencing nurses’ decision to wean emerged, as follows: physiological influences; clinical reassessment and decision making; the nurse's experience, confidence and education; the patient's medical history and current ventilation; the intensive care working environment; and use of protocols. The findings highlight the complex nature of weaning patients from mechanical ventilation and the major role of the nurse in this process.     

Factors that influence state policies for caregivers of patients with chronic kidney disease and how to impact them

When individuals with chronic kidney disease require ongoing assistance with activities of daily living and disease management, the consistent care provided by family caregivers often averts the need for institutional placement These caregivers may experience physical and mental burden when supports are not in place to provide occasional help and relief In some states, public programs have been developed to provide assistance to family caregivers, such as respite care, caregiver training, and tax credits. However, policies among the states are not consistent. This study identified factors that have influenced the development of family caregiver-friendly policies and programs in two study states, Connecticut and New Jersey. The case study method used in this research utilized data from informant interviews, document review, and observation of select meetings and hearings to identify 11 factors or themes that impacted public policy development benefiting family caregivers. Two primary factors, state fiscal environment/philosophy and advocacy, were found to be critical to the policymaking process. Based on these findings, specific measures are described that nephrology nurses can take to help influence adoption of policies benefiting caregivers. In addition, information to help caregivers access available programs through agencies, organizations, and informational Web sites is identified.     

A video analysis of how physiotherapists communicate with patients about errors of performance: insights for practice and policy

Objectives

To describe and elucidate skilled practices by which physiotherapists communicate with patients about problems of ongoing or recent performance of physical treatment activities; to offer a sociological perspective on this area of practice; to examine relations between actual communication practice and official (Chartered Society of Physiotherapy) recommendations; to explore problems associated with formulating standards pertaining to communication and suggest how these might be addressed.

Design

Video recordings of physiotherapy treatment sessions (n = 74) were analysed using conversation analysis—an observational, inductive, social science methodology.

Setting

Inpatient rehabilitation units in four English hospitals.

Participants

Twenty-one stroke patients aged 52-86 years and 10 senior physiotherapists with 3-23 years of postqualification experience.

Results and conclusions

A variety of practices were identified. Managing shortcomings of performance often involves identifying and/or correcting the problem in a manner that deals sensitively with the negative connotations of physical non-competence. Characteristics of these practices include indirectness and ambiguity. As such, they do not conform to some official recommendations. However, good interactional reasons underlie the observed patterns. It is suggested that official guidance should acknowledge the complexity of communication and its measurement. Recommendations should be based upon a thorough understanding of the interactional tasks and practices entailed in physiotherapy. Recommendations should be explicitly tentative and refer to broad principles. By elucidating specific communication strategies, their consequences and the considerations that underlie them, conversation analytic research into physiotherapy communication has the potential to inform guidelines, and provide resources for developing and teaching communication skills.     

癌症病人主要照顾者沟通认知现状调查

[目的]探讨癌症病人主要照顾者沟通认知现状。[方法]对住院癌症病人的主要照顾者进行沟通认知问卷调查。[结果]在主要照顾者的沟通认知项目中得分最高的是"沟通可给予病人情感支持",得分最低的是"沟通可使病人正确认识疾病"。不同年龄、文化程度、有无医护沟通指导的主要照顾者的沟通认知存在差异。[结论]主要照顾者对沟通在帮助病人认识疾病方面的重要性认识不足。