The application of a factor evaluation system for community nursing in the Netherlands

In the literature both advantages and disadvantages are mentioned for factor and prototype patient classification systems. In this study a secondary analysis is used to explore the variance which is explained by a prototype and a factor evaluation classification system of the same patients. In the prototype evaluation system, the care types which were applied resulted in heterogeneous visit times. To explore the factor evaluation system, multiple regression analyses were executed with the average visit time per patient as dependent variable and the activities (separate or aggregated per category) as independent variables. Results show that the activities explain the average visiting time per patient better than the developed care types do.     

The attitudes of British fundholding general practitioners to community psychiatric nursing services

This study was designed to explore the attitudes of Brush fundholding general practitioners to community psychiatric nurses and the services they currently provide, and may provide in the future The information was collected by postal questionnaire Seventy-two fundholding general practitioners were identified within the East Sussex Family Health Authority, England, 20 (27%) completed and returned the questionnaire The instrument was based on previously published work, with some adaptations relating to the fundholding element The results confirmed previous research findings suggesting a favourable attitude towards community psychiatric nurses, and also identified the services they should provide Three areas in need of urgent research were highlighted     

Population views on access to community nursing services in Finland

The aim of this study was to evaluate potential access to personal community nursing services and the desirability of these services from the point of view of different population groups Potential access to personal community nursing services was defined as having one or more particular nurses to contact when needing help and advice in health matters The desirability of these services was defined as the respondents'estimation of how useful they considered it to be for them to have access to personal community nursing services A computer-assisted telephone interview for the population living in the catchment areas of 10 health centres in Finland was conducted A random sample of the total population aged 16–79 years was drawn from the population register Logistic regression revealed that gender, type of community and employment status had best explanatory power in having potential access to personal nursing services and in considering these services desirable However, many of those who considered personal nursing services very desirable, indicated that they did not have potential access to such services Most of these persons were elderly and had a chronic disease or disability Developing access to personal community nursing services particularly for these population groups appears to be needed     

影响北京地区急性心肌梗死患者应用急救医疗服务的因素

目的 探讨我国北京地区应用急救医疗服务(EMS)救治急性心肌梗死(AMI)的状况以及影响患者选择EMS的因素.方法 采用前瞻性、横断面研究方法,入选2005年9月至2006年12月来自北京21家医院的868例ST段抬高的急性心肌梗死(STEMI)患者,将符合AMI的诊断标准,并排除患者由于另外的临床表现而入院后发生的AMI等情况后,最后入选803例.根据是否应用EMS到达医院分为EMS组和自我转运组两组,采用χ2检验、多因素logistic回归分析(Forwald:Conditional method)等统计方法,对比分析两组资料.结果 仅有39.5%的患者使用EMS到达指定的医院(EMS组n=317),60.5%的患者自我到达医院(自我转运组n=486).逐步logistic回归分析表明,年龄较大[95%可信区间(CI):1.013～1.038,OR=1.026,P=0.000]、夜间发病(95% CI:1.171～2.186,OR=1.600,P=0.003)、症状无法忍受(95% CI:1.300～2.668,OR=1.863,P=0.001)、接受过心脏病发作的知识训练(95% CI:2.597～6.554,OR=4.125,P=0.000)以及较高经济收入(95% CI:1.123～1.717,OR=1.389,P=0.002)、有心力衰竭(95% CI:1.401～2.051,OR=5.300,P=0.014)和脑卒中病史(95% CI:1.036～2.811,OR=1.707,P=0.036)等患者非常显著地应用了EMS.EMS组从发病到医院就诊的时间明显缩短(M,110:143min,P=0.000).结论 年龄较大、夜间发病、症状无法忍受、接受过心脏病发作的知识训练以及较高经济收入、有心力衰竭和脑卒中病史等是预测患者应用EMS的独立变量.     

正确认识护士职业倦怠的相关因素及应对策略

1974年美国临床心理学家Freudenberg研究职业紧张时提出了“职业倦怠”(Jobburnout)这个概念,指个体在工作重压下产生的身心疲劳与耗竭的状态,他认为职业倦怠是一种最容易在助人行业中出现的情绪性耗竭的症状^[1]。Maslach等人把工作上长期的情绪及人际应激源做出反应而产生的心理综合征称为职业倦怠。职业倦怠由情绪衰竭(emotionalexhaustion)、不人性化(depersonalization)、个人成就感降低(diminishedpersonalaccomplishment)3个维度构成。一般认为,职业倦怠是个体不能顺利应对工作压力时的一种极端反应,是个体伴随于长时期压力下而产生的情感、态度和行业的衰竭状态。职业倦怠是人们心理亚健康的一种表现,又称“职业枯竭”。中国人力资源调查报告显示,中国正进入工作倦怠现象的高峰期,职业倦怠将成为现在社会职场的“流行病”。尽管职业倦怠存在于很多行业,但是护理工作是一种特殊的、高风险的职业,劳动强度大,危险性高,极易产生职业倦怠。长期以来护士一直是职业倦怠研究的重点人群之一,而大量的研究结果也充分证明,职业倦怠在护理人员身上尤为明显。     

Older people's willingness to use home care nursing services

AIM: This paper reports a study exploring willingness to use home care nursing services among older people and discussing the implications for long-term and home care nursing policies. BACKGROUND: The proportion of older people is increasing in all societies across the world. Correspondingly, Korean society has experienced a rapid growth in its population of older people, and this is expected to increase from 7.2% in 2000 to 14.4% in 2019. The government is in the process of developing publicly-financed long-term care for older people, and home care nursing services are expected to be provided as an element of this care. Methods. A cross-sectional study design was used, employing data from a nationally representative interview survey with 1834 respondents conducted during May and July, 2001. Univariate and logistic regression analyses were conducted. RESULTS: Willingness to use home care nursing services differed according to whether co-payment was required. About half the respondents answered that they would not use the services; 43% expressed a willingness to use them without co-payment; and 5% were very willing to use them even with co-payment. People with lower incomes showed greater willingness to use the services with no co-payment, while the high income group showed the greatest willingness under co-payment. Sex, living with adult children, living area, activities of daily living, and chronic conditions were associated with willingness. Older people who had known about or used home care nursing services previously showed greater willingness. CONCLUSIONS: Co-payment guidelines for minimizing unmet needs are required, especially for older people with low incomes. A positive evaluation from those who knew about or had used such services is expected to contribute to the use of home care nursing services by older people.     

Community nursing in The Netherlands

Major developments and changes are currently taking place in the Dutch health care system and community nurses are reacting now to assure they have their proper place in the future setup. Community nurses in other Western countries can perhaps find new ways to contribute to their national health schemes by following their example.     

糖尿病视网膜病变相关因素分析与社区护理

目的:探讨糖尿病患者视网膜病变发生的相关因素社区护理方法.方法:将205例糖尿病住院患者根据糖尿病视网膜病变(DR)诊断标准将患者分为DR组(158例)与非DR组(47例),对其基本情况如年龄、病程、血压及空腹血糖等实验室检查指标进行统计,分析DR发生的相关因素,针对病变因素实施相应的社区护理干预.结果:DR组糖尿病病程更长,尿素、尿酸、血压、WBC、中性粒细胞更高,两组比较有统计学意义(P<0.05);DR组与非DR组比较年龄的构成和空腹血糖差异无统计学意义(P>0.05).结论:对DR患者在社区实施降糖治疗和健康教育等护理干预措施,能提高患者的自护能力,有效控制血糖、血压和预防DR的发生,提高糖尿病患者的生活质量.     

影响疗养护理安全的相关因素及对策

<正>牢固树立安全发展理念,切实把安全发展的要求落实到疗养护理工作的方方面面,对于提高护理质量,推动疗养护理事业又好又快发展,具有十分重要的意义。本文     

The discharge liaison nurse at the interface of hospital and community nursing services

The organization of nursing into hospital and community services makes the smooth transition of care between hospital and community difficult to establish. This paper describes the function of discharge liaison nurses as one facet of a study designed to determine how hospital and community nurses perceive their provision of continuing patient care. Semi-focused interviews were conducted with 12 hospital nurses and 12 community nurses to explore their perceptions of discharge planning related experiences. Hospital and community nurses both relied on discharge liaison nurse to provide a link between hospital and community services. The practice of discharge liaison nurses as facilitators and co-ordinators of discharge planning are discussed.     

The use of medication compliance devices by district nursing services

This article presents a critical review of the literature relating to medication compliance devices and the findings of a survey that examined the use of such devices by district nursing services. The UKCC (1992) does not regard the loading of compliance devices by nurses as safe practice; however, compliance devices continue to be used by district nurses. The evidence base concerning the value and use of medication compliance devices is examined and significant gaps in the literature relating to the use of such devices are identified. There is an absence of studies that focus on the effect of compliance devices on adherence among older patients and the nature and frequency of drug administration errors involving these devices. The survey findings show that nurse-loaded compliance devices are used in over one-third of the sample. Further research is necessary to assess the clinical effectiveness of, and clinical risk attached to, compliance devices for older patients in the community. It is suggested that this is an issue of serious concern for primary care groups considering the principles of clinical governance.     

Extending community health nursing services. The Student Learning Center.

Faced with scarce resources, the Visiting Nurse Association of Omaha (VNA), Bishop Clarkson College, Creighton University, and University of Nebraska Medical Center collaborated to maintain services. Baccalaureate students learned to deliver community health nursing while serving a population in need of these services, but not coverable by funding sources. The Student Learning Center established by the VNA enabled 254 students to provide 5,035 home visits to families without funding sources.