病房爱心学校白血病患儿的人文关怀需求评估

目的 探讨人文关怀需求评估在白血病患儿爱心学校的应用及效果.方法 通过入院初期、住院治疗期、出院期采用人文关怀需求评估表对患儿实施持续动态评估,了解患儿的学习需求并满足其需求.结果 患儿参与爱心学校课程的积极性、家长对病房爱心学校及护理服务满意度均显著提高(P＜0.05,P＜0.01).结论 通过对患儿的持续动态评估,责任护士及志愿者能更直观地了解患儿的需求,降低其盲目性,也使得患儿能更主动学习,提升了医院的社会服务功能.     

Effects of nurses volunteering for health promotion of community elderly persons

目的 探讨护士志愿者参与社区老年健康促进管理的方法及效果.方法 成立以医院专科护士、社区工作人员、老年人及子女代表的社区老年健康促进管理协会,10名三级医院护士志愿者进社区,对400名老年人进行志愿服务,包括进行健康状况及需求调查,印发健康教育宣传册,开展健康讲座,建立短信及网络平台,按照老年人健康状况分层进行指导和护理.结果 干预后老年人健康行为采纳率显著高于实施前(P＜0.05,P＜0.01).结论 专业护士志愿者进社区,对社区老年健康促进起到了积极作用.     

对居家老年退休护理人员关爱志愿服务探索

目的 探讨为老年退休护理人员提供关爱志愿服务的方法及成效。 方法 招募在职护理人员及护理院校学生志愿者为有需求的居家退休护理人员定期开展电话或上门志愿服务。 结果 志愿服务6个月，参与服务的志愿者33名，接受志愿服务的退休护理人员29名。退休护理人员认为志愿服务能够解决实际困难、增强积极情绪、感到被重视。志愿者为退休护理人员提供上门服务49人次。78.8%的志愿者认为收获很大或较大；84.9%的志愿者有很大或较大成就感。 结论 开展志愿服务对于创新老年服务模式、切实关爱居家老年人及改善老年人的生活体验具有重要意义。     

护士与医务社工及志愿者三位一体服务模式在先天性心脏病患儿中的应用

目的 探索护士、医务社工、志愿者“三位一体”护理服务模式在先天性心脏病患儿中的应用效果。 方法 护士、医务社工、志愿者组成护理团队,对住院先天性心脏病患儿及家庭开展游戏治疗服务、心理关爱服务、慈善救助服务、健康宣讲服务及主题活动服务。 结果 2018年1月至2021年12月,游戏辅导2 897例患儿,心理关爱服务764个家庭,慈善救助1 897例患儿,健康宣讲服务2 149例次。2018~2021年住院患者体验与满意度调查满意率分别为98.47%、98.59%、98.67%、98.79%。护士、医务社工、志愿者均认为提高了沟通能力。 结论 护士、医务社工、志愿者“三位一体”护理服务模式从心理、经济、健康教育等方面为患儿及家属提供服务,有效提高了服务对象满意度。     

护士志愿者参与社区老年健康促进的探讨

目的探讨护士志愿者参与社区老年健康促进管理的方法及效果。方法成立以医院专科护士、社区工作人员、老年人及子女代表的社区老年健康促进管理协会,10名三级医院护士志愿者进社区,对400名老年人进行志愿服务,包括进行健康状况及需求调查,印发健康教育宣传册,开展健康讲座,建立短信及网络平台,按照老年人健康状况分层进行指导和护理。结果干预后老年人健康行为采纳率显著高于实施前(P<0.05,P<0.01)。结论专业护士志愿者进社区,对社区老年健康促进起到了积极作用。     

医院在职护理人员志愿服务认知和参与动机调查

目的 了解在职护理人员对志愿者服务的认知、意愿及动机,为开展护理人员志愿服务提供参考.方法 采用自设问卷,通过整群抽样法对158名在职护理人员的志愿服务认知、意愿及动机进行问卷调查.结果 参加志愿服务的在职护理人员对志愿服务认知得分和意愿程度高于未参加人员(P＜0.05,P＜0.01),其志愿服务动机中的社会动机得分高于未参加人员(均P＜0.01).结论 通过参与志愿服务有利于提高在职护理人员对志愿服务的认知、意愿和社会动机,有利于医患关系和谐发展.     

医学生志愿者安宁疗护实践体验的质性研究

目的 探讨医学生志愿者参与癌症晚期患者安宁疗护志愿服务实践的感受和体验，为医学生志愿者安宁疗护培训提供参考。 方法 采用质性研究方法对参与安宁疗护志愿服务的10名医学生志愿者进行半结构式深入访谈，采用Colaizzi 7步法分析访谈资料。 结果 提炼出4个主题，即认同安宁疗护理念、积极体验、消极体验、安宁疗护相关技能欠缺。 结论 充分运用医学生志愿者认同安宁疗护理念及积极体验激发其志愿服务的热情，针对其消极体验和相关技能欠缺，安宁疗护机构应完善志愿者管理，加强死亡教育、沟通交流技巧和灵性照顾能力培训，提升医学生志愿者的安宁疗护胜任力。     

持续改进护理质量有效保障病人安全

黄石市爱康医院是一所集医疗、教学、科研、急救、预防保健为一体的综合性三级医院,共有临床科室17个、两个社区卫生服务中心、五个社区卫生服务站,病床508张,护理人员288名.医院始建于1917年,为鄂东南地区有着悠久历史的医院之一,2004年由冶钢集团公司医院改制为全国第一家民营的三级综合医院.     

三级综合医院护士科研能力培训工作坊的应用

目的 探讨基于工作坊模式的三级综合医院护士科研能力培训的效果。方法 运用文献分析法构建基于工作坊模式的三级综合医院护士科研能力培训体系（包括40项课程内容,27课时;培训师资包括临床护理专家、医疗博士、统计学博士、护理学研究生和护理教育专家;采用不同方式进行考核）,于2017年11月至2018年6月在湖北省某三级医院选取50名临床护士,采用该模式进行培训,采用护理科研能力自评量表和科研创新情况评价培训效果。结果 培训后临床护士的护理科研能力总分显著高于培训前（P<0.01）;培训后临床护士发表论文数,专利、新业务新技术、科研课题获批项目数高于培训前。结论 构建的工作坊模式的三级综合医院护士科研能力培训体系具有实用性,应用于临床护士的培训可提高临床护士的科研能力,改善护士科研创新能力。     

HIV同伴志愿者培训体系的构建

目的 构建HIV同伴志愿者培训指标体系,为扩充我国HIV同伴志愿者人员储备提供参考。方法 基于证实个案抽样开展描述性质性研究, 访谈医务人员、同伴志愿者以及HIV/AIDS患者三方利益关联人,以修订和完善课题组前期基于现实主义整合研究基础拟定的培训体系一级指标,以及研究团队讨论细化的二级指标和三级指标。结果 访谈对象提出将信息支持、工具性支持以及情感支持作为培训体系的重要内容,并对研究团队拟定的同伴志愿者培训指标体系的全面性十分认可。最终确定 HIV同伴志愿者培训指标体系包含信息支持、工具性支持、情感支持、社会互动性支持和决策支持5个一级指标,11个二级指标和26个三级指标。结论 形成的HIV同伴志愿者培训指标体系可用于培训HIV同伴志愿者。     

Screening for mutations in candidate genes for hypospadias

Hypospadias, a condition with a frontally placed urethral orifice on the penis, is the most common malformation in males. During fetal development several components are necessary for normal male genital development. Testosterone and dihydrotestosterone act via the androgen receptor but a defective receptor function results in different degrees of genital malformations. Testosterone-5α-reductase converts testosterone to dihydrotestosterone, which is crucial for normal differentiation, and a total lack of this enzyme results, in syndromes with hypospadias. The Wilms' tumour 1 (WT1) gene is expressed in the fetal gonad and genital malformations can occur due to WT1 gene mutations. These genes are therefore strong candidate genes for hypospadias. We have analysed 35 boys with hypopadias and one girl diagnosed as with complete androgen insensitivity syndrome, using exon by exon polymerace chain reaction (PCR) amplification of the AR, WT1 and 5α-reductase genes and screened for point mutations and performed subsequent DNA sequencing. No mutations in any of these genes were found in the 26 patients with isolated hypospadias. Two patients with severe hypospadias with cryptorchidism were found to carry mutations in the androgen receptor gene. Also the girl with clinically diagnosed complete androgen insensitivity was found to be homozygous for a splice mutation in the 5α-reductase gene. In summary, mutations in the WT1, AR and 5α-reductase genes are not common causes of isolated hypospadias. Received: 1 October 1997 / Accepted: 4 May 1998     

Improvement in dressings for packet therapy for psoriasis

目的 探索银屑病封包疗法中安全、舒适、经济、简便的换药方法.方法 对99例(其中双侧肢体病变30例)前臂或背部需要封包疗法的慢性斑块状银屑病患者均分为三组各43例次,分别采用绷带、保鲜膜、自制棉布方巾作为封包敷料进行包扎,1次/d.2周后评价效果.结果 三组疗效比较,差异无统计学意义(P＞0.05)；三组封包时间、敷料松脱、局部过敏率比较,差异有统计学意义(均P＜0.01).结论 棉布方巾用于银屑痛封包疗法具有操作时间短、封包牢固、安全的优点,且相对优于绷带和保鲜膜包扎.     

Legal imperatives for consent for children participating in research

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Evidence for the need for anaesthesia in the neonate

Neonates are both capable of experiencing pain and memory formation, albeit implicit memory. During surgical procedures, insufficient ablation of the stress response and possible implicit memory formation of intra-operative events might result in adverse early and long-term outcomes. Neonates deserve the same respect as adult patients. It is thus the responsibility of the anaesthetist to provide sufficient anaesthesia for neonates undergoing surgery. A critical approach in weighing the risks and benefits of exposing a neonate to anaesthesia is prudent, and truly elective surgery should be delayed.     

Mechanical simulators for training for laparoscopic surgery in urology

BACKGROUND AND PURPOSE: The introduction of laparoscopic surgery into urology has led to new training concepts differing significantly from previous concepts of training for open surgery. This paper focuses on the type and importance of mechanical simulators in laparoscopic training. MATERIALS AND METHODS: On the basis of our own studies and experience with the development of various concepts of laparoscopic training, including different modules (i.e., Pelvi-trainer, animal models, clinical mentoring) since 1991, we reviewed the current literature concerning all types of simulators. We focused on training for laparoscopic ablative and reconstructive surgery using mechanical simulators. RESULTS: The principle of a mechanical simulator (i.e., a box with the possibility of trocar insertion) has not changed during the last decade. However, the types of Pelvi-trainers and the models used inside have been improved significantly. According to the task of the simulator, various sophisticated models have been developed, including standardized phantoms, animal organs, and even perfused segments of porcine organs. For laparoscopic suturing, various step-by-step training concepts have been presented. These can be used for determination of the ability of a physician with an interest in laparoscopic surgery, but also to classify the training status of a laparosopic surgeon. CONCLUSIONS: Training in laparoscopic surgery has become an important topic, not only in learning a procedure, but also in maintaining skills and preparing for the management of complications. For these purposes, mechanical simulators will definitely play an important role in the future.     

Minimal requirements for ejaculates used for in vitro fertilization

Minimal requirements for ejaculates to be used for in vitro fertilization of human oocytes are defined. Experimental results obtained a total concentration of at least 5 X 10(6) spermatozoa per ml are required, with at least 30% of the sperm showing normal motility and normal morphology in the differential spermiocytogram. The total volume of ejaculate should not be less than 1 ml. A total of 140 ejaculates from patients taking part in the in vitro fertilization program were examined. In 60 ejaculates (42.9%) bacteria concentrations of greater than 10(5)/ml were found. Eighty (57.1%) of the probes were negative or had bacteria concentrations less than 10(4)/ml. Mycoplasma was found in 30 of the examined ejaculates (21.4%) and the second most frequent group of microorganisms were enterococci found in 15 patients (10.7%). Anaerobic organisms in concentrations of more than 10(5)/ml were not detected. After insemination of one or more pelviscopically obtained oocytes with sperm of the husband in 14 out of 22 cases (63.6%) with bacteria concentrations greater than 10(5)/ml the cleavage of at least one oocyte occurred leading to an embryo-transfer rate of 63.6%. In 14 of 31 ejaculates with negative bacteriological findings (45.2%) at least one of the inseminated oocytes was fertilized. Direct effect of microorganism contaminated sperm on the human in vitro fertilization system resulting in reduced fertilization rates cannot be demonstrated.(ABSTRACT TRUNCATED AT 250 WORDS)