护士对进展期胃癌患者癌因性疲乏认知和应对质性研究

目的:了解肿瘤科护士对进展期胃癌患者癌因性疲乏的态度。方法:采用质性研究法,深度访谈10名肿瘤科护士对进展期胃癌患者癌因性疲乏的认知和应对。结果:总4个主题:护士对癌因性疲乏认知度不够,护士对患者疲乏不重视;护士缺乏获取缓解患者疲乏方法的知识路径,护士缺少缓解患者疲乏的规范化操作规程。结论:肿瘤科护士癌因性疲乏相关知识水平亟待提高,癌因性疲乏管理态度与护理实践需求之间存在差距,且知识技能更新困难,需进一步探寻针对癌因性疲乏的护理干预方案。     

《成人癌因性疲乏临床护理指南》的构建研究

[目的]构建《成人癌因性疲乏临床护理指南》。[方法]复旦大学JBI循证护理合作中心组织专家,以JBI循证卫生保健模式为理论框架,结合国内外指南构建方法,构建形成本土化的《成人癌因性疲乏护理指南》,并进行试点应用,从系统、护士和病人3个层面评价指南的应用效果。[结果]形成的《成人癌因性疲乏护理指南》主要包含癌因性疲乏症状筛查和评估、干预(一般性干预措施、对症处理、支持治疗)等方面的推荐意见,该指南在AGREE系统6个维度的标准化总分均高于85%,且临床实施过程具有可行性。[结论]遵循规范的指南构建方法形成了《成人癌因性疲乏护理指南》,经临床试用有一定的可行性,推广性有待进一步的研究。     

《艾滋病临床护理实践指南》在临床应用实践中的质性研究

目的了解《艾滋病临床护理实践指南》在艾滋病病房中的应用情况以及护士应用该指南的促进因素和阻碍因素。方法 2020年6-7月,选取上海市、南宁市、昆明市3所艾滋病定点医院住院病房中的一线临床护士及护理管理者为研究对象,通过半结构式访谈收集资料,采用内容分析法进行资料分析,借助Nvivo 11.0软件对访谈资料进行编码。结果共纳入16名研究对象,归纳出3个主题。分别为指南应用下护理实践的内容、护士应用指南的促进因素和阻碍因素以及指南更新的建议。结论护士应用指南的促进因素和阻碍因素包括指南相关因素、卫生系统因素以及护士个人因素。建议在更新指南时扩大关注人群,将非HIV相关慢性病管理纳入更新目录。     

成年肿瘤患者癌因性疲乏筛查与评估的证据总结

目的 评价总结成年肿瘤患者癌因性疲乏筛查与评估的最佳证据,为临床护理人员实施癌因性疲乏的管理提供参考。方法 采用PICO的方法确定科学问题,明确检索策略和纳排标准,计算机检索建库至2019年3月Up To Date、苏格兰院际指南网、英国国家卫生与临床优化研究所、加拿大安大略注册护士协会、美国国立指南网、中国医脉通指南网、美国国家综合癌症网络、美国临床肿瘤协会、加拿大心理社会肿瘤协会、肿瘤护理协会、安大略省癌症护理中心、Cochrane Library、JBI图书馆、PubMed、中国知网、万方、维普及中国生物医学文献数据库关于成年肿瘤患者癌因性疲乏筛查和评估的证据,包括临床决策、临床指南、证据总结。由2名研究者对文献进行质量评价、证据提取与综合。结果 共纳入文献6篇,包括临床决策1篇、指南4篇、证据总结1篇,最终总结出筛查时机、筛查工具、筛查者、评估时机、评估内容、评估者、筛查评估方法及培训8个方面12条最佳证据。结论 成年肿瘤患者癌因性疲乏筛查与评估的最佳证据可为临床应用提供循证依据,护理人员可根据证据进行临床护理实践。     

妇科肿瘤护士对癌因性疲乏的认知与护理行为调查

[目的]通过调查了解妇科肿瘤护士对癌因性疲乏认知及护理行为情况,从而针对性开展相关继续教育,不断提高我科癌症病人生存质量、护理质量与护理满意度。[方法]通过参考国内外相关文献资料自行设计调查问卷,对我科108名护士进行癌因性疲乏认知调查。[结果]本研究调查显示,妇科肿瘤护士对癌因性疲乏的认知情况,护士对癌因性疲乏的定义与疾病的关系、常见的症状、测量方式、程度分级及干预方式认知程度分别为75.00%、50.93%、68.52%、31.48%、75.00%、59.26%。妇科肿瘤护士对癌因性疲乏的态度,88.89%的护士认为癌因性疲乏有必要采取相应的护理干预措施。病人产生癌因性疲乏后72.22%及以上妇科肿瘤护士会及时进行相关各项处理,但其中50.93%的护士不会对病人的疲乏建立记录。[结论]妇科肿瘤护士对癌因性疲乏认识不足,需加强妇科肿瘤护士对癌因性疲乏知识了解,组织开展癌因性疲乏护理的学习,从而提高我科癌症病人生存质量及护理质量与护理满意度。     

中医护理技术在癌因性疲乏护理中的应用现状及展望

对中医护理技术和癌因性疲乏的概念、中医护理技术在癌因性疲乏护理中的临床应用现状及展望进行综述,旨在为中医护理技术在癌因性疲乏护理的临床应用和相关研究提供参考。     

胃癌术后病人化疗期间癌因性疲乏的调查分析

[目的]了解胃癌术后病人化疗期间癌因性疲乏的发生情况及严重程度。[方法]采用便利抽样法,应用自行设计的一般资料调查表及Piper修订疲乏量表(RPFS)对93例胃癌术后化疗的病人进行化疗期间癌因性疲乏发生情况及严重程度的问卷调查。[结果]胃癌术后病人化疗期间癌因性疲乏的总体发生率为86%,其平均得分为2.73分±2.22分,各维度得分由高到低依次为躯体疲乏、认知疲乏、行为疲乏和情感疲乏;34.4%胃癌术后病人化疗期间癌因性疲乏持续时间不超过1周;40.9%的病人认为每天没有固定的疲乏形态。[结论]胃癌术后病人化疗期间大部分存在癌因性疲乏,临床护士应重视对病人疲乏情况的评估,根据评估结果采取针对性的护理措施,提高病人的生活质量。     

血液科护士同情心疲乏体验的质性研究

目的 了解血液科护士的同情心疲乏心理体验,为医院及护理管理者制订应对策略、促进护士心身健康提供依据。方法 采用现象学研究方法,选取浙江省3所三级甲等医院的17名血液科护士进行面对面的半结构式个人访谈,使用Colaizzi七步资料分析法分析、整理资料。结果 血液科护士的同情心疲乏体验可归纳为2大主题：同情心疲乏的形成与发展、同情心疲乏的应对方式。结论 血液科护士同情心疲乏的发生发展过程与多种因素相关,很大程度影响了该群体的工作及生活状态,血液科护士对此的应对方式不同。管理者应重视血液科护士同情心疲乏体验,及早发现并有效调节,以促进护士心身健康,提高护理服务质量。     

癌因性疲乏患者瑜伽运动管理的最佳证据总结

目的 系统检索、提取、汇总和分析癌因性疲乏患者瑜伽运动管理的最佳证据，为临床制订基于证据的癌因性疲乏患者瑜伽运动决策和干预提供循证依据。方法 计算机检索BMJ最佳临床实践、UpToDate、英国国家卫生与临床优化研究所指南网、加拿大安大略注册护士协会指南网、苏格兰学院间指南网、美国国家综合癌症网络、指南国际网络、医脉通、澳大利亚乔安娜布里格斯研究所循证卫生保健中心图书馆、Cochrane图书馆、PubMed、Web of Science、CINAHL、万方数据库、中国知网、中国生物医学文献数据库、美国癌症研究学会网站和美国肿瘤护理学会网站中关于癌因性疲乏患者瑜伽运动的所有证据，包括临床实践指南、证据总结、临床决策、专家共识、系统评价等，检索时间为建库至2021年12月。由2名研究人员独立进行文献筛选和质量评价，根据主题进行证据提取、归纳和汇总。结果 最终共纳入7篇文献，包括1篇指南和6篇系统评价。通过2名研究人员共同讨论，提取归纳癌因性疲乏患者瑜伽运动管理相关证据共22条，汇总9个主题，分别为运动认知、运动效果、瑜伽类型、运动评估、运动指导与监督、运动对象、制订原则、运动参数、评价工具...     

基于CiteSpace的国内癌因性疲乏护理相关文献的可视化分析

目的:对我国近20年癌因性疲乏护理研究相关文献进行计量学分析,探究癌因性疲乏护理研究的现状及发展方向,为我国癌因性疲乏相关的护理工作及研究提供思路.方法:在中国知网(CNKI)近20年收录的文献中,以"癌因性疲乏护理"为主题词进行检索,确定发文量、作者、机构、关键词4个方面,用CiteSpace 5.5.R2软件进行分析.结果:纳入文献1128篇,运用CiteSpace 5.5.R2软件绘制知识图谱对文献进行分析,呈现出4个特征:国内有关癌因性疲乏的护理文献逐年增涨,2016年至今为繁荣时期;国内针对不同癌症导致的癌因性疲乏,有不同方向的护理科研合作团队;国内高校与其附属医院对于癌因性疲乏的护理研究合作较为紧密;"睡眠质量""心理弹性""有氧运动"是国内近年癌因性疲乏护理研究的热点.结论:癌因性疲乏护理日益受到护理研究人员的关注,但需继续提高年发文量,进一步加强机构、作者之间的合作关系,并对癌因性疲乏护理研究热点进一步探讨,促进癌因性疲乏护理研究的发展,为癌症病人提供更全面的护理.     

Nursing professionals' experiences of the facilitators and barriers to the use of telehealth applications: a systematic review of qualitative studies

The aim of the study was to synthesise the best available research evidence on nursing professionals' experiences of the facilitators and barriers to the use of online telehealth services in nursing practice. Telehealth is used to deliver healthcare services and health‐related information by means of information and communication technology (ICT ). The systematic review of qualitative studies was conducted using thematic synthesis of previous studies. International electronic databases PubMed, CINAHL , Eric, Web of Science/Web of Knowledge and Scopus, and Finnish databases Medic and Ohtanen were searched in spring 2013. In addition, the search was complemented in fall 2015. Following critical appraisal, 25 studies from 1998 to fall 2015 were reviewed and the findings were synthesised. Both facilitators and barriers were grouped into five main categories which were related to nurses' skills and attitudes, nurses' work and operations, organisational factors, patients and technology. The highest number of facilitators and barriers was found in the category focusing on nurses' work and operations. Based on the findings, nurses' skills and attitudes are preventing factors in the implementation of telehealth. There is also a need to focus on patients' role in telehealth usage although the findings support positive adoption of ICT tools among patients. The findings call for further development of technological tools used in nursing practice and healthcare services. The change from traditional face‐to‐face nursing to the use of telehealth calls for local agreements and further discussions among professionals on how this change will be accepted and implemented into practice. In addition, organisations need to make sure that nurses have enough resources and support for telehealth use.     

肿瘤科护士工作满意度和同情心负荷的相关性研究

目的探讨肿瘤科护士工作满意度与同情心负荷状况,并分析二者的相关性。方法采用卡劳斯克与米勒满意度量表和同情心负荷量表对424名肿瘤科护士进行调查。结果肿瘤科护士工作满意度总分为(100.57±15.07)分;同情心满足感得分为(34.20±5.33)分,同情心疲乏得分为(20.09±4.53)分,工作倦怠得分为(18.15±4.20)分。工作满意度与同情心负荷呈正相关(P0.01),与同情心疲乏、工作倦怠呈负相关(P0.01或P0.05)。结论通过提高护士工作满意度可激发其同情心满足感,缓解同情心疲乏,促进护士身心健康,保证临床护理质量。     

Point-of-care used in the treatment of older patients with cancer. The perception and experience of nurses

BackgroundNursing tasks are changing as the proportion of people over the age of 65 years is increasing and is expected to double over the next four decades. New innovative solutions such as Point of Care Treatment (POCT) are being tested in oncological settings in order to optimise treatment, and this changes the nurse management in oncology. There is a need to explore oncology nurses' perception and experience when implementing the innovations in order to understand the implications for nursing and the treatment of older patients with cancer.MethodsQualitative research with face to face interviews with nurses working in oncology. Sample size (Mean = 8). Data were recorded verbatim, transcribed, and thematic analysis used.ResultsThree themes were identified: a, A great advantage in nursing, b, Change of practice in nursing care, c, Challenges in shifting roles. A majority of the participants had the perception that POCT treatment was an advantage not only for the nursing profession but for the older patients in cancer treatment as well. Monitoring the older patients with cancer at home would prevent them from accessing the hospital and get exposed to viral infections as well as saving them the journey to the hospital. Involvement from relatives, clear communication and management of the device and data transferred is essential.ConclusionsThe use of POCT in oncology will shift the nurses' tasks on the ward as well as improve treatment for older patients with cancer.     

临床护理人员对下肢深静脉血栓的认知现状和预防措施落实情况的调查

目的调查某地三级甲等综合性医院临床护理人员对下肢深静脉血栓(deep venous thrombosis,DVT)的认知现状以及DVT预防措施的落实情况,以期为进一步提高护理人员下肢DVT的预防和护理水平提供依据。方法 2016年9月,便利抽样法选取某地市区8所三级甲等综合性医院临床护理人员1166名为研究对象。采用自行设计的"临床护理人员对下肢DVT认知现状和DVT预防措施落实现状的调查问卷"对其进行调查。结果本调查中1166名护理人员对下肢DVT相关知识的认知得分为71~240分,平均(181.24±32.04)分。不同年龄、学历、护龄、能力层级、职称、职务、有无下肢DVT患者护理经验及有无阅读相关指南经历的护士,其下肢DVT相关知识认知评分差异均有统计学意义(均P0.05)。护理人员临床下肢DVT预防措施落实情况得分为33~115分,平均(100.45±14.17)分。不同学历、有无下肢DVT患者护理经验及有无阅读相关指南经历护士,其临床下肢DVT预防措施落实情况评分的差异均有统计学意义(均P0.05)。护理人员下肢DVT相关知识的认知现状得分与下肢DVT预防措施落实现状得分之间呈正相关(r=0.584,P0.001)。结论临床护理人员下肢DVT相关知识掌握情况处于中等水平,下肢DVT预防措施落实情况较好。医院应重点加强对工作时间5年以内、中专学历的低年资护理人员的培训和学历教育。     

An exploration of nurses'' perceptions regarding the implementation of a best practice guideline on the assessment and management of foot ulcers for people with diabetes

The aim of this qualitative study was to explore nurses' perceptions regarding the implementation of a best practice guideline (BPG) on the assessment and management of foot ulcers for people with diabetes. Fourteen nurses from a community care setting and three hemodialysis units participated in five focus groups and one individual interview. The findings focus on key points regarding the impact of BPG implementation in the areas of patient outcomes, nursing practice, and interdisciplinary teamwork.     

Truth-telling to patients' terminal illness: What makes oncology nurses act individually?

PurposeNurses encounter the challenge of truth-telling to patients' terminal illness (TTPTI) in their daily care activities, particularly for nurses working in the pervasive culture of family protectiveness and medical paternalism. This study aims to investigate oncology nurses' major responses to handling this issue and to explore what factors might explain oncology nurses' various actions.MethodsA pilot quantitative study was designed to describe full-time nurses' (n = 70) truth-telling experiences at an oncology centre in Taipei. The potential influencing factors of nurses' demographic data, clinical characteristics, and truth-telling attitudes were also explored.ResultsMost nurses expressed that truth-telling was a physician's responsibility. Nevertheless, 70.6% of nurses responded that they had performed truth-telling, and 20 nurses (29.4%) reported no experience. The reasons for inaction were “Truth-telling is not my duty”, “Families required me to conceal the truth”, and “Truth-telling is difficult for me”. Based on a stepwise regression analysis, nurses' truth-telling acts can be predicted based on less perceived difficulty of talking about “Do not resuscitate” with patients, a higher perceived authorisation from the unit, and more oncology work experience (adjusted R² = 24.1%).ConclusionsOncology care experience, perceived comfort in communication with terminal patients, and unit authorisation are important factors for cultivating nurses' professional accountability in truth-telling. Nursing leaders and educators should consider reducing nursing barriers for truth-telling, improving oncology nurses' professional accountability, and facilitating better quality care environments for terminal patients.     

Cancer rehabilitation from the perspectives of oncology nurses in Korea

The purpose of this study was to understand the perception of oncology nurses and how it is related to cancer rehabilitation in Korea. A qualitative study with three focus groups consisting of 6–8 Korean oncology nurses (n = 21) was conducted. The interviews were thematically analyzed. Two main themes for the attributes of cancer rehabilitation were “comprehensive activities of nurses” and “active involvement of survivors.” Six subthemes from the oncology nurses' care experiences were identified: “incorporating partnership and sharing feelings,” “fulfilling individualized needs,” “providing timely and practical support,” “enhancing internal strength with optimistic mindset,” “regaining functional independence,” and “getting family members in.” The findings suggest that oncology nurses can play a key role in rehabilitation for cancer survivors. Nursing interventions focused on comprehensive activities of nurses as well as active involvement of survivors can be effective in enhancing cancer survivors' strength and resilience in order to lead a healthy life. Oncology nurses need to be taught a psychosocial intervention based on individualized assessment and family partnership for cancer survivors.     

Barriers to,and facilitators of post‐operative pain management in Iranian nursing: a qualitative research study

Background: Unrelieved post‐operative pain continues to be a major clinical challenge, despite advances in management. Although nurses have embraced a crucial role in pain management, its extent is often limited in Iranian nursing practice. Aim: To determine Iranian nurses' perceptions of the barriers and facilitators influencing their management of post‐operative pain. Methods: This study was qualitative with 26 participant nurses. Data were obtained through semi‐structured serial interviews and analysed using the content analysis method. Findings: Several themes emerged to describe the factors that hindered or facilitated post‐operative pain management. These were grouped into two main themes: (1) barriers to pain management after surgery with subgroups such as powerlessness, policies and rules of organization, physicians leading practice, time constraints, limited communication, interruption of activities relating to pain, and (2) factors that facilitated post‐operative pain management that included the nurse–patient relationship, nurses' responsibility, the physician as a colleague, and nurses' knowledge and skills. Conclusion: Postoperative pain management in Iran is contextually complex, and may be controversial. Participants believed that in this context accurate pain management is difficult for nurses due to the barriers mentioned. Therefore, nurses make decisions and act as a patient comforter for pain after surgery because of the barriers to effective pain management.