中文版Braden QD压力性损伤风险评估量表在患儿中的信效度研究

目的对Braden QD压力性损伤风险评估量表进行汉化并检验其信效度。方法在获得原量表作者授权后,对原量表进行翻译、回译、检译、跨文化调适以及预调查,形成中文版Braden QD量表;采用方便抽样法选取323例住院患儿进行问卷调查,以测量量表的信度和效度。结果量表的Cronbach′sα系数为0.760,折半信度为0.820,各条目删除后新的Cronbach′sα系数均较删除前的Cronbach′sα系数低,组内相关系数为0.991(P<0.01);量表水平内容效度指数和条目水平内容效度指数均为1.000,探索性因子分析共抽取2个公因子,累积方差贡献率为63.959%,验证性因子分析结果显示模型拟合良好。结论中文版Braden QD量表经验证后具有良好的信效度,可用于我国住院患儿压力性损伤风险评估。     

临床护士培训负荷调查量表设计

目的设计临床护士培训负荷调查量表并检验其信效度,为了解临床护士的培训负荷提供工具。方法根据认知负荷理论,参照美国国家航天局任务负荷指数,结合临床实际、专家讨论及文献查阅,设计临床护士培训负荷调查量表。经小样本测试形成正式量表后,调查重庆市17所医院的1 165名护士以检验量表的信效度。结果正式量表包括培训形式负荷、培训内容负荷、时间/频率负荷、培训身心负荷4个维度,共21个条目。量表的总体Cronbach′sα系数为0.798,分半信度为0.875,各维度Cronbach′sα系数为0.724~0.925;探索性因子分析提取4个公因子,累积方差贡献率为62.769%;各条目的因子载荷值为0.487~0.922。结论临床护士培训负荷调查量表具有较好的信效度,可作为测量临床护士培训负荷的调查工具。     

护士道德勇气量表的汉化及信效度检验

目的对英文版护士道德勇气量表(NMCS)进行汉化,并检验其中文版在中国临床护士群体中的信效度。方法严格遵循Brislin双人翻译-回译的模式对英文版NMCS进行翻译、回译及文化调适等,形成中文版NMCS,并通过对504名临床护士进行问卷调查检验中文版NMCS的信效度。结果中文版NMCS内容效度指数0.910,采用因子分析法评价量表的结构效度,探索性因子分析共提取出4个公因子,累积方差贡献率为60.567%;验证性因子分析显示,模型拟合度χ~2/df为2.100,RMSEA=0.066,NFI=0.843、TLI=0.897、IFI=0.911、CFI=0.910。量表Cronbach′sα系数为0.905,各维度Cronbach′sα系数为0.778～0.902;量表的折半信度为0.884,各维度折半信度为0.769～0.868;量表的重测信度为0.935,各维度重测信度为0.722～0.837。结论中文版NMCS具有良好的信效度,可以用于评估国内临床护士的道德勇气。     

中文版知识共享行为量表用于临床护士信效度的测评

目的对英文版知识共享行为量表(KSBS)进行汉化并检测信效度。方法严格按照"翻译-回译-文化调适-预试验"程序对KSBS进行汉化,选取346名临床护士检测中文版KSBS的信效度。结果量表经主成分因子分析共提取4个因子(书面贡献、组织沟通、个人互动、社团实践)19个条目,解释变异量的67.253%。各维度与临床护士知识共享行为量表的相关系数为0.753~0.884,各维度之间相关系数为0.377~0.614;量表总的Cronbach′sα系数为0.923,各维度Cronbach′sα系数为0.727~0.921;量表分半信度系数为0.797,各维度分半系数为0.662~0.855。结论中文版KSBS用于临床护士具有较好的信度和效度,可以用于测量我国内地临床护士的知识共享行为。     

护士伦理行为量表的汉化及信效度检验

目的 汉化护士伦理行为量表修订版(the Ethical Behavior Scale for Nurses-Revise),并检验其信效度。方法 获取原量表作者授权后，通过正译、回译、文化调适、认知性访谈和预调查对原量表进行汉化，形成中文版护士伦理行为量表。选取535名临床护士进行调查，以评价量表信效度。结果 中文版护士伦理行为量表包括3个维度、15个条目。条目水平的内容效度指数为0.890～1.000,量表水平的内容效度指数为0.985;探索性因子分析提取3个公因子，累计方差贡献率为60.952%。量表总的Cronbach′s α系数为0.892,3个维度的Cronbach′s α系数分别为0.897、0.870、0.838;Guttman分半信度为0.918。结论 中文版护士伦理行为量表具有良好的信效度，适合作为中国文化背景下护士伦理行为的评估工具。     

中文版气管切开术后患者生活质量量表的信效度检验

目的引进气管切开术后长期置管患者生活质量量表(TQOL),并检验信效度。方法按照Brislin跨文化翻译原则对TQOL进行汉化及文化调适,使用中文版TQOL量表调查153例气管切开术后患者的生活质量,分析其信效和效度。结果中文版TQOL保留22个条目,因子分析共提取生理状况、躯体功能状况、社会/家庭状况、满意程度4个公因子,累计贡献率达68.45%。量表内容效度指数为0.920,Cronbach′sα系数为0.907,各因子Cronbach′sα系数为0.824~0.912,Guttmann折半系数为0.925(均P0.01)。结论中文版TQOL具有良好的信效度,适合中国文化背景下气管切开术后长期置管患者生活质量的测量。     

基于护士视角的护患关系量表开发与信效度检验

目的基于护士视角编制护患关系量表,并检验其信效度。方法以人性照护理论为理论基础,通过文献回顾、参考国内外相关量表,根据护士访谈结果,结合中国国情及专家访谈形成初始量表,预调查472名护士及正式调查379名护士对量表进行信效度检验,并请10名专家验证量表的内容效度。结果护患关系量表包含护患信任和以患者为中心的护理2个因子,共9个条目。量表各项指标值均达到拟合度标准,有较好的结构效度;量表水平的内容效度指数(S-CVI)为0.900;量表总体Cronbach′s α系数为0.873,护患信任和以患者为中心的护理2个因子的Cronbach′s α系数分别为0.900、0.883。结论开发的护患关系量表具有较好的信效度,可用于护士视角的护患关系测量。     

护士悲伤状态量表的汉化及信效度检验

目的 汉化护士悲伤状态量表(Grief State Scale for Nurses, GSSN)并在临床护士中检验信效度。方法 获得原量表作者的授权，严格按照Brislin模型对护士悲伤状态量表进行翻译、回译，通过文化调适后形成中文版护士悲伤状态量表。2022年12月采用便利抽样法选取湖州市2所三级甲等医院221名临床护士行正式调查，在调查2周后从中随机抽取30名护士再次填写量表，评价中文版护士悲伤状态量表的信效度。结果 中文版护士悲伤状态量表的Cronbach′s α系数为0.813,4个维度的Cronbach′s α系数分别为0.729、0.855、0.846、0.929;重测信度为0.915。总量表的平均内容效度指数为0.980,条目水平内容效度指数为0.833～1.000。探索性因子分析共提取出4个公因子，累积方差贡献率74.232%。结论 中文版护士悲伤状态量表具有良好的信效度，适用于测量护士职业悲伤水平。     

经皮冠脉介入术患者健康素养量表的编制及信效度检验

目的 编制经皮冠状动脉介入术(PCI)患者健康素养量表，并评价其信度和效度，为PCI患者提供健康素养测量工具。方法 依据Netbeam健康素养理论，参考已有量表，结合半结构式访谈，经过2轮专家咨询形成预试量表。对310例PCI术后患者调查，应用临界比值、相关性分析、同质性检验、信效度分析对条目进行调整，形成正式量表。结果 PCI患者健康素养量表包含3个维度，分别为功能性健康素养、交流性健康素养与批判性健康素养，共27个条目。量表水平的内容效度指数为0.879,条目水平的内容效度指数为0.803～1.000;量表Cronbach′s α系数为0.824,各维度的Cronbach′s α系数为0.740～0.886;量表的重测信度为0.841,各维度的重测信度为0.627～0.827;探索性因子分析共提取3个因子，累计方差贡献率为68.109%;验证性因子分析结果显示，卡方自由度比值(χ²/df)=2.004、近似误差的均方根(RMSEA)=0.052、递增拟合指数(IFI)=0.924、规范适配指数(TLI)=0.912、比较拟合指数(CFI)=0.909,均达到模...     

临床护士护理伦理学KAP调查问卷的研制

目的研制可行性强、信效度佳的临床护士护理伦理学KAP调查问卷,为护理伦理学研究提供工具。方法采用Delphi、文献分析法,建立临床护士护理伦理学KAP调查问卷初稿,经2轮专家咨询形成临床护士护理伦理学KAP调查初始问卷,预调查后结合调查结果对问卷进行再修订,最终形成临床护士护理伦理学KAP调查问卷。结果临床护士护理伦理学KAP调查问卷专家权威系数为0.89,内容效度0.99,Cronbach′sα系数0.746,各维度Cronbach′sα系数为0.644～0.907。结论临床护士护理伦理学KAP调查问卷具有良好的信效度。     

The prevalence of potentially traumatic events in childhood and adolescence

This paper examines exposure to potentially traumatic events from middle childhood through adolescence, and vulnerability to such exposure. Analyses are based on the first 4 annual waves of data from a longitudinal general population study of youth in western North Carolina, involving 4,965 interviews with 1,420 children and adolescents and their parents or guardians. Participants reported on DSM extreme stressors (high magnitude events), other potentially traumatic events (low magnitude events), and background vulnerability factors. In this general population sample, one-quarter experienced at least one high magnitude event by age 16, 6% within the past 3 months. One third experienced a low magnitude event in the past 3 months. The likelihood of such exposure increased with the number of vulnerability factors.     

Tracking and Reporting Outcomes Of Procedural Sedation (TROOPS): Standardized Quality Improvement and Research Tools from the International Committee for the Advancement of Procedural Sedation

Many hospitals, and medical and dental clinics and offices, routinely monitor their procedural-sedation practices—tracking adverse events, outcomes, and efficacy in order to optimize the sedation delivery and practice. Currently, there exist substantial differences between settings in the content, collection, definition, and interpretation of such sedation outcomes, with resulting widespread reporting variation. With the objective of reducing such disparities, the International Committee for the Advancement of Procedural Sedation has herein developed a multidisciplinary, consensus-based, standardized tool intended to be applicable for all types of sedation providers in all locations worldwide. This tool is amenable for inclusion in either a paper or an electronic medical record. An additional, parallel research tool is presented to promote consistency and standardized data collection for procedural-sedation investigations.     

Peroperative and immediate postoperative adverse events in patients undergoing elective general and orthopaedic surgery: The Gothenburg study of perioperative risk (PROPER). Part II

All anaesthetic and surgical procedures impose a certain risk of complications. However, reliable estimates of this risk from prospective studies are rare. This study is a prospective clinical epidemiological study of 1361 consecutive patients subjected to elective general and orthopaedic surgery.
These patients were followed from an extensive preoperative assessment to three months after the operation. In this report the peroperative and early postoperative period in the postoperative care unit or intensive care unit is described.
General anaesthesia was given to 59% and regional/local anaesthesia to 41%. Adverse peroperative events occurred in 19%. The most common were circulatory events (11%), respiratory (4%), and allergic events (1%). Most events were of minor severity. However, with the official registration system, only 1 out of 8 events was detected. In the postoperative unit one or more adverse event was noted in 47% of the cases. These were dominated by circulatory (18.4%) and respiratory events (5.0%). CNS depression was noted in 6.8% of the cases. Most per- and postoperative event variables were highly correlated to the degree of surgical stress. In conclusion, a new concept for preoperative assessment and the registration of events during and after surgery was used. In this way, a large number of events of importance, not least for quality assurance, were found that would be missed with the official coding system. In a previous report we could show that even minor events affected the cost of care substantially.     

高敏C反应蛋白对糖尿病患者心血管危险事件的预测作用及机制

背景 糖尿病患者是易并发心血管疾病的高危人群.最近有研究表明高敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)是一种普遍存在于糖尿病患者,并能反映心血管危险性的标志物之一.目的 分析总结血浆hs-CRP浓度与糖尿病患者发生心血管危险事件的相关性及其预测机制的文献资料.内容 描述C反应蛋白(C-reactive protein,CRP)的生物学特性、正常血浆浓度及其影响因素;hs-CRP与糖尿病之间的关系;hs-CRP对心血管危险事件的预测作用;hs-CRP预测心血管危险事件的可能机制.趋向 血浆CRP水平对糖尿病患者远期心血管危险事件有一定预测作用,也有相应的病理机制证明.hs-CRP的临床应用还需要深入研究和不断探索,以充分发挥其应有的医学价值.     

Safety and efficacy of tocilizumab for rheumatoid arthritis: a systematic review and meta-analysis of clinical trial studies

The present systematic review and meta-analysis was conducted to assess the effect of tocilizumab (TCZ) in patients with rheumatoid arthritis (RA). We systematically searched all potential articles in the main databases, including PubMed, Scopus, EMBASE, Web of Sciences (ISI), and Cochrane Center. The search was subsequently updated in December 2020. The initial review and extraction of information were performed independently by two authors to collect the first author and publication year; sample size; mean age of the intervention and control groups; the dose of TCZ, and the follow-up duration. Outcomes of interest include the ACR20, ACR50, ACR70, total complication rate, and the occurrence of remission. Any disagreements between the reviewers were resolved by discussion and re-check of the article and consultation with a third reviewer. After reviewing and culling, 15 clinical trials comparing the clinical efficacy of TCZ and its comparators in the treatment of patients with RA entered the qualitative and quantitative synthesis. Tocilizumab 8 mg was statistically better than 4 mg or placebo for ACR responses. Significant clinical adverse events in patients with RA treated with TCZ, such as abnormal liver function tests (LFTs) and infections, were more frequent than in comparator groups. This systematic review and meta-analysis suggest that the combination therapy of TCZ with other drugs such as methotrexate and disease-modifying antirheumatic drugs has been studied for various clinical effects concerning safety and clinically significant adverse events. Although the data are promising, long-term performance and safety data need to be fully identified, as well as the risks and benefits of TCZ, especially appropriate timing, dosage, and regimen.     

Including interpersonal events on hassle and uplift scales: verification employing global and molecular events

A recent hassle and uplift study indicated that interpersonal events were generally missing from scales measuring these concepts—a finding consistent with the daily diary literature. This paper addresses two shortcomings of the hassle and uplift study. First, this research controlled for individual differences within its methodology. Second, it adhered more closely to diary research by examining the inclusion of interpersonal events at a molecular level (i.e. specific types of events). By employing university student participants (n = 289) the study sought to examine if interpersonal daily hassles and uplifts, at a global and molecular level, would predict stress and well‐being over and above individual differences and non‐interpersonal events. One of four distress and well‐being outcomes was improved in the global and all four in the molecular stepwise regression analyses. Weight of evidence suggests that interpersonal events are important inclusions on hassle and uplift scales. The anomalous global and molecular findings are also discussed. Copyright © 2003 John Wiley & Sons, Ltd.     

非甾体类抗炎药在围术期使用的心血管事件风险的Meta分析

目的评价在围术期使用非甾体类抗炎药(NSAIDs)的心血管不良事件的风险。方法计算机检索PubMed、Web of Science、Medline、Cochrane Library、CNKI和万方数据库中正式发表的中英文文献,收集NSAIDs在围术期使用的随机对照试验(RCT),前瞻性队列研究和回顾性研究等,通过心血管不良事件(心肌梗死、心绞痛、心肌缺血、心律失常)的发生情况来评价NSAIDs的心血管不良事件的风险。结果共纳入8篇文献15 623例患者,其中非选择性NSAIDs文献有5篇(n=13 019),选择性环氧化酶-2(COX-2)抑制剂文献有3篇(n=2 604)。NSAIDs在围术期使用减少了心血管不良事件的发生(OR=0.59,95%CI 0.45~0.77,P=0.000 1),非选择性NSAIDs在围术期使用减少了心血管不良事件的发生(OR=0.42,95%CI 0.31~0.58,P0.001),选择性COX-2抑制剂在围术期或短期使用增加了心血管不良事件的发生(OR=2.53,95%CI 1.26~5.09,P=0.009)。结论具有心血管风险的患者围术期建议使用非选择性NSAIDs。     

Toward the standardization of life stress assessment: Definitional discrepancies and inconsistencies in methods

There has been considerable controversy about methods for assessing life stress. However, self-report checklists and interview-based measures (the predominant approaches used in current research) differ in several respects, ranging from basic definitions through theoretical assumptions. Most research comparing these two approaches has focused on global comparisons in predicting disorder, which fail to take into account more specific information on how the methods vary. The present article outlines three stages of assessment for life stress: definition, operationalization, and quantification. Detailed examination of these stages with a sample of depressed patients helps to demonstrate in an explicit manner how self-report checklists and interview-based methods differ at successive stages of the measurement process. Data are presented that indicate large endpoint discrepancies attributable to specific differences in the definitional and operational procedures used in the two assessment approaches. The nature of the discrepancies found is discussed, along with the implications for assessing life stress and testing its implications for health and well-being.