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目的总结综合医院住院患者自杀预防的相关证据,为预防住院患者自杀提供参考。方法根据问题开发工具PIPOST确立综合医院住院患者自杀预防的循证问题,检索Cochrane图书馆、JBI循证卫生保健国际合作中心图书馆、BMJ Best Practice、美国国立指南库(NGC)、加拿大安大略注册护士协会(RNAO)循证护理指南、Wiley Online Library、JAMA、Pub Med以及中国生物医学文献库(CBM),进行文献质量评价,并对证据进行总结。结果纳入8篇文献,总结出15项证据,包括自杀风险评估、自杀安全管理、自杀治疗护理、自杀随访及自杀守门人培训5个主题。结论综合医院住院患者自杀预防的证据实证性强,可用于临床。护理人员在应用证据时应评估具体临床情形及障碍因素,结合专业判断形成有效、可行的自杀预防策略,动态评价证据应用效果,切实防范自杀行为。 相似文献
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目的了解综合医院护士对住院患者自杀预防认知状况,为更好地预防患者自杀提供建议。方法采用自行设计的护士对住院患者自杀预防认知调查问卷,对412名临床护士进行调查。结果护士对住院患者自杀预防认知总均分9.56±2.20,正确率45.52%,其中自杀一般知识均分6.83±1.68,正确率52.54%,自杀预防知识均分2.73±1.41,正确率34.07%。不同年龄、工作年限、职称、学历护士对住院患者自杀预防认知水平比较,差异有统计学意义(P0.05,P0.01)。有护理自杀倾向/自杀未遂患者经历的护士自杀预防知识得分高于无经历者(P0.05)。结论综合医院护士预防住院患者自杀的认知水平尚不理想,护理管理者应结合影响因素开展培训。 相似文献
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目的构建综合医院住院患者自杀风险评估指标体系,为临床护理人员评估自杀提供工具。方法采用文献研究法、焦点小组讨论法、德尔菲专家咨询法筛选评估指标,运用层次分析法确定指标权重,建立住院患者自杀风险评估指标体系。结果 2轮专家咨询问卷有效回收率分别为94.29%、90.91%,权威系数分别为0.849、0.857,协调系数分别为0.308、0.343;最终构建的住院患者自杀风险评估指标体系包括3个一级指标、8个二级指标及24个三级指标,并确定各级指标权重。结论住院患者自杀风险评估指标体系被专家认可,可进一步开展临床实证研究。 相似文献
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目的 了解综合性医院护理人员对患者自杀的态度,并分析影响因素,为制订针对性的干预措施提供参考。
方法 采用便利抽样法选取湖北省10所综合性医院的980名护理人员,采用综合性医院护理人员对患者自杀态度问卷进行调查。
结果 共112名(11.4%)护理人员对患者自杀的态度总体上为理解或宽容,864名(88.2%)为中立或矛盾,4名(0.4%)持反对或排斥态度。多元线性回归分析结果显示,医院等级、通过媒体网络途径获取自杀预防相关知识、个人月收入、是否经历患者自杀事件、工作科室是影响护理人员对患者自杀态度的主要因素(均P<0.05)。
结论 综合性医院护理人员对患者自杀的态度总体上为中立或矛盾。需加强护理人员对住院患者自杀预防的培训,引导护士树立理性的生命价值观和自杀态度,切实履行好维护患者生命安全的“守门人”角色,以预防住院患者自杀。 相似文献
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目的通过问卷调查法了解三级综合医院医护合作的现状,分析其影响因素。方法采用目的抽样法在重庆市6所三级综合医院中抽取1 019名医护人员,运用中文版医护合作量表进行问卷调查。结果医护合作量表得分总分78.42±15.16,条目均分3.73±0.72,医生医护合作总分及各维度得分显著高于护士(均P0.01)。多元回归分析显示,医生中职业兴趣、医护合作意愿及外科、急诊科是其主要影响因素(调整R2=0.246);护士中职业兴趣、医护合作意愿是其主要影响因素(调整R2=0.251)。结论三级综合医院医护合作处于中等偏上水平,需进一步加强;医护双方应关注影响医护合作的因素,在治疗护理过程中共同决策,促进医疗护理质量的不断提高。 相似文献
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目的 调查综合医院护理人员决策参与现状并分析影响因素,以期为提高护理人员决策参与水平提供参考.方法 采用一般资料调查表、中文版工作效能条件量表、决策参与量表对湖北省4所综合医院护理人员2268人进行调查.结果 有效调查护理人员2136人,其决策参与总分为(37.75±11.25)分.多元线性回归分析显示,结构授权中的正式权力、信息、资源及一般资料中的年龄、医院等级和月收入为护理人员决策参与的预测因子(P<0.05,P<0.01).结论 护理人员决策参与处于低下水平,其决策参与程度受多因素影响.管理者应创建有利于护理专业实践的工作环境,从而促进护理人员决策参与水平提升. 相似文献
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Zeilig G Weingarden H Shemesh Y Herman A Heim M Zeweker M Dudkiewicz I 《The journal of spinal cord medicine》2012,35(1):22-27
Introduction
Remunerative employment is a major concern of individuals with chronic disabilities, among them, those with longstanding poliomyelitis (LSP). Although LSP is not rare there are almost no data related to work participation.Purpose
The aims of the current study were to determine the effects of a number of social and functional variables as barriers or facilitators to work participation in persons with LSP.Patients and methods
Charts of 123 LSP patients of working age that were seen in the post-polio outpatient clinic, between the years 2000 and 2005 were reviewed for the study. Data on age, gender, family status, level of function in activities of daily living, basic, and extended (B-ADL and E-ADL), and mobility were then analyzed for correlation to the vocational status.Results
Seventy-two people (58.5%) were employed at the time of the survey. Gender and marital status were not found to significantly differ as regard to employment. Using assistive devices for mobility or being dependent for basic ADL were associated with lower levels of employment. Driving was positively associated with the employment status of the LSP individuals.Conclusion
Persons with LSP encounter important barriers to work participation, particularly on the International Classification of Functioning, Disability, and Health (ICF) components of activity and environment. 相似文献14.
结肠CT仿真内镜成像的影响因素及对策的实验研究 总被引:3,自引:0,他引:3
目的探讨结肠CT仿真内镜(CTC)的影响因素及应对策略。方法在4段新鲜离体猪结肠的不同位置植入0.5~2cm大小、形态各异的4小块肌肉或淋巴组织模拟病变;先后在充气和灌注2.5%的泛影葡胺溶液后采用GE公司64层螺旋CT以不同的毫安和螺距比的组合进行50cm范围的4次扫描,观察并比较每段结肠及其病变在不同状态下随扫描条件、观察阈值的变化情况。结果每段结肠及其病变随毫安的缩小和螺距比的增大,CT剂量指数和剂量长度乘积同步降低,两组图像的质量都变差,CTC观察阈值的范围逐渐变窄,肠内壁在观察阈值范围的中间区域平滑,向两端的伪影逐渐增多,但4个模拟病灶通过改变观察阈值都可以被发现。充气组随着观察阈值的逐渐降低,肠壁逐渐变厚而管腔逐渐缩小,突入肠管的致密病灶逐渐增大,而扁平病灶及小结节灶在观察阈值范围的中间区域较两端显示更清楚;灌注泛影葡胺组与此相反,并且图像质量更差。结论结肠内的充填物及扫描条件对结肠CTC的成像有影响,但其成像效果可以通过改变观察阈值来进行解决。 相似文献
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In many patients with critical limb ischaemia, vascular reconstructive surgery is the only alternative to amputation to relieve severe rest pain or treat ischaemic ulcers and digital gangrene. Over a 4-year period, 402 patients with critical ischaemia of the lower limb were seen in the Derby Hospitals. One hundred and forty eight of these patients required primary amputation, 52 were treated with radiologically controlled angioplasty and in the remaining 208 patients, 218 surgical procedures for limb salvage were carried out. The overall operative mortality of patients undergoing limb salvage surgery was 9% with 72% of patients surviving 2 years or more. Postoperative mortality was greater in those patients over 70 years (16% vs 6% P less than 0.02). Patient survival at 2 years was reduced in patients over 70 years at the time of surgery (49% vs 83% P less than 0.001) and in those with 2 or more medical conditions (57% vs 71% P less than 0.001) present in the perioperative period. Overall limb salvage in surviving patients was 92% at 1 year and 91% at 2 years following surgery. Successful limb salvage at 2 years following femorodistal surgery alone was lower and related and to both infrapopliteal run off (2-3 vessels 87% vs 1 vessel 68% P less than 0.01) and the graft material used (vein 87%, Dardik 76%, Goretex 58%, P less than 0.01). 相似文献