预防中心静脉导管相关性感染认知和行为问卷的信效度分析

目的编制适用于护理人员预防中心静脉导管相关性感染的认知和行为调查问卷,并检验其信效度。方法在查阅相关文献、专家咨询的基础上初步编制了中心静脉导管相关性感染预防的认知和行为调查问卷,采用方便抽样法对河南省某三级甲等医院220名护士进行问卷凋查。使用Cronbachα系数、因子分析、内容效度指数考察问卷的信度与效度。结果因子分析表明目标问卷有良好的结构效度,32个条目有较高的负荷值,所反映的导管相关感染的基本知识、手卫生与消毒、导管的置入与维护、穿刺点敷料的护理、感染的诊断和处理等5个维度与初步设计问卷的结构基本相符;问卷各条目的内容效度指数在0.625～1.0之间,量表水平的内容效度指数为0.92;总Cronbachα系数为0.803,5个维度的Cronbachα系数分别为0.691、0.781、0.667、0.780、0.793。结论该问卷具有较好的稳定性和可靠性,可以作为评价护士中心静脉导管相关性感染的预防认知及行为现状的可靠工具。     

ICU护士对常用监护仪报警应答疲劳知信行问卷的编制与信效度检验

[目的]编制ICU护士对呼吸机及心电监护仪报警应答疲劳知识、态度和行为问卷,并检验其信效度。[方法]以知信行模式为理论指导,通过文献查阅、头脑风暴法作为问卷条目池和构想维度的主要来源,经两轮德尔菲法专家函询和调查225名ICU护士并进行信效度检验以确定问卷。[结果]最终形成问卷共25个条目,其中知识维度7个条目,态度维度9个条目,行为维度9个条目;问卷探索性因子分析共产生7个因子,累计解释变异量为59.315%,其内容效度为0.903,问卷Cronbach′sα系数为0.887,重测信度为0.867。[结论]ICU护士对呼吸机及心电监护仪报警应答疲劳知识、态度和行为问卷信效度良好,可用于测评ICU护士报警应答疲劳。     

护士职业价值观量表的编译和评价

[目的]开发适用于度量我国护理本科生的护士职业价值观水平的中文版量表。[方法]对Darlene Weis和Mary Jane Schank的英文版护士职业价值观量表进行翻译、回译和本土化修订。采用中文版问卷对广州市5所院校1 171名护理本科生展开调查,并对结果进行信度及效度分析。[结果]中文版护士职业价值观量表因子分析产生的4个因子共能解释总变异的63.49%;其Cron-bach’sα系数为0.959,各分量表的Cronbach’sα系数分别为0.929、0.903、0.863和0.729。[结论]中文版护士职业价值观量表有较好的信度和效度,其维度设置适用于我国护理本科生。     

中文版护理理论课程教学评价工具的研制

[目的]初步研制1份中文版护理理论课程教学的评价工具,并对其心理属性予以分析。[方法]引进日文版护理理论课程教学评价工具,进行量表的修订,然后对某高校护理学院全日制本科护生进行测评,应用Cronbach’sα、因子分析进行内部一致性和结构效度的检验。[结果]量表共7个维度、38个条目;内部一致性信度检验Cronbach’sα为0.968;7个维度Cronbach’sα系数为0.678-0.921;结构效度检验：因子分析累计方差贡献率71.9%。[结论]修订后的中文版护理理论课程教学评价量表信效度良好,可用于我国护理理论课程的教学评价。     

重症监护室医护人员实施早期康复行为意向问卷的编制及信效度检验

目的 编制重症监护室(intensive care unit, ICU)医护人员实施早期康复行为意向问卷并检验其信效度，为展开相关研究提供测评工具。方法 基于计划行为理论，通过文献分析、专家咨询、小组讨论形成初始问卷。采用便利抽样法对上海市3所三级甲等医院的202名ICU医护人员进行调查。通过项目分析筛选条目，探索性因子分析评估结构效度，最终确定问卷条目。计算Cronbach’α系数和重测信度对问卷信度进行评价。结果 最终形成了包含5个维度26个条目的问卷。探索性因子分析共提取了5个公因子，累积方差贡献率为70.51%。问卷各条目水平的内容效度为0.800～1.000,问卷水平的内容效度为0.813。问卷总的Cronbach’s α系数为0.941,各维度Cronbach’s α系数均>0.7。问卷总重测信度为0.995,各维度的重测信度为0.932～1.000。结论 ICU医护人员实施早期康复行为意向问卷具有良好的信度和效度，值得推广应用。     

中文版护理理论课程教学评价工具的研制

[目的]初步研制1份中文版护理理论课程教学的评价工具,并对其心理属性予以分析。[方法]引进日文版护理理论课程教学评价工具,进行量表的修订,然后对某高校护理学院全日制本科护生进行测评,应用Cronbach’sα、因子分析进行内部一致性和结构效度的检验。[结果]量表共7个维度、38个条目;内部一致性信度检验Cronbach’sα为0.968;7个维度Cronbach’sα系数为0.678~0.921;结构效度检验:因子分析累计方差贡献率71.9%。[结论]修订后的中文版护理理论课程教学评价量表信效度良好,可用于我国护理理论课程的教学评价。     

医护合作量表的汉化及信效度检验

目的译制中文版医护合作量表(Nurse-Physician Collaboration Scale,NPCS),并对其效度和信度进行初步评价。方法采用经Brislin法翻译和文化调试的中文版NPCS量表,对325名临床护士和220名临床医生进行调查,并对结果进行信、效度检验。结果中文版NPCS量表保留21个条目,因子分析提取3个公因子,累计贡献率达64.329%。护士和医生问卷的Cronbach’sα系数分别为0.946和0.947,且各维度的Cronbach’sα系数均>0.7。护士和医生问卷的Guttman折半系数分别为0.881和0.879,重测信度分别为0.713和0.809。结论修订后的中文版NPCS量表具有良好的信、效度,适用于在中国医疗背景下对医护合作状况的评价和测量。     

脑卒中患者后遗症期运动知识-态度-社会支持问卷的编制及信效度检验

目的编制脑卒中患者后遗症期运动知识-态度-社会支持问卷,并对其信效度进行检验,以期为脑卒中患者运动水平影响因素的调查提供工具。方法在查阅相关文献、课题组讨论、专家咨询、预实验的基础上编制脑卒中患者后遗症期运动知识-态度-社会支持问卷。采用便利抽样法对江苏省苏州市的110名后遗症期脑卒中患者进行问卷调查,使用内容效度指数、结构效度、Cronbach’sα系数检验问卷的信度与效度。结果在问卷的3个维度中最终形成19个条目,问卷整体水平的内容效度指数为0.94,各条目的内容效度指数在0.78~1之间;因子分析显示各条目有较高的负荷值,所反映的问卷知识、态度、社会支持3个因子与初步设计的问卷结构基本相符,3个因子共解释总方差的72.94%;总Cronbach’sα系数为0.938,知识、态度和社会支持3个维度的Cronbach’sα系数分别为0.970、0.779和0.783。结果均提示该问卷有较好的信效度。结论此问卷编制过程符合规范,对脑卒中患者具有较高特异性,加之拥有较好的稳定性和可靠性,可以成为评价脑卒中患者后遗症期运动相关知识水平及其态度和社会支持状况的可信工具。     

ICU护士预防肠内营养并发症知信行问卷的初步编制及信效度检验

目的编制ICU护士预防肠内营养并发症知信行问卷并对其进行信效度检验, 为评估ICU护士的肠内营养相关知识、态度、行为提供有效测评工具。方法以知信行理论为结构框架, 应用文献回顾、小组讨论、德尔菲专家函询法形成初始问卷。采用便利抽样法, 2021年11—12月选取天津市5所医院在职ICU护士204人进行调查, 测定问卷的信效度。结果 ICU护士预防肠内营养并发症知信行问卷包括知识、态度、行为3个维度共40个条目, 累计方差贡献率为68.499%;总问卷及各维度Cronbachα的系数分别是0.965、0.946、0.914和0.908;总问卷内容效度为0.929, 各条目内容效度为0.818～1.000。结论编制完成的ICU护士预防肠内营养并发症知信行问卷具有良好的信效度, 对测量ICU护士预防肠内营养并发症的认知现状与临床实践活动水平具有较好的适用性。     

护理管理者领导力问卷编制及信度、效度初步检验

目的:编制适用于我国护理管理者领导力问卷,并检验其信度、效度。方法:采用在文献回顾、参考相关理论及问卷、实地考察、专家咨询和评定基础上初步编制的护理管理者领导力问卷,共164名护理管理者完成问卷测试,并用SPSS分析软件进行信度、效度检验。结果:平均内容效度比(CVI值)为0.913,探索分析性因子分析问卷得到29个项目,形成7个因子,即创新能力、感召力、决断力、亲和力、协调能力、控制力和激励能力,KMO值为0.846,χ2=2038.186,P=0.000,各因子载荷范围为0.459～0.845;问卷总的内部一致性信度Cronbach’sα系数为0.826,7个维度的内部一致性信度Cronbach’sα系数范围为0.712～0.784;重测信度Cronbach’sα系数为0.784;校正得折半信度Cronbach’sα系数为0.876。结论:问卷的信度、效度分析表明本问卷具有比较好的稳定性和可靠性。     

现代残疾康复理念、政策与社区康复体系研究

本研究分析了当代残疾康复的理念和理论架构,构建了以国际公约、决议和政策、国内法律和政策以及操作性工具3个层次的康复理论体系;运用包容性发展,分析探讨了当代社区康复的体系和特点;就发展康复事业、为残疾人提供全面系统的康复服务提出相关的政策建议。     

我院文职护士管理和培训的实践与体会

目的构建文职护士培训、使用及管理的科学方法。方法通过规范管理、科学施训、作为骨干大胆任用等多种管理方式,使文职护士得到充分的发展。结果文职护士群体成长为医院优秀骨干,首批满3年的文职护士顺利通过续聘考核。结论科学的管理培训是文职护士成长的重要基石,对医院护理管理有着重要作用。     

Comparison of short-term and long-term protocols for stabilization and preservation of RNA and DNA of Leishmania, Trypanosoma, and Plasmodium

Molecular tools continue to be important in the prevention and control of parasitic diseases. However, using these techniques directly in the field remains a major challenge. Therefore, the preservation of clinical samples collected from endemic field areas for later analysis remains an important preanalytical process. This study aimed at identifying a suitable protocol for stabilization and preservation of RNA and DNA in bioclinical specimens for Trypanosoma, Leishmania, and Plasmodium research. Both spiked and unspiked blood samples were preserved in 7 protocols (different media; storage temperatures). Samples were evaluated for possible degradation of DNA and RNA along the storage duration up to the 10th week. Nucleic acid targets were assessed as follows: (i) Trypanosoma and Plasmodium RNA analysis was done using real-time nucleic acid sequence-based amplification (RT-NASBA) for 18S rRNA and for stage-specific Pfs25 mRNA, respectively; (ii) Trypanosoma DNA assessment analysis was conducted by using a conventional PCR for 18S rDNA; (iii) Leishmania RNA analysis was performed with a quantitative NASBA for 18S rRNA and Leishmania DNA assessment with an RT-PCR for 18S rDNA. Findings suggested that a newly developed L3™ buffer proved to be reliable and suitable for both short- and long-term preservation of parasite nucleic acid material. This buffer is envisaged to be suitable for utilization in field situations where resources are limited.     

国内外唇腭裂专科护理发展现状的文献研究及分析

目的了解和分析国内唇腭裂专科护理工作发展的现状。方法检索并分析万方医学网、中国知网、Springer Link及PubMed英文数据库近6年有关唇腭裂手术的围术期护理、患儿的喂养、手术安全管理、围术期疼痛研究以及心理护理的相关文献。结果共检索出国内文献89篇(核心期刊20篇)、国外文献22篇,其中围术期护理38篇、患儿的喂养16篇、手术安全管理10篇、围术期疼痛研究10篇、心理护理15篇。结论与国外文献相比,国内论文总结和回顾性居多,应增加研究探讨性论文,从而促进唇腭裂临床护理工作专科化的发展。     

History of violence and subjective health of mother and child

Objective: To study the self-reported prevalence of experienced violence among a cohort of women about two years after giving birth, their health during pregnancy, pregnancy outcomes and their experience of their child’s health.

Setting and subjects: In 2011, a total of 657 women participated in phase III of the Childbirth and Health Cohort Study in Icelandic Primary Health Care, 18 to 24 months after delivery. The women had previously participated in phase I around pregnancy week 16 and phase II 5–6 months after delivery. Data were collected by postal questionnaires.

Main outcome measures: Women’s reported history of experienced violence, sociodemographic and obstetric background, self-perceived health, the use of medications and their child’s perceived health.

Results: In phase III, 16% of women reported experiencing violence. These women felt less support from their current partner (p?p?p?p?p?p?=?0.008).

Conclusions: Our study confirms that a history of violence is common among women. A history of violence is associated with various maternal health problems during and after pregnancy, a higher rate of caesarean sections and maternal reports of health problems in their child 18–24 months after birth.

• KEY POINTS

• Violence is a major concern worldwide. Understanding the impact of violence on human health and developing effective preventive measures are important elements of any public health agenda.

• ??The reported prevalence of experiencing violence was 16% among women attending antenatal care in the primary health care setting in Iceland.

• ??Women with a history of violence reported worse health in general during pregnancy and delivered more often by caesarean section, compared to women with no such history.

• ??Mothers with a history of violence also evaluated the general health of their child as worse than women with no such history.

• ??The findings of this study support the importance of recognizing and addressing experienced violence among women in primary care.

     

城乡学童个性行为特征调查

目的探讨农村与城市儿童的个性行为特征。方法将97名农村学龄儿童设为农村组,97名城市学龄儿童设为城市组,采用艾森克个性问卷一儿童版和Achenbach’s 行为量表一儿童版进行评定分析。结果两组学龄儿童艾森克个性问卷各维度评分均无显著性差异（P均〉0．05）,且与全国常模相一致（P均〉0．05）;农村组男学童Achenbach’s行为量表违纪行为、攻击行为及外向型因子分均显著高于城市组,女学童退缩、社交问题因子分均显著高于城市组（P〈0．05或0．01）,其他因子分均无显著性差异（P均〉0．05）。结论农村与城市儿童个性无显著差异,而农村儿童存在较多的行为问题,可能与其所受教养和生活方式有关。     

Rates and risks of transmission of smallpox and mechanisms of prevention

In 1980, the World Health Organization declared smallpox eradicated from the world; the last known natural case had occurred in Somalia in 1977, and the United States had stopped routinely vaccinating its citizens in 1972. However, with increasing concerns regarding domestic and international terrorism, smallpox has resurfaced as a potential threat to global health. We review the direct and indirect modes of smallpox transmission and how patterns of transmission vary substantially, depending on the severity of circulating disease, vaccination status, environmental and socioeconomic factors, and the setting of an outbreak. We examine mechanisms for controlling outbreaks of disease and preventing further transmission in the event of an outbreak, with an emphasis on smallpox vaccination.     

通用设计原则与产品研发策略

本文介绍了通用设计的概念和设计原则,并阐述了根据此原则实施通用设计的产品研发策略。通用设计惠及的不仅是残疾人,也惠及了包括普通公众在内的广泛人群,以及企业。应将通用设计的原理应融入政府相关政策和未来发展的规划中,为残疾人以及更多人群提供合理便利的通用设计产品。     

胃癌DNA含量与E-cad、EGFR表达的关系及其意义

目的　探讨胃癌组织DNA含量与E cad、EGFR表达的关系 ,评价其在浸润、转移潜能及预后判断中的作用。方法　应用图像分析仪及SP免疫组化法检测 30例正常胃黏膜上皮、30例不典型增生和 5 0例胃癌组织DNA含量与E cad、EGFR蛋白表达情况。结果　①正常胃黏膜上皮、Ⅰ、Ⅱ、Ⅲ级不典型增生及胃癌组的DI、PI、S %、>5c %逐渐增高 ,与胃癌分期、淋巴结转移显著相关 (P <0 0 1)。②E cad在正常胃黏膜上皮阳性表达率 10 0 % ,EGFR呈阴性表达 ;Ⅰ、Ⅱ、Ⅲ级不典型增生及胃癌E cad阳性表达率逐渐降低 ,EGFR的阳性表达率逐渐升高 ,且差异显著 (P <0 0 5 ) ;E cad表达减弱、EGFR表达升高与胃癌分化差、淋巴结转移显著相关 (P <0 0 1)。③E cad表达阴性的胃癌DNA指数及EGFR表达水平显著高于E cad阳性 (P <0 0 1)。结论　检测DNA含量及E cad、EGFR蛋白表达有助于胃癌的早期诊断及转移潜能和预后的判断。     

Quality and suitability of antimicrobial discs: theoretical and practical sources of error and variability

ABSTRACT

Introduction: The use of antimicrobial discs remains one of the main methods for assessing antibiotic activity. Most discs are made to one of three main standards (FDA, WHO, DIN); these all describe an assay method for assessing the quality of discs using a linear method. Theory predicts a curved relationship, and this is backed up in many cases in practice. In such cases, the assays are potentially invalid. Other sources of uncertainty arising from the manufacturing processes employed are also discussed.

Areas covered: This includes error arising from applying FDA, WHO, and DIN standards, the manufacturing techniques employed, and variation in the materials used in production. The need for a specification that relates directly to the use of the discs is also discussed.

Expert opinion: Manufactured discs, some of which may be out of specification due to curvature and other sources of error, have been used to establish quality zone sizes. Quality zone sizes have then been used to measure the quality of discs. This circular quality system where there is no quantitative check is potentially unsafe. In the many decades of their use, there has been no comprehensive check on the quality of manufactured discs using quantitative, validated assays.