ICU护士心理资本、工作压力与工作幸福感的相关性研究

目的了解ICU护士心理资本、工作压力与工作幸福感的现状,探讨心理资本和工作压力对工作幸福感的影响。方法便利抽样选择山东省某市2所三级甲等综合医院224名ICU护士为研究对象,采用心理资本问卷、护士工作压力源量表、工作幸福感量表对其进行调查。结果 ICU护士心理资本总分为(89.19±11.05)分,工作压力总分为(74.83±12.89)分,工作幸福感总分为(82.92±12.78)分;ICU护士的性别、对目前工作的满意程度以及是否会再次选择ICU护理工作为工作幸福感得分的影响因素(P0.05)。心理资本总分及各维度与工作幸福感总分呈正相关(P0.01),工作压力总分及各维度与工作幸福感总分呈负相关(P0.05),心理资本总分、工作压力中护理工作及专业和管理及人际关系2个维度是ICU护士工作幸福感的主要预测变量(R2=0.410)。结论医院护理管理者应采取积极措施,提高ICU护士的心理资本,降低其工作压力,以提高其工作幸福感。     

手术室护士工作压力、心理弹性与主观幸福感的关系研究

[目的]探讨手术室护士工作压力、心理弹性与主观幸福感的关系。[方法]2016年6月—2016年12月采用护士工作压力量表、心理弹性量表及主观幸福感量表对30名手术室护士工作压力、心理弹性及主观幸福感进行调查,应用Pearson单因素分析手术室护士工作压力、心理弹性与主观幸福感的关系。[结果]手术室护士工作压力总评分为52.85分±0.28分,心理弹性总评分为18.25分±2.12分,主观幸福感总评分为40.82分±0.74分。手术室护士工作压力总评分及其工作量及时间分配、护理专业及工作与心理弹性评分、主观幸福感总评分、生活满意度、积极情感评分呈负相关(P0.05),而与消极情感评分呈正相关(P0.05)。多元回归分析显示:影响手术室护士主观幸福感的因素包括护士婚姻状况、薪酬待遇、心理弹性。[结论]工作压力可影响手术室护士主观幸福感,通过提高手术室护士心理弹性及薪酬待遇对改善护士主观幸福感有积极作用。     

某三级甲等中医院临床护士总体幸福感与工作压力的调查研究

[目的]了解某三级甲等中医院临床护士总体幸福感与工作压力现状及其影响因素。[方法]采用一般资料问卷、总体幸福感量表和中国护士工作压力源量表对成都市某三级甲等中医院105名护士进行问卷调查。[结果]中医院临床护士总体幸福感得分为69.10分±12.62分,与国内女性常模相比差异无统计学意义(P0.05);护士工作压力源总分为67.58分±22.05分;Pearson相关性分析显示,总体幸福感与工作压力源呈负相关(P0.01或P0.05)。[结论]中医院临床护士总体幸福感较好,但工作压力较大,影响其总体幸福感,减轻护士工作压力可提高其总体幸福感。     

某三级甲等医院急诊科护士幸福感与工作压力的相关性研究

[目的]研究某三级甲等医院急诊科护士幸福感与工作压力的相关性。[方法]采用便利抽样法选取我院急诊科室37名护士填写护士压力源量表及幸福感量表调查问卷,对数据进行统计分析。[结果]急诊科护士主观幸福感总分为115.66分±21.39分,压力源总分为12.82分±2.09分,急诊科护士主观幸福感与工作压力呈负相关(r=-0.598,P0.05)。[结论]提高急诊科护士主观幸福感采取措施缓解其工作压力十分必要。     

ICU护士工作压力、工作幸福感与组织支持感的相关性分析

[目的]分析重症监护室(ICU)护士工作压力、工作幸福感与组织支持感的相关性。[方法]2019年1月—2019年2月采用方便抽样法选择宣城市3家三级医院67名ICU护士作为调查对象,对其工作压力、工作幸福感及组织支持感进行调查,并进行Pearson相关性分析。[结果]ICU护士工作压力总分为(84.23±15.14)分,属于中等偏上水平;工作幸福感总分为(86.61±12.38)分,属于中等水平;组织支持感总分为(50.36±9.64)分,属于中等偏上水平。ICU护士工作压力与组织支持感呈负相关(r=-0.935,P0.01),工作幸福感与组织支持感呈正相关(r=0.917,P0.01)。[结论]ICU护士工作压力、工作幸福感与组织支持感密切相关,管理层应结合医院实际情况,针对性地制定管理策略。     

危重症专科护士工作压力源、心理资本与职业生涯相关性研究

[目的]了解危重症专科护士工作压力源、心理资本、职业生涯状况现状,探讨其相关性。[方法]采用中国护士工作压力源量表、心理资本问卷、职业生涯状况评价量表对山东省12所三级甲等综合医院247名危重症专科护士进行调查分析。[结果]危重症专科护士的工作压力源总分为(92.13±20.17)分,心理资本得分为(105.47±13.35)分,职业生涯状况总分为(79.19±11.63)分。工作压力源总分与职业生涯总分、职业满意度维度呈负相关(P0.05);心理资本总分与各维度与职业生涯总分呈正相关(P0.05)。心理资本总分、工作压力源总分是危重症专科护士职业生涯状况的主要预测变量(R~2=0.318)。[结论]危重症专科护士职业生涯状况有待改善,减轻工作压力、加强心理资本的培养是促进专科护士的职业生涯科学发展的重要因素。     

90名监护室护士心理资本、工作压力与工作幸福感的关系

目的:调查研究90名监护室护士心理资本、工作压力与工作幸福感之间的关系。方法:随机选取沧州市人民医院90名监护室护士作为研究对象,收集护士一般资料,运用护士心理资本问卷、护士工作压力量表和护士工作幸福感问卷调查90名监护室护士的心理资本、工作压力和工作幸福感,并分析三者的关系。结果:90名监护室护士心理资本总得分平均为(90.12±10.35)分,处于中高水平;工作压力总得分平均为(75.13±8.27)分,处于中等水平,工作幸福感总得分平均为(83.25±9.35)分,处于中高水平;心理资本各维度均与工作幸福感呈正相关,差异有统计学意义(P<0.05);工作压力与工作幸福感呈负相关,差异有统计学意义(P<0.05)。结论:监护室护士的工作压力会降低其工作幸福感,心理资本可调节压力,护理管理者应通过提高监护室护士的心理资本来降低监护室护士工作压力,提高其幸福感。     

护士控制感对主观幸福感的影响及自尊的中介作用

[目的]探讨护士控制感与自尊对主观幸福感的影响,着重验证自尊在控制感与主观幸福感之间的中介作用。[方法]采用控制感量表、自尊量表、主观幸福感量表对西安市397名护士进行调查。[结果]护士控制感总分为17.59分±4.74分,高于非大学生成人常模11.0分±5.6分。自尊量表总分为32.12分±4.22分,高于均值20分。主观幸福感量表总分为57.25分±11.74分,其中积极情绪得分为22.07分±7.68分,消极情绪得分为15.58分±5.00分,生活满意度得分为19.59分±5.74分。不同婚姻、生育情况及聘用形式护士主观幸福感总分比较差异有统计学意义(P0.05)。护士控制感与主观幸福感呈负相关(P0.05),自尊与主观幸福感呈正相关(P0.05)。回归分析显示,控制感能够预测自尊水平与主观幸福感,且自尊能够预测主观幸福感。结构方程模型分析显示,自尊在控制感和主观幸福感之间有中介作用。[结论]护士控制感可以影响主观幸福感,自尊在其中扮演重要的中介作用。     

某三级甲等医院低年资护士工作压力与主观幸福感的调查研究

目的 了解低年资护士的工作压力和主观幸福感现状及其影响因素.方法 采用中国护士工作压力源量表和Campbell主观幸福感量表,对南充市某三级甲等综合医院290名在职低年资护士进行问卷调查.结果 低年资护士的工作压力较大,主观幸福感较低.其工作专业、工作量与时间、患者护理、管理人际、压力总分与主观幸福感总分呈负相关(P＜0.01).结论 减轻低年资护士工作压力源,可提高其总体幸福感.     

三级甲等医院护士主观幸福感与工作满意度的关系调查

[目的]了解三级甲等医院临床护士主观幸福感与工作满意度的关系。[方法]以三级甲等医院350名临床护理人员为研究对象,采用一般资料调查表、总体幸福感量表、临床护士工作满意度量表进行问卷调查,并进行相关分析。[结果]护士的主观幸福感总分为76.56分±11.64分,工作满意度总均分为3.19分±0.41分;护士的主观幸福感与工作满意度呈正相关(P<0.01),管理、与同事关系、工作负荷、家庭与工作的平衡成为影响临床护士主观幸福感的主要因素(P<0.05或P<0.01)。[结论]三级甲等医院护士主观幸福感总体水平较高,管理、工作负荷、同事关系、家庭与工作平衡对护士的主观幸福感有影响。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.