医养结合背景下昆明市三级医院护理人员临终关怀态度及影响因素分析

目的 了解昆明市三级综合医院护理人员临终关怀态度现状,并分析其影响因素.方法 采用便利抽样法,于2019年7—11月选取云南省4所医院老年病科、急诊科、外科、肿瘤科等科室的护理人员398名作为调查对象.采用一般资料调查问卷、中文版佛罗梅尔特临终关怀态度量表进行调查.结果 护理人员临终关怀态度总分为(97.26±9.74...     

三级医院临床护士临终关怀态度现状及影响因素分析

目的：探讨三级医院临床护士临终关怀态度现状及影响因素，为提高临床护士临终关怀服务质量提供依据。方法：采用便利抽样法，使用一般资料调查表、中文版佛罗梅尔特临终关怀态度量表(FATCOD-B)、护士对安宁护理的自我效能问卷，对山东省2所三级医院579名临床护士进行横断面调查。结果：临床护士临终关怀态度总分为(98.65±9.54)分，回归分析结果显示，自我效能、自觉重要程度、劳动关系、以往照护终末期患者及其家属的经历、是否接受过安宁护理相关培训是临终关怀态度的影响因素(P<0.05)。结论：临床护士临终关怀态度积极性不高，通过对其影响因素分析，建议护理管理者采取调整薪酬体系、增加教育培训等干预对策，提高护士的临终关怀态度。     

护理人员对临床异常事件报告的态度及其影响因素

目的了解护理人员对临床异常事件报告的态度及其影响因素。方法采用自行设计的护理人员对临床异常事件报告态度调查问卷对上海市4所三级甲等医院和3所二级甲等医院共411名护理人员进行问卷调查。结果护理人员对临床异常事件报告态度总体评分为（3．23±0．39）分,不同年龄组的护理人员态度得分差异有统计学意义（P〈0．01）,护理人员的教育程度和所在科室对态度得分有影响（P〈0．01或P〈0．05）。结论护理人员对临床异常事件报告的态度呈中等水平,年龄、教育程度及科室的不同对其报告态度有不同程度的影响。医院管理部门应根据医院的具体情况,灵活多样地采取相应措施,引导护理人员端正临床异常事件报告态度,营造良好的医院安全管理氛围。     

昆明市综合医院护士姑息照护知识与态度现状调查

目的：调查昆明市综合医院护士姑息照护知识及态度现状,并分析其影响因素,为后期综合医院护士的姑息照护培训提供参考。方法：采取便利抽样法选择昆明市综合医院护士共664名,采用一般资料问卷、姑息照护知识问卷（PCQN）和姑息照护Bradley态度问卷进行调查。结果：昆明市综合医院护士姑息照护知识总分为（9.43±2.44）分,态度总分为（35.35±3.05）分。多重线性回归分析结果显示,科室、职称、教育培训是综合医院护士姑息照护知识总分的影响因素,而科室、职称是姑息照护态度总分的影响因素。结论：昆明市综合医院护士姑息照护知识欠佳、态度有待改善。建议对综合医院护士,特别是低职称、非肿瘤科室护士进行姑息照护的教育培训。     

高校实习护生临终关怀态度及影响因素调查分析

摘要：目的 了解云南省实习护生对临终关怀态度及其影响因素。 方法 通过分层抽样的方式选取12所医学院校实习护生780名为调查对象，中文版Frommelt临终关怀态度量表进行调查。结果 所调查实习护生临终关怀态度得分处于中等水平，对患者的同理心不足，沟通能力较欠缺。不同性别、学历、自愿选择所学专业、照顾临终患者的意愿、以往照护经历及丧亲经历对护生临终关怀态度的差异有统计学意义（p＜0.05）。 结论 医学院校及培养基地在临终关怀教学过程中应注重唤起护生的同理心，加强护生与临终患者及家属的沟通技巧培养，制定情景模拟式课堂教学，构建护生临终关怀培训方案，帮助护生提升临终照护水平，为我国打造临终照护的优质护理后备队。     

临床护士安宁疗护态度的现状调查与思考

目的 对我院临床护理人员安宁疗护的态度进行问卷调查,了解影响护理人员安宁疗护态度的影响因素。方法 使用中文版佛罗梅尔特临终关怀态度量表（FATCOD-B）,采用便利抽样法对233名临床护士进行问卷调查。结果临床护士的FATCOD-B总分为(94.61±9.32),临床护士的安宁疗护态度与学历、工作年限、以往是否接受过相关教育有关,差异有统计学意义（p<0.05）。结论临床护士对安宁疗护态度存在不足,需根据临床工作需要及相关影响因素加大培训及教育的力度,切实提高临床护士安宁疗护的认知及能力。     

二级医院临床护理人员临终关怀认知及影响因素调查

摘要：目的 对临床护理人员临终关怀认知、态度及行为进行调查，为临床开展临终关怀工作提供依据。方法 自设问卷，对１３１名二级医院临床护理人员进行有关临终关怀的认知、态度及行为的调查。结果 临床护理人员临终关怀知识来源渠道局限，认知、态度及行为评分分别为６１．３１±１９．９３、６１．１１±１８．２７、３９．１４±１４．８３。影响临床护士开展临终关怀的主要因素有经济收入少（４０．８％），害怕家属不满或引起纠纷（３６．８％）。结论 二级医院临床护理人员缺乏临终关怀知识。应拓展学习渠道提高其临终关怀知识水平，针对影响因素采取措施推进临终护理在临床的开展。关键词：临床护理人员 ；　临终关怀；　认知；　相互影响因素；　数据收集中图分类号：Ｒ４７；Ｒ４８　　文献标识码：Ｃ　　文章编号：１００１-４１５２（２００７）０７-００５８-０２     

护理人员对于临终关怀认识调查分析

目的通过对护理人员临终关怀认识的调查,了解中国目前临终关怀的发展现状,为进一步开展多种形式的临终关怀相关教育,提高医院的整体护理质量提供科学依据。方法采用自行设计的问卷表,通过随机抽样方法对112名在职护理人员进行问卷调查。结果大多数护理人员不能很好地掌握临终关怀的相关知识,且主要通过杂志书籍和大众传播媒体等自学方式了解,缺乏系统的学习培训。结论护理人员普遍缺乏临终关怀知识,且缺乏学习平台。临终关怀事业发展道路受到诸多阻碍,但经济落后、人口老龄化严重等问题使临终关怀事业的发展迫在眉睫。     

护理人员对待死亡及临终关怀态度的调查

目的了解护理人员对待死亡及临终关怀态度,了解医院目前临终关怀现状.方法对我院262名护士进行死亡态度及死亡观的问卷调查.结果护士对待临终关怀照护的态度积极(S3=3.78士0.86),对个人死亡及濒死的态度无明显的倾向性(S1=3.26±1.05);67.9%的人不相信"生命永存"及"轮回转世",74.8%的人接受死亡是不可避免的事实;医院目前临终关怀现状不理想(S4=2.93±0.80);有必要开展临终关怀(S5=4.30±0.52)及学习临终关怀知识(S8=4.11±0.52).结论护理人员对待临终关怀照护的态度积极,对死亡的心理承受力低;医院临终关怀服务现状不能满足社会发展需要,有必要对护理人员加强死亡观及临终关怀教育,促进临终关怀事业的发展.     

临床护士临终关怀培训态度和需求调查分析

目的:调查分析临床护士临终关怀培训态度和需求,为开展个性化临终关怀培训提供依据。方法:采用便利抽样方法对7192例临床护士进行问卷调查,并统计分析不同结构护士调查结果。结果:临床护士对临终关怀培训态度较积极,81.7%的临床护士认为开展临终关怀培训是必需的。不同年龄组、工作年限、职称、工作科室、教育程度护士对临终关怀培训需求差异有统计学意义(P0.05)。结论:管理者应依据不同结构临床护士的特点及其需求,开展个性化临终关怀培训,以提高我国临终关怀服务质量。     

Primary care and specialty care in the age of HAART

The advent of complex highly active antiretroviral therapy (HAART) brings to light the issue of whether people with HIV infection or AIDS should be managed by a primary care physician or by an HIV specialist. There is no HIV specialist per se, however, experience can increase the skills needed to treat this disease. Experience is defined as having treated between 5 and 20 patients living with HIV. Primary care physicians have historically developed skills in treating chronic multisystem diseases, but HIV has gained a new complexity with the battery of antiretroviral medications available. Primary care physicians must now learn about viral dynamics and resistance, viral load measurements, and the specifics of each available drug. In addition, educating patients to comply with their regimens requires counseling skills, knowledge of adverse effects management, and managing lifestyle issues. Consulting with experienced practitioners on various aspects of HIV infection and AIDS is useful and the network of medical consultants should always be strengthened. All patients deserve to be treated by a physician with current skills in providing antiretroviral therapy, as well as by a committed primary care physician.     

Antipsychotic utilization in the intensive care unit and in transitions of care

PurposeThe objective of this study was to quantify the rate at which newly initiated antipsychotic therapy is continued on discharge from the intensive care unit (ICU) and describe risk factors for continuation post–ICU discharge.Materials and methodsThis is a retrospective cohort study of all patients receiving an antipsychotic in the ICUs of a large academic medical center from January 1, 2005, to October 31, 2011. Medical record review was conducted to ascertain whether a patient was newly started on antipsychotic therapy and whether therapy was continued post–ICU discharge.ResultsA total of 39,248 ICU admissions over the 7-year period were evaluated. Of these, 4468 (11%) were exposed to antipsychotic therapy, of which 3119 (8%) were newly initiated. In the newly initiated cohort, 642 (21%) were continued on therapy on discharge from the hospital. Type of drug (use of quetiapine vs no use of quetiapine: odds ratio, 3.2; 95% confidence interval, 2.5-4.0; P < .0001 and use of olanzapine: odds ratio, 2.4, 95% confidence interval, 2.0-3.1; P ≤ .0001) was a significant risk factor for continuing antipsychotics on discharge despite adjustment for clinical factors.ConclusionsAntipsychotic use is common in the ICU setting, and a significant number of newly initiated patients have therapy continued upon discharge from the hospital.     

Psychological care of children and family in the critical care setting

Admission to the critical care setting can be a traumatic experience for a child and his or her parents. Besides providing physical care, the nurses should assess the psychological and emotional responses of the children and their parents. By integrating the child's psychosocial development and the principles of family-centered care into critical care nursing, the impacts of emergency admission on hospitalized children and their families can be reduced in order to facilitate adaptation on the part of the families.