自护理论在乳腺癌根治术患者护理中的应用

目的探讨奥瑞姆（Orem）自护理论在护理乳腺癌根治术患者中的应用。方法对2005年2月至2006年1月与2004年1月至2005年1月各42例乳腺癌根治术患者，分别采用自护理论模式与传统分级护理模式相比较。结果自护模式组患者平均住院日、并发症发生率及平均住院费用均低于传统护理模式组（P〈0．01），生活自理能力均高于传统护理模式组（P〈0．01）。结论自护理论在护理乳腺癌根治术患者中起重要指导作用，以奥瑞姆自护理论为指导的护理模式能有效地控制病情，预防并发症，促进乳腺癌根治术患者的康复，提高护理质量。     

自我护理理论应用于老年糖尿病护理的体会

探讨自我护理理论应用于糖尿病临床护理的实践意义和价值。方法：利用自我护理理论的3种基本护理方法，即完全补偿性护理、部分补偿性护理、支持教育，对30例住院老年糖尿病患者及家属进行有针对性的护理指导。结果：糖尿病患者及家属的知识水平和自我管理能力增强，未再出现严重并发症。结论：保持健康的生活方法，坚持严格的自我护理管理，不仅可以延缓疾病的进展，减少并发症的发生，而且还在不同程度上提高了患者的生命质量。     

Homeless Parents'Perceptions of Parenting Stress

PURPOSE. To describe homeless parents' perceptions of parenting stress as potential indicators of needs for support in parenting roles.
SAMPLE. Forty-seven homeless parents (30 mothers, 17 fathers).
METHODS. Subjects completed the Parenting Stress Index to measure perceived parenting stress in the areas of child domain, parent domain, and life stress.
FINDINGS. Homeless mothers and homeless fathers both identified the child domain as the most frequent source of stress. T tests showed a significant dierence between groups only in the parent domain sub- scale of competence.
CONCLUSIONS. Findings from this study indicate the need to include parenting stress questions in an initial nursing or health assessment.     

Mothering in Public: A Meta-Synthesis of Homeless Women With Children Living in Shelters

ISSUES AND PURPOSE The purpose of this paper is to synthesize the current qualitative literature on homeless women with children living in shelters. METHODS Eighteen qualitative studies on homeless women with children living in shelters were included in the synthesis. The meta‐synthesis was conducted using the meta‐ethnographic approach of Noblit and Hare (1988). RESULTS Six reciprocal translations (themes) of homeless mothers caring for their children in shelters emerged: On becoming homeless, protective mothering, loss, stressed and depressed, survival strategies, and strategies for resolution. PRACTICE IMPLICATIONS The results may be used by healthcare workers as a framework for developing intervention strategies directed toward helping mothers find new solutions to dealing with shelter living and innovative ways to resolve their homelessness.     

Orem自理理论在胰岛素泵治疗患者中的临床应用

目的 有效控制血糖,提高糖尿病患者生活质量.方法 60例糖尿病患者随机分为实验组(30例)及对照组(30例).两组患者采用不同的护理系统及健康教育,比较带泵后7 d不同时间点(空腹,早餐后2 h,午餐后2 h,晚餐后2 h,22:00,03:00)血糖,低血糖发生率,皮下红肿、硬结发生率,病人的满意度.结果 实验组病人不同时间点血糖、低血糖发生率、皮下红肿、硬结发生率、病人的满意度明显优于对照组(P＜0.01,P＜0.05).结论 应用Orem自理理论能帮助糖尿病胰岛素泵治疗患者有效控制血糖,减少和延缓糖尿病各种并发症,提高患者生活质量.     

运用Orem自理学说指导精神分裂症病人自我护理

目的 :探讨运用Orem的自理学说对精神分裂症病人自我护理的影响。方法 :用住院病人护理观察量表(NOSIE)对 135例住院精神分裂症病人采用随机对照设计 ,实验组运用Orem理论采取相应的护理措施 ,对照组按精神科一般护理常规 ,在入组时和 2个月后用NOSIE进行评定分析。结果 :实验组社会兴趣、个人卫生等积极因素的提高和精神病表现、迟缓等消极因素的恢复明显优于对照组。结论 :运用Orem的自理学说能明显提高精神分裂症病人的自我护理能力 ,促使病人早日回归社会     

Accuracy of Nursing Diagnoses: Concept Development

The concept of accuracy of nursing diagnoses was developed by the author as a first step of theory development related to nursing diagnosis. Accuracy is conceptually redefined as a continuous variable and as such contrasts with the prevailing view of accuracy that diagnoses are either accurate or inaccurate. The conceptual definition of accuracy of a nursing diagnosis and a delineation of the characteristics of accuracy emphasize the relativistic nature of the concept.     

自理理论在造口护理中的应用现状

肠造口在大肠癌、肛肠疾病治疗中起着不可替代的作用。由于肠造口改变了原有的正常生理排便方式,造成患者自我形象紊乱,并使其生理、心理、社会交往上造成了障碍。绝大多数患者通过短暂的住院治疗和护理后,其余时间均在院外度过。如何帮助造口患者掌握相关知识,提高其生活质量已成为医护人员面临的新挑战。     

人体物质输入输出系统:护理科学特有人体理论探讨

人体物质输入输出系统理论是在事物普遍联系哲学观点、相似论和科学类比方法指导下，在抽取人体消化、呼吸和泌尿子系统结构与功能共性基础上提出的涵盖这３个子系统的理论。人体物质输入输出系统的基本结构包括躯体开口结构、人体开放管腔和特化复膜结构，其基本功能是在躯体性输入输出和机体性输入输出两个水平上实现人体物质输入输出。至少２７个护理诊断条目落入人体物质输入输出系统范畴，和至少１３项护理操作技术嵌入人体开放管腔或躯体开口结构，是提出人体物质输入输出系统理论的护理实践基础。     

Quality of Nursing Diagnoses: Evaluation of an Educational Intervention

PURPOSE: To investigate the effects on the quality of nursing diagnostic statements in patient records after education in the nursing process and implementation of new forms for recording. METHODS: Quasi-experimental design. Randomly selected patient records reviewed before and after intervention from one experimental unit (n = 70) and three control units (n = 70). A scale with 14 characteristics pertaining to nursing diagnoses was developed and used together with the instrument (CAT-CH-ING) for record review. FINDINGS: Quality of nursing diagnostic statements improved in the experimental unit, whereas no improvement was found in the control units. Serious flaws in the use of the etiology component were found. CONCLUSION. Nurses must be more concerned with the accuracy and quality of the nursing diagnoses and the etiology component needs to be given special attention. PRACTICE IMPLICATIONS: Education of RNs in nursing diagnostic statements and peer review using standardized evaluation instruments can be means to further enhance RNs' documentation practice.     

行为训练对“三无”精神分裂症患者的康复效果

目的：探讨行为训练对“三无”精神分裂症患者的康复效果。方法72例“三无”精神分裂症患者按入院顺序分为两组,对照组36例接受常规治疗及护理,研究组36例在此基础上进行行为训练。分别于训练前及训练后8周用护士住院患者观察量表（NOSIE）、精神病患者生存质量问卷（QOL-P）进行效果评定。结果训练前两组患者NOSIE、QOL-P评分差异无统计学意义（P＞0．05）。训练8周后,研究组患者NOSIE评分个人卫生（19．06±3．15）分、社会兴趣（16．89±2．64）分、社会能力（20．11±2．79）分,均高于对照组（14．44±2．71）,（12．28±2．71）,（13．67±2．22）分,激惹（12．00±3．28）分和退缩（8．61±2．78）分,均低于对照组（17．33±2．99）,（14．00±2．53）分,两组比较差异有统计学意义（t分别为6．656,7．314,10．086,7．218,8．602;P＜0．01）;研究组QOL-P总分（54．58±8．77）分,低于对照组（77．78±5．49）分,两组比较差异有统计学意义（t＝13．443,P＜0．01）。结论行为训练有助于提高“三无”精神分裂症患者的生活及社会能力,对改善生活质量、促进疾病康复有积极作用。     

行为矫正干预对流浪精神分裂症患者生活自理能力的影响

目的探讨行为矫正干预对流浪精神分裂症患者生活自理能力的影响。方法52例流浪精神分裂症患者随机分为两组,对照组26例接受常规治疗及护理,干预组26例在常规治疗与护理的同时给予行为矫正。分别于干预前及干预后8周用护士住院患者观察量表（NOSIE）进行影响效果评定。结果干预前2组患者NOSIE评分差异无统计学意义（P〉0．05）。干预8周后,干预组患者NOSIE评分社会能力（35．10±3．89）分、社会兴趣（28．87±3．08）分、个人整洁（28．15±2．41）分,均高于对照组（20．34±2．38）分,（19．98±2．54）分,（21．43±2．42）分,比较差异有统计学意义（t分别为17．56,12．03,9．01,P〈0．01）;迟缓（6．78±2．11）分、抑郁（5．23±1．38）分,均低于对照组（11．59±2．65）分,（11．79±2．65）分,两组比较差异有统计学意义（t分别为7．61,11．2,P〈O．01）;激惹比较差异无统计学意义（P〉0．05）。结论行为矫正干预有助于提高流浪精神分裂症患者的生活自理能力,可缓解护理人员的部分工作压力。     

汉人流行病学调查:酗酒是动脉粥样硬化的危险因子

目的探讨汉人酗酒与动脉粥样硬化(As)之间的关系。方法(1)随机选择心绞痛、心肌梗死、心肌纤维化、脑梗死、脑溢血等As相关疾病患者165例,分析以下构成比(R)大小:(a)按酗酒年限分组,各组中As相关病人数在165人中的R(a);(b)按日均酒精量分组,各组中As相关病人数在165人中的R(b);(c)按疾病种类分组,各组中酗酒病人数在该组病人数中的R(c)。(2)随机选择酗酒脂肪肝(F)44人,酗酒非脂肪肝(N)32人,健康对照(C)50人,测定以下指标:(a)血脂:甘油三酯(TG),总胆固醇(TC),低密度脂蛋白胆固醇(LDL-C),高密度脂蛋白胆固醇(HDL-C)。(b)肝功能:丙氨酸转氨酶(ALT),γ-谷氨酰转移酶(GLT),胆碱脂酶(CHE),总胆汁酸(TBA),总胆红素(TB il)。禁酒1月后复查。结果(1)R(a)随酗酒年限而增大,R(b)随日均酒精量而增大,R(c)在87.50%~94.11%之间。(2)F,N组中,LDL-C,HDL-C无变化,而TG,TC增高;两组Tb il和N组CHE无变化,而两组ALT,GLT,TBA和F组CHE增高;禁酒1月后,两组TG,TC,LDL-C,HDL-C,Tb il,CHE无变化,而ALT,GLT仍高于C组。结论酗酒是汉人As的危险因子,其机制与慢性肝细胞损伤致脂质代谢紊乱有关。     

应激理论在护理专业的应用现状

对应激理论自出现以来在各个领域得到广泛应用,本文对应激理论在护理专业的应用进行回顾,从应激理论的来源,疾病所致应激反应的护理,应激性疾病的护理,各种原因所致的心理应激的护理,特殊职业(护士)人群应激,处理对策及发展趋势等几个方面来揭示护理领域的应激理论运用,以更好的指导临床护理实践,促进学科发展。     

The Use of Nursing Diagnoses in Perioperative Documentation

PURPOSE. To clinically validate the nursing diagnoses of the first Finnish version of Perioperative Nursing Data Set (PNDS) by using them in perioperative documentation. METHODS. Nursing diagnoses were used in documentation in four operating departments with 250 patients. In analysis, nonparametric tests were applied. FINDINGS. While intraoperatively nursing diagnoses focused on physiological concerns, postoperatively the focus shifted to that of recovery. CONCLUSIONS. The findings revealed the importance of safety‐related routines in perioperative care. Nursing diagnoses in the Finnish version of PNDS are sensitive in describing the rationales for perioperative care. IMPLICATIONS FOR NURSING PRACTICE. Nursing classifications illustrate the nursing process in a structured form. Nursing diagnosis is an early step in the decision‐making process that aims to achieve expected outcomes in nursing care. TARKOITUS: Validoida PNDS‐luokituksen suomalaisen version diagnoositermit käyttämällä niitä perioperatiivisen hoitotyön kirjaamisessa. MENETELMÄT: Hoitotyön diagnooseja käytettiin kirjaamisessa 250 potilaan kohdalla. Aineiston analyysissä käytettiin ei‐parametrisiä testejä. TULOKSET: Hoidon intraoperatiivisessa vaiheessa korostuvat potilaan fysiologiaan liittyvät ja postoperatiivisessa vaiheessa potilaan toipumiseen liittyvät hoitotyön diagnoosit. JOHTOPÄÄTÖKSET: Perioperatiivisessa hoitotyössä painottuvat potilaan hoidon turvallisuuteen tähtäävät rutiinit. PNDS‐luokituksen suomalaisen version diagnoositermejä voidaan käyttää kuvaamaan leikkauspotilaiden hoidon tarpeita. TULOSTEN HYÖDYNNETTÄVYYS: Hoitotyön prosessia voidaan kuvata rakenteisesti hoitotyön luokituksilla. Hoitotyön diagnoosin määrittäminen on osa päätöksentekoprosessia tavoitteena tunnistaa ja saavuttaa toivotut tulokset potilaan hoidossa.