综合医院护士对住院患者自杀预防认知的调查研究

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。     

知信行理论模式用于急诊科护士的患者自杀风险培训

目的探讨知信行理论模式用于急诊科护士患者自杀风险培训的效果。方法组建自杀风险教育多学科团队,采用知信行理论模式对143名急诊科护士进行为期3个月的患者自杀风险培训,比较培训前后护士的自杀态度和自杀护理行为。结果培训后,急诊科护士自杀态度总分及3个维度得分显著低于培训前,自杀护理行为得分显著高于培训前(P0.05,P0.01)。结论知信行理论模式用于急诊科护士患者自杀风险培训可有效改善护士对自杀的态度,规范其患者自杀护理行为。     

急诊科自杀未遂患者的简要自杀风险干预

目的 探讨降低急诊科自杀未遂患者自杀意念的有效方法.方法 依据《照顾有自杀风险的成年患者——急诊科共识指南》制订简要自杀风险干预流程清单,对57例急诊科住院或留观的自杀未遂患者进行干预.结果 57例患者均未再出现自杀行为.干预前及干预后6个月患者自杀态度及自杀意念比较,差异有统计学意义(均P＜0.01).结论 实施简要...     

护理人员对住院患者自杀预防知信行的调查研究

目的 对护理人员住院患者自杀预防的知识、态度、行为水平进行现况调查,为开展护理人员 自杀预防学习提供参考.方法 采用自制护理人员对住院患者自杀预防知信行调查问卷,对445名护理人员进行调查.结果 护理人员对住院患者自杀预防的知识、态度、行为得分分别为(42.56±6.96)分、(30.02±4.31)分、(52.45±8.02)分,总分为(125.00±15.15)分.是否使用过心理评估量表、是否使用过自杀风险评估工具、是否参与患者自杀预防培训是护理人员 自杀预防知信行的主要影响因素(均P＜0.01).结论 护理人员对住院患者自杀预防知识态度行为总体呈中等偏上水平,管理者应当重视并针对护士开展自杀预防的培训学习.     

自杀守门人培训及在护理领域的应用研究进展

对护士进行自杀守门人培训是帮助护士提高自杀识别与干预能力的有效措施.通过对自杀守门人的概念、培训方法、效果评价及在护理领域的应用进行综述,以期为构建和完善我国护士的自杀预防培训计划提供参考,从而有效防御患者自杀行为.     

综合医院护理人员对患者自杀态度及影响因素研究

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。     

神经内科抑郁症状患者自杀的预警干预

目的探讨预警干预对神经内科抑郁症状患者自杀防范的效果。方法对神经内科抑郁自评量表得分大于50分的112例患者实施预警干预,采用自杀意念自评量表测量干预前后患者的自杀意念得分。结果干预前后患者抑郁得分比较,差异有统计学意义(P0.01);自杀意念得分除掩饰因子外,其他因子及总分干预前后比较,差异有统计学意义(均P0.01)。结论基于抑郁自评量表评估的预警干预,可有效缓解神经内科住院患者抑郁症状,减轻自杀意念,对自杀防范有积极作用。     

社区护士对老年居民跌倒预防认知的调查

目的了解社区护士对老年人跌倒预防的认知情况,为制定社区老年人跌倒预防工作方案提供参考。方法采用自行设计的问卷,对宁波市20所社区卫生服务中心的220名护士进行老年人跌倒预防认知情况调查。结果 93.64%社区护士愿意参加老年人跌倒预防知识技能培训,84.54%愿意参与社区老年人跌倒预防管理。社区护士对老年人跌倒预防认知总分(75.54±12.27)分,其中跌倒知识(54.07±10.24)分,知识条目均分为3.40~3.77分,处于中等水平;跌倒态度(21.47±3.60)分,各条目均分为4.20~4.40分,态度总体良好。有无接受过跌倒预防相关知识培训,既往有无对老年人进行跌倒风险评估、有无对老年人进行跌倒预防教育的社区护士在跌倒预防知识得分及总体得分方面存在差异(均P0.01)。结论社区护士对老年人跌倒预防态度较好,但需采取多种形式对社区护士进行跌倒预防相关知识培训,使社区护士更好地掌握老年居民跌倒预防知识和技能。建议开展和推进社区老年人跌倒预防工作。     

药师参与的健康教育对社区老年人用药安全的影响

目的提升社区老年人用药安全性。方法对60名≥60岁的社区老年人,由药师和护士组成的健康教育团队给予60min公开课集体指导及20~30min个体化指导各1次,并发放社区老年人用药安全宣传手册及书面化个体化指导单1份。于干预前及干预后2周测量研究对象用药安全认知、态度及自我效能得分。结果干预后社区老年人用药安全认知、态度及自我效能得分显著高于干预前(均P0.01)。结论药师和护士联合健康教育能提高社区老年人用药安全认知、态度及自我效能。     

社区医务人员糖尿病干预的知识行为及态度调查

目的 了解长沙市社区医务人员关于糖尿病干预的知识(K)、态度(A)、行为(P)的基本情况,为相关部门采取措施更新、提高社区医务人员的知识、技术水平提供参考.方法 利用自制的一般资料调查表和KAP调查问卷对长沙市21个社区卫生服务中心的234名社区医务人员进行调查.结果 社区医务人员糖尿病干预知识得分26.34±4.78,态度得分18.09±4.74,行为水平得分8.33±3.46.糖尿病干预态度与知识及糖尿病干预行为与知识之间具有正向相关关系(r＝0.232、0.162,P＜0.01、P＜0.05).结论 社区医务人员关于糖尿病干预的知识水平较低,态度得分较高,行为水平不能达到理想水平.应通过提高社区医务人员的态度和知识来提高其行为水平.     

Suicidality in people surviving a traumatic brain injury: Prevalence, risk factors and implications for clinical management

Background: A systematic search was conducted of the literature addressing suicidality after traumatic brain injury (TBI). Results from population-based studies found that people with TBI have an increased risk of death by suicide (3-4 times greater than for the general population), as well as significantly higher levels of suicide attempts and suicide ideation. Clinical studies have also reported high levels of suicide attempts (18%) and clinically significant suicide ideation (21-22%) in TBI samples.

Methods and Results: In reviewing risk factors, two prognostic studies using multivariate analysis were identified. Adjusted risk statistics from these studies found an elevated risk of suicide for people with severe TBI in comparison to concussion (hazard ratio 1.4, 95% CI 1.15-1.75) and an elevated risk of suicide attempts among people displaying post-injury suicide ideation (adjusted odds ratio 4.9, 95% CI 1.79-13.17) and psychiatric/emotional distress (adjusted odds ratio 7.8, 95% CI 2.11-29.04).

Conclusions: To date, little evidence exists for the role of pre-morbid psychopathology, neuropathology, neuropsychological impairments or post-injury psychosocial factors as major risk factors for post-injury suicidality. Finally, there has been little empirical examination of approaches to suicide prevention. Therefore, current best practice is based on clinical judgement and the untested extrapolation of prevention approaches from other clinical populations.     

肿瘤科护士自杀“守门人”培训效果评价

目的 探讨肿瘤科护士自杀“守门人”培训效果,以提高护士预防患者自杀能力。方法 选择56名肿瘤科护士作为研究对象,成立培训小组,根据自杀“守门人”Living Works培训体系,参考自杀学和肿瘤心理学相关文献制订培训方案,并对其进行自杀预防基础知识概述、自杀风险评估、自杀干预训练、随访与事后成长4次培训。结果 培训后,肿瘤科护士的自我效能感、自杀警告信号意识总分及各维度评分显著高于培训前,且自杀预防知识正确率显著高于培训前(P<0.05,P<0.01)。结论 自杀“守门人”培训有利于提升肿瘤科护士的自我效能感,增强识别自杀警告信号能力,并提高肿瘤科护士的自杀预防知识。     

综合医院住院患者自杀风险评估指标体系的建立

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。     

Post-traumatic stress disorder following a suicide attempt

How commonly does a suicide attempt lead to post-traumatic stress disorder? The terrifying nature of events before and after many suicide attempts and the increasing rates of suicide attempts in the general population suggest that PTSD as a result of a suicide attempt should not be a rare occurrence. However, a thorough review of the literature revealed no reports. We provide one case report and discuss the theoretical, clinical, and research questions linking traumatic suicide attempts to subsequent PTSD.     

Crisis intervention for attempted suicide in Shanghai,China

Suicide, which is a common problem in China, is attracting more attention from Chinese psychiatrists at present. This study reports on the demographic characteristics of 75 suicide attempters and discusses the effects of crisis intervention (CI) management of these people in Shanghai. Most of them are under 35 years of age and have very poor relationships with their partners and parents. It appears that 77.3 per cent of the attempters can improve and are able to cope with stressful events through supportive psychotherapy and brief problem-oriented psychotherapeutic management. The author suggests that CI can be an immediate, effective and practical approach when used to prevent suicide and parasuicide in the community in China.     

自杀基因联合其他疗法治疗肿瘤的研究进展

肿瘤的基因治疗经多年研究已取得了许多令人瞩目的成就,其中自杀基因疗法的发展尤为迅速,是一种颇具临床应用前景的基因治疗策略。但是自杀基因治疗的单独应用仍有不少局限性,如转染效率低、诱导免疫反应能力弱、缺乏组织特异性、易引起肿瘤耐药性、对肿瘤细胞类型有依赖等。所以,研究自杀基因与其他肿瘤疗法的联合应用以及不同自杀基因之间协同作用以寻求更有效的抗肿瘤效应已逐渐成为非常有前景的治疗手段。本文就近几年自杀基因联合其他疗法治疗肿瘤的研究进展作综述。     

Substance use disorder in the anaesthetist

Anaesthetists have a higher incidence of substance use disorder when compared with other doctors. This might be due to the ease of access to intravenous opioids, propofol, midazolam, inhalational agents and other anaesthetic drugs. Alcohol use disorder continues to be the most common problem. Unfortunately, the first sign that something is amiss might be the anaesthetist's death from an accidental or deliberate overdose. While there are few accurate data, suicide is presumed to be the cause of death in approximately 6–10% of all anaesthetists. If we are to prevent this, substance use disorder must be recognised early, we should ensure the anaesthetist is supported by their department and hospital management and that the anaesthetist engages fully with treatment. Over 75% of anaesthetists return to full practice if they co-operate fully with the required treatment and supervision.