Neuman系统模式在降低新护士心理压力中的应用

介绍Neuman系统模式在降低新护士心理压力中的应用,提出以Neuman系统模式为理论框架,将新护士看作是一个具有生理、心理、社会文化、发展及精神等变量的综合体,对新护士进行全面评估,分析新护士应激源问题,并提出相应的管理对策,以降低新护士心理压力.     

基于Neuman理论的心理危机干预对新型冠状病毒肺炎患者心理压力情绪及睡眠质量的影响

目的 探讨基于Neuman理论的心理危机干预对新型冠状病毒肺炎患者心理压力、情绪及睡眠质量的影响.方法 将79例新型冠状病毒肺炎患者按照住院时间分为研究组41例,对照组38例,两组均给予常规心理疏导和睡眠护理,研究组在此基础上给予基于Neuman理论的心理危机干预,观察住院全程.干预前后比较两组汉密顿焦虑量表、汉密顿抑...     

应用Neuman保健系统模式对非精神科住院患者心理压力状况的调查

目的 了解住院患者所承受的压力源以及突出的心理压力问题.方法 采用非精神科住院患者心理压力评估量表对150例非精神科住院患者进行调查,分析住院患者承受的压力源和突出的心理压力问题.结果 住院患者存在一定程度的心理压力,其中盼望早日康复是平均得分最高的压力源(7.21±3.17)分;而担心患病后自己在家中的地位降低的得分最低(2.56±2.15)分.患者的心理压力状况与年龄、性别、文化程度、家庭收入、婚姻状况等呈现显著相关性.结论 住院患者存在一定心理压力,不同心理压力源的心理压力反应不同,应针对不同类别的压力源开展有针对性的心理护理,提高住院患者的生活质量和护理质量.     

应用Neuman保健系统模式研制非精神科住院病人心理压力评估量表

[目的]应用Neuman保健系统模式研制非精神科住院病人心理压力评估量表,并对其信度、效度等进行检验.[方法]通过发放开放式调查问卷形成条目池,通过专家效度检测对条目进行筛选,再次发放问卷,对量表的信度、效度等测量学特征进行检测.[结果]正式量表包括个体内压力源、人际间压力源、个体外压力源3个维度,共计48个条目.其内在一致性系数为0.957 7,内容效度指数为0.941,效标关联效度为0.718,区分度t=-31.286,P＜0.01,均在测量学可接受范围内.[结论]所形成的量表有较好的信度和效度,是一种较全面、简便易行、操作性及甄别性较强的非精神科住院病人的心理评估工具.     

应用Neuman保健系统模式对非精神科住院患者心理压力状况的调查

目的了解住院患者所承受的压力源以及突出的心理压力问题。方法采用非精神科住院患者心理压力评估量表对150例非精神科住院患者进行调查，分析住院患者承受的压力源和突出的心理压力问题。结果住院患者存在一定程度的心理压力，其中盼望早日康复是平均得分最高的压力源（7．21±3．17）分；而担心患病后自己在家中的地位降低的得分最低（2．56±2．15）分。患者的心理压力状况与年龄、性别、文化程度、家庭收入、婚姻状况等呈现显著相关性。结论住院患者存在一定心理压力，不同心理压力源的心理压力反应不同，应针对不同类别的压力源开展有针对性的心理护理，提高住院患者的生活质量和护理质量。     

Neuman保健系统模式及其在急诊护理中的应用

介绍了Neuman理论的核心内容；并将Neuman理论应用于急诊护理中，按照Neuman理论的思路对患进行全面评估。根据评估内容找出护理问题及定出护理计划，取得良好护理效果，提示Neuman理论同样适用于急诊护理，对急诊护理有指导作用。     

Neuman系统模式对肾移植患者焦虑、抑郁的影响

目的通过观察Neuman(纽曼)系统模式对肾移植患者焦虑、抑郁的影响,探讨Neuman系统模式在肾移植患者应用前景.方法观察我院2003年1月～2004年1月30例肾移植患者术前、术后1周、术后1月的焦虑、抑郁情况,采用SDS、SAS评分系统评价其分值.结果采用Neuman系统模式护理后,患者术后1周和术后1月的SDS、SAS评分与术前SDS、SAS评分比较有显著性差异(P＜0.001),术后患者的焦虑、抑郁得到了明显改善.结论采用系统模式护理肾移植患者可以明显改善其焦虑、抑郁状况,这种理论在肾移植患者的护理上具有指导意义.     

住院患者心理状况及其影响因素的研究进展

综合分析近年来对住院患者心理状况及其影响因素的研究,结果发现住院患者存在多种因素诱发的多种心理问题,但是在临床护理工作中常规评估工具的缺乏和对心理问题严重性的认识的不足,阻碍了心理护理的发展。所以发展常规评估工具,对住院患者的心理问题进行一个全面而深入的研究,提高医护人员对其心理问题的重视,是解决问题的有效方法。     

住院患者满意度问卷的研制及信效度检验

目的 发展住院患者满意度问卷,并进行信效度检验,为评价住院患者对住院服务的满意度提供有效工具.方法 抽取北京市某三级甲等医院的314名出院患者,使用问卷进行电话调查.对调查结果进行探索性因子分析,结合因子分析的结果和专家组讨论,对条目进行筛选和调整,并进行信度和效度检验.结果 最终形成的住院患者满意度问卷由5个因子、15个条目组成,5个因子的累计解释量为67.921％；问卷的CVI系数为0.987,Cronbach's α系数为0.868,均在测量学可接受的范围.结论 最终形成的住院患者满意度问卷有较好的信效度及可行性,可作为住院患者满意度的评价工具.     

终末期心力衰竭患者姑息照护研究进展

目的 探索适合我国国情的姑息照护模式,对心力衰竭患者实施针对性的姑息照护干预措施提供依据.方法 检索中外相关文献,从现状、存在问题及发展方向的角度,阐述姑息照护模式在终末期心力衰竭患者中的应用进展.结果 描述了终末期心力衰竭患者的姑息照护需求,介绍了目前常用的转诊姑息照护机构的评估工具,包括预后评估工具、惊讶问题工具,以及姑息照护需求评估工具,分析了不同姑息照护模式对终末期心力衰竭患者结局的影响,以及姑息照护在终末期心力衰竭患者中发展面临的阻碍.结论 当前研究探索了适合终末期心力衰竭患者的姑息照护模式及应用、转诊筛查/需求评估工具,取得了一定的成果,今后有待研究何种姑息照护措施对终末期心力衰竭患者最优选,开发、应用适合我国终末期心力衰竭患者的姑息照护需求评估工具.     

N eum an 理论在子宫全切术后患者心理危机干预中的应用价值

目的：阐释Neuman系统模式的核心内容,探讨以Neuman理论为指导的护理方法在子宫全切术后患者心理危机干预中的应用价值。方法选取在我院妇科入住的136例子宫全切术后存在抑郁状态的患者,随机分为干预组和对照组,干预组采用根据Neuman理论设定的心理危机干预措施;对照组采取常规生活护理,并于干预前后以汉密顿抑郁量表（HAMD）评价干预效果。结果心理干预后治疗组患者 HAMD总评分显著改善（P＜0．05）,同时,焦虑/躯体化、绝望感、认知障碍3类因子分较对照组显著改善,差异有显著意义（ P＜0．05）。结论以Neu-man理论为指导的护理方法在子宫全切术后患者心理危机干预中具有较高的应用价值,值得在各级医院护理人员中推广。     

Clinical variance in assessing risk of pressure ulcer development

Nurses working in one area health service (AHS) in Sydney, Australia, expressed concern about the development of pressure ulcers in hospitalized patients. Anecdotal evidence suggested that a variety of approaches were being used to assess patients to identify those at risk of pressure ulcer development. A questionnaire was distributed to all registered nurses (n = 2113) in clinical settings within the AHS. Data were analysed using frequency distribution. The response rate was 40% (n = 850), of which 444 were useable. Nurses generally do not use a tool to assess pressure ulcer risk potential, but rely on a range of practice procedures and risk indicators. It is recommended that a pressure ulcer project group be established to evaluate existing tools or, if necessary, develop a tool for the assessment of patients to identify those at risk of developing pressure ulcers.     

纽曼系统护理模式对原发性高血压患者血压及遵医行为的影响

目的探讨纽曼系统护理模式对原发性高血压患者血压控制情况及遵医行为的影响。方法将100例原发性高血压患者随机分为对照组(50例)和观察组(50例)。观察组采用纽曼系统模式,对照组采用全程护理服务模式。比较两组患者血压控制情况及遵医行为的差异。结果观察组患者血压控制效果较好的有47例(94.0%),对照组有30例(60.0%);观察组患者相关知识掌握较好的有39例(78.0%),对照组有30例(60.0%);观察组患者遵医行为优于对照组,两组比较,P<0.05,差异具有统计学意义。结论对高血压病患者实施纽曼系统护理模式,可有效控制和稳定患者的血压,提高患者遵医行为和疾病知识的掌握。     

The Neuman Systems Model Institute: testing middle-range theories

The credibility of the Neuman systems model can only be established through the generation and testing of Neuman systems model-derived middle-range theories. However, due to the number and complexity of Neuman systems model concepts/concept interrelations and the diversity of middle-range theory concepts linked to these Neuman systems model concepts by researchers, no explicit middle-range theories have yet been derived from the Neuman systems model. This article describes the development of an organized program for the systematic study of the Neuman systems model. Preliminary work, already accomplished, is detailed, and a tentative plan for the completion of further preliminary work as well as beginning the actual research conduction phase is proposed.     

Stressors in five client populations: Neuman systems model-based literature review

AIM: This paper reports a literature review identifying and categorizing client system stressors in Neuman systems model-based studies. BACKGROUND: To date, literature reviews related to the Neuman systems model have focused broadly on all concepts of the model. The concept of stressors has been selected by the Neuman Systems Model Research Institute as the focus for an initial collaborative research project. METHOD: Cooper's five-stage integrative review method was used: problem formulation, data collection, data evaluation, analysis and interpretation, and dissemination. The Neuman systems model research literature from 1983 to February 2005 was searched using Fawcett's Neuman systems model bibliography and a follow-up review of the CINAHL database using the keywords 'Neuman systems model' and 'stressors'. A total of 87 studies published as journal articles or book chapters between 1983 and 2005 were reviewed; 13 of the 87 studies met the definition of 'stressor studies'. FINDINGS: Stressors were identified in five client populations: caregivers, cancer survivors, ICU patients in intensive care units, care receivers, and parents whose children were undergoing day surgery. The most common data collection method was the interview, and investigator-developed interview guides were most often used. Evidence of categorization of intra-, inter- and extra-personal stressors was present. The following overall stressors were identified: burden of responsibility (caregivers); awareness of vulnerability (cancer survivors); being overwhelmed (patients in intensive care units); loss of control (parents); and frustration with role changes (care receivers). CONCLUSIONS: These data could form the basis for nursing practice as well as future research within a collaborative environment. Given the existing body of knowledge concerning Neuman system model-derived middle range theory concepts in the caregiver population, the middle-range theory of caregiver role strain could be tested empirically.     

Using the Neuman systems model for best practices

Human beings with unmet needs related to their health and illnesses are the central focus of the domain of nursing. It is proposed in this column that nurses who conduct their practice from a nursing theory base, while assisting individuals and families to meet their health needs, are more likely to provide comprehensive, individualized care that exemplifies best practices. The Neuman systems model has been widely acclaimed to guide practice, yet specific examples are few in the published literature. The purpose of this column is to present two case studies based upon Neuman systems model; one case is directed toward family care, and the other demonstrates care with an individual. Theory-based exemplars serve as teaching tools for students and practicing nurses. These case studies illustrate how nurses' actions, directed by Neuman's wholistic principles, integrate evidence-based practice and generate high quality care.     

纽曼系统模式在肝硬化失代偿期患者护理中的应用

目的研究纽曼系统模式用于肝硬化失代偿期患者的护理效果。方法将肝硬化失代偿期患者150例,按照随机数字表分成观察组和对照组各75例,对照组依照临床分级护理内容标准及患者自理能力评估量表进行护理,观察组在此基础上根据患者机体内外因素、人际因素等方面存在的压力源对机体弹性防线、正常防线、抵抗防线的影响,应用纽曼系统模式进行一、二、三级预防措施干预,两组均于人院时及出院后随访1年,采用汉密尔顿抑郁量表（HRSD）、简明健康状况问卷（SF-36）中文版进行测评,比较两组患者抑郁症状、生存质量、住院时间、随访1年再住院率及病死率。结果观察组干预后HRSD评分、SF-36评分、住院时间分别为（33．4±4．1）分,（74．6±4．5）分,（10．2±3．5）d,优于对照组的（46．3±5．2）分,（56．1±5．1）分,（14．3±4．5）d,两组比较差异有统计学意义（t分别为11．40,9．30,1．41;P〈0．05）;观察组患者随访1年再住院率、病死率分别为24％,10％,明显低于对照组的53％,24％,两组比较差异有统计学意义（x2分别为2．1,3．4;P〈0．01）。结论纽曼系统模式用于肝硬化患者的护理有较好的效果,该模式可在临床进一步推广和应用。     

A community nursing center for the health promotion of senior citizens based on the Neuman systems model

This article describes a community nursing center that provided clinical learning experiences for students from two schools of nursing. Work at the center was based on the Neuman systems model, which views the client as a system in interaction with environmental stressors. Nursing interventions focused on health promotion services for an underserved elderly population. The benefits of using the Neuman systems model for patient care, education, and research are outlined.